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1.
Cient. dent. (Ed. impr.) ; 20(3): 147-154, sept.-dic. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-229901

RESUMO

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)


Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)


Assuntos
Dente Decíduo , Pulpectomia/instrumentação , Pulpectomia/métodos , Dente Molar , Odontopediatria/métodos
2.
Cient. dent. (Ed. impr.) ; 20(3): 147-154, sept.-dic. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-EMG-519

RESUMO

Introducción: Los dientes primarios juegan un importante papel en el crecimiento y desarrollo general de los niños, por lo que es necesario conservarlos hasta el momento de su recambio fisiológico. Cuando existe una afectación pulpar que compromete la vitalidad del diente, la pulpectomía se convierte en un reto para el odontopediatra debido a la compleja anatomía radicular de los dientes primarios. En esta revisión bibliográfica se darán a conocer diferentes sistemas de limas usados en odontopediatría, y así brindar una mirada actualizada de la instrumentación rotatoria al realizar pulpectomías en los molares primarios. Material y Método: se realizó una búsqueda bibliográfica en Pubmed y Web of Science de acuerdo con criterios de inclusión y exclusión previamente establecidos. Resultados: tras aplicar los criterios de inclusión y exclusión fueron seleccionados un total de 30 referencias bibliográficas de los últimos 15 años. Conclusión: las limas rotatorias pediátricas pueden considerarse alternativas seguras y más eficientes en la realización de pulpectomías en molares primarios, ya que se reduce el tiempo de tratamiento, se produce desbridamiento completo de los conductos y se mantiene la función del diente hasta su exfoliación. (AU)


Introduction: Primary teeth play an important role in the growth and development of children, so it is necessary to keep them until the moment of their physiological replacement. When there is a pulp involvement that compromises the vitality of the tooth, pulpectomy treatment becomes a challenge for the pediatric dentist due to the complex root anatomy of primary teeth. This review of the literature will present different file systems used in primary teeth and provide an updated look at rotary instrumentation when performing pulpectomies on primary molars. Material and Method: a bibliographic search was carried out in Pubmed and Web of Science according to previously established inclusion and exclusion criteria. Results: after applying the inclusion and exclusion criteria, a total of 30 bibliographic references from the last 15 years were selected. Conclusion: pediatric rotary files can be considered safe and more efficient alternatives in performing pulpectomies on primary molars, due to treatment time is reduced, complete debridement of the root canals is produced, and tooth function is maintained until exfoliation. (AU)


Assuntos
Dente Decíduo , Pulpectomia/instrumentação , Pulpectomia/métodos , Dente Molar , Odontopediatria/métodos
3.
Med. oral patol. oral cir. bucal (Internet) ; 28(6): e504-e511, nov. 2023. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-227367

RESUMO

Background: Third molars have the highest prevalence of impaction in teeth and can cause pathological damage on the adjacent second molars. This study aims to evaluate the effects of factors related to impacted third molars on external root resorption (ERR) in adjacent second molars using cone-beam computed tomography (CBCT). Material and Methods: In CBCTs, the effect of impacted third molars on the root surface of adjacent second molars was investigated. Inclusion criteria for subjects were being older than 16 and younger than 55, presence of at least one impacted third molar and adjacent second molar. Exclusion criteria were pathology, a follicle gap greater than 5 mm, crowned second molar, severe decay, an artifact on a radiologic image, and previous surgery on the second or third molars. The investigations were made based on age range, gender, tooth inclination, Pell-Gregory classification, retention type, contact area, root formation, pericoronal width, and tooth absence on the same quadrant for potential risk factors. The collected data were statistically analyzed with R software. The Chi-Square test was used to find out any significant difference. Logistic regression analyses were done for potential risk factors for ERR. Results: A total of 437 impacted third molars and adjacent second molars were investigated using CBCT. Of these, 381 met the inclusion criteria. Mesioangular and horizontal inclination, Pell-Gregory Class B-C, contact area, and retention type were found the statistically potential risk factors for ERR. Conclusions: The impacted third molar with horizontal or mesioangular position, and osseous retention, with Pell and Gregory Class B and C, are more likely to cause external root resorption in adjacent second molars. (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/epidemiologia , Reabsorção da Raiz/etiologia , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada de Feixe Cônico/métodos , Estudos Transversais , Dente Molar/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem
4.
Av. odontoestomatol ; 39(2)abr.-jun. 2023. ilus, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-223396

RESUMO

Objetivo: Determinar los diámetros mesiodistal, vestíbulo palatino y vestíbulo lingual, de las primeras molares permanentes de ambos maxilares para la estimación del sexo, en los estudiantes de Odontología de la Universidad Nacional Federico Villarreal, Lima-Perú. Material y métodos: El tipo de investigación empleado fue descriptivo con un diseño no experimental, la técnica aplicada fue la observación directa, la población estuvo constituida por 605 estudiantes. Se realizó la toma de impresiones de ambos maxilares con silicona de condensación para obtener los modelos de estudio, se utilizó un calibrador vernier digital para hacer las medidas mesiodistal y vestíbulo palatino y vestíbulo lingual, las medidas se realizaron a una muestra de 207 modelos de ambos sexos. Resultados: La característica odontométrica con respecto al diámetro vestíbulo -palatino/lingual de ambos maxilares, para el sexo masculino tuvo un diámetro de 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) y 11.02mm (pza.46) y valores de 10.88mm (pza16), 10.93mm (pza.26), 10.77mm (pza.36), y 10.74mm (pza.46), en el sexo femenino; en lo referente a la característica odontométricas mesio-distal se encontró un diámetro de 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) y 11.45mm (pza.46) para el sexo masculino y valores de 10.56mm (pza. 16), 10.58mm (pza.26), 11.10 mm (pza.36), y 11.2mm (pza.46), en el sexo femenino. Conclusión: Los diámetros mesiodistales y vestíbulo palatino fueron mayores en el sexo masculino. (AU)


Objective: To determine the mesiodistal, palatal vestibule and lingual vestibule diameters of the first permanent molars of both jaws for the estimation of sex, in Dentistry students of the Federico Villarreal National University, Lima-Peru. Material and methods: The type of research used was descriptive with a non-experimental design, the applied technique was direct observation, the population consisted of 605 students. Impressions of both jaws were made with condensation silicone to obtain the study models, a digital vernier caliper was used to make the mesiodistal and palatal vestibule and lingual vestibule measurements, the measurements were made on a sample of 207 models of both sexes. Results: The odontometric characteristic with respect to the vestibule-palatal/lingual diameter of both jaws, for the male sex had a diameter of 11.2mm (pza.16), 11.3mm (pza.26), 11.01mm (pza.36) and 11.02mm (pza.46) and values of 10.88mm (pza.16), 10.93mm (pza.26), 10.77mm (pza.36), and 10.74mm (pza.46), in the female sex; Regarding the mesio-distal odontometric characteristic, a diameter of 10.8mm (pza.16), 10.76mm (pza.26), 11.44mm (pza.36) and 11.45mm (pza.46) was found for the male sex. and values of 10.56mm (pza.16), 10.58mm (pza.26), 11.10mm (pza.36), and 11.2mm (pza.46), in the female sex. Conclusion: The mesiodistal and palatal vestibule diameters were greater in males. (AU)


Assuntos
Humanos , Palato/anatomia & histologia , Boca/anatomia & histologia , Dente Molar/anatomia & histologia , Peru , Epidemiologia Descritiva , Estudantes de Odontologia , Universidades
5.
Med. oral patol. oral cir. bucal (Internet) ; 27(5): e468-e475, September 01, 2022. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-209814

RESUMO

Background: We aimed to histomorphometrically evaluate the effects of Leucocyte-Platelet-Rich Fibrin (L-PRF),with and without the combination of a bone grafting material, for alveolar ridge preservation using an in vivocanine model.Material and Methods: Seven dogs (Female Beagles, ~18-month-old) were acquired for the study. L-PRF wasprepared from each individual animal by drawing venous blood and spinning them through a centrifuge at 408RCF-clot (IntrasSpin, Intra-Lock, Boca Raton, FL). L-PRF membranes were obtained from XPression fabrication kit (Biohorizons Implant Systems, Inc., AL, USA). A split mouth approach was adopted with the first molarmesial and distal socket defects treated in an interpolated fashion of the following study groups: 1) Empty socket (negative control); 2) OSS filled defect 3) L-PRF membrane; and 4) Mix of Bio-Oss® with L-PRF. After six weeks,samples were harvested, histologically processed, and evaluated for bone area fraction occupancy (BAFO), vertical/horizontal ridge dimensions (VRD and HRD, respectively), and area of coronal soft tissue infiltration.Results: BAFO was statistically lower for the control group in comparison to all treatment groups. Defects treatedwith Bio-Oss® were not statistically different then defects treated solely with L-PRF. Collapsed across all groups,L-PRF exhibited higher degrees of BAFO than groups without L-PRF. Defects filled with Bio-Oss® and Bio-Oss®with L-PRF demonstrated greater maintenance of VRD relative to the control group. Collapsed across all groups,Bio-Oss® maintained the VRD and resulted in less area of coronal soft tissue infiltration compared to the emptydefect. Soft tissue infiltration observed at the coronal area was not statistically different among defects filled withL-PRF, Bio-Oss®, and Bio-Oss® with L-PRF.Conclusions: Inclusion of L-PRF to particulate xenograft did not promote additional bone heading at 6 weeks invivo. ... (AU)


Assuntos
Animais , Feminino , Cães , Processo Alveolar , Regeneração Óssea , Leucócitos , Dente Molar , Fibrina Rica em Plaquetas , Extração Dentária , Alvéolo Dental/cirurgia
6.
Med. oral patol. oral cir. bucal (Internet) ; 27(4): 1-8, July 2022. graf, ilus
Artigo em Inglês | IBECS | ID: ibc-209801

RESUMO

Background: A study is made of the findings of high-magnification rigid endoscopy at the root end surface following apicoectomy of teeth subjected to periapical surgery.Material and Methods: A cross-sectional study was made of patients subjected to periapical surgery at the Unitof Oral Surgery and Implantology (University of Valencia, Valencia, Spain) between 2011 and 2019. Followingapicoectomy, the root end surfaces were inspected, with the evaluation of untreated canals, isthmuses, craze lines,crack lines, opaque dentin and gaps. Likewise, an analysis was made of the association between patient age andthe tooth type and restoration and the presence of craze lines, cracks, opaque dentin and gaps.Results: The final sample consisted of 168 patients subjected to periapical surgery, with 177 operated teeth and206 roots. Untreated canals were observed in 14 roots (6.8%). Isthmuses were identified in 74 roots (35.9%),particularly in the mesial root of the lower first molar (94.1%). In turn, craze lines were identified in 8.3% of theroots, cracks in 3.9%, and gaps in 53.4%. The prevalence of opaque dentin was 78.3%, with a greater presence inposterior teeth (90.3% in premolars and 86.2% in molars) than in anterior teeth (50.6%) (p<0.001). Patient age andtooth restoration showed no correlation to the studied parameters.Conclusions: Craze lines and crack lines were observed in less than 10% of the roots, though opaque dentin wasidentified in 73% of the roots, particularly in posterior teeth, and gaps were found in over half of the canals. (AU)


Assuntos
Humanos , Apicectomia/métodos , Cavidade Pulpar/cirurgia , Dente Molar , Raiz Dentária/cirurgia , Estudos Transversais
7.
Av. odontoestomatol ; 38(1): 21-29, ene.-mar. 2022. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-203125

RESUMO

Introducción: Una de las dificultades de los tratamientos endodónticos son las variaciones anatómicas de las raíces y sistema de canales radiculares. Existe poca información sobre prevalencia y distribución espacial de estas variaciones en casos reportados con CBCT (del inglés Cone-Beam Computed Tomography). El propósito de la presente revisión fue analizar las variaciones anatómicas en primer y segundo molar permanente mandibular con tratamiento endodóntico evaluadas con CBCT. Materiales y métodos: Se seleccionaron artículos con casos de tratamiento endodóntico en primer o segundo molar permanente mandibular. Se determinaron el número, distribución espacial de variaciones anatómicas radiculares y canales. Además, el número y tipo de alteraciones de forma. Resultados: La mayor prevalencia del número y distribución espacial de raíces en primer molar fue de tres raíces [1M (mesial), 2D (distal)] con un 76,5% y cuatro raíces (2M, 2D) con un 55,6% en segundo molar. La mayor prevalencia del número y distribución de canales radiculares para el primer y segundo molar fue de cuatro canales: 1mesiovestibular, 1mesiolingual, 1distovestibular y 1distolingual, con un 30% y 90,9% de los casos seleccionados respectivamente. La distribución de alteraciones de forma fue de 8,7% para geminación y de 2,1% para taurodontismo. Conclusiones: La variación anatómica de raíces del primer y segundo molar inferior permanente con más frecuencia fue de tres y cuatro respectivamente. La variación anatómica de canales con más frecuencia fue de cuatro: 2M y 2D. El número de alteraciones de forma fueron poco frecuentes, presentando geminaciones y taurodontismo, solo en segundos molares.


Introduction: One of the difficulties of endodontic treatments is the anatomical variations of the roots and the root canal system. There is little information on the prevalence and spatial distribution of these variations in cases reported with CBCT (Cone-Beam Computed Tomography). The purpose of this review was to analyze the anatomical variations in the mandibular first and second permanent molars with endodontic treatment evaluated with CBCT. Materials and methods: Articles with cases of endodontic treatment in the first or second permanent mandibular molar were selected. The number, spatial distribution of anatomical variations of roots and canals were determined. The number and type of shape alterations were also determined. Results: The highest prevalence regarding number and spatial distribution of root in the first molar was three roots (1M (mesial), 2D (distal)) with 76.5% and four roots (2M, 2D) with 55.6% in second molar. The highest prevalence regarding number and distribution of root canals for the first and second molars was four channels: 1 mesiobuccal, 1 mesiolingual, 1 distobuccal and 1 distolingual, with 30% and 90.9% of the cases selected, respectively. The distribution of shape alterations was 8.7% for gemination and 2.1% for taurodontism. Conclusions: The anatomical variation of roots of the first and second permanent lower molars with the most frequency was three and four respectively. The most frequent anatomic variation of channels was four: 2M and 2D. The number of shape alterations were less frequent, presenting geminations and taurodontism, only in second molars.


Assuntos
Humanos , Ciências da Saúde , Endodontia , Dente Molar , Tomografia Computadorizada de Feixe Cônico/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos
8.
Med. oral patol. oral cir. bucal (Internet) ; 26(2): e118-e125, Mar. 2021. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-224430

RESUMO

Background: Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was todetermine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetateis effective in preventing surgical complications related to impacted lower third molar extractions.Material and Methods: A randomized, double-blind, split-mouth study was performed. Fifteen patients were re-cruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test orplacebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply thegel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, andthe opposite gel applied. The following parameters were diagnosed/evaluated and then recorded: alveolar osteitisfollowing Blum’s criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healingat day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesicpill intake.Results: A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveo-lar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). Nostatistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consump-tion between two groups. But statistically lower postoperative pain during the 7 days after surgical extractionswas found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effectswere reported.(AU)


Assuntos
Humanos , Masculino , Feminino , Alvéolo Seco , Extração Dentária , Dente Molar/cirurgia , Própole , Complicações Pós-Operatórias , Complicações Intraoperatórias , Medicina Bucal , Cirurgia Bucal , Patologia Bucal , alfa-Tocoferol/administração & dosagem , Ácido Ascórbico/administração & dosagem , Projetos Piloto
9.
Endodoncia (Madr.) ; 38(3): 16-25, dic. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-200309

RESUMO

OBJETIVO: Comparar en raíces mesiales de primeros molares mandibulares ex vivo, la acción de distintos sistemas de instrumentación en la conformación y limpieza de los conductos radiculares. Material y MÉTODOS: Se emplearon 25 raíces, cuyos conductos radiculares fueron instrumentados con los sistemas: WaveOne Gold, Reciproc, Mtwo, ProTaper Next y ProTaper Gold. Las raíces fueron seccionadas transversalmente a nivel de los tercios cervi-cal, medio y apical, y las muestras se analizaron con microscopía Confocal. En cada tercio se evaluó: a) Acción de los instrumentos sobre las paredes del conducto radicular, b) Presencia de istmos y su relación con la preparación quirúrgica y c) Medición en micrómetros cuadradas de las zonas no instrumentadas. Para la evaluación estadística se utilizó el análisis de varianza de dos factores con medidas repetidas en el factor tercio. El nivel de significación fue establecido en P < 0,05.RESULTADOS: Todos los sistemas mostraron una preparación regular de la superficie dentinaria excepto el Reciproc R25 que produjo zonas de desgarramiento de dentina. Con todos ellos se generaron fisuras dentinarias, dispuestas perpendiculares, oblicuas o paralelas a la pared del conducto radicular. Los istmos presentaban restos impactados en su interior. En ocasiones, ambos conductos mesiales se encontraban unidos por un istmo determinando a veces un conducto mediomesial. Se observó entre un 19.4% y 42.2% de la superficie de los conductos radiculares no instrumentada, sin diferencias significativas entre grupos ni entre tercios


OBJECTIVE: To compare ex vivo, the action of different systems in cleaning and shaping the mesial root canals of mandibular first molars. Material and METHODS: 25 roots were instrumented with the following systems: WaveOne Gold, Reciproc, Mtwo, ProTaper Next, and ProTaper Gold. The roots were cross-sectioned at the level of the cervical, middle, and apical thirds, and the samples were analyzed with Confocal microscopy. In each third, the following aspects were evaluated: a) Action of the instruments on the walls of the root canal, b) Presence of isthmus and their relationship with the surgical preparation, and c) Measurement in square micrometers of the non-instrumented areas. For the statistical evaluation, the two-factor analysis of varianza with repeated measures in the third factor was used. The level of significance was established at P < 0,05. RESULTS: All systems showed a regular preparation of the dentin surface except Reciproc R25 which produced areas of dentinal tears. With every system, dentin cracks were generated, arranged perpendicular, oblique, or parallel to the wall of the root canal. The isthmus showed the presence of debris packed inside. On occasions, both mesial canals were unified by an isthmus, sometimes conforming a middle mesial canal. Between 19.4% and 42.2% non-instrumented root canal surface was observed, without significant differences between groups or between thirds. CONCLUSIONS: None of the system used completely cleaned and shaped the root canals, leaving a significant porcentage of the dentinal walls non-instrumented


Assuntos
Humanos , Preparo de Canal Radicular/instrumentação , Instrumentos Odontológicos , Dente Molar/cirurgia , Microscopia Confocal , Propriedades de Superfície , Valores de Referência , Dentina , Análise Fatorial
10.
Endodoncia (Madr.) ; 38(2): 20-25, oct. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-198456

RESUMO

INTRODUCCIÓN: El primer molar superior se caracteriza por tener 3 raíces y cuatro conductos radiculares. La presencia de cuatro raíces es un hallazgo inusual, pocas veces reportado en la literatura. CASO CLÍNICO: Acude a la consulta un paciente caucásico con pulpititis irreversible del 2.6. Se decide iniciar el trata-miento de conductos, pero dada la diferente morfología radicular visible radiográficamente, se realiza una CBCT previa. En el corte axial, se aprecian 4 raíces, con ápices totalmente independientes. Además, la raíz mesiovestibular presenta un único conducto y forma redondeada. Con la ayuda del microscopio se realiza una apertura inusual y se localizan los cuatro conductos. Finalizadas la instrumentación, irrigación y obturación, se recubre el acceso cameral con composite, para la posterior realización de una incrustación, capaz de sellar la caries cervical y restaurar los puntos de contacto. En el control 2 años posterior, el paciente está totalmente asintomático y la restauración demuestra su funcionalidad y estética. CONCLUSIÓN: Las anomalías anatómicas pueden presentar-se en cualquier diente. Encontrar un primer molar superior con más de tres raíces es un hallazgo muy extraño, pero gracias a la ayuda de la radiología tridimensional, se pudo visualizar y tratar de forma adecuada. Ante cualquier imagen radiográfica donde no se pueda apreciar con claridad la anatomía dental a tratar, debemos realizar varias proyecciones radiográficas o una CBCT para poder conocer la morfología real a la que nos enfrentamos


INTRODUCTION: The upper first molar is characterized by having three roots and four root canals. The presence of four roots is an unusual finding, rarely reported in the literature. CLINICA CASE: A caucasian patient with irreversible pulpititis of 2.6 comes to the dental clinic. It was decided to start the root canal treatment, but due to the different root morphology visible radiographically, a previous CBCT was performed. In the axial section, 4 roots are seen, with completely independent apexes. Furthermore, the mesiovestibular root has a single canal and a rounded shape. With the help of the microscope, an unusual opening is made and the four canals are located. After the instrumentation, irrigation and obturation are completed, the cameral access is covered with composite, for the subsequent inlay, capable of sealing cervical caries and restoring the contact points. In the control 2 years later, the patient is completely asymptomatic and the restoration demonstrates its functionality and aesthetics. CONCLUSIONS: Anatomic anomalies occur in any tooth. Finding an upper first molar with more than three roots is a very strange finding, but thanks to the help of three-dimensional radiology, it was able to be properly visualized and treated. Before any radiographic image where the dental anatomy to be treated cannot be clearly seen, we must carry out several radiographic projections or a CBCT to be able to know the real morphology that we are facing


Assuntos
Humanos , Masculino , Adulto , Tratamento do Canal Radicular/métodos , Dente Molar/cirurgia , Restauração Dentária Permanente/métodos , Radiografia Dentária , Raiz Dentária/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Resultado do Tratamento
11.
Med. oral patol. oral cir. bucal (Internet) ; 25(5): e634-e643, sept. 2020. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-196519

RESUMO

BACKGROUND: Hemostasis is of critical importance in endodontic surgery. Studies on bleeding control in maxillary molars are scarce. The present study compares the efficacy of two hemostatic techniques in controlling bleeding in endodontic surgery. MATERIAL AND METHODS: A randomized two-arm pilot study involving 30 patients with peri-radicular lesions in maxillary molars (first and second molars) was carried out including the following hemostatic agents: polytetrafluoroethylene (PTFE) strips as an adjunct to epinephrine impregnated gauze (test group; n = 15) and aluminum chloride (Expasyl(TM)) (control; n = 15). Bleeding control was independently assessed by the surgeon and by two blinded observers before and after application of the hemostatic agent, and was classified as either adequate (complete bleeding control) or inadequate (incomplete bleeding control). RESULTS: Bleeding control was similar in both groups. Simple binary logistic regression analysis failed to identify variables affecting bleeding control. Only the height of the keratinized mucosal band (≥ 2 mm) suggested a decreased risk of inadequate bleeding control of up to 89% (OR = 0.11; p = 0.06). CONCLUSIONS: No difference in the efficacy of bleeding control was observed between PTFE strips as an adjunct to epinephrine impregnated gauze and aluminum chloride in maxillary molars


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hemostasia Cirúrgica/métodos , Raiz Dentária/cirurgia , Cavidade Pulpar/cirurgia , Hemostáticos/uso terapêutico , Dente Molar/cirurgia , Politetrafluoretileno/uso terapêutico , Epinefrina/uso terapêutico , Cloreto de Alumínio/uso terapêutico , Tratamento do Canal Radicular/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Modelos Logísticos , Resultado do Tratamento , Maxila/cirurgia
12.
Med. oral patol. oral cir. bucal (Internet) ; 25(3): e395-e402, mayo 2020.
Artigo em Inglês | IBECS | ID: ibc-196328

RESUMO

BACKGROUND: Deciding whether or not to extract third molars remains a controversial situation in dental practice. Image exams support this decision by enabling a close view of the third molar, its adjacent bone and its relationship with the second molar. This study aimed to assess and compare second molar bone loss adjacent to impacted mandibular third molar in panoramic radiographs (PAN) and cone beam computed tomography (CBCT) scans. MATERIAL AND METHODS: A sample of 70 patients was selected (n=124 teeth). Each patient had a set of a panoramic radiograph and CBCT scans consecutively taken for dental treatment purposes. In PAN and CBCT, mandibular third molars were classified based on their position and bone loss of the adjacent second molar. Agreement between PAN and CBCT scans was assessed and quantified. RESULTS: Outcomes of bone loss assessment were different between PAN and CBCT scans (p < 0.05). Bone loss was found in 62.9% of the PAN, while in CBCT scans it was found in 80%. In particular, nearly 29% (n=27) of the teeth that were classified without bone loss in PAN were classified with bone loss in CBCT scans. Mesioangular and horizontal third molars had a statistically significant association with bone loss of the adjacent second molars (p < 0.05). In general, PAN underestimated the severity of bone loss compared to CBCT scans (p < 0.05). CONCLUSIONS: Diagnosing second molar bone loss due to impaction of adjacent third molar in PAN may be challenging because of false negatives. Impacted third molars justify preoperative CBCT scans if second molar bone loss needs to be precisely assessed for a more detailed and reliable treatment plan


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Perda do Osso Alveolar/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Radiografia Panorâmica/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Índice de Gravidade de Doença , Valores de Referência , Variações Dependentes do Observador , Valor Preditivo dos Testes
13.
Cient. dent. (Ed. impr.) ; 17(1): 19-26, ene.-abr. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-189745

RESUMO

La pérdida ósea vertical en los sectores posteriores maxilares es un hecho frecuente tras la extracción dental. En muchas ocasiones para rehabilitar estas zonas podemos emplear técnicas de regeneración u optar por un abordaje más conservador con implantes cortos. En el presente caso clínico mostramos un caso rehabilitado bilateralmente con dos técnicas diferentes: elevación de seno y la inserción de implantes cortos, con un seguimiento de ocho años donde ambas técnicas han logrado resultados igualmente predecibles


Vertical bone loss in the posterior maxillary sectors is a frequent occurrence after tooth extraction. These areas can often be rehabilitated using regeneration techniques or by opting for a more conservative approach with short implants. The present clinical case shows bilateral rehabilitation with two different techniques: sinus lift and the insertion of short implants, with a follow-up of 8 years where both techniques have achieved equally predictable results


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Atrofia , Maxila/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Implantes Dentários , Maxila/patologia , Dente Molar/patologia , Radiografia Panorâmica
14.
Med. oral patol. oral cir. bucal (Internet) ; 24(4): e545-e554, jul. 2019. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-185669

RESUMO

Background: Mandibular sagittal split osteotomy (MSSO) may incur unfavorable split and sensorineural injuries. Knowledge of the anatomic location of the mandibular canal (MC) and bone thickness in the region of interest for MSSO, and the possible variations by age and gender can assist in avoiding such complications. Purpose: To study the location of the MC and bone thickness in the region of MSSO by cone-beam computed tomography (CBCT) radiographs and to evaluate the possible variations by age and gender in a Jordanian population. Material and Methods: This retrospective radio-anatomical study examined all CBCT radiographs for patients treated over three years at the University of Jordan Hospital, Amman, Jordan. Distances from the MC to the cortical external surfaces and MC diameter (MCD) were measured by a reliable observer at three predetermined regions for MSSO: region (A) [mandibular foramen area], region (B) [mandibular angle area] and region (C) [directly mesial to the second molar]. Gender and age differences in all measurements were then compared using non-parametric Mann-Whitney U test. Results: The final study radiographs comprised a total of 202 CBCT belonged to a cohort of 202 subjects; 91 males (45.1%) and 111 (54.9%) females, with mean age (± SD) of 42.94 ± 18.54 years (range 18-90 years). Whereas only the bone thickness superior, buccal and inferior to MC in regions (B) and (C), and MCD in the three regions exhibited significant (p < 0.05) gender differences, all measured distances exhibited statistically significant (p < 0.05) differences between young and adult patients. Conclusion: The location of MC and bone thickness in the region of MSSO were significantly variable according to age, but exhibited sexual diamorphism only in regions (B) and (C). This fundamental knowledge should be considered during MSSO planning


No disponible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Tomografia Computadorizada de Feixe Cônico , Mandíbula , Dente Molar , Osteotomia , Estudos Retrospectivos
15.
Endodoncia (Madr.) ; 37(1): 20-27, jun. 2019. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186292

RESUMO

El conocimiento de la morfología del sistema de conductos radiculares y sus posibles variaciones, es fundamental para poder realizar un tratamiento endodóntico con mayor predictibilidad y una mayor tasa de éxito. El presente estudio, se elaboró con la finalidad de conocer la morfología del sistema de conductos en primeros molares permanentes superiores e inferiores, en Nicaragua, tomando como muestra 60 molares extraídos. Objetivo: Determinar mediante el uso de CBCT, la morfología radicular de primeros molares permanentes. Material y métodos: Se realizaron dos grupos, 30 primeros mola-res superiores y 30 primeros molares inferiores, montados sobre una placa de acrílico. Se realizó un CBCT previo de la anatomía radicular, haciendo cortes por cada milímetro de la raíz, obteniendo un total de 15 cortes por diente, los cuales fueron analizados detenidamente, observando la morfología interna del sistema de conductos, siguiendo la clasificación de Vertucci. 1Resultados: Según la clasificación de Vertucci, la morfología radicular más frecuente en molares superiores fue la tipo I (40%), en molares inferiores fue la tipo IV en raíces mesiales (36.7%) y tipo I en raíces distales (66.7%). Los primeros molares superiores pre-sentaron 3 raíces en el 100% de las muestras, y 4 conductos en el 43.3% de las muestras, mientras los primeros molares inferiores presentaron 2 raíces en el 93.3% de las muestras y 3 conductos en el 43.3% de las muestras


The knowledge of the root canal system morphology and its possible variations is fundamental to be able to perform an endodontic treatment with greater predictability as well as a higher success rate. The present study was elaborated with the purpose to know the morphology of the canal system in upper and lower permanent first molars, in Nicaragua, taking as sample 60 extracted molars. Objective: To determine, through the use of CBCT, the root morphology of permanent, superior and inferior first molars. Material and methods: Two groups, 30 first upper molars and 30 lower first molars, were mounted on an acrylic plate. The CBCT was performed on the roots, making cuts for each millimeter, in total obtaining 15 cuts, which were analyzed carefully and observing the internal morphology of the root canal system was observed, following the Vertucci classification. 1Results: According to the Vertucci classification, the most frequent root morphology in upper molars was type I (40%), in lower molars it was type IV in mesial roots (36.7%) and type I in distal roots (66.7%). The first upper molars had 3 roots in 100% of the samples, and 4 canals in 43.3% of the samples, while the lower first molars had 2 roots in 93.3% of the samples and 3 canals in 43.3% of the samples


Assuntos
Humanos , Cavidade Pulpar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Molar/diagnóstico por imagem , Dentição Permanente , Dente Molar/anatomia & histologia , Nicarágua , Estudos Transversais , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem
16.
Int. j. clin. health psychol. (Internet) ; 19(2): 115-123, mayo 2019. tab, graf, ilus
Artigo em Inglês | IBECS | ID: ibc-184933

RESUMO

Background/Objective: To study pain-brain morphometry associations as a function of post-surgery stages (anesthesia, pain and analgesia) in an acute pain model. Method: Impacted mandible third molar were extracted. Before surgery, an anatomical T1 scan was obtained. Regional brain volumen and subcortical nuclei shapes were obtained. Statistical analyses were done using multiple regression, being pain scores the predictors and voxel volumes, subcortical nuclei volumes and subcortical nuclei shapes, the outcomes. Results: Pain was significantly larger at pain than at anesthesia and analgesia stages, and was higher during anesthesia than during analgesia. Pain intensity was related to grey matter in several cortical (Insula, Mid Frontal and Temporal Gyruses, Precuneus, Anterior Cingulate), and subcortical nuclei (Hippocampus, Thalamus, Putamen, Amygdala), depending of the post-surgical stage. A larger number of brain areas showed significance at pain that at anesthesia and analgesia stages. Conclusions: The relationships of regional brain volumes and subcortical nuclei shapes with pain scores seemed to be unsteady, as they changed with the patient's actual pain stage


Antecedentes/Objetivo: Se trata de determinar la asociación entre dolor percibido y morfometría cerebral en tres etapas postquirúrgicas (anestesia, dolor y analgesia), en un modelo de dolor agudo. Método: Se obtuvo una imagen cerebral estructural de alta resolución y posteriormente se extrajeron los terceros molares mandibulares impactados. Se realizó un análisis morfométrico para determinar volumen cerebral y forma de núcleos subcorticales. Se realizaron análisis de regresión múltiple, siendo la intensidad del dolor el predictor, y el volumen y la forma de los núcleos subcorticales, medidos pre-cirugía, las variables dependientes. Resultados: El dolor experimentado fue mayor en la etapa de dolor que en las de anestesia y analgesia, y mayor en anestesia que en analgesia. El dolor se asoció con el volumen de materia gris en áreas corticales (insula, giros frontal medial y temporal, precuneus y cingulado anterior) y subcorticales (hipocampo, tálamo, putamen y amígdala). El número de áreas asociadas al dolor experimentado fue mayor en la etapa de dolor que en las de anestesia y analgesia. Conclusiones: La relación entre volumen cerebral regional y forma de núcleos subcorticales con la intensidad del dolor no es fijo, sino que varía en función de la etapa post-quirúrgica (magnitud del dolor)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Cérebro/anatomia & histologia , Dente Molar/cirurgia , Medição da Dor , Modelos Logísticos , Doença Aguda , Imageamento por Ressonância Magnética
17.
Pediatr. aten. prim ; 20(78): 183-188, abr.-jun. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-174701

RESUMO

La hipomineralización de incisivos y molares es un trastorno de desarrollo de los primeros molares y de los incisivos permanentes. El esmalte afectado es frágil y se puede desprender fácilmente, dejando expuesta la dentina, lo cual favorece la sensibilidad dentinaria y el desarrollo de lesiones cariosas. Los posibles factores etiológicos se asocian a alteraciones durante la gestación y a algunas enfermedades de la primera infancia. Los pacientes afectados por hipomineralización de incisivos y molares exhiben signos y síntomas clínicos definidos, lo que permite clasificarlos de acuerdo con la gravedad y con las características de la hipomineralización. El tratamiento de los niños afectados por hipomineralización de incisivos y molares debe ir dirigido, en primer lugar, al diagnóstico de las lesiones y al establecimiento del riesgo de caries. Cuando se presenten molares con ruptura del esmalte y exposición dentinaria, se debe emplear un manejo integral con control de la conducta y la ansiedad, con el objetivo de ofrecer a los pacientes un tratamiento sin dolor que permita la restauración y el mantenimiento de una salud bucal adecuada, por lo que es importante establecer medidas de control de la caries


The hypomineralization of the incisors and molars is a developmental enamel defect affecting one to four permanent first molars frequently associated with affected incisors. The enamel breakdown is common in the affected mo lars resulting in hypersensitivity and to dental caries development. The possible etiological factors are as sociated with systemic cause occurring in pregnancy, around the time of birth or in the first childhood. The treatment of children affected by molar-incisor hypomineralization should be focused, first, on the diagnosis of the lesions and the establishment of caries risk. A comprehensive management of behavior and anxiety should be offered in patients with enamel cracks and exposed dentin in molars, in order to offer a painless treatment with long life restorations and proper oral health maintenance. It is also important to establish caries control procedures


Assuntos
Humanos , Criança , Desmineralização do Dente/diagnóstico , Incisivo/anormalidades , Dente Molar/anormalidades , Anormalidades Dentárias/diagnóstico , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Anormalidades Dentárias/terapia
18.
Cient. dent. (Ed. impr.) ; 14(3): 221-224, sept.-dic. 2017. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-170393

RESUMO

El taurodontismo es una anomalía del desarrollo que afecta a la morfología del tejido pulpar. Los dientes con esta alteración, presentan una amplia cámara pulpar en sentido ocluso-apical más allá de la unión amelocementaria. El objetivo de este artículo es describir de forma sintetizada y actualizada los métodos biométricos que pueden ser utilizados en el diagnóstico de taurodontismo en dentición permanente. Éstos nos permiten determinar no sólo la presencia de taurodontismo sino también el grado en el que esta alteración puede presentarse (hipertaurodontismo, mesotaurodontismo e hipotaurodontismo). A pesar de la evolución que han experimentado a lo largo del siglo pasado, la principal desventaja que presentan estas valoraciones métricas en la actualidad, es la dificultad para localizar los puntos de referencia de una forma reproducible sobre radiografías panorámicas (AU)


Taurodontism is a developmental anomaly that affects the morphology of the pulp tissue. The teeth with this alteration, present a large pulp chamber in occlusal-apical sense beyond the amelocementary union. The objective of this article is to describe in a synthesized and updated way the biometric methods that can be used in the diagnosis of taurodontism in permanent dentition. These allow us to determine not only the presence of taurodontism but also the degree to which this alteration can occur (hypertaurodontism, mesotaurodontism and hypotaurdontism). In spite of the evolution that they have undergone during the last century, the main disadvantage that present these metric valuations at present, is the difficulty to locate the points of reference of a reproducible form on panoramic radiographs (AU)


Assuntos
Humanos , Polpa Dentária/anormalidades , Biometria/métodos , Dentição Permanente , Anormalidades Dentárias/diagnóstico por imagem , Anormalidades Dentárias/fisiopatologia , Radiografia Panorâmica/instrumentação , Radiografia Panorâmica , Dente Molar/anormalidades , Dente Molar/diagnóstico por imagem
20.
Med. oral patol. oral cir. bucal (Internet) ; 22(6): e796-e799, nov. 2017. tab
Artigo em Inglês | IBECS | ID: ibc-168757

RESUMO

Background: The Evaluation of the degree of lower third molar (L3M) extraction difficulty is extremely important for both clinicians and patients. This study aimed to evaluate the validity of a new index (Kharma scale) as a preoperative predictor index of the difficulty of surgical removal of impacted L3M. Material and Methods: Extraction difficulty of a series of 49-impacted L3M was predicted preoperatively by Kharma scale, and postoperative difficulty was assessed with a modified Parant scale. Results: The sensitivity of Kharma scale, as a predictor of difficulty, was 18.2% and the specificity was 68.4%. Likelihood ratios for the Kharma categories also indicated that the scale is of little value for predicting a difficult extraction. There was no significant association between the Kharma score and duration of operation, but highmodified Parant scores were significantly associated with longer operations. Conclusions: The proposed Kharma scale was unreliable as preoperative predictor of the L3M extraction difficulty, and both radiological and clinical information must be taken into account (AU)


No disponible


Assuntos
Humanos , Dente Molar/cirurgia , Extração Dentária/efeitos adversos , Extração Dentária/tendências , Previsões/métodos , Período Pré-Operatório
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