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OBJECTIVES: To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints. MATERIAL AND METHODS: Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression. RESULTS: Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture. CONCLUSIONS: Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often. CLINICAL RELEVANCE: Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture.
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Ferulas Periodontales , Movilidad Dentaria , Humanos , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Movilidad Dentaria/terapia , Diente Molar , Diente Premolar , Índice Periodontal , Anciano , Resultado del Tratamiento , AdultoRESUMEN
OBJECTIVES: This study aimed to identify predictors associated with the tooth loss phenotype in a large periodontitis patient cohort in the university setting. METHODS: Information on periodontitis patients and nineteen factors identified at the initial visit was extracted from electronic health records. The primary outcome is tooth loss phenotype (presence or absence of tooth loss). Prediction models were built on significant factors (single or combinatory) selected by the RuleFit algorithm, and these factors were further adopted by regression models. Model performance was evaluated by Area Under the Receiver Operating Characteristic Curve (AUROC) and Area Under the Precision-Recall Curve (AUPRC). Associations between predictors and the tooth loss phenotype were also evaluated by classical statistical approaches to validate the performance of machine learning models. RESULTS: In total, 7840 patients were included. The machine learning model predicting the tooth loss phenotype achieved AUROC of 0.71 and AUPRC of 0.66. Age, periodontal diagnosis, number of missing teeth at baseline, furcation involvement, and tooth mobility were associated with the tooth loss phenotype in both machine learning and classical statistical models. CONCLUSIONS: The rule-based machine learning approach improves model explainability compared to classical statistical methods. However, the model's generalizability needs to be further validated by external datasets. CLINICAL SIGNIFICANCE: Predictors identified by the current machine learning approach using the RuleFit algorithm had clinically relevant thresholds in predicting the tooth loss phenotype in a large and diverse periodontitis patient cohort. The results of this study will assist clinicians in performing risk assessment for periodontitis at the initial visit.
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Aprendizaje Automático , Periodontitis , Fenotipo , Pérdida de Diente , Humanos , Masculino , Femenino , Periodontitis/complicaciones , Persona de Mediana Edad , Adulto , Curva ROC , Movilidad Dentaria , Factores de Riesgo , Algoritmos , Registros Electrónicos de Salud , Estudios de Cohortes , Área Bajo la Curva , Defectos de Furcación , AncianoRESUMEN
AIM: To evaluate site-related changes in periodontal pocket depth (PPD) after non-surgical periodontal therapy and to identify predictors for PPD changes in a retrospective patient data analysis. MATERIALS AND METHODS: PPD, clinical attachment level, bleeding on probing, tooth mobility (TM), furcation involvement (FI), abutment status, adherence to supportive periodontal care (SPC) and SPC follow-ups were obtained from fully documented patient data before periodontal therapy (baseline, T0), after active periodontal therapy (APT, T1) and during SPC (T2). PPD changes were classified into deteriorated or unchanged/improved at the site level. Multi-level logistic regression analysis was performed to identify factors influencing PPD changes during SPC. RESULTS: This retrospective study included 51 females and 65 males (mean T0 age: 54.8 ± 10.1 years, 25 smokers, 12 diabetics) suffering from Stage III/IV periodontitis. Evaluation outcome: T0/16,044 sampling sites/2674 teeth; T1/15,636/2606; T2/14,754/2459. During 9.0 ± 2.3 years SPC, PPD decreased (-1.33 ± 0.70 mm) by 21.8% of the sites, remained unchanged by 41.4% and increased (1.40 ± 0.78 mm) by 36.8%. Distopalatal FI (p < .001, odds ratio [OR]: 0.252, 95% confidence interval [CI] for OR: 0.118-0.540), residual pockets (p < .001, OR: 0.503, 95% CI: 0.429-0.590) and TM Degrees I-III (Degree I: p = .002, OR: 0.765, 95% CI: 0.646-0.905; Degree II: p = .006, OR: 0.658, 95% CI: 0.489-0.886; Degree III: p = .023, OR: 0.398, 95% CI: 0.180-0.879) correlated significantly with increasing PPD. CONCLUSIONS: Over 75% of PPD remained unchanged or increased during SPC. Distopalatal FI, TM Degrees I-III and residual pockets after APT lead to worsening of periodontal pockets.
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Bolsa Periodontal , Humanos , Masculino , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Bolsa Periodontal/terapia , Anciano , Movilidad Dentaria , Adulto , Índice Periodontal , Pérdida de la Inserción Periodontal/terapia , Defectos de Furcación/terapia , Progresión de la EnfermedadRESUMEN
BACKGROUND: Prematurity resulted from pathological migration of periodontally involved teeth with the loss of vertical stopping points between teeth, which can lead to teeth over eruption with dimensional changes favoring occlusal discrepancies. Therefore, evaluating and comparing the effect of guided tissue regeneration followed by orthodontic intrusion as opposed to orthodontic intrusion tracked by guided tissue regeneration in the treatment of an over-erupted tooth with angular bone loss. METHODS: Twenty teeth in ten cases were selected with at least two teeth with vertical over-eruption and angular bone loss with the presence of their opposing. In group one, ten teeth over-erupted were treated by guided tissue regeneration followed by orthodontic intrusion, whereas, in group two, ten teeth over-erupted were treated by orthodontic intrusion followed by guided tissue regeneration. They were evaluated clinically for pocket depth, bleeding on probing, and tooth mobility. Radiographical evaluation assessed by cone beam computed tomography. RESULTS: Clinically, there existed a statistically significant difference (P value ≤ 0.05) in favor of group one at six months post and in favor of group two at one year from re-evaluation regarding pocket depth and tooth mobility. Radiographically, in group one, there was a statistically significant improvement (P value ≤ 0.05) at six months post-guided tissue regeneration or orthodontic intrusion regarding defect depth and dimensional changes of the defect area, with a statistically significant difference (P value ≤ 0.05) in favor of group two at one year from re-evaluation phase regarding defect depth and defect area dimensional changes. CONCLUSION: There was a short-term improvement in group one, which deteriorated over a long period compared with group two, so it is preferable to start orthodontic intrusion before guided tissue regeneration.
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Pérdida de Hueso Alveolar , Movilidad Dentaria , Humanos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Movilidad Dentaria/terapiaRESUMEN
PURPOSE: To study the influence of tooth mobility on the accuracy of conventional impressions. MATERIALS AND METHODS: In total, 10 patients with mobile anterior teeth and 10 healthy patients were treated with conventional impressions and intraoral digital impressions. The digital impression group was recorded as standard data, the mobile teeth group was recorded as the experimental group, and the healthy anterior teeth group was recorded as the control group. We imported digital impression and irreversible hydrocolloid impression files into Geomagic Wrap and marked reference points to execute N-point alignment, then we recorded the coordinates. Paired-samples t test was used to analyze whether the point coordinates of mobile teeth were statistically significant (a = .05). One-way ANOVA was used to analyze whether there was a relationship between coordinate differences and tooth mobility in the distal, coronal, and buccal directions (a = .05). RESULTS: In the buccal and coronal directions, the difference was statistically significant between the conventional and digital impression groups. In the buccal direction, the accuracy differences of I-degree and II-degree mobile teeth were 0.149 mm and 0.401 mm, respectively. In the coronal direction, the differences were 0.128 mm and 0.233 mm, respectively. Meanwhile, ANOVA analysis showed that there was a relationship between point coordinate difference and tooth mobility in the buccal and coronal directions. CONCLUSIONS: Conventional impressions can influence the accuracy of mobile tooth impressions. Therefore, digital impressions should be adopted for mobile teeth impressions.
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Técnica de Impresión Dental , Movilidad Dentaria , Humanos , Proyectos Piloto , Femenino , Masculino , Adulto , Materiales de Impresión DentalRESUMEN
BACKGROUND/AIMS: The recommendations for splinting are well established for the injuries of permanent dentition; however, ambiguity still exists for the injuries in primary dentition. Hence, this study aimed to determine the most appropriate dimensions of stainless steel wire and its extent, for achieving the physiologic mobility in primary dentition. MATERIAL AND METHODS: This study was designed as an in vitro experiment by using a typodont model of primary dentition. The baseline mobility of primary maxillary incisors was calibrated to the physiologic mobility of natural primary incisors by using a Teflon tape wrapped around the roots of resin teeth. Splinting was done using a stainless steel wire of 0.2 mm (Group I), 0.3 mm (Group II), and 0.4 mm (Group III). These groups were subdivided (a, b, and c) on the basis of the extent of the splint, and pre splint mobility (Pre-PV) and post-splint mobility (Post-PV) were tested by Periotest M. The splint effect was calculated by subtracting Post-PVs and Pre-PVs. RESULTS: The normal values of mobility in healthy human volunteers ranged from 10.5 to 13. The overall splint effect was higher in Group III irrespective of the extent of the splint, whereas it was found to be the lowest in Group I (b and c). The splint effect increased with the extent of the splint in all the groups. Among all the groups, the splint effect on the anchor teeth was observed to increase with the extent of the splint and the diameter of the wire. CONCLUSION: The mobility of the injured and anchor teeth splinted with 0.2-mm stainless steel wire was similar to the pre-splint and physiologic mobility. The most favorable extension was one tooth adjacent to the injured tooth on each side for both 0.2- and 0.3-mm wires.
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Alambres para Ortodoncia , Avulsión de Diente , Movilidad Dentaria , Diente Primario , Humanos , Diente Primario/lesiones , Movilidad Dentaria/terapia , Avulsión de Diente/terapia , Acero Inoxidable , Incisivo/lesiones , Técnicas In Vitro , Férulas (Fijadores) , Modelos DentalesRESUMEN
OBJECTIVES: Orthodontic retainers should restrict physiological tooth mobility as little as possible. While this has been investigated for multistranded retainers, there is a lack of data for novel CAD/CAM retainers. To address this, the present study compared the restriction of physiological tooth mobility in multistranded retainers and different CAD/CAM retainers. MATERIAL/METHODS: One group of multistranded (n = 8) and five groups of CAD/CAM retainers (nickel-titanium (NiTi), titanium grade 5 (Ti5), polyetheretherketone (PEEK), zirconia (ZrO2), and cobalt-chromium (CoCr); each n = 8) bonded from canine to canine were investigated for their influence on vertical and horizontal tooth mobility using an in vitro model of a lower arch in a universal testing machine. Load-deflection curves were determined and statistically analysed. RESULTS: All retainers restricted tooth mobility to varying extents. The retainers had less of an influence on vertical tooth mobility, with less of a difference between retainers (14%-38% restriction). In contrast, significant (P ≤ 0.05) differences were observed between retainers in the restriction of horizontal tooth mobility. ZrO2 retainers had the greatest impact, restricting horizontal tooth mobility by 82% (68 ± 20 µm/100N), followed by CoCr (75%, 94 ± 26 µm/100N) and PEEK (73%, 103 ± 28 µm/100N) CAD/CAM retainers, which had comparable effects on horizontal tooth mobility. Ti5 (54%, 175 ± 66 µm/100N) and NiTi (34%, 248 ± 119 µm/100N) CAD/CAM retainers had less of an influence on horizontal tooth mobility, and were comparable to multistranded retainers (44%, 211 ± 77 µm/100N). LIMITATIONS: This is an in vitro study, so clinical studies are needed to draw clinical conclusions. CONCLUSIONS: Multistranded and CAD/CAM retainers have different effects on tooth mobility in vitro. These effects should be further explored in future in vivo studies.
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Aleaciones , Benzofenonas , Níquel , Polímeros , Titanio , Movilidad Dentaria , Humanos , Circonio , Diseño Asistido por ComputadoraRESUMEN
BACKGROUND/AIM: Luxation is a common traumatic dental injury treated with a wire composite (WC) splint. However, bulk-fill flowable composite and conventional packable composite have not been compared for retaining these splints. Therefore, the objectives of this randomized controlled trial were (1) to compare retention of WC splints, and (2) to compare adhesive point dimension, application and removal time, and effect on tooth mobility between the two WC splints. MATERIALS AND METHODS: In this parallel group, non-inferiority double blind randomized controlled trial, a total of 90 patients, aged 16-50 years participated. They were randomly allocated into two groups, the packable composite group (PC) n = 45 and the bulk-fill flowable composite group (BF-FC) n = 45 by lottery method. Following measurements were taken at the splint application appointment. Horizontal tooth mobility measured via Periotest, splint application time, and frontal images of splinted teeth to measure the percentage composite adhesive point area. After 2 weeks, splints were visually inspected for retention, whereas mobility and removal times were also recorded. Statistically, comparisons were made using independent samples sample T-test, Fisher's exact test, and Mann-Whitney U at p ≤ .05. RESULTS: A total of 88 patients with 156 luxated teeth completed the trial, as two patients were lost to follow-up. Two patients in the PC group reported with completely de-bonded splints while none de-bonded in the BF-FC group. Both groups were similar in terms of splint retention (p = .352), reduction of mobility (p = .426), and splint removal times (p = .372). The BF-FC group performed significantly better in adhesive point dimension percentages (p < .001) and splint application time (p < .001). CONCLUSION: Both groups were comparable in most parameters of the study. However, for BF-FC group application time and adhesive point dimension were significantly less.
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Luxaciones Articulares , Avulsión de Diente , Movilidad Dentaria , Humanos , Resinas Compuestas , Férulas (Fijadores) , Avulsión de Diente/terapia , Movilidad Dentaria/terapia , Adolescente , Adulto Joven , Adulto , Persona de Mediana EdadRESUMEN
INTRODUCTION: To investigate the differences in the incidence rates of suspected stage 0/1 osteonecrosis of the jaw (ONJ) and incidence risk of relevant clinical findings of suspected stage 0 ONJ between patients treated with sequential therapy comprising weekly teriparatide for 72 weeks followed by alendronate for 48 weeks vs. those who received monotherapy with alendronate for 120 weeks. MATERIALS AND METHODS: Suspected stage 0/1 ONJ was defined by non-specific symptoms. Tooth mobility and periodontal symptoms (gingival bleeding, swelling, and/or pain) were selected as clinical findings of suspected stage 0 ONJ. Poisson regression models were applied to calculate the incidence rate ratios of suspected stage 0/1 between the teriparatide group (TG) and alendronate group (AG). Generalized linear models were used to calculate the risk ratios of clinical findings between groups. RESULTS: Two hundred and sixty-one participants in the TG and 344 in the AG answered a structured questionnaire on oral health and were included in this study. There were no significant differences between the groups in the incidence rate of suspected stage 0/1 ONJ at both 72 and 120 weeks. The risk ratio of the TG to AG for tooth mobility was 0.34 (95% confidence interval [CI] 0.13-0.88, p = 0.02) at 72 weeks and 0.90 (95% CI 0.40-2.03, p = 0.83) at 120 weeks. The incidence rate of tooth mobility related to periodontal symptoms decreased in the TG and increased in the AG during the study. CONCLUSION: Tooth mobility accompanied by clinical periodontal symptoms may be a useful early sign of stage 0 ONJ.
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Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Osteoporosis , Movilidad Dentaria , Humanos , Alendronato/efectos adversos , Osteonecrosis de los Maxilares Asociada a Difosfonatos/epidemiología , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos/efectos adversos , Pueblos del Este de Asia , Osteoporosis/tratamiento farmacológico , Osteoporosis/epidemiología , Osteoporosis/complicaciones , Reproducibilidad de los Resultados , Teriparatido/efectos adversos , Movilidad Dentaria/inducido químicamenteRESUMEN
The purpose of the study is to analyze the condition of the oral cavity tissues to choose the method of adhesive splinting of the anterior teeth. Increasing the efficiency of patient curation strategies and tactics based on forecasting the functional capabilities of the dental and periodontal complex. In the period from 2017 and 2021, 81 male and female patients aged 35 to 45 years were examined and treated for preventive examination and rehabilitation at the University Clinic Educational and Medical Center of Bukovinian State Medical University and diagnosed with periodontitis of varying severity. The following criteria were taken into account when forming patient groups: type of bite, absence of foci of chronic infection in the body, absence of multiple lesions of hard dental tissues, depth of periodontal pocket. During the examination, attention was paid to the shape of the dental arch, the inclination of the crowns of the teeth in the anterior region, the location of individual teeth, occlusion, the state of the oral vestibule (places of attachment of the transitional fold, depth, presence of gingival recession). Among the pathological conditions that interfere with splinting, the following were identified: traumatic occlusion (95.7%), anomalies in the location of individual teeth, fan-shaped tooth separation, crowded teeth (73.5%), pathology of the oral vestibule (46.7%), and the third degree of tooth mobility. These pathological conditions required preliminary orthodontic preparation or surgical treatment. The predominant complaints in periodontal tissue diseases were gum bleeding when brushing teeth (82.7%), tooth mobility of varying degrees (80.2%), bad breath (40.7%), and tooth bleeding when eating (30.8%). Oral hygiene was not maintained by 45.6% of the surveyed. The pathology of the attachment of the transitional fold of the oral cavity was detected in 46.7% of patients, that is, almost half of the examined. Abnormalities of the position of individual teeth were found in 73.5% of the examined. Traumatic occlusion was detected in 95.7% of the subjects.
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Enfermedades Periodontales , Periodontitis , Movilidad Dentaria , Humanos , Masculino , Femenino , Movilidad Dentaria/terapia , Bolsa PeriodontalRESUMEN
OBJECTIVE: To review the factors that influence the accuracy of the maxillomandibular relationship at maximum intercuspation (MIP) acquired by using intraoral scanners (IOSs). MATERIAL AND METHODS: A systematic search was performed using five databases: MEDLINE/PubMed, Cochrane, Embase, World of Science, and Scopus. A manual search was also completed. Studies assessing the factors that influence the MIP acquired by using IOSs were included and organized based on the analyzed factor. Studies were evaluated by applying the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: Twenty-nine articles were included. Seven factors have been identified: IOS system, scan extension, edentulous areas, number, location, and extension of occlusal records, occlusal force, tooth mobility, and alignment methods. Nine studies evaluated the influence of IOS system. Four studies assessed the influence of the extension of the arch scan. Three studies evaluated the effect of edentulous spaces. Four studies agreed on the impact of the number, location, and extension of the occlusal records on the MIP accuracy. One study assessed the influence of the occlusal force, showing a smaller average interocclusal space with increased occlusal force. One study evaluated the influence of tooth mobility. Seven studies analyzed the influence of the alignment method on the MIP accuracy. CONCLUSIONS: Most of the studies reported no difference on the MIP accuracy between half- and complete-arch scans. Areas with 2 or more missing teeth reduce the MIP accuracy. A bilateral and frontal record including 2 teeth or a bilateral posterior occlusal including at least 4-teeth is indicated for maximizing the MIP accuracy. CLINICAL IMPLICATIONS: When a complete-arch intraoral scans is obtained, a bilateral and frontal record including 2 teeth or a bilateral posterior occlusal record including at least 4-teeth is recommended for maximizing the accuracy of the MIP. When a half-arch intraoral scan is acquired, a posterior occlusal record including at least 4-teeth is indicated for optimizing the accuracy of the MIP.
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Boca Edéntula , Movilidad Dentaria , Humanos , Imagenología Tridimensional , Técnica de Impresión Dental , Modelos Dentales , Arco Dental/diagnóstico por imagen , Diseño Asistido por ComputadoraRESUMEN
OBJECTIVES: To validate a new tooth mobility simulating in vitro model for biomechanical tests of dental appliances and restorations. MATERIAL AND METHODS: Load-deflection curves for teeth in CAD/CAM models (n = 10/group, 6 teeth/model) of the anterior segment of a lower jaw with either low tooth mobility (LM) or high tooth mobility (HM) were recorded with a universal testing device and a Periotest device. All teeth were tested before and after different ageing protocols. Finally, vertical load capacity (Fmax) was tested in all teeth. RESULTS: At F = 100 N load, vertical/horizontal tooth deflections before ageing were 80 ± 10 µm/400 ± 40 µm for LM models and 130 ± 20 µm/610 ± 100 µm for HM models. Periotest values were 1.6 ± 1.4 for LM models and 5.5 ± 1.5 for HM models. These values were within the range of physiological tooth mobility. No visible damage occurred during ageing and simulated ageing had no significant effect on tooth mobility. Fmax values were 494 ± 67 N (LM) and 388 ± 95 N (HM). CONCLUSION: The model is practical, easy to manufacture and can reliably simulate tooth mobility. The model was also validated for long-term testing, so is suitable for investigating various dental appliances and restorations such as retainers, brackets, dental bridges or trauma splints. CLINICAL RELEVANCE: Using this in-vitro model for high standardised investigations of various dental appliances and restorations can protect patients from unnecessary burdens in trials and practice.
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Movilidad Dentaria , Humanos , Diseño Asistido por Computadora , Modelos DentalesRESUMEN
BACKGROUND: Smokeless tobacco (SLT) products of several different types are widely used in several South Asian countries including Pakistan. These products are consumed in different forms and with different names. The study aims to determine adverse effects of the SLT consumption on periodontal tissues. METHODS: This cross sectional study was conducted in Karachi, Pakistan. It recruited 377 users of (SLT) with 231 males (61.3%) and 146 females (38.7%) of age 15 to 45 years. After obtaining informed consent, quantitative data were collected via a questionnaire followed by intra oral clinical examination to determine presence of periodontal diseases using community periodontal index (CPI). To determine the association between periodontal diseases and smokeless tobacco consumption habits, Chi Square test was conducted. RESULTS: Gingival recession (Class II-IV) (65.8%) was the most prevalent periodontal disease among SLT users. CPI score was high (CPI score 3 and 4) in 31.3% participants, whereas tooth loss was found in 21%. Among types of SLT products, gutka (28.6%) and betel quid (23.3%) were most commonly used. Using SLT for five or more years was found to be associated with a high CPI score, gingival recession (Class II-IV), moderate to severe tooth mobility, and presence of tooth loss. CONCLUSIONS: The study found statistically significant association between duration in years of using SLT and periodontal disease including gingival recession, tooth mobility and tooth loss. However, no significant results were found between retention during single use and frequency of SLT use per day. However, the link of these factors with the periodontal disease cannot be eliminated.
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Recesión Gingival , Enfermedades Periodontales , Tabaco sin Humo , Pérdida de Diente , Movilidad Dentaria , Masculino , Femenino , Humanos , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Tabaco sin Humo/efectos adversos , Recesión Gingival/epidemiología , Recesión Gingival/etiología , Estudios Transversales , Enfermedades Periodontales/epidemiología , Enfermedades Periodontales/etiología , Uso de TabacoRESUMEN
The aim of this study is to examine and evaluate physiologic tooth mobility and movement in different groups of patients. Four groups of patients were examined and recordings were taken. Group A1 consisted of 12 undergraduate students under the age of 30, A2 consisted of 11 members of staff over the age of 30 and A3 consisted of 9 patients with periodontal disease between the ages of 40-65 years old. The fourth Group B, 14 patients between 30-70 years old, received single-tooth restorations and recordings were taken immediately after, a month and four months following the cementation of the restoration. Patients in the first 3 groups showed no significant change in tooth mobility and movement between appointments. The fourth group demonstrated a non-statistically significant increase in tooth mobility following the cementation of the restoration due to the force applied on the occlusal surface of the tooth during the cementation process, while tooth movement was not observed beyond that of physiological tooth migration. Regardless of the age or the restorations a patient receives over the years, with careful occlusal consideration, no significant changes in tooth mobility and movement should be observed.
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Movilidad Dentaria , Humanos , Adulto , Persona de Mediana Edad , Anciano , Preescolar , Movilidad Dentaria/terapia , DenticiónRESUMEN
Background and Objectives: Recognizing the significance of a hermetic apical seal for successful root canal treatment, the present investigation aimed to evaluate two sealing materials through an in vitro analysis, as well as to ascertain the clinical outcomes of patients treated with these two sealers in an in vivo setting. Materials and Methods: For the in vitro part of the study, two control groups of thirty monoradicular teeth were obturated with two sealers. Then, the sealers' performance was tested based on a predefined protocol. Group A included 30 patients treated with an epoxy oligomer resin-based sealer (Adseal, MetaBiomed), while Group S comprised 30 patients treated with a polymeric calcium salicylate-based sealer (Sealapex, Kerr). Samples were sectioned and evaluated under the microscope to determine the sealer's tightness by measuring the dye penetration into the root canal filling. For the in vivo part, a prospective study was designed to include 60 patients with chronic apical periodontitis in two endodontic treatment groups, using the same two sealers. Results: The in vitro analysis found that dye penetration in Group A was 0.82 mm (±0.428), while in Group S, the dye penetration was statistically significantly deeper, being 1.23 mm (±0.353). In the in vivo part of the study, the periapical index (PAI) significantly decreased 6 months after endodontic treatment, with 80.0% of patients in Group A having a PAI score of 2 compared to only 56.7% in Group S (p-value = 0.018). Similarly, tooth mobility scores significantly decreased after treatment, but with no difference between groups. The marginal bone loss decreased significantly more in the Adseal group compared to the Sealapex group (23.3% vs. 50.0%, p-value = 0.032). At the same time, 40.0% of patients in Group S had failed tooth healing compared to only 13.3% in Group A (p-value = 0.048). Conclusions: The in vitro study showed that Adseal had a better sealing capacity and a lower degree of dye penetration compared to Sealapex. However, on clinical evaluation in the in vivo study, both patient groups exhibited significant improvements in periapical index, tooth mobility scores, and pain reduction following endodontic treatment. Nevertheless, patients treated with Adseal showed a significantly greater improvement in PAI values, tooth mobility, and teeth healing after treatment. Overall, Adseal, as an endodontic sealer, may provide better sealing capabilities and enhanced clinical outcomes in the treatment of chronic apical periodontitis.
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Periodontitis Periapical , Periodontitis , Movilidad Dentaria , Humanos , Resinas Epoxi , Estudios Prospectivos , Periodontitis Periapical/terapiaRESUMEN
Introduction: Periodontitis is a chronic inflammatory disease that results in the destruction of supporting tissue and bone leading to tooth mobility. Tooth mobility if untreated can lead to tooth loss. However, very few studies exist for its assessment. The aim of this study was to find out the prevalence of tooth mobility among patients visiting a tertiary care centre. Methods: This descriptive cross-sectional study was conducted among individuals visiting a tertiary care dental hospital from 1st April to 30th June 2022 after obtaining ethical clearance from the Institutional Review Committee (Reference number: 2202202202). Individuals more than 13 years who gave consent and fulfilled the study criteria were enrolled. Tooth mobility was assessed using Lindhe and Nyman's classification. Proforma also included demographics, simplified oral hygiene index, gingival index, body mass index, and smoking status. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 163 patients, 65 (39.88%) patients (32.36-47.40, 95% Confidence Interval) had tooth mobility. Conclusions: The prevalence of tooth mobility was higher than in studies done in similar settings. Keywords: periodontitis; prevalence; tooth mobility.
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Movilidad Dentaria , Humanos , Centros de Atención Terciaria , Estudios Transversales , Índice de Masa Corporal , Índice de Higiene OralRESUMEN
INTRODUCTION: Dental implants are an artificial substitute for extracted or missing teeth in the oral cavity and are valuable for improving dental health and quality of life. While many studies on implants can be found, few studies examine their effects on adjacent teeth and tissues. The study aimed to examine complications of teeth adjacent to dental implants in the posterior region. METHODS: In this retrospective case-control study, clinical data of patients treated with implants in the posterior segment were extracted from the medical records in a single community dental clinic between January 9, 2010 and January 9, 2020. The patients were examined clinically and radiographically every 6 months. Data on the adjacent teeth to the dental implants were collected and divided into two groups, complications ("study group") versus no-complications ("control group"). Multivariate logistic regression analysis was performed to find a possible correlation between the complications and the variables checked, followed by checking specific variables in the complication group. RESULTS: A total of 1072 patients were included in the study. There were 179 patients (16.7%) with complications in adjacent teeth, while 893 patients had no documented complications. Predisposing factors for secondary caries were smoking (OR = 2.2, CI = 1.3-3.8) and a higher number of implants (OR = 1.6, CI = 1.1-2.5). Tooth crack and tooth fracture were analyzed together and found to be related to osteoporosis (OR = 8.9, CI = 2.9-27.6), whereas males were more prone to teeth fracture (OR = 2.8, CI = 1.1-7.4). Tooth mobility was related to a higher number of implants (OR = 16.5, CI = 3.7-73.8). Further analyzing the complication group solely, there was a statistical significance for age in primary caries and tooth mobility (p = 0.045). In addition, a higher number of implants was more prevalent with tooth mobility (p = 0.002), wider implant platform was more significant with primary caries (p = 0.012), and periodontal Stage III was more prone to tooth mobility (p < 0.001). The distance between the implant and adjacent tooth was also statistically significant-close proximity with tooth mobility and high distance with dental caries (p = 0.04). CONCLUSIONS: We found a relatively high rate of complications in teeth adjacent to dental implants. Secondary caries was the most common complication. Good understanding and proper position of the implants is essential to avoid adjacent teeth complications.
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Caries Dental , Implantes Dentales , Fracturas de los Dientes , Movilidad Dentaria , Masculino , Humanos , Caries Dental/inducido químicamente , Caries Dental/terapia , Implantes Dentales/efectos adversos , Movilidad Dentaria/inducido químicamente , Movilidad Dentaria/complicaciones , Estudios Retrospectivos , Estudios de Casos y Controles , Calidad de VidaRESUMEN
OBJECTIVE: To evaluate and compare the impact of two removable partial dentures (acrylic removable partial denture [ARPD] and metallic removable partial denture [MRPD]) on periodontal tissues of the remaining teeth in the first 12 months of denture use. MATERIALS AND METHODS: This prospective clinical study included 40 patients, of which 20 received ARPDs, 20 received MRPDs, nine in the maxilla, and 11 in the mandible each. The patients were 45-65 years old; 24 were females, and 16 were males. Patients' demographic details, clinical indicators of periodontal complications, and biochemical measurement of Hs-C-reactive protein (CRP) and alkaline phosphatase (ALP) were considered. One-way analysis of covariance and Friedman were used to measure the differences in clinical periodontal parameters between the two types of dentures. RESULTS: The significant findings were: Plaque index (PLAQ) scores for abutment teeth were higher in MRPD wearers (mean = 12.15) than ARPD wearers (mean = 10.45), whereas ARPD users had significantly higher mean bleeding on probing (BOP) values (mean = 1.5) than MRPD users (mean = 0.00); mobility of abutment teeth showed no significant differences; timeline comparisons showed a significant increase in the percentage of nonabutment teeth mobility in ARPD users (p = .028) compared with MRPD users over the same follow-up period (p = .102). CONCLUSIONS: For a short-term period of 1 year, periodontal and mobility parameters have no significant impact on the abutment and nonabutment teeth of ARPD and MRPD users. Moreover, biochemical markers (CRP and ALP) for periodontal inflammation exhibited no significant difference in both types of dentures.
Asunto(s)
Dentadura Parcial Removible , Movilidad Dentaria , Masculino , Femenino , Humanos , Persona de Mediana Edad , Anciano , Dentadura Parcial Removible/efectos adversos , Estudios Prospectivos , Índice Periodontal , Periodoncio , Movilidad Dentaria/etiologíaRESUMEN
This study aimed to evaluate the effect of splinting material type and material location on the force resistance of splinted periodontally compromised teeth with hypermobility. Extracted teeth including the target tooth (maxillary second premolar) and its adjacent teeth were placed into the alveolar sockets of a dental arch model via artificial periodontal ligaments made of elastic impression material. Three different experimental models with varied target tooth mobility including Periotest® values (PTVs) of 20, 30, and 40 were fabricated (named models #20, #30, and #40, respectively). For each experimental model, the force resistance of tooth splinting was tested using the following four materials: everStick PERIO (glass fiber reinforcement: GFR), FORESTAFLEX (braided stainless steel: BSS), Ortho-FlexTech (stainless steel chain: SSC), and Super-Bond (MMA-based resin cement: MRC). The evaluated measures were the PTV after tooth splinting and the required load to cause tooth displacements of 0.05 mm and 0.10 mm in the vertical and lateral directions, respectively. The splinting material type and material location as well as the original PTV of target the tooth significantly affected all the evaluated measures (p < 0.001). MRC revealed the significantly highest force resistance of tooth splinting regardless of material location in each experimental model and was followed by GFR. The PTVs of splinted teeth were comparable to those of adjacent anchor teeth in models #20 and #30 when using GFR, while that was comparable in model #40 when using MRC. Meanwhile, the load causing certain tooth displacement showed a similar tendency to previous-reported data with healthy teeth in model #20 when using GFR, while that showed a similar tendency in models #30 and #40 when using MRC. Overall results concluded that splinting material type and location play a role in the resistance against the deflection force of splinted periodontally compromised hypermobile tooth. It was noted that MRC provided the highest resistance against the deflection force of splinted teeth regardless of material location whereas GFR maintained the physiologically considered tooth mobility.
Asunto(s)
Movilidad Dentaria , Humanos , Acero Inoxidable , Ligamento Periodontal , Diente PremolarRESUMEN
Background and Objectives: Progesterone and estrogen modify the bone metabolism directly related to the periodontium, this study aimed at answering the question whether fluctuations in the levels of these hormones or the use of their synthetic equivalents in modern contraceptives have a significant impact on the natural tooth mobility (TM) in its alveolus. Materials and Methods: Sixty healthy women who had never been pregnant and when interviewed reported either (1) having regular menstruations every 28-30 days or (2) taking oral two-phase two-ingredient hormonal contraceptives formed, respectively, groups M and S in the study. TM evaluated as the Periotest value (PTV) was checked in the menstruation, ovulation, and luteal phases of the menstrual cycle (group M) and on the days corresponding to the moment of the menstrual cycle in group S. Results: Although the PTV-s were within the limits of norm, the canines and the molars were always more stable than the other teeth. In group M, the TM was statistically comparable (p > 0.05) in the menstrual and ovulation phases, thus significantly increased (p < 0.001) in the luteal phase. The TM remained constant (p = 0.758) in all studies in group S. The results demonstrated that the canines and the molars in the luteal phase were significantly more mobile in group M than in group S (p < 0.001), although increased mobility of the teeth in group M affected the canines and the first molars to a significantly lesser degree than the other teeth. Conclusions: However, since women between 20 and 30 years old constitute the majority of ortho-dontic patients, possible determination of the optimum moment of force application in relation to the sex hormones cycle, namely, to its luteal phase, is clinically very promising.