Ectopic eruption of the first permanent molar: Predictive factors for irreversible outcome.

INTRODUCTION: The present study aimed to analyze possible factors involved in irreversible (IRR) ectopic eruption (EE) of the first permanent molar and explore potential predictors for the IRR outcome. METHODS: Children aged 4-11 years, with at least 1 EE and who took their first panoramic radiograph before the age of 8 years, were selected in this study. The subjects were assigned to the self-correcting (SC) and IRR groups. Patients' age, sex, distribution of EE, and accompanying dental anomalies were recorded. Eruptive angulation (EA) of the first permanent molar, the grade of root resorption in the second deciduous molar, the magnitude of impaction index (MOII), and horizontal distance were measured on the panoramic radiographs. Chi-square tests and independent-sample t test were used for nominal and continuous variables, respectively. The receiver operative characteristic curve was used to determine the critical value. RESULTS: A total of 406 children with 634 first permanent molars, presenting EE, were enrolled, with 61.3% of the teeth in the SC group. Sex of children with EE and distribution of EE were not relevant to the IRR outcome. The presence of supernumerary teeth might be a protective factor for the IRR outcome. The increasing severity of root resorption in the second primary molar indicated an IRR outcome. A higher MOII and a larger EA suggested an IRR outcome with moderate-to-high quality. The horizontal distance exhibited debatable results, with a low predictive quality. CONCLUSION: Close monitoring and early intervention would benefit children with increasing severity of distal atypical resorption in the second primary molar, higher MOII, and larger EA.

Clinical evidence of photobiomodulation therapy (PBMT) on implant stability and success: a systematic review and meta-analysis.

BACKGROUND: Photobiomodulation therapy (PBMT), a type of light therapy that uses the concept of photobiomodulation, is developed to promote bone healing. Clinical studies have been conducted to assess the influence of PBMT on dental implant stability and success rate. This is the first systematic review and meta-analysis to assess the effect of PBMT and methodological quality of these studies on implants in human clinical trials. METHODS: An electronic search was performed in Pubmed, Embase, and the Cochrane Controlled Register of Trials (CENTRAL). RESULTS: Initially, 675 articles were identified, among which only 8 met the inclusion criteria. Four of the 8 studies presented a low risk of bias, whereas the other 4 were of moderate risk. Our review focused on implant success rates and implant stability measured at days 0 and 10, and at 3, 4, 6, and 12 weeks. No significant differences were observed between the PBMT group and the control group regarding implant stability or success rate. CONCLUSIONS: The existing clinical studies did not provide sufficient evidence to observe positive effects of PBMT on implants in patients. An increased number of high-quality clinical randomized controlled trials (RCTs) are required to verify the data and to draw convincing conclusions.

Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis.

BACKGROUND: Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. METHODS: Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. RESULTS: Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. CONCLUSIONS: Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

Ectopic eruption of maxillary first permanent molars: Risk factors and association with alveolar and maxillary characteristics on children.

Background/purpose: The etiology of the ectopic eruption (EE) of the maxillary first permanent molars (FPM) remains unclear and controversial. This study was designed to explore the dental and skeletal factors for EE of the FPM in children. Materials and methods: Children aged 6-10 years were recruited to this study. Subjects were assigned to the ectopic eruption group (EEG) and the normal eruption group (NEG). Lateral cephalometric radiographs and panoramic radiographs were measured by angular and linear indices. Results: The prevalence of EE of maxillary FPM was higher in males and at younger ages. Subjects with skeletal class III malocclusion were more likely to be diagnosed with EE of maxillary FPM. The SNA, ANB, FMIA, Wits, Ptm-A, ANS-PNS, overbite, and overjet were significantly different between the EEG and the NEG. The length of the posterior region of the maxillary alveolar bone, U6-OP, and eruptive angulation of the maxillary FPM were statistically different between the two groups. Conclusion: Male sex, skeletal class III malocclusion, mesial inclination of the maxillary FPM, hypoplasia of the maxilla, and insufficient length of the posterior region of the maxillary alveolar bone were related to EE of the maxillary FPM.

IL-1α Regulates Osteogenesis and Osteoclastic Activity of Dental Follicle Cells Through JNK and p38 MAPK Pathways.

Inflammatory cytokines such as interleukin-1α (IL-1α) are increased in teeth with periapical lesions. Primary teeth with periapical lesions have a propensity for accelerated eruption of the successors. In this study, we asked whether increased levels of IL-1α in the dental follicle (DF) occurring as the result of periapical lesions promote tooth eruption, possibly due to enhanced osteoclastic remodeling of DF cells (DFCs). To this end, we studied the effect and possible mechanism of IL-1α on osteogenic differentiation, osteoclastogenic activity, and matrix remodeling of DFCs. Results demonstrated that DFCs cultured with IL-1α exhibited reduced osteogenic capacity, higher osteoclastogenic activity, and stronger invasive ability. Phosphorylation of JNK and p38 was upregulated, and pretreatment with SB203580 and SP600125 reversed the effect of IL-1α on DFCs. Neonatal rats subjected to subcutaneous injection of an IL-1 receptor antagonist exhibited a reduced number in activated osteoclasts, increased expression of alkaline phosphatase and osteopontin, and delayed tooth eruption. These data support our hypothesis that increased IL-1α cytokine levels as they occur during periodontal and periapical inflammation cause osteoclastic remodeling of the alveolar socket as a requirement for tooth eruption and thus may indirectly promote the vertical eruption of teeth toward the occlusal plane.

Balloon kyphoplasty or percutaneous vertebroplasty for osteoporotic vertebral compression fracture? An updated systematic review and meta-analysis.

BACKGROUND: Both kyphoplasty (KP) and vertebroplasty (VP) are effective for patients with osteoporotic vertebral compression fracture (OVCF), but which approach might be more effective remains unclear, so we decided to update earlier systematic reviews. OBJECTIVE: Review and analyze studies published as of August 2015 that compared clinical outcomes and complications of KP versus VP. DESIGN: Systematic review and meta-analysis. SEARCH METHOD: Published reports up to August 2015 were found in PubMed, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). SELECTION CRITERIA: Randomized controlled trials (RCTs) and prospective and retrospective cohort stud.ies comparing KP and VP in patients with OVCF. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the studies and extracted data. RESULTS: Thirty-two studies involving 3274 patients fulfilled the inclusion criteria. There were significant differences between the two groups in short- and long-term postoperative changes in measures of pain intensity and dysfunction (P < .01), in anterior and middle height (P < .01), kyphotic angle (P < .01), and time to injury, but not in posterior height (P=.178). There were no significant differences in the rate of postoperative fractures including adjacent and total fractures, but cement leakage to the intraspinal space was greater in the VP group (P=.035). KP surgery took longer and required a greater volume of injected cement. CONCLUSIONS: KR resulted in better pain relief, improvements in Oswestry dysfunction and radiographic outcomes with less cement leakage, but further RCTs are needed to verify this conclusion. LIMITATIONS: Only four RCTs with a certain of risk of bias. Most studies were observational.