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1.
Wiad Lek ; 74(3 cz 1): 441-449, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813447

RESUMEN

OBJECTIVE: The aim is to determine the clinical and morphological dependencies, which are important for diagnostics, treatment and prediction of outcomes of pathological processes in the region of the LTM with complicated eruption, as based on the study of histopathological changes of paradental tissue (mucous membrane, walls of retromolar pocket, alveolar bone tissue). PATIENTS AND METHODS: Materials and methods: The materials of the study were 34 biopsy specimens of pathologically altered soft tissue and parodontium obtained as a result of pericoronectomy, extraction of the LTM and other surgical interferences performed based on the relevant indications in 28 patients in the region of the LTM with complicated eruption. Morphological and statistical research methods were used. RESULTS: Results: The local pathological processes, which chronologically precede the destructive changes in the hard tissue of a tooth (caries), are developed in patients of both genders with complicated LTM eruption in soft tissue of parodontium and the adjacent bone tissue of the alveolar wall in the majority of cases. As per biopsy examinations, the frequency of the main pathological processes in paradental tissue in case of complicated LTM eruption varies from 25 to 60 % of the number of biopsy specimens and occurs in various combinations in patients with different values of clinical parameters. The correlation relationships between the patients' clinical data and the morphological parameters of damage to paradental tissue are weak, multidirectional and uncertain in the majority of combinations (considering the available number of biopsy specimens studied). The close certain positive dependence between the damage of the squamous epithelium and the inflammation activity in the lamina propria mucosae, covering the tooth: in the vast majority of cases, the presence of damaged epithelium (within the biopsy specimen) is associated with the inflammation of high activity, was established as based on correlation relationships between the morphological parameters of damage to paradental tissue. CONCLUSION: Conclusions: The found pathological changes and the correlations justify surgical tactics on paradental soft and osseous tissues that are directed on the LTM sparing.


Asunto(s)
Tercer Molar , Erupción Dental , Femenino , Humanos , Masculino , Diente Molar , Tercer Molar/cirugía , Membrana Mucosa , Periodoncio
2.
Evid Based Dent ; 22(1): 20-21, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33772125

RESUMEN

Aim This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to compare the efficacy of different caries removal techniques: complete caries removal (CCR), selective caries removal (SCR) and stepwise caries removal (SWR) for deep carious lesions in vital primary teeth.Data sources The design of this review followed the PRISMA guidance ( http://www.prisma-statement.org/ ). Relevant studies were identified using electronic databases (PubMed [Medline], Cochrane Library, EMBASE) and finally reference lists were screened. The US National Institutes of Health Trials Register (NIHTR; http://clinicaltrials.gov ) and World Health Organisation International Clinical Trials Registry Platform (WHO ICTRP; http://apps.who.int/trialsearch ) were used to help assess publication bias, as it was not possible to test funnel plot asymmetry. Duplicates were located and eliminated using EndNote X7 programme.Study selection To be included, studies had to be published RCTs comparing SCR or SWR with CCR as caries removal strategies for deep carious lesions in vital primary teeth. The outcomes were pulp exposure, pulpo-periodontal complications (clinical and radiological failures) and/or restorative failures. RCTs applying these caries removal techniques were excluded if one of the other trial arms did not involve caries removal (that is, Hall Technique, therapeutic sealing of cavity lesions). Initially, 1,374 potentially eligible articles were identified, out of which 15 (English or French language only) were selected for full-text screening, which included ten relevant references corresponding to eight studies.Data extraction and synthesis Two authors independently extracted data using a piloted data extraction sheet, with a third reviewer resolving any disagreements. The authors performed conventional intention-to-treat and per-protocol meta-analyses, and calculated odds ratios (ORs) as effect estimates in the random-effects model, using Revman5.Results The eight included RCTs were conducted between 1977 and 2018. They include 669 patients and 824 teeth, with follow-up ranging from four weeks to 24 months. Collective results showed reduced risk of pulp exposure after SCR (OR: 0.10, 95% CI [0.04, 0.25]) or SWR (OR: 0.20, 95% CI [0.09, 0.44]), compared with CCR. There was a higher risk of composite restorative failure (OR: 2.61, 95% CI [1.05, 6.49]) using United States Public Health Service (USPHS) criteria, after SCR was compared with CCR only in intention-to-treat analysis. However, when comparing the risk of clinical or radiographic failure of pulpo-periodontal complications, no difference was found between SCR, CCR or SWR.Conclusion The conclusions of the paper are that there is a significant decrease in pulp exposure risk with SCR and SWR in comparison with CCR. However, there is a need for further studies with less risk of bias powered to report on the long-term outcomes of pulpo-periodontal health and restoration longevity.


Asunto(s)
Susceptibilidad a Caries Dentarias , Caries Dental , Manejo de Datos , Caries Dental/terapia , Humanos , Diente Molar , Diente Primario , Estados Unidos
3.
Evid Based Dent ; 22(1): 36-37, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33772133

RESUMEN

Objectives To examine whether periodontal injection of platelet-rich plasma (PRP) could accelerate orthodontic tooth movement.Methods A split-mouth randomised controlled clinical trial was conducted among 16 female participants. Canines were retracted on 0.017 x 0.025-inch stainless steel archwires through closed-coil springs attached on first molars with mini-screws for anchorage preservation. The intervention side received PRP + CaCl2 solution and the control side CaCl2 only. Intraligamental injections were performed during the canine retraction period every three weeks (zero, three and six weeks). The rate of canine retraction was assessed through superimposition of digital models every month for a total of four months. Assessment of associated pain was conducted by questionnaire.Results During the four-month period, a faster rate of canine retraction was detected on the intervention side only for the first month. Following cessation of PRP injections, the rate of canine retraction on the intervention side was initially slower than and then similar to that on the control side. An increase of pain was reported on both sides.Conclusions PRP could accelerate orthodontic tooth movement in the short term with no prolonged effects.


Asunto(s)
Plasma Rico en Plaquetas , Técnicas de Movimiento Dental , Diente Canino , Femenino , Diente Molar , Acero Inoxidable
4.
Evid Based Dent ; 22(1): 38-39, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-33772134

RESUMEN

Study design A double-blind randomised clinical trial, conducted between June 2009 and June 2011, in a paediatric dental department in a Brazilian dental school.Study selection Children aged 3-8 years, in good general health, with deep carious lesions (caries radiographically located in the inner quarter of dentine) affecting either one or two surfaces in primary molars were eligible for inclusion. Teeth were excluded if clinical or radiographic evidence of pulpal inflammation or necrosis or clinical mobility were observed. Pre-cooperative children were also excluded.Clinical procedures and success criteria Following a coin toss, 120 teeth were randomly assigned to two groups: 55 in the total caries removal (TCR) group and 65 in the selective caries removal (SCR) group. Procedures were carried out by three paediatric dentists under local anaesthesia and restored, using a layering technique, with composite under rubber dam. Restorations were evaluated at 3, 6, 12, 18, 24 and 36 months, using the US Public Health Service (USPHS) scale, by a single-blinded and calibrated examiner. A Charlie or Delta score, on the USPHS scale, at the margins of the restorations was considered as restoration failure. Gingival bleeding score, type of cavity (one or two surfaces) and presence of caries (active or inactive) were recorded as secondary outcomes; however, presence alone did not constitute restoration failure.Results Average survival rate of restorations across all teeth was 68% after 36 months, with SCR statistically significantly lower at 57% compared to TCR at 81% (p = 0.004). Annual failure rates for SCR and TCR were 17.3% and 6.7%, respectively. Two-surface restorations had lower survival rates (58%) compared to single-surface restorations (87%) (p = 0.02). Type of cavity and gingival bleeding statistically influenced the chance of restoration failure at 36 months.Conclusions Composite restorations placed after SCR in primary molars were found to fail more often compared to those restored after TCR. Two-surface cavities and poor gingival health negatively impacted restoration success.


Asunto(s)
Susceptibilidad a Caries Dentarias , Caries Dental , Brasil , Niño , Preescolar , Resinas Compuestas , Caries Dental/terapia , Fracaso de la Restauración Dental , Restauración Dental Permanente , Método Doble Ciego , Humanos , Diente Molar/cirugía , Tasa de Supervivencia , Diente Primario
5.
Braz Oral Res ; 35: e035, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33759971

RESUMEN

The aim of this study was to investigate the segregation patterns of molar incisor hypomineralization (MIH) in families, given the evidence that its etiology is influenced by genetics. Clinically, MIH may be detected in parents and/or siblings of MIH-affected children. Our study included children with at least one first permanent molar affected by MIH (proband) and their first-degree relatives (parents and siblings). The participants were examined clinically to detect MIH, according to the European Academy of Paediatric Dentistry criteria (2003). A total of 101 nuclear families (391 individuals) were studied. Proband diagnosis was followed by MIH classification of the subject, his parents and siblings, as affected, unaffected, or unknown. Segregation analysis was performed using the multivariate logistic regression model of the Statistical Analysis for Genetic Epidemiology package, and segregation models (general transmission, environmental, major gene, dominant, codominant and recessive models). The Akaike information criterion (AIC) was used to evaluate the most parsimonious model. In all, 130 affected individuals, 165 unaffected individuals, and 96 unknown individuals were studied. Severe MIH was found in 50.7% of the cases. A segregation analysis performed for MIH revealed the following different models: environmental and dominance (p = 0.05), major gene (p = 0.04), codominant (p = 0.15) and recessive models (p = 0.03). According to the AIC values, the codominant model was the most parsimonious (AIC = 308.36). Our results suggest that the codominant model could be the most likely for inheriting MIH. This result strengthens the evidence that genetic factors, such as multifactorial complex defect, influence MIH.


Asunto(s)
Hipoplasia del Esmalte Dental , Incisivo , Niño , Hipoplasia del Esmalte Dental/epidemiología , Hipoplasia del Esmalte Dental/genética , Humanos , Patrón de Herencia , Diente Molar , Prevalencia
6.
Eur J Paediatr Dent ; 22(1): 10-14, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719476

RESUMEN

AIM: In vitro evaluation of cleanliness of root canal walls of primary molars after preparation with the Self-Adjusting-File and Mtwo-instruments and final irrigation with citric acid and sodium hypochlorite. MATERIALS AND METHODS: s Study Design: In 23 matched pairs, teeth were prepared either with SAF or with Mtwo NiTi-instruments, and final irrigation was performed with 2 mL citric acid and 4 mL NaOCl. Roots were split longitudinally, SEM-images were taken, and smear layer was evaluated by two blinded observers using a four-grade score. Statistical evaluation was performed with Mann-Whitney-U-Test and Wilcoxon Signed Rank Test (P<0.05). RESULTS: No significant difference between SAF and Mtwo (P=0.9454) was observed. Overall removal of the smear layer was significantly better in the coronal part of the root canal than in the apical one (P=0.0004393). Mtwo showed no significant difference in cleanliness when comparing the coronal and apical part of the root canal (P=0.1089), whereas SAF cleaned the coronal part of the root canal significantly better than the apical part (P=0.00108). CONCLUSION: None of the two instruments was superior concerning cleanliness in root canals of primary molars. Both show good cleaning ability when using an irrigation protocol with citric acid and sodium hypochlorite.


Asunto(s)
Cavidad Pulpar , Capa de Barro Dentinario , Humanos , Microscopía Electrónica de Rastreo , Diente Molar/cirugía , Irrigantes del Conducto Radicular , Preparación del Conducto Radicular , Hipoclorito de Sodio
7.
Eur J Paediatr Dent ; 22(1): 19-25, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719478

RESUMEN

AIM: There is insufficient evidence on the outcome of pulpotomies in carious exposed young permanent molars with newer biomaterials. This study aimed to compare Mineral Trioxide Aggregate (MTA) and Biodentine as pulpotomy materials in carious exposed vital immature mandibular first permanent molars. MATERIALS AND METHODS: Study design: Sixty immature first mandibular permanent molars, with carious exposure were randomly assigned to an MTA or Biodentine group in a split-mouth design. After the amputation of the coronal pulp, the pulp stumps were covered with one of the study materials and coronal restorations placed. Blinded clinical and radiographic evaluations were performed at baseline. Following this there were evaluations at 6, 12 and 18 months where comparisons between and within the two groups were made. RESULTS: A high success was observed in both groups for all outcome measures for clinical success, with no significant difference between them. The mean survival time for the Biodentine and MTA groups was (17.8 and 18 months) with 95% confidence interval (17.4-18.2) and (18 .0-18.0) months respectively. Similarly, there were no significant differences between the Biodentine and MTA groups for radiographic success (P<0.001) with an increase in root length and increasing apical closure observed in both groups. CONCLUSIONS: Both materials were equally effective in the treatment of cariously exposed vital immature mandibular first permanent molars.


Asunto(s)
Materiales de Recubrimiento Pulpar y Pulpectomía , Pulpotomía , Compuestos de Aluminio/uso terapéutico , Compuestos de Calcio , Combinación de Medicamentos , Humanos , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Óxidos/uso terapéutico , Materiales de Recubrimiento Pulpar y Pulpectomía/uso terapéutico , Silicatos/uso terapéutico , Resultado del Tratamiento
8.
Eur J Paediatr Dent ; 22(1): 35-40, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719481

RESUMEN

BACKGROUND: The aim of this paper is to illustrate the use of a modified vertical holding appliance (G-VHA) to obtain the vertical control of maxillary molars and tongue stimulation in order to achieve a transverse activation in growing patients with dental open bite without the patient's compliance. CASE REPORTS: The G-VHA is a modified trans-palatal bar with a resin pad covering the Omega central loop and two adjunctive lateral loops to ensure the bar flexibility. The G-VHA is designed to direct the force of the tongue against the upper molars to generate intrusion and at the same time to stimulate and re-educate the tongue. Two cases of dental open bite in growing patients are illustrated. Both patients were successfully treated, and the open bite was fully corrected thanks to molar intrusion, following counterclockwise rotation of the mandible and tongue correction. Finishing of alignment was performed in phase II of the treatment with conventional appliances. CONCLUSION: The G-VHA proved to be effective in controlling the vertical position of maxillary molars promoting the counter-clockwise rotation of the mandible and stimulating a different tongue posture.


Asunto(s)
Mordida Abierta , Cefalometría , Humanos , Mandíbula , Diente Molar , Mordida Abierta/terapia , Diseño de Aparato Ortodóncico , Técnicas de Movimiento Dental
9.
Niger J Clin Pract ; 24(3): 425-434, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33723119

RESUMEN

Objective: This study aimed to compare the clinical efficacy and survival rates of the hall technique (HT), and conventional restoration (CR) for the management of occlusoproximal carious lesions in primary molars. Materials and Methods: This clinical study observed 35 children (aged 4-8 years). Exclusion criteria included symptoms of pulpal or periradicular pathology or systemic conditions requiring special dental considerations. For each child, at least one tooth was treated with HT and one with CR. The primary outcome measures were minor and major clinical failure rates. Plaque and gingival scores of the teeth were also evaluated. Friedman test and Wilcoxon signed ranks test were used to compare the plaque and gingival index scores for each arm. Chi-square tests were used for comparisons of clinical outcomes, plaque-gingival index, and distribution of ICDAS categories among treatment arms (P < 0.05). Results: Thirty-three of 35 (94.2%) participants returned for 1-year follow-up. HT showed statistically significantly higher treatment survival rate and fewer minor failures than CR (P = 0.040). The rate of major failures was minimal (2 of 84 teeth) and did not differ between treatments (P = 0.092). In both treatment groups, the gingival score and plaque score were significantly decreased at the 1-year follow-up (P < 0.05). Conclusion: HT was a more successful method for managing caries in primary molars than CR, both for symptoms of pulpal disease and longevity of the restorations. HT is a simplified method of managing carious primary molars using SSCs cemented with no local anesthesia, caries removal, or tooth preparation.


Asunto(s)
Caries Dental , Acero Inoxidable , Niño , Preescolar , Coronas , Caries Dental/terapia , Susceptibilidad a Caries Dentarias , Restauración Dental Permanente , Humanos , Diente Molar , Diente Primario
10.
Niger J Clin Pract ; 24(3): 435-442, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33723120

RESUMEN

Aims: To investigate the root canal anatomy and the incidence of fused roots in maxillary first molar (MFM) and maxillary second molar (MSM) teeth in the Turkish population and compare them to teeth with separate roots using cone-beam computed tomography (CBCT). Methods: CBCT images of 616 MFMs and 703 MSMs were analyzed from 402 patients for the number of roots and the presence of fusion. The canal configuration of teeth with separate and fused roots was compared. Type of fusion and canal merging positions were determined. A P value of less than 0.05 was considered significant. Results: Five hundred and seventy-one (92.69%) MFMs had three separate roots, one (0.16%) had four roots and the incidence of root fusion was 7.14%. An additional mesiobuccal (MB) canal was present in 79.34% of the teeth with three separate roots. There was no merging of canals in 36 of 44 teeth with fused roots. The prevalence of fusion was higher in the MSMs (23.47%). The incidence of three and four separate roots in MSM teeth was 74.68% and 1.85%, respectively. The prevalence of additional MB canals in teeth with three separate roots was 53.14%. There was no canal merging in 60% of the fused rooted teeth. There were two-merged canals in 31.52% and multiple merged canals in 8.48% of the MSMs. Conclusions: In the Turkish population, the incidence of root fusion in the MFMs and MSMs was 7.14% and 23.47%, respectively, with more canal merging in the MSMs.


Asunto(s)
Homosexualidad Masculina , Minorías Sexuales y de Género , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar/diagnóstico por imagen , Humanos , Masculino , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
11.
Braz Oral Res ; 35: e13, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33656097

RESUMEN

This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person's Chi-square, Fisher's exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians' education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.


Asunto(s)
Caries Dental , Hipoplasia del Esmalte Dental , Brasil/epidemiología , Niño , Estudios Transversales , Caries Dental/epidemiología , Hipoplasia del Esmalte Dental/epidemiología , Humanos , Incisivo , Diente Molar , Prevalencia
12.
J Clin Pediatr Dent ; 45(1): 22-28, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33690822

RESUMEN

OBJECTIVE: To determine the clinical and radiographic success of Biodentine® (BD) and Ferric Sulfate (FS) as primary molar pulpotomy materials and to compare their outcomes. STUDY DESIGN: Retrospective data was obtained from the electronic health records (EHR) of a university-based pediatric dental clinic. Participants were enrolled according to specified inclusion and exclusion criteria. Two trained and calibrated examiners evaluated the EHR using validated criteria for clinical and radiographic outcomes. Study data was numerically coded and analyzed. Cohen's Kappa and Chi-square tests were used (p<0.05). RESULTS: Eighty-three participants (62.7% females, age range two to eight years, average age of 4.5 years) with 102 pulpotomies were enrolled. FS was used in 78% (n=79) and BD in 22% (n=23) of the cases. Follow-up periods ranged from six to 36 months (mean of 17 months). BD showed 100% clinical and radiographic success, while FS demonstrated 84% clinical and 70% radiographic success. The two groups were compared at one year with no statistically significant differences. At 18 months, BD outperformed FS clinically (p=.012) and radiographically (p=.001). Intra-rater and inter-rater agreement were κ>0.88. CONCLUSIONS: Both materials can be recommended for clinical practice, however BD may be the preferred choice for its better outcomes at 18 months.


Asunto(s)
Compuestos de Calcio , Pulpotomía , Niño , Preescolar , Combinación de Medicamentos , Femenino , Compuestos Férricos/uso terapéutico , Humanos , Masculino , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Estudios Retrospectivos , Silicatos/uso terapéutico , Diente Primario , Resultado del Tratamiento
13.
J Clin Pediatr Dent ; 45(1): 8-11, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-33690833

RESUMEN

The presence of carious lesions in children associated with developmental defects of enamel is frequently observed. Restoring these affected teeth can be a challenge for the clinician. Teeth with enamel defects may have poor or limited resin adhesion and some may require repeated restoration. Prefabricated zirconia permanent molar crowns were recently introduced as an option for restoring severely decayed and broken down young permanent molars. These new restorations offer an efficient, esthetic, and economic option to restore severely broken down carious permanent molars that may be associated with enamel defects in partially or fully erupted molars. A clinical case of a 13-year-old female patient is presented. She had a mandibular second permanent molar that demonstrated significant caries and loss of much of the clinical crown, which was treated with a vital pulpotomy and restored with a prefabricated zirconia crown.


Asunto(s)
Restauración Dental Permanente , Circonio , Adolescente , Niño , Coronas , Femenino , Humanos , Diente Molar
14.
Gen Dent ; 69(2): 28-32, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661111

RESUMEN

This case report describes an intraosseous neurilemoma, observed radiographically as a multilocular lesion, in a 12-year-old patient. Physical examination revealed facial asymmetry, swelling on the right side of the mandibular body, and bone expansion in the region of the base of the buccal sulcus. Panoramic radiography revealed a multilocular radiolucency on the right side of the mandibular body in the periapical region extending from the distal region of the first premolar root to the second molar and adjacent to the third molar. Evaluation of a radiograph obtained 3 years earlier for an orthodontic assessment revealed that the lesion was present, appearing as a unilocular radiolucency near the root of the mandibular right first molar. An incisional biopsy of the multilocular lesion was performed, and Antoni A and Antoni B histologic patterns were identified by microscopic analysis. Immunohistochemical analysis was conducted, and neoplastic cells stained positive for the S-100 protein. The patient underwent conservative surgical excision of the lesion, and no recurrence was observed during 7 years of clinical follow-up. Based on analysis of the present case and previous cases reported in the literature, intraosseous neurilemoma, especially its multilocular variant, is an uncommon neoplasm. In the present case, evaluation of the lesion when it was first radiographically detectable, prior to orthodontic treatment, would have permitted a more limited surgical approach for the excision of a small intraosseous lesion.


Asunto(s)
Recurrencia Local de Neoplasia , Neurilemoma , Niño , Humanos , Mandíbula , Diente Molar , Neurilemoma/diagnóstico por imagen , Neurilemoma/cirugía , Radiografía Panorámica
15.
Gen Dent ; 69(2): 64-68, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661118

RESUMEN

Taurodontism, usually associated with genetic disorders, is an anomaly in dental development in which the tooth presents with a vertically elongated pulp chamber due to an invagination failure of the Hertwig epithelial sheath. This article presents 2 case reports describing the endodontic treatment of permanent taurodontic molars in systemically healthy patients. In case 1, a maxillary left first molar presented with hypertaurodontism and 5 root canals. In case 2, a mandibular left second molar presented with hypertaurodontism and a C-shaped canal. Treatment of both teeth was based on careful radiographic evaluation with magnification, which allowed the root canal orifices to be identified and the endodontic treatment to be performed. Chemical-mechanical preparation was performed with mechanized instruments and a 2.5% sodium hypochlorite solution. As an auxiliary protocol to finish cleaning, passive ultrasonic irrigation was performed, and a thermoplastic filling technique was used. When complex internal anatomy and accessory root canals are present, endodontic treatment of a tooth presenting with hypertaurodontism can be challenging. Given the complexities of the present cases, the positive outcomes can be attributed to the use of magnification during endodontic procedures and meticulous attention to tooth preparation and obturation techniques.


Asunto(s)
Cavidad Pulpar , Anomalías Dentarias , Cavidad Pulpar/diagnóstico por imagen , Humanos , Diente Molar/diagnóstico por imagen , Preparación del Conducto Radicular , Tratamiento del Conducto Radicular , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/terapia
16.
Pediatr Dent ; 43(1): 24-27, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33662246

RESUMEN

Purpose: The purpose of this study was to investigate whether primary molars treated with composite resins (CRs) and stainless steel crowns (SSCs) during an oral rehabilitation under general anesthesia (GA1) required retreatment at a second oral rehabilitation under GA (GA2). Methods: Records were examined from 296 healthy patients with more than one dental rehabilitation under general anesthesia from June 2012 to January 2019. Data included treatment details and demographic information. Frequencies and means were recorded. An analysis was completed using logistic regression and chi-square for categorical variables. Results: For primary first molars, 43 percent of CRs placed at GA1 were treated with SSCs at GA2. For primary second molars, 35 percent of CRs placed at GA1 were treated with SSCs at GA2. There was no statistically significant difference in retreatment rates by molar type (P equals 0.27). Eight percent of SSCs placed on any molar at GA1 required retreatment at GA2. Conclusions: Primary molars treated with stainless steel crowns using general anesthesia had the lowest percentage of retreatment compared to those treated with composite resins. Strong consideration should be given to the placement of SSCs on primary molars in patients with early childhood caries under general anesthesia. Placement of primary molar SSCs during initial treatment under general anesthesia may reduce the need for additional treatment in the future.


Asunto(s)
Coronas , Acero Inoxidable , Anestesia General , Niño , Preescolar , Humanos , Diente Molar , Retratamiento , Diente Primario
17.
Pediatr Dent ; 43(1): 28-33, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33662247

RESUMEN

Purpose: The purposes of this study were to determine the presence of interproximal carious lesions in the primary molars and assess the risk to adjacent and contralateral surfaces when caries is detected in one quadrant. Methods: Clinical records of high caries-risk children, including bitewing radiographs, were assessed for interproximal caries and the extent of marginal ridge breakdown. The carious lesions were scored radiographically by two calibrated examiners with excellent inter- and intraexaminer reliability. Correlations for the presence of adjacent surface caries and caries in another quadrant were determined by employing the strength of the associations, as quantified using chi-square analysis. Results: A total of 1,290 pairs of primary molars (A and B, I and J, K and L, S and T) were included. Only eight percent of interproximal surfaces were caries-free. Approximately 70 percent of the adjacent surfaces (A and B, I and J, K and L, and S and T) exhibited carious lesions in the enamel when there was enamel caries in one quadrant. Furthermore, 90 percent of the adjacent surfaces exhibited caries in the dentin if one adjacent interproximal surface exhibited dentinal caries. Conclusions: In high caries-risk children, only a small proportion of surfaces remain caries-free, and the adjacent surface caries prevalence remains high at 70 percent to 80 percent. The presence of interproximal caries in one quadrant is a good indicator of caries in the other quadrants, as is the marginal ridge breakdown which indicates the proximity to the pulp.


Asunto(s)
Caries Dental , Diente Primario , Niño , Caries Dental/diagnóstico por imagen , Esmalte Dental/diagnóstico por imagen , Humanos , Diente Molar/diagnóstico por imagen , Radiografía de Mordida Lateral , Reproducibilidad de los Resultados
18.
J Prosthodont ; 30(S1): 43-51, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33783093

RESUMEN

PURPOSE: The impact of mediotrusive (MT) occlusal contacts has been a topic of controversy and confusion in both clinical practice and in the dental literature. The purpose of this Best Evidence Consensus Statement was to explore whether MT interferences are harmful in the natural or therapeutic occlusion directed by 4 focus questions relating to prevalence, jaw function, jaw dysfunction and biomechanical models. MATERIALS AND METHODS: An electronic search in October 2020 sought evidence in MEDLINE (Ovid) using (mediotrus* OR nonworking side OR nonworking contact OR balancing side OR interfer* side OR premature contact) in the multipurpose (.mp) search field; and in Google Scholar using permutations of the above. Supplementary articles were sourced from the associated reference lists. There was no language restriction. The search yield was reviewed in duplicate. RESULTS: The electronic search identified 420 articles. Following screening, 164 were selected for eligibility assessments. Of these, 47 were included in the current paper. CONCLUSIONS: Non-standardized nomenclature and methodology is used to identify MT interferences in patient populations, with resultant prevalence varying from 0% to 77%, (median = 16%). MT interferences may alter the biomechanics of mandibular function. Together with the presence of repeated high loads resultant strain can manifest as pathophysiology of the temporomandibular joint and associated muscle structures. MT interferences should be avoided in any therapeutic occlusal scheme to minimize pulpal, periodontal, structural and mechanical complications or exacerbation of temporomandibular disorders (TMDs). Naturally occurring molar MT interferences should be eliminated only if signs and symptoms of TMDs are present. Literature supports there being a biomechanical basis which can explain how MT interferences may affect temporomandibular joint morphology and jaw function.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Consenso , Humanos , Mandíbula , Diente Molar , Articulación Temporomandibular
19.
Orthod Craniofac Res ; 24 Suppl 1: 31-38, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33652500

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate the long-term position of erupted third molars after maxillary total arch distalization using modified C-palatal plates (MCPPs) in adolescents and to identify factors associated with these positions. SETTING AND SAMPLE POPULATION: Sixty-two third molars (male: 20, female: 42) in Class II patients treated with MCPPs and thirty-nine teeth for the Control group (male: 22, female: 17). MATERIALS AND METHODS: Samples were analyzed using panoramic radiographs taken initially (T0), after treatment (T1) and after >3 years retention (T2). Third molars were classified as downward (Group A, N = 31; males: 12, females: 19) and upward (Group B, N = 31; males: 8, females: 23) based on their vertical position after treatment. Analysis of variance and multiple logistic regression analysis were performed. RESULTS: The vertical position of the third molars of Group A, Group B, and the Control showed a 2.2, 3.5 and 2.7 mm downward movement at T2. However, there was no difference in the amount of third molar eruption among the groups. Regarding factors affecting the vertical distance of the third molar, Age, C8-OP, ∠8-OP and D7-T at the initial affected vertical position of the third molars after molar distalization (P < .05). CONCLUSIONS: Group A and B showed no difference in the third molar eruption during retention after total arch distalization. This study suggests that it might be unnecessary to extract the developing third molar before molar distalization in Class II adolescents.


Asunto(s)
Maloclusión de Angle Clase II , Tercer Molar , Adolescente , Cefalometría , Femenino , Humanos , Masculino , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Técnicas de Movimiento Dental
20.
Ned Tijdschr Tandheelkd ; 128(3): 161-166, 2021 Mar.
Artículo en Holandés | MEDLINE | ID: mdl-33734222

RESUMEN

Eruption of mandibular second molars usually occurs around the age of 12. Incomplete eruption of second molars in such young patients can lead to loss of the molars, due to caries, root resorption or periodontal pathology. When a pathology of this kind develops, the treatment option for a mesially impacted molar is often to extract the tooth. If tooth eruption is, however, monitored closely by the dentist and/or orthodontist, early treatment can be considered in order to preserve the tooth. Partially impacted second molars can be placed in a functional anatomical position by surgical uprighting and repositioning. As long as certain conditions are met, this results in sound functionality with preservation of the full dentition. In cases of incomplete eruption, this treatment option should therefore be considered by dentists and orthodontists before extracting the second molars.


Asunto(s)
Mandíbula , Diente Impactado , Humanos , Diente Molar/cirugía , Tercer Molar , Erupción Dental , Técnicas de Movimiento Dental , Diente Impactado/cirugía
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