RESUMEN
In this study, we assessed spatial and temporal variations in the trophic structure of fish assemblages in the Yellow Sea during spring and summer 2022 and compared their isotopic niches between the Provisional Measure Zone (PMZ) and Korea's west areas (non-PMZ) within the Yellow Sea. Spatial and temporal differences in the diversity and dominant species of fish assemblages were found between the PMZ and non-PMZ areas between the seasons. The mean δ13C values of fish assemblages were relatively higher in the non-PMZ areas than in the PMZ areas. In contrast, no significant differences were found in the mean δ15N values between the areas. Generally, the isotopic niche indices were relatively narrow in the PMZ areas compared to those in the non-PMZ areas. Overall, these spatial differences between the PMZ and non-PMZ areas suggest different trophic diversity of fish assemblages, resulting from site-specific variations in environmental conditions and community composition.
Asunto(s)
Ecosistema , Peces , Animales , Isótopos de Nitrógeno/análisis , Isótopos de Carbono/análisis , Estaciones del AñoRESUMEN
A surgically implantable device is an inevitable treatment option for millions of people worldwide suffering from diseases arising from orthopedic injuries. A global paradigm shift is currently underway to tailor and personalize replacement or reconstructive joints. Additive manufacturing (AM) has provided dynamic outflow to the customized fabrication of orthopedic implants by enabling need-based design and surface modification possibilities. Surgical grade 316L Stainless Steel (316L SS) is promising with its cost, strength, composition, and corrosion resistance to fabricate 3D implants. This work investigates the possibilities of application of the laser powder bed fusion (L-PBF) technique to fabricate 3D-printed (3DP) implants, which are functionalized with a multilayered antimicrobial coating to treat potential complications arising due to postsurgical infections (PSIs). Postsurgical implant-associated infection is a primary reason for implantation failure and is complicated mainly by bacterial colonization and biofilm formation at the installation site. PLGA (poly-d,l-lactide-co-glycolide), a biodegradable polymer, was utilized to impart multiple layers of coating using the airbrush spray technique on 3DP implant surfaces loaded with gentamicin (GEN). Various PLGA-based polymers were tested to optimize the ideal lactic acid: glycolic acid ratio and molecular weight suited for our investigation. 3D-Printed PLGA-GEN substrates sustained the release of gentamicin from the surface for approximately 6 weeks. The 3DP surface modification with PLGA-GEN facilitated cell adhesion and proliferation compared to control surfaces. The cell viability studies showed that the implants were safe for application. The 3DP PLGA-GEN substrates showed good concentration-dependent antibacterial efficacy against the common PSI pathogen Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis). The GEN-loaded substrates demonstrated antimicrobial longevity and showed significant biofilm growth inhibition compared to control. The substrates offered great versatility regarding the in vitro release rates, antimicrobial properties, and biocompatibility studies. These results radiate great potential in future human and veterinary clinical applications pertinent to complications arising from PSIs, focusing on personalized sustained antibiotic delivery.
Asunto(s)
Antiinfecciosos , Gentamicinas , Humanos , Gentamicinas/farmacología , Gentamicinas/química , Staphylococcus aureus , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Staphylococcus epidermidis , Polímeros , Impresión TridimensionalRESUMEN
The efficacy of hot isostatic pressing (HIP) for enhancing fatigue performance is investigated for additively manufactured (AM) Ti-6Al-4V. The limitations of HIP are probed by varying the initial material state via the selection of AM system, powder chemical composition, and process parameters. We demonstrate that the fatigue performance of HIP'd AM Ti-6Al-4V depends on the as-built quality of the material. Differences in common material attributes, such as pre-HIP defect populations or post-HIP microstructure morphology, are shown to be insufficient to explain the observed discrepancies in performance. This implies that additional microstructure attributes or localized deviations from the expected structure control the failure of this material. Finally, HIP parameters outside ASTM recommendations were explored, where a reduced temperature and high-pressure treatment yielded significantly improved fatigue performance.
RESUMEN
Additive manufacturing of metallic materials, a layer-wise manufacturing method, is currently gaining attention in the biomedical industry because of its capability to fabricate complex geometries including customized parts fitting to patient requirements. However, one of the major challenges hindering the full implementation of additively manufactured parts in safety-critical applications is their poor mechanical performance under cyclic loading. This study investigated both quasi-static bending properties (bending stiffness, bending structural stiffness, and bending strength) and bending fatigue properties of additively manufactured (AM) commercially pure titanium (CPTi) limited contact dynamic compression plate (LC-DCP) constructs based on ASTM International standard for metallic bone plates (ASTM F382). In addition, the effect of post surface treatment methods including single shot-peened (SP), dual shot-peened (DP), and chemically assisted surface enhancement (CASE) on bending fatigue performance was also evaluated. Results indicated that bending stiffness and bending structural stiffness of AM CPTi LC-DCPs are comparable to conventionally manufactured (CM) counterparts; however, the bending strength of AM CPTi LC-DCPs is lower than CM counterparts. While the fatigue strength of as-built AM CPTi LC-DCPs is lower compared to the CM counterparts, AM CPTi LC-DCPs after post surface treatments (SP, DP, and CASE) exhibit statistically comparable fatigue strength to the CM CPTi LC-DCPs.
Asunto(s)
Placas Óseas , Titanio , Fenómenos Biomecánicos , Humanos , Ensayo de MaterialesRESUMEN
Aim: Additively manufactured (3D printed), stainless steel implants were coated with dexamethasone using gelatin, chondroitin sulfate for use in bone graft surgeries. Materials & methods: The drug and polymers were deposited on the implants with a rough surface using a high precision air brush. The gelatin-chondroitin sulfate layers were cross-linked using glutaraldehyde. Results: The drug content uniformity was within 100 ± 5%, and the thickness of the polymer layer was 410 ± 5.2 µm. The in vitro release studies showed a biphasic pattern with an initial burst release followed by slow release up to 3 days. Conclusion: These results are very promising as the slow release implants can be further tested in vivo in large animals, such as cattle and horses to prevent the inflammatory cascade following surgeries.
Asunto(s)
Huesos/lesiones , Dexametasona , Gelatina , Prótesis e Implantes , Animales , Bovinos , Caballos , Polímeros , Impresión TridimensionalRESUMEN
We report the intermittent burst of a super rogue wave in the multi-soliton (MS) regime of an anomalous-dispersion fiber ring cavity. We exploit the spatio-temporal measurement technique to log and capture the shot-to-shot wave dynamics of various pulse events in the cavity, and obtain the corresponding intensity probability density function, which eventually unveils the inherent nature of the extreme events encompassed therein. In the breathing MS regime, a specific MS regime with heavy soliton population, the natural probability of pulse interaction among solitons and dispersive waves exponentially increases owing to the extraordinarily high soliton population density. Combination of the probabilistically started soliton interactions and subsequently accompanying dispersive waves in their vicinity triggers an avalanche of extreme events with even higher intensities, culminating to a burst of a super rogue wave nearly ten times stronger than the average solitons observed in the cavity. Without any cavity modification or control, the process naturally and intermittently recurs within a time scale in the order of ten seconds.
RESUMEN
We propose and investigate a metallic Fresnel zone plate (FZP/MFZP) implemented on a silver-coated optical fiber facet for super-variable focusing of light, the focal point of which can be drastically relocated by varying the wavelength of the incident light. We numerically show that when its nominal focal length is set to 20 µm at 550 nm, its effective focal length can be tuned by ~13.7 µm for 300-nm change in the visible wavelength range. This tuning sensitivity is over 20 times higher than that of a conventional silica-based spherical lens. Even with such high tuning sensitivity with respect to the incident wavelength change, the effective beam radius at the focal point is preserved nearly unchanged, irrespective of the incident wavelength. Then, we fabricate the proposed device, exploiting electron- and focused-ion-beam processes, and experimentally verify its super-variable focusing functionality at typical red, green, and blue wavelengths in the visible wavelength range, which is in good agreement with the numerical prediction. Moreover, we propose a novel MFZP structure that primarily exploits the surface-plasmon-polariton-mediated, extra-ordinary transmission effect. For this we make all the openings of an MFZP, which are determined by the fundamental FZP design formula, be partitioned by multi-rings of all-sub-wavelength annular slits, so that the transmission of azimuthally polarized light is inherently prohibited, thereby leading to super-variable and selective focusing of radially polarized light. We design and fabricate a proof-of-principle structure implemented on a gold-coated fused-silica substrate, and verify its novel characteristics both numerically and experimentally, which are mutually in good agreement. We stress that both the MFZP structures proposed here will be very useful for micro-machining, optical trapping, and biomedical sensing, in particular, which invariably seek compact, high-precision, and flexible focusing schemes.
RESUMEN
INTRODUCTION: Previous occasional successes after delayed replantation suggest that the presence of viable cells may not be the only factor for successful periodontal regeneration in delayed replantation. Various other factors such as proteins or the extracellular matrix (ECM) may play a role in this process. The purpose of this study was to characterize changes in the proteome components of periodontal ligament (PDL) tissue after hypothermic preservation of the tooth. METHODS: Extracted teeth were divided into 4 groups: immediate sampling, sampling after 1 week of preservation at 4°C, sampling after 2 weeks of preservation at 4°C, and sampling after 1 week of dry storage at room temperature as a negative control. PDL tissues were collected from the root and stored immediately in liquid nitrogen. The tissues were subjected to 2-dimensional gel electrophoresis, and spot selection was executed. Selected spots that maintained the protein volume were then processed with matrix-assisted laser desorption and ionization time-of-flight mass spectrometry to identify the nature of the proteins. RESULTS: Thirty-five selected spots were analyzed. Sixteen spots were identified as vimentin, and 3 spots were type VI collagen. The size of the 16 vimentin spots decreased gradually with increasing storage time, from 0 to 2 weeks, and decreased rapidly after dry storage. However, only the dry storage group differed significantly from the immediately sampled group. CONCLUSIONS: Vimentin was the most prominent protein followed by type VI collagen in volumetrically maintained protein spots. Although these proteins are known to be closely related with ECM integrity, the role of these proteins in delayed replantation is beyond the scope of this study. Further studies are needed to elucidate the possible role of these proteins for periodontal healing of delayed replantation.
Asunto(s)
Colágeno/metabolismo , Criopreservación/métodos , Ligamento Periodontal/metabolismo , Proteoma/metabolismo , Vimentina/metabolismo , Electroforesis en Gel Bidimensional , Humanos , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Supervivencia Tisular , Reimplante DentalRESUMEN
We propose a fiber-optic-plasmonic hybrid device that is based on a corrugation-assisted metal-coated angled fiber facet (CA-MCAFF) for wavelength-dependent off-axis directional beaming (WODB). The device breaks into two key structures: One is the MCAFF structure, which is a modified Kretschmann configuration implemented onto a fiber platform, thereby being able to generate a unidirectional surface plasmon with dramatically enhanced properties in terms of non-confined diffracted radiation loss and operational bandwidth. The other is the periodic corrugation structure put on the MCAFF, thereby enabling WODB functionality out of the whole structures. The corrugated metal surface out-couples the surface plasmon mode to free-space optical radiation into a direction that varies with the wavelength of the optical radiation with excellent linearity. We perform extensive numerical investigations based on the finite-element-method and analyze the out-coupling efficiency (OCEout) and spectral bandwidth (SBout) of the proposed device for various designs and conditions. We determine the seven structural parameters of the device via taking sequential optimization steps. We deduce two optimal conditions particularly for the fiber-facet angle, in terms of the averaged OCEout or the SBout in the whole visible wavelength range (400 - 700 nm), which eventually leads to OCEout = 30.4% and SBout = 230 nm or to OCEout = 24.5% and SBout = 245 nm, respectively. These results suggest substantial enhancements in both OCEout and SBout, in comparison with the performance properties of a typical nano-slit-based device having a similar type of WODB functionality. The proposed CA-MCAFF is a simple, compact and efficient WODB device that is fully compatible with the state-of-the-art optical fiber technology.
RESUMEN
We numerically investigate quasi-mode-locked (QML) multi-pulse dynamics in a fiber ring laser cavity in the anomalous dispersion regime. We show that the laser cavity can operate in five constitutively different QML regimes, depending on the saturation power of the saturable absorber element and the length of the passive fiber section that parameterize the overall nonlinearity and dispersion characteristic of the laser cavity. We classify them into the incoherent noise-like-pulse, partially-coherent noise-like-pulse, symbiotic, partially-coherent multi-soliton, and coherent multi-soliton regimes, accounting for their coherence and multi-pulse formation features. In particular, we numerically clarify and confirm the symbiotic regime for the first time to the best of our knowledge, in which noise-like pulses and multi-solitons coexist stably in the cavity that has recently been observed experimentally. Furthermore, we analyze the shot-to-shot coherence characteristics of the individual QML regimes relative to the amount of the nonlinear-phase shift per roundtrip, and verify a strong correlation between them. We also show that the net-cavity dispersion plays a critical role in determining the multi-pulse dynamics out of the partially-coherent noise-like-pulse, symbiotic, and partially-coherent multi-soliton regimes, when the cavity bears moderate nonlinearity. We quantify and visualize all those characteristics onto contour maps, which will be very useful and helpful in discussing and clarifying the complex QML dynamics.
RESUMEN
INTRODUCTION: Periodontal involvement has been thought to be a contraindication for intentional replantation. This retrospective study aimed to assess clinical outcomes after intentional replantation of teeth with periodontal involvement and to explore potential predictors of outcomes. METHODS: Teeth with a history of intentional replantation between March 2000 and December 2014 and with 1 or 2 preoperative periodontal pockets ≥6 mm among 6 sites evaluated per tooth were included. A total of 103 teeth were included, and 74 teeth were followed up for more than 6 months. Outcomes were assessed as improved (a decrease in the number and depths of periodontal pockets and the size of periapical radiolucency and no external root resorption or sign/symptoms) or failed. Data were analyzed with Kaplan-Meier survival analysis and a Cox proportional regression model. RESULTS: Cumulative improved rates declined from 89% at 1 year to 68% at 4 years. A Cox proportional regression model identified the patient's age (P = .049; hazard ratio, 2.552) and the number of preoperative periodontal pockets with a depth ≥6 mm (P = .041; hazard ratio, 2.523) as predictors of outcomes in the replantation of periodontally involved teeth. CONCLUSIONS: Periodontal involvement is not an absolute contraindication to intentional replantation. The teeth with 1 preoperative periodontal pocket ≥6 mm and the subjects aged ≤40 years had 2.5 times and 2.6 times lower probability of failure, respectively, than the teeth with 2 pockets and the subjects aged >40 years. Therefore, these factors need to be carefully considered for intentional replantation.
Asunto(s)
Enfermedades Periodontales/cirugía , Reimplante Dental , Adulto , Femenino , Humanos , Masculino , Enfermedades Periodontales/complicaciones , Bolsa Periodontal/complicaciones , Bolsa Periodontal/cirugía , Estudios Retrospectivos , Reimplante Dental/métodos , Resultado del TratamientoRESUMEN
INTRODUCTION: We aimed to simultaneously investigate the effects of topical anesthesia on needle insertion and injection pain in the labial mucosa of the maxillary central incisors of patients awaiting apical surgery and to assess the relationship between patients' anxiety and pain scores. METHODS: Forty-four patients scheduled for apical surgery of the maxillary anterior incisor or canine were included, and all completed the Modified Dental Anxiety Scale (MDAS) questionnaire. One piece of Xylocaine (AstraZeneca, Sodertalje, Sweden) gauze was applied to the right or left side of the labial vestibule below the central incisor according to a randomization process, and 1 piece of water gauze was applied to the contralateral side of the labial vestibule. Each piece of gauze remained in place for 2 minutes. The subjects were asked to rate their pain according to the numeric rating scale immediately after needle insertion and anesthetic solution injection. RESULTS: Topical anesthetic application significantly reduced both insertion- and injection-related pain. Injection pain was significantly higher than insertion pain throughout the experiment. The difference in pain scores between the placebo and topical anesthetic groups was significantly greater for insertion pain than injection pain. The group with higher MDAS scores showed significantly higher pain scores, except for insertion pain reported by the topical anesthetic group, which did not show a significant difference between MDAS score groups. CONCLUSIONS: The topical anesthetic was highly effective for both insertion and injection pain during infiltration anesthesia in the maxillary central incisors. Highly anxious patients reported higher pain scores; however, topical anesthetics reduced the effect of anxiety on increasing pain.
Asunto(s)
Anestesia Local , Anestésicos Locales/administración & dosificación , Ansiedad/etiología , Inyecciones/psicología , Dolor/psicología , Adulto , Anciano , Anestesia Dental , Método Doble Ciego , Femenino , Humanos , Inyecciones/efectos adversos , Masculino , Persona de Mediana Edad , Dolor/etiología , Dolor/prevención & control , Dimensión del Dolor , Encuestas y Cuestionarios , Adulto JovenRESUMEN
INTRODUCTION: Teeth with a C-shaped canal have been regarded as a challenge for nonsurgical root canal treatment (RCT) and apical microsurgery because of their anatomic variations and low accessibility. For such teeth, intentional replantation might be a treatment option. The purpose of this study was to investigate the prognostic factors for the clinical outcome of intentionally replanted teeth with a C-shaped canal. METHODS: We retrospectively investigated patients who had undergone intentional tooth replantation at the Department of Conservative Dentistry, Yonsei University Dental Hospital, Seoul, Korea, from June 2002 to November 2015. Consequently, 41 intentionally replanted teeth with C-shaped canals were identified. The cumulative survival rate and related prognostic factors were assessed based on clinical and radiographic examination using survival analysis. RESULTS: The cumulative survival rate of intentionally replanted teeth with a C-shaped canal was 83.4% at 4 years and 73.0% at 11 years postoperatively. Based on Cox proportional hazard regression analysis, extraoral time (≤15 minutes vs >15 minutes) and retrofilling material (ProRoot MTA [Dentsply, Tulsa, OK] vs others) were significantly associated with tooth survival (P < .05). CONCLUSIONS: Extraoral time exceeding 15 minutes and the use of ProRoot MTA as a retrofilling material were significantly associated with a lower survival of intentionally replanted teeth with C-shaped canals. With improved clinical procedures based on an understanding of the prognostic factors, intentional replantation would be a favorable treatment option for treating teeth with a C-shaped canal.
Asunto(s)
Cavidad Pulpar/anomalías , Reimplante Dental/métodos , Adulto , Cavidad Pulpar/cirugía , Femenino , Humanos , Estimación de Kaplan-Meier , Masculino , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Reimplante Dental/efectos adversos , Resultado del TratamientoRESUMEN
INTRODUCTION: Intentional replantation is an alternative to tooth extraction and prosthetic replacement when conventional endodontic treatment modalities are unfeasible or contraindicated. This study assessed tooth retention and healing after intentional replantation and explored predictors of these outcomes. METHODS: Data of intentional replantation procedures performed between March 2000 and December 2010 were collected prospectively, excluding teeth with preoperative periodontal and root defects. A cohort of 159 teeth was followed up for 0.5-12 years. Retention and healed status without complications (periapical radiolucency, external root resorption, ankylosis, signs/symptoms, probing ≥6 mm) was recorded and analyzed with Kaplan-Meier survival analysis and Cox proportional hazard regression model (P < .05). RESULTS: Complications leading to extraction occurred in 8 of 159 teeth (5%). Kaplan-Meier survival function suggested 93% cumulative 12-year retention. Cumulative healed rates declined from 91% at 6 months to 77% at 3 years. The healed rate was significantly lower for maxillary teeth without preoperative periapical radiolucency, replanted in more than 15 minutes, and root-end filled with ProRoot MTA. Cox regression identified extraoral time ≤15 minutes as predictor of complication-free healing (P < .04; hazard ratio, 2.767; 95% confidence interval, 1.053-7.272). CONCLUSIONS: This prospective cohort study of contemporary intentional replantation suggested a cumulative 12-year retention rate of 93% and healed rate of 77% after 3 years. Healing occurred 1.7 times more frequently in teeth replanted within 15 minutes. Although most complications occurred within 1 year after replantation, follow-up should extend for at least 3 years to capture late complications.
Asunto(s)
Reimplante Dental/métodos , Reimplante Dental/estadística & datos numéricos , Resultado del Tratamiento , Adulto , Cuidados Posteriores , Anquilosis , Femenino , Humanos , Masculino , Evaluación del Resultado de la Atención al Paciente , Periodontitis Periapical/etiología , Modelos de Riesgos Proporcionales , Estudios Prospectivos , República de Corea , Resorción Radicular/etiología , Análisis de Supervivencia , Factores de Tiempo , Enfermedades Dentales/etiología , Extracción Dental , Reimplante Dental/efectos adversos , Raíz del Diente , Cicatrización de HeridasRESUMEN
INTRODUCTION: Tooth autotransplantation is a treatment option that has the potential to restore masticatory function and esthetics to edentulous spaces resulting from extracted teeth. The purpose of this study was to investigate the prognostic factors and clinical outcomes for autotransplanted teeth with complete root formation. METHODS: Patients who had received tooth autotransplantation in the Department of Conservative Dentistry, Yonsei University Dental Hospital, Seoul, Korea, from July 2001 to August 2010 were electronically searched, and a total of 105 cases of autotransplanted teeth met the inclusion criteria. Tooth survival, inflammatory root resorption (IRR), ankylosis, and related prognostic factors were assessed by using the survival analysis that was based on clinical and radiographic examination. RESULTS: The cumulative tooth survival rate was 68.2% at 12 years after the tooth autotransplantation. According to the Cox proportional hazard regression analysis, patient age, donor position, and extraoral time were significantly associated with tooth survival (P < .05). Donor extraction type was significantly associated with IRR (P < .05), and transplantation timing and initial stability were significantly associated with ankylosis (P < .05) CONCLUSIONS: Patients less than 45 years of age, maxillary donor teeth, and an extraoral time of less than 15 minutes were associated with significantly higher tooth survival. Surgical extraction of the donor tooth was associated with a significantly higher incidence of IRR. Immediate transplantation after the extraction of the recipient site's tooth and low initial stability were associated with a significantly lower incidence of ankylosis.
Asunto(s)
Raíz del Diente/trasplante , Diente/trasplante , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Orales/efectos adversos , Procedimientos Quirúrgicos Orales/métodos , Pronóstico , Análisis de Supervivencia , Tomografía Computarizada por Rayos X , Diente/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Trasplante Autólogo , Insuficiencia del Tratamiento , Resultado del TratamientoRESUMEN
INTRODUCTION: The aim of this study was to evaluate the retreatment efficacy and amount of residual sealer in a single canal filled with either EndoSequence BC (Brasseler, Savannah, GA) or AH Plus (Dentsply DeTrey, Konstanz, Germany). METHODS: Canal obturation with gutta-percha and sealer was performed in 28 human teeth using the continuous wave technique. Group 1 (n = 13) used AH Plus sealer, and group 2 (n = 15) used EndoSequence BC sealer. After 7 days, the root fillings were removed using Gates Glidden drills and a nickel-titanium rotary system. Retreatment time was measured in seconds. Canal cleanliness was examined by scanning electron microscopy. The remaining debris in the canal space and penetration into dentinal tubules were evaluated by confocal microscopy. Retreatment time was compared using the Student t test, and differences in sealer penetration and remaining debris between the groups were analyzed using the Mann-Whitney U test (P < .05). RESULTS: There was no significant difference between the 2 groups in the amount of dentin penetration, amount of debris, or retreatment time. With respect to penetration depth, the AH Plus group showed a slightly higher percentage than the BC group, with a significant difference only in the portion 6 mm from the apex (P < .05). Scanning electron microscopic images showed significant debris remaining on canal walls in both groups, whereas canal patency in retreatment was achieved in every specimen. CONCLUSIONS: The present study shows that EndoSequence BC sealer and AH Plus sealer have similar efficacy in dentin penetration and retreatment efficacy.
Asunto(s)
Compuestos de Calcio/administración & dosificación , Cavidad Pulpar/ultraestructura , Dentina/ultraestructura , Resinas Epoxi , Materiales de Obturación del Conducto Radicular , Obturación del Conducto Radicular/métodos , Silicatos/administración & dosificación , Humanos , Microscopía Confocal , Microscopía Electrónica de Rastreo , Retratamiento , Capa de Barro Dentinario/ultraestructuraRESUMEN
Tooth autotransplantation is a viable treatment option for tooth replacement when a suitable donor tooth is available. These case reports described significant vertical bone growth after autotransplantation of a mature third molar. The left mandible third molars (n = 2) were transplanted to the missing tooth in the left mandible. The patient follow-up period was 10 years after transplantation. Clinical examination revealed no mobility of the transplanted tooth. Radiographic examination indicated that bone regeneration occurred around the transplanted tooth. Vertical bone growth was observed in the cervical area of the root surface and the recipient bone. In autotransplantation of mature teeth, long-term follow-up results indicate that vertical bone growth can be expected if viability of the periodontal ligament cells is maintained.
Asunto(s)
Maxilares/fisiopatología , Tercer Molar/fisiopatología , Tercer Molar/trasplante , Procedimientos Quirúrgicos Ortognáticos , Osteogénesis , Trasplante Autólogo , Adulto , Caries Dental/cirugía , Estudios de Seguimiento , Humanos , Maxilares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tercer Molar/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Erupción Ectópica de Dientes/cirugía , Trasplante Autólogo/métodosRESUMEN
PURPOSE: The purpose of this study was to retrospectively evaluate the survival of periodontally hopeless teeth that were intentionally extracted and replanted after a delay and to compare the radiographic characteristics of the survival group with those of the failure group. METHODS: The clinical and radiographic data from patients who underwent delayed intentional replantation between March 2000 and July 2010 were reviewed. Twenty-seven periodontally hopeless teeth were extracted and preserved in medium supplemented with antibiotics for 10-14 days. The teeth were then repositioned in the partially healed extraction socket and followed for 3 to 21 months. The radiographic parameters were analyzed using a paired t test and the cumulative survival rate was analyzed using Kaplan-Meier analysis. RESULTS: Seven replanted teeth failed and the overall cumulative survival rate was 66.4%. In the survival group, the amount of bone loss was reduced from 68.45% to 34.66% three months after replantation. There was radiologic and clinical evidence of ankylosis with 5 teeth. However, no root resorption was found throughout the follow-up period. In the failure group, bone formation occurred from the bottom of the socket. However, a remarkable radiolucent line along the root of a replanted tooth existed. The line lengthened and thickened as time passed. Finally, in each case of failure, the tooth was extracted due to signs of inflammation and increased mobility. CONCLUSIONS: Delayed intentional replantation has many advantages compared to immediate intentional replantation and could serve as an alternative treatment for periodontally involved hopeless teeth. However, techniques for maintaining the vitality of periodontal structures on the tooth surface should be developed for improved and predictable results.
RESUMEN
INTRODUCTION: This prospective study examined the potential prognostic factors of endodontic microsurgery and compared the predictors of an isolated endodontic lesion with those of both an isolated endodontic lesion and an endodontic-periodontal lesion. METHODS: Data were collected from the Microscope Center of the Department of Conservative Dentistry at the Dental College of Yonsei University, Seoul, Korea, between March 2001 and March 2011. A total number of 584 teeth were included, and all clinical procedures were performed by a single operator (E.K.). The evaluation was performed at least 1 year after surgery. For statistical analysis of the predisposing factors, the chi-square test and logistic regression were performed. RESULTS: Of the 584 cases treated, 431 cases came for recall after a period of at least 12 months. Sex (female), tooth position (anterior), arch type (maxilla), and lesion type (isolated endodontic lesion) were found to have a positive effect on surgical outcome. With regards to isolated endodontic lesions, the tooth position (anterior), arch type (maxilla), and type of restoration (single/splinted crown, short bridge, and removable partial denture abutment) were found to be pure positive predictors. CONCLUSIONS: In endodontic microsurgery, it is likely that preoperative factors, particularly the tooth position and arch type, have a greater influence on the healing outcome than intra- and post-operative factors.
Asunto(s)
Apicectomía/métodos , Microcirugia/métodos , Adulto , Compuestos de Aluminio/uso terapéutico , Compuestos de Calcio/uso terapéutico , Coronas , Pilares Dentales , Arco Dental/anatomía & histología , Enfermedades de la Pulpa Dental/cirugía , Recubrimientos Dentinarios/uso terapéutico , Combinación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/anatomía & histología , Maxilar/anatomía & histología , Metilmetacrilatos/uso terapéutico , Microcirugia/instrumentación , Persona de Mediana Edad , Óxidos/uso terapéutico , Enfermedades Periapicales/cirugía , Piezocirugía/instrumentación , Piezocirugía/métodos , Pronóstico , Estudios Prospectivos , Obturación Retrógrada/instrumentación , Obturación Retrógrada/métodos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Silicatos/uso terapéutico , Diente/cirugía , Resultado del Tratamiento , Adulto Joven , Cemento de Óxido de Zinc-Eugenol/uso terapéuticoRESUMEN
INTRODUCTION: Autotransplantation of immature teeth can be an option for premature tooth loss in young patients as an alternative to immediately replacing teeth with fixed or implant-supported prostheses. The present case series reports 4 successful autotransplantation cases using computer-aided rapid prototyping (CARP) models with immature third molars. METHODS: The compromised upper and lower molars (n = 4) of patients aged 15-21 years old were transplanted with third molars using CARP models. Postoperatively, the pulp vitality and the development of the roots were examined clinically and radiographically. The patient follow-up period was 2-7.5 years after surgery. RESULTS: The long-term follow-up showed that all of the transplants were asymptomatic and functional. Radiographic examination indicated that the apices developed continuously and the root length and thickness increased. The final follow-up examination revealed that all of the transplants kept the vitality, and the apices were fully developed with normal periodontal ligaments and trabecular bony patterns. CONCLUSIONS: Based on long-term follow-up observations, our 4 cases of autotransplantation of immature teeth using CARP models resulted in favorable prognoses. The CARP model assisted in minimizing the extraoral time and the possible Hertwig epithelial root sheath injury of the transplanted tooth.