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1.
Am J Orthod Dentofacial Orthop ; 159(3): 305-311, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33641814

RESUMEN

INTRODUCTION: The early diagnosis and interception of potential maxillary canine impaction is the most desirable approach for correcting their path of eruption. However, there is still a lack of evidence regarding the effect of rapid maxillary expansion (RME) on labially impacted canines. This study aimed to investigate the age-related effect of RME on labially impacted maxillary canines in order to reduce the risk of their impaction in the mixed dentition and to examine the proper timing of interceptive treatment. METHODS: All patients aged 7-10 years were treated with an RME appliance using the same protocol. The distance to the occlusal plane, axis to the midline, and distribution in different sectors-depending on the patients' age-were evaluated for maxillary canines before and after treatment on panoramic radiographs in order to detect changes in the position of the impacted canines. These geometric measurements in the impacted canines were also validated by observing the nontreated canines at each age. RESULTS: Significant differences existed between the impacted canines and the erupted canines in all 3 categories in all age groups. RME treatment modulated the position of the impacted canines in all age groups. Interestingly, a statistically significant difference before and after RME in all categories was detected in patients aged <8 years. A discriminant analysis also showed a positive association of RME treatment with the risk of labially impacted canines. The standardized regression coefficients showed that the angulation of the maxillary canine was the most important predictor for impaction. CONCLUSIONS: Our findings indicate that RME treatment in the early mixed dentition was effective for managing labially impacted maxillary canines. An age of 7-8 years with early mixed dentition might be the most appropriate timing for therapeutic intervention on the basis of RME treatment for buccal canine impaction.


Asunto(s)
Técnica de Expansión Palatina , Diente Impactado , Estudios de Casos y Controles , Niño , Diente Canino/diagnóstico por imagen , Humanos , Maxilar/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Diente Impactado/terapia
2.
Am J Orthod Dentofacial Orthop ; 159(4): 536-544, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33568277

RESUMEN

Treatment of an impacted incisor with a dilacerated root is challenging for clinicians because of the position of the impacted incisor, the abnormality of the root, unfavorable prognosis, and, especially, the long treatment duration. We report on 2 young patients who had inversely impacted maxillary central incisors with developing labially dilacerated roots. Both patients were treated by a novel surgical approach, in situ rotation, by which the crowns of the inversely impacted incisors were carefully rotated to a relatively normal position, whereas the apical location remained relatively unchanged. About 2 weeks after surgery, spontaneous eruption of the treated incisors was observed. Three months later, the postoperative central incisors were further aligned into the maxillary arch with a fixed orthodontic appliance. Follow-up visits 2 or 3 years after surgery indicated that the positions of the dilacerated incisors maintained stability with good gingival esthetics, and the pulpal vitality was favorable. The roots grew further in a relatively normal direction of the incisor's longitudinal axis, which was different from the initial curvature angle. Moreover, with the in situ rotation surgery, treatment time was greatly reduced and resulted in a favorable prognosis compared with conventional treatment.


Asunto(s)
Incisivo , Diente Impactado , Estética Dental , Humanos , Incisivo/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Rotación , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/cirugía , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
3.
Am J Orthod Dentofacial Orthop ; 159(2): e135-e147, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33388201

RESUMEN

INTRODUCTION: The purposes of this study were to characterize the 3-dimensional position of teeth adjacent to impacted canines and examine whether impaction affects canine development using cone-beam computed tomography. METHODS: Cone-beam computed tomography images of 34 unilateral maxillary impacted canines (12 males, 22 females; mean age, 16.5 years) were collected. Twenty-one canines were palatally impacted (PIC), and 13 were buccally impacted (BIC). Angular measurements of lateral incisors (LIs), first premolars, and the impacted canines positions relative to a 3-dimensional coordinate system and canines' volume, length, and shape of the roots, were compared between the affected and contralateral control sides. The influence of canine position and severity of impaction was examined. Statistics included the paired t test, Wilcoxon signed rank test, and McNemar test. RESULTS: In the PIC group, LIs showed significant mesiobuccal rotation (-17.1°), mesial angulation (8.4°), and buccal root torque (5°) and first premolars mesiobuccal rotation (6.1°). In the BIC group, LIs displayed mesiobuccal rotation (-18°) and significant palatal root torque (-5°). The canine volumes were similar in BICs and slightly smaller in PICs. The lengths were shorter in both, but root hooks were more prevalent in BICs. The severity of impaction affected the measured variables. CONCLUSIONS: The differential position of the adjacent teeth is pathognomonic for PIC vs BIC, and impaction seems to affect canine development. The findings provide evidence-based clinical and radiographical clues for early diagnosis of canine displacement and planning the most efficient treatment strategy. In addition, they support timely orthodontic eruption before the development of the apical third of the root.


Asunto(s)
Diente Canino , Diente Impactado , Adolescente , Diente Premolar , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Femenino , Humanos , Incisivo , Masculino , Maxilar/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen
4.
Head Face Med ; 17(1): 1, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451343

RESUMEN

BACKGROUND: The aim of the present study was to compare two different anchorage systems efficiency to disinclude impacted maxillary canines using as evaluation tool superimposed Cone Beam Computed Tomography (CBCTs). METHODS: The study has been conducted with two parallel groups with an allocation ratio of 1:1. Group test received treatment using as anchorage a miniscrew, control group was treated using an anchorage unit a trans palatal arch (TPA). Both groups received a calibrated traction force of 50 g. CBCT before treatment and 3 months after traction were superimposed and canine tip and root movement were evaluated in mm/month ratio. RESULTS: No differences were observed between groups for apex displacement, tip displacement and observation timespan. Twenty-two patients (12 female, 10 male, mean age:13.4 years) undergoing orthodontic treatment for impacted maxillary canines were recruited for this study. No differences were observed between groups for apex displacement, tip displacement and observation timespan. CONCLUSIONS: The present pilot study provided no evidence that indirect anchorage on miniscrews could make canine disimpaction faster than anchorage on a TPA. An apex root movement of 0.4-0.8 mm per month was found, while average canine tip movement ranged between 1.08 mm and 1.96 mm per month. No miniscrews failures were observed. TRIAL REGISTRATION: The study reports the preliminary results of the randomized clinical trial registered at www.register.clinicaltrials.gov (registration number: NCT01717417 ).


Asunto(s)
Diente Canino , Diente Impactado , Adolescente , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Femenino , Humanos , Masculino , Maxilar/diagnóstico por imagen , Proyectos Piloto , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
6.
Am J Orthod Dentofacial Orthop ; 159(3): 258-270, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33495062

RESUMEN

INTRODUCTION: The objective of this study was to evaluate the 3-dimensional changes in alveolar bone morphology after traction of buccally vs palatally unilateral maxillary impacted canines (MIC). METHODS: Following a split-mouth model, 27 cone-beam computed tomography images of unilaterally MIC (14 palatally and 13 buccally) and 27 contralateral unimpacted controls were obtained before and after traction using nickel-titanium closed-coil springs and a rigid anchorage appliance. Alveolar bone height and width were measured in the axial, coronal, and sagittal slides by 3 calibrated orthodontists, taking into account the impaction characteristics. A t test was used to compare the 2 groups, and a paired t test was applied for intragroup comparisons (both sides). A multiple linear regression model was used to evaluate the influence of the predictor variables on alveolar bone dimensional changes. RESULTS: The alveolar height showed a significantly greater decrease in palatally MIC (2.09 to 2.79 mm) than buccally MIC (0.28 to 0.57 mm) (P <0.05) for all surfaces. However, the alveolar width increased similarly in both groups up to 1.36 mm. In general, the affected side had a more significant height loss and greater increases in alveolar width than the nonaffected side. Regression analysis indicated that buccally MIC and age decreased alveolar changes, whereas female sex increased alveolar changes (P <0.05). CONCLUSIONS: MIC traction with nickel-titanium closed-coil springs and heavy anchorage induces significant 3-dimensional changes in alveolar bone characterized by alveolar bone height decreases and cervical alveolar bone width increases. The height decrease is greater in palatally than in buccally MIC.


Asunto(s)
Diente Impactado , Tracción , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Femenino , Humanos , Incisivo , Maxilar/diagnóstico por imagen , Estudios Retrospectivos , Diente Impactado/diagnóstico por imagen
7.
J Oral Maxillofac Surg ; 79(3): 520-531, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33338418

RESUMEN

PURPOSE: The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal. PATIENTS AND METHODS: Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05. RESULTS: From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P < .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P < .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes. CONCLUSIONS: Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction.


Asunto(s)
Tercer Molar , Diente Impactado , Adulto , Femenino , Humanos , Mandíbula , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Estudios Prospectivos , Extracción Dental , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Adulto Joven
8.
Am J Orthod Dentofacial Orthop ; 159(2): 167-174, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33342674

RESUMEN

INTRODUCTION: This research aimed to analyze the prevalence of root dilaceration in buccally impacted canines (BICs) and palatally impacted canines (PICs) with their adjacent teeth based on a retrospective cone-beam computed tomography (CBCT) investigation. METHODS: Pretreatment CBCT images of 145 subjects with unilateral maxillary canine impaction and 145 age- and sex-matched subjects without impaction were used. Prevalence of dilaceration (subclassified to root curvature and apical hook based on severity) in canines and adjacent teeth was determined in CBCT records. The root length of maxillary impacted canines was measured for further morphologic evaluations. RESULTS: Impacted canines had a significantly higher prevalence of root dilaceration than the control group and compared with the erupted contralateral canines in the experimental group (P < 0.001 for both). A significantly higher prevalence of root dilaceration was found in adjacent lateral incisors of the PICs subgroup than that of the control group (P < 0.001). Adjacent premolars had a higher prevalence of dilacerated roots in the PICs subgroup (P < 0.001) than the control group, but not for the BICs subgroup. Significantly higher prevalence of curvature (P < 0.001 for both) and hook (P = 0.008 and P < 0.001, respectively) were found in BICs and PICs roots compared with the control group. Both types of impacted canines had significantly shorter roots than the control group (P < 0.001 for both). CONCLUSIONS: BICs and PICs have a higher tendency to present root dilaceration and shorter roots. Unlike BICs, adjacent teeth to PICs were more frequently observed to have root dilaceration.


Asunto(s)
Diente Canino , Diente Impactado , Diente Premolar , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Humanos , Incisivo , Maxilar/diagnóstico por imagen , Estudios Retrospectivos , Diente Impactado/diagnóstico por imagen
9.
Angle Orthod ; 90(6): 751-757, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378508

RESUMEN

OBJECTIVES: To compare the impact of primary canine and primary first molar extractions with extractions of only the primary canine regarding correction of palatally displaced canines (PDCs). MATERIALS AND METHODS: Thirty-two children aged 9.5-13.5 years with 48 PDCs were randomly allocated to either the double-extraction group (DEG) or single-extraction group (SEG). Clinical and radiographic examinations were performed at baseline and at 6-month intervals until the canine emerged or orthodontic treatment was started. Outcome measures were: emergence of maxillary canine (yes/no), emergence of maxillary canine into a favorable position (yes/no), and maxillary canine positional change (angulation and sector). Factors influencing PDC emergence were analyzed using logistic regression. RESULTS: In the DEG, 64% (16/25) of canines emerged into the oral cavity vs 78% (18/23) in the SEG (P = .283). Favorable PDC position at trial end was seen in 64% (16/25) of the DEG vs 57% (13/23) of the SEG (P = .600). Significant distal movement of PDCs was recorded in the DEG and SEG, though no significant difference was observed between groups. Significant predictors of canine emergence were initial canine angulation (Angle A) (P = .008) and space conditions at T0 (P = .030). CONCLUSIONS: Double or single primary tooth extraction procedures are equivalent in supporting PDC eruption into the oral cavity and into a favorable position in the dental arch. Initial canine angulation and space assessments may be used as predictors of successful PDC eruption.


Asunto(s)
Erupción Ectópica de Dientes , Diente Impactado , Adolescente , Niño , Diente Canino/diagnóstico por imagen , Diente Canino/cirugía , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Ortodoncia Interceptiva , Erupción Ectópica de Dientes/diagnóstico por imagen , Erupción Ectópica de Dientes/terapia , Extracción Dental , Diente Primario , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Resultado del Tratamiento
10.
Gerodontology ; 37(4): 411-415, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33179813

RESUMEN

OBJECTIVE: This report discusses the clinical relevance of a novel case of an odontoma and transmigrated canine in the setting of florid cemento-osseous dysplasia (COD), hypercementosis and moderate to severe periodontitis in a 66-year-old patient. BACKGROUND: An odontoma may infrequently impede tooth eruption and rarely has been implicated with canine transmigration. COD is a benign fibro-osseous lesion associated with decreased vascularity and poorer surgical intervention. MATERIALS AND METHODS: A partially edentulous woman, in no acute distress, underwent clinical and radiographic evaluation in pursuit of comprehensive dental care. RESULTS: Radiographic assessment demonstrated multiple occult pathologies of the mandible, including compound odontoma, canine transmigration, florid COD, hypercementosis and moderate to severe periodontitis, a concurrence thought to be previously unreported. Furthermore, the presence of the odontoma and transmigrated canine is apparently the second reported case in the geriatric population. CONCLUSIONS: The attending clinician should carefully weigh removal of an impacted and transmigrated canine associated with an odontoma in the setting of COD and compromised bone, particularly in older individuals. When surgical intervention is deferred in these clinical situations, patients should continue to be monitored for clinical and radiographic development of pathologic processes.


Asunto(s)
Displasia Fibrosa Ósea , Odontoma , Diente Impactado , Anciano , Diente Canino/diagnóstico por imagen , Femenino , Humanos , Mandíbula , Odontoma/complicaciones , Odontoma/diagnóstico por imagen , Odontoma/cirugía , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
11.
Am J Orthod Dentofacial Orthop ; 158(6): 849-855, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33131921

RESUMEN

INTRODUCTION: The management of impacted, unerupted, or malpositioned mandibular second molars with orthodontic therapy requires special attention in order to achieve normal anatomic positioning within the dental arch. We present a surgical approach to managing these teeth combining exposure and surgically-assisted forced eruption. METHODS: This retrospective single-group cohort study followed 260 impacted mandibular second molars. The molars were exposed and surgically uprighted. An orthodontic bracket was bonded to aid in orthodontic traction, and the wound was packed to prevent soft tissue growth over the crown of the exposed molar. Patients were followed for a minimum of 6 months after uprighting, during which the following outcomes were measured: the degree of success of the eruption one the basis of the clinical occlusal relationship to the opposing dentition, radiographic evidence of bone fill, the periodontal status of the teeth involved, and tooth vitality. RESULTS: A total of 260 mandibular second molars were uprighted in 177 patients (83 female, 94 male) with an average age of 14.8 years. Outcomes showed that 255 molars (98.1%; 95% confidence interval, 96.3-99.8) were successfully uprighted. Complications included infection/abscess in 3 molars and fractured root requiring extraction in 2 molars. All remaining 255 teeth tested vital, 17 teeth had periodontal pocketing of more than 5 mm, and 235 of the teeth had occlusal contact after healing. CONCLUSIONS: Surgically-assisted forced eruption with or without orthodontic forced eruption is a safe, successful, and viable approach to managing unerupted or malpositioned mandibular second molars in the adolescent population.


Asunto(s)
Mandíbula , Diente Impactado , Adolescente , Estudios de Cohortes , Femenino , Humanos , Masculino , Mandíbula/cirugía , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Tercer Molar , Estudios Retrospectivos , Erupción Dental , Técnicas de Movimiento Dental , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
12.
Eur. j. anat ; 24(6): 485-490, nov. 2020. tab, ilus
Artículo en Inglés | IBECS | ID: ibc-198389

RESUMEN

The gubernacular canal or gubernacular tract is filled by the gubernacular cord, which includes fibrous connective tissue containing peripheral nerves, blood and lymphatic ducts besides the epithelial cells from the fragmented dental laminae, including epithelial growth factor. The purpose of this study was to evaluate the gubernacular tract in unerupted supernumerary teeth by cone beam computed tomography. Sixty-four unerupted supernumerary teeth were selected from 44 patients (21 females, 23 males, 12-68 years). Gubernacular tract characteristics were evaluated in five different groups: No alteration, bending of gubernacular tract, contraction of gubernacular tract, obliterations of gubernacular tract, difference between erupted direction. Unerupted supernumerary teeth were classified according to their position. The presence and characteristics of the gubernacular tract in the supernumerary teeth were evaluated by cone beam computed tomography. In our study, the frequency of the gubernacular tract was found to be 31.7%. There was no significant difference between the presence of gubernacular tract and gender, age and gubernacular tract characteristics. It was found that gubernacular tract characteristics did not change according to gender, quadrant, age and unerupted positions. Cone beam computed tomography is an efficient method for the evaluation of the gubernacular tract in unerupted supernumerary teeth. Conducting these studies in larger populations will provide more detailed information about the prognosis of impacted supernumerary teeth


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Diente Supernumerario/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/métodos , Diente Canino/anatomía & histología , Estudios Retrospectivos , Germen Dentario/diagnóstico por imagen
13.
Am J Orthod Dentofacial Orthop ; 158(4): e29-e36, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32988572

RESUMEN

INTRODUCTION: The primary objective of this study was to compare the aesthetic outcome of palatally impacted canines treated with an open or closed surgical exposure technique using the Maxillary Canine Aesthetic Index (MCAI) at least 1 year after debonding. Secondary objectives were set on the periodontal outcome, tooth color, pulpal status, and self-reported contentment. METHODS: The sample of this retrospective study consisted of 53 patients with an average age of 20 years and 7 months at the time of the investigation. A total of 53 canines were investigated. All canines were aesthetically scored with the MCAI. Other outcome variables were investigated, such as gingival inflammation, pocket probing depth, vitality, percussion sensitivity, and tooth color. All patients received a questionnaire to evaluate their appraisal of different parameters. RESULTS: A statistically significant difference (P < 0.001) was found between the groups treated with an open and closed technique in terms of the MCAI. The closed technique scored excellent in terms of aesthetics, whereas the open technique scored good. The closed technique had more discoloration (P < 0.001) and a delayed response to the cold test (P = 0.021). In general, patients were satisfied with both techniques but considered the treatment time to be very long. CONCLUSIONS: A closed surgical exposure of palatally impacted maxillary canines is preferred in terms of aesthetics when measured with the MCAI. There was no difference between the 2 techniques in terms of periodontal outcome. Canines treated with a closed exposure tended to have a darker color and delayed response to cold testing.


Asunto(s)
Diente Canino/diagnóstico por imagen , Diente Canino/cirugía , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Adulto , Estética , Estudios de Seguimiento , Humanos , Estudios Retrospectivos , Adulto Joven
14.
Dental Press J Orthod ; 25(4): 68-74, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965389

RESUMEN

OBJECTIVE: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. METHODS: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). RESULTS: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). CONCLUSIONS: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


Asunto(s)
Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Diente Impactado/diagnóstico por imagen , Humanos , Mandíbula/diagnóstico por imagen , Diente Molar , Cirujanos Oromaxilofaciales , Ortodoncistas , Radiografía Panorámica , Erupción Dental , Extracción Dental
16.
Artículo en Inglés | MEDLINE | ID: mdl-32981872

RESUMEN

OBJECTIVE: The aim of this cross-sectional accuracy study was to compare panoramic reconstruction (PR) and multiplanar reconstruction (MPR) images, which are used to establish the prognosis for impacted mandibular third molars in relation to professional decision making. STUDY DESIGN: Images of 10 patients who had undergone cone beam computed tomography (CBCT) examination were selected, resulting in 2 distinct groups of images, with 10 in each group: PR and MPR. To check prognostic accuracy, 2 images from each group were randomly selected and reinserted into the sample, totaling 24 images. A questionnaire was completed by 54 professionals: 27 orthodontists and 27 oral and maxillofacial surgeons (OMFSs). Data were evaluated by using the χ2 and McNemar's tests and Kappa statistics at P < .05. RESULTS: There were no statistically significant differences when isolated PR images were compared with MPR images by orthodontists (P = .72) or OMFSs (P = .45). However, there were significant differences in the professional decision regarding the prognosis for impacted teeth, where OMFSs indicated the need for more extractions compared with orthodontists (P < .0001). CONCLUSIONS: There are no differences between PR and multiplanar CBCT images with regard to the determination of the prognosis for impacted mandibular third molars. However, there was a difference in the decision making between the different specialties.


Asunto(s)
Diente Impactado , Tomografía Computarizada de Haz Cónico , Estudios Transversales , Humanos , Mandíbula/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Pronóstico , Radiografía Panorámica , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
17.
Oral Maxillofac Surg Clin North Am ; 32(4): 561-570, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32912779

RESUMEN

Impacted incisors, canines, premolars, and second molar are problems encountered frequently by general dentists, orthodontists, and oral and maxillofacial surgeons. The etiology of impacted teeth is multifactorial. Traditional radiographs can be used for location of the impacted tooth but 3-D CBCT is superior in evaluating the tooth's position. Successful management requires an interdisciplinary approach with an orthodontist responsible for the overall success of the treatment plan. Surgical exposure of these impacted teeth is accomplished using an open or closed surgical procedure. Choosing the appropriate surgical procedure and orthodontic treatment plan will result in a stable, predictable, and aesthetic result.


Asunto(s)
Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Diente Premolar , Diente Canino , Estética Dental , Humanos , Maxilar , Diente Molar
19.
Am J Orthod Dentofacial Orthop ; 158(5): 752-758, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32863085

RESUMEN

Nonmineralized cysts and cyst-like lesions that frequently occur in the mandible include ameloblastomas, odontogenic keratocysts, and dentigerous cysts. They have specific features of well-demarcated, unilocular, and radiolucent lesions that are often associated with tooth impaction. Although it rarely occurs, these cysts can become extremely large. Furthermore, cyst enlargement causes additional symptoms that can challenge the success of tooth recovery through orthodontic treatment. This clinical report presents the successful eruption of 2 impacted molars in a large dentigerous cyst treated with marsupialization and orthodontic traction using an orthodontic miniplate anchorage over a 4-year treatment period.


Asunto(s)
Quiste Dentígero , Quistes Odontogénicos , Diente Impactado , Quiste Dentígero/diagnóstico por imagen , Quiste Dentígero/cirugía , Humanos , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Erupción Dental , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
20.
Am J Orthod Dentofacial Orthop ; 158(4): 495-504, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32741561

RESUMEN

INTRODUCTION: The mesio-angulated impaction of mandibular third molars makes them unsuitable as donor teeth for tooth autotransplantation. However, uprighted molars may be applicable for autotransplantation. This study aimed to determine the amount of periodontal ligament (PDL) on the root surfaces of extracted third molars after an application of uprighting force and to examine the amount of PDL at the tension and compression sites. METHODS: In this prospective cohort study, 15 mesio-angulated mandibular third molars (iM8s) from 15 patients planned for orthodontic extraction, were uprighted using springs connected to miniscrews, whereas 15 nonopposing and fully erupted mandibular third molars from 15 other patients served as controls. The altered angulation was monitored and assessed from panoramic radiographs. All 30 molars, removed by simple extraction, were stained with 0.04% (w/v) toluidine blue to analyze the percentages of stained PDL on the root surfaces. RESULTS: An average period of 3.4 months was necessary to upright the iM8s at a mean rate of 8.3° per month. The mean percentage of stained PDL on the loaded iM8s was significantly greater than that on the unloaded molars (P <0.05). The mean percentages of stained PDL were significantly increased at the cervical and middle thirds and the buccal, mesial, and distal surfaces of the loaded iM8s compared with those of the unloaded molars (P <0.05), whereas the apical third and the lingual surface, corresponding to the compression sites, showed no significant increases. CONCLUSIONS: Orthodontic uprighting leads to significantly increased proliferative PDL on certain radicular portions and surfaces of iM8s, which might be useful for tooth autotransplantation.


Asunto(s)
Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Diente Impactado/diagnóstico por imagen , Humanos , Mandíbula/diagnóstico por imagen , Ligamento Periodontal/diagnóstico por imagen , Estudios Prospectivos , Técnicas de Movimiento Dental
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