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1.
Oral Maxillofac Surg Clin North Am ; 32(4): 593-609, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33004150

RESUMEN

Extensive reviews have concluded that grafting of the socket reduces bone loss regardless of product or method. However, nothing has been shown to reliably and completely maintain alveolar dimensions. We advocate a biologically driven and anatomically based approach for reconstruction of the socket. There are various socket manipulations that we have found to predictably prepare a site for dental implant. The combination of graft construct design and socket management maximizes graft success for any practitioner. Each socket should be treated individually, and products or methods used that are coincident with the complexity of the defect in question.


Asunto(s)
Aumento de la Cresta Alveolar , Alveolo Dental/cirugía , Humanos , Extracción Dental
2.
J Indian Soc Pedod Prev Dent ; 38(3): 311-314, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33004731

RESUMEN

Eruption of the first tooth at 6 months of age is a significant stage in a child's life. However, the presence of a tooth in the oral cavity of a newborn can lead to a lot of delusions. Natal and neonatal teeth are of utmost importance not only to a dentist but also for a pediatrician due to parental anxiety, folklore superstitions, and numerous complications associated with it. The present case report describes a 1.5 cm × 1.5 cm, slow-growing, soft-tissue gingival mass which developed following the extraction of a tooth-like structure in a 4-month-old male patient. Histological examination revealed that it contained a tooth-like hard tissue intermingled with bone and fibrous tissue. Based on clinical and histological findings, the present case was diagnosed as gingival hyperplasia with displaced tooth buds of 71 and 81, which might be due to chronic irritation or traumatic extraction of the neonatal teeth. No abnormal recurrence of the lesion was detected during the follow-up period. However, postoperative clinical and radiographic photographs further reconfirmed the absence of tooth in relation to 71 and 81.


Asunto(s)
Dientes Neonatales/cirugía , Extracción Dental/efectos adversos , Huesos , Niño , Encía , Humanos , Lactante , Recién Nacido , Masculino , Erupción Dental
3.
J Contemp Dent Pract ; 21(6): 640-644, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-33025933

RESUMEN

AIM: The purpose of this research was to survey the effect of low-level laser irradiation time on socket healing in rats. MATERIALS AND METHODS: This randomized nonblinded animal study was done on 24 male rats that were divided into four groups. First maxillary molars of rats were extracted through general anesthesia, and laser was used in all four groups: first group with zero radiation time, second group with 3 minutes, third group with 5 minutes, and fourth group with 10 minutes of radiation by the diode laser (power: 100 mW, wavelength: 980 nm). Half of the rats (three rats) were sacrificed on the 3rd day and another half of rats were sacrificed on the 7th day. Then, the presence of angiogenesis, bone trabeculae, fibroblasts, neutrophil cells, macrophage cells, and lymphocyte cells was assessed. Data were analyzed by SPSS (version 21) using parametric tests. RESULTS: Among 24 rats, on the 3rd day, the percentage of macrophage and bone trabecula increased significantly in the 5 minute group (p = 0.041 and p < 0.01, respectively). Other changes in days 3 and 7 were not statistically significant (p > 0.05). CONCLUSION: Low-level laser radiation can accelerate the process of tooth socket healing, which was particularly noticeable in the 5 minute radiation over 3 days. CLINICAL SIGNIFICANCE: Using a low-level laser can be helpful in accelerating the healing of the tooth socket and reduce the complications after tooth extraction.


Asunto(s)
Láseres de Semiconductores , Terapia por Luz de Baja Intensidad , Animales , Láseres de Semiconductores/uso terapéutico , Masculino , Ratas , Extracción Dental , Alveolo Dental , Cicatrización de Heridas
4.
Shanghai Kou Qiang Yi Xue ; 29(3): 287-292, 2020 Jun.
Artículo en Chino | MEDLINE | ID: mdl-33043346

RESUMEN

PURPOSE: To analyze 8-year cone-beam CT (CBCT) data of early, delayed and late implantation around maxillary area of patients with single dental implant after tooth extraction, and to investigate the effect of implantation at different times on implants, in order to provide valuable information for correct selection of appropriate implant timing after tooth extraction. METHODS: Clinical data of 68 patients who received single-tooth implant after tooth extraction in our hospital from January 2010 to December 2010 were retrospectively analyzed. According to different implantation times, the patients were divided into three groups: group A (n=25), group B (n=24) and group C (n=19). All patients were followed up for 8 years, and the buccal bone defects were recorded. The adjacent bone level and bone defects were analyzed based on CBCT images and posteroanterior(PA) radiographs. The data were processed with SPSS 18.0 software package. RESULTS: The success rate of mini-implants was 92.59%(150/162). Univariate analysis of variance showed that there was significant difference in the success rate of implantation among three groups(P<0.05). Paired comparison showed that the success rate of implantation among three groups was the highest in group C, followed by group B and group A (P<0.05). 8-year CBCT image data of 51 patients included 16 in group A, 20 in group B and 15 in group C. The adjacent bone levels showed no significant difference between CBCT and PA images(P>0.05). Insertion torque and pullout torque showed no significant difference among three groups(P>0.05). Implant timing, insertion torque and pullout torque were the high-risk factors affecting implant success rate(P<0.05). After 8 years of implant placement, there was no significant difference in bone level among three groups (P>0.05). In the second stage of operation, bone defect rate of group C was significantly less than that of group A and B (P<0.05). The average maxillary bone level of implants with no bone defects was lower than that of implants with dehiscence-type defects (P<0.05). CONCLUSIONS: Implant placement time after extraction has no impact on adjacent bone level, but different implant times can affect the success rate of implant; moreover, the indication of immediate implant should be strictly controlled.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Retrospectivos , Extracción Dental
5.
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
6.
Int J Oral Implantol (Berl) ; 13(3): 235-239, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32879928

RESUMEN

PURPOSE: Piezoelectric bone surgery was introduced into clinical practice almost 20 years ago as an alternative method for cutting bone in dental surgical procedures, in an attempt to reduce the disadvantages of using conventional rotary instruments. The aim of this Consensus Conference was to evaluate the current evidence concerning the use of piezoelectric surgery in oral surgery and implantology. MATERIALS AND METHODS: Three working groups conducted three meta-analyses with trial sequential analysis, focusing on the use of piezoelectric surgery in impacted mandibular third molar extraction, lateral sinus floor elevation and implant site preparation. The method of preparation of the systematic reviews, based on comprehensive search strategies and following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, was discussed and standardised. RESULTS: Moderate/low evidence suggests that piezoelectric surgery is significantly associated with a more favourable postoperative course (less pain, less trismus) after impacted mandibular third molar extraction than conventional rotary instruments. Moderate evidence suggests that implants inserted with piezoelectric surgery showed improved secondary stability during the early phases of healing compared with those inserted using a drilling technique. Strong/moderate evidence suggests that piezoelectric surgery prolongs the duration of surgery in impacted mandibular third molar extraction, sinus floor elevation and implant site preparation, but it is unclear whether the slight differences in duration of surgery, even if statistically significant, represent a real clinical advantage for either operator or patient. Weak evidence or insufficient data are present to draw definitive conclusions on the other investigated outcomes. CONCLUSIONS: Further well-designed trials are needed to fully evaluate the effects of piezoelectric surgery, especially in implant site preparation and sinus floor elevation.


Asunto(s)
Elevación del Piso del Seno Maxilar , Diente Impactado , Consenso , Humanos , Piezocirugía , Extracción Dental , Trismo
7.
Artículo en Inglés | MEDLINE | ID: mdl-32926003

RESUMEN

Horizontal and vertical reduction of the ridge has to be expected after tooth extraction. Immediate implant placement and provisionalization is a viable treatment option that can help to minimize those changes. Additionally, it can better meet a patient's expectations about the treatment, reducing time and invasiveness. The aim of this prospective study is to evaluate the stability of the hard and soft tissues surrounding single immediate implants placed in the esthetic zone, as well as evaluating patient satisfaction. A total of 16 implants were placed, and 15 could be evaluated at the 3-year follow-up. Radiographic and clinical data was recorded after this period. Some marginal bone level reduction was detected after 3 years but was not statistically significant. The soft tissues, measured at 3 points, showed stability and even better positions with respect to the day of the final restoration placement. Patient satisfaction was analyzed using the modified Oral Health Impact Profile questionnaire (OHIP-14), and high satisfaction values were reported. The implementation of a precise surgical and prosthetic protocol when an immediate implant is placed into a fresh extraction socket is likely to result in high survival and success rates combined with excellent patient satisfaction. After the 3-year follow-up, favorable results were present.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Estética Dental , Estudios de Seguimiento , Humanos , Satisfacción del Paciente , Estudios Prospectivos , Extracción Dental , Alveolo Dental/cirugía , Resultado del Tratamiento
8.
Prim Dent J ; 9(3): 54-58, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32940591

RESUMEN

When undertaking dental extractions in modern dental practice, two of the complications that have the potential to cause most apprehension for clinicians are the risks of osteonecrosis of the jaws and uncontrollable haemorrhage. This is especially the case when treating older patients because of the increased likelihood of co-morbidities and accompanying polypharmacy which can predispose patients to these problems. Specific medications of concern to practitioners in relation to osteonecrosis risk are antiangiogenic and antiresorptive drugs. Patients taking dual antiplatelet therapy and direct oral anticoagulants require consideration in relation to bleeding risk. With these medications coming increasingly to the forefront over recent years, guidance has been developed by organisations such as the Scottish Dental Clinical Effectiveness Programme (SDCEP). Appropriate use of these guideline should ensure that patients felt to be at particular risk of these complications can frequently be safely managed in primary care. This article aims to provide advice on recognising patients at risk, and to discuss how to utilise key messages within published guidelines when making treatment decisions. The overall intent is to help primary care clinicians who are likely to encounter these patients more and more.


Asunto(s)
Conservadores de la Densidad Ósea , Osteonecrosis , Anticoagulantes , Humanos , Atención Primaria de Salud , Extracción Dental
9.
Int J Oral Maxillofac Implants ; 35(5): 1037-1044, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32991656

RESUMEN

PURPOSE: This study examined a new 3D volumetric analysis method for the assessment of baseline-to-12-month changes of the soft tissue volume at early and immediately placed tapered implants after loading with ceramic single crowns. MATERIALS AND METHODS: Eligible patients with one incisor, canine, or premolar to be extracted were included. The patients were divided randomly into early-placement or immediate-placement groups. Tapered implants (BLT, Institut Straumann) were placed after the extractions. In the early-placement group, the implants were placed 8 weeks after extraction. In the immediate-placement group, the implants were placed immediately after the extraction. All implants healed transmucosally, and the final crowns were inserted after healing (baseline). Impressions were made at screening, baseline, and 12 months after crown insertion (Permadyne, 3M). The casts were scanned (Imetric 4D) and aligned, and a superimposed area of interest (AOI) (labial/buccal aspects) was defined to assess the volumetric changes (GOM Inspect). Specific software (3Matic, Materialise NV) was used for volumetric analysis. The vertical mucosal recession was measured at each time point. Repeated-measures one-way analysis of variance and the Tukey method were used for statistical analysis (SPSS 22, IBM). RESULTS: Twenty tapered implants (16 regular and four narrow) were placed in 20 patients (12 men and 8 women) in the early-placement (EP; n = 10) and immediate-placement (IP; n = 10) groups, respectively. Threedimensional volumetric analysis revealed soft tissue volume loss in both groups of 10.0 ± 16.5 mm3 (EP) and 24.3 ± 21.3 mm3 (IP) between baseline and 12 months (P = .6). The analysis also revealed local differences in the changes, displaying both localized gain and loss in both groups. CONCLUSION: With this novel 3D analysis method, true volumetric soft tissue differences, ie, both localized gain and loss, were specified between the treatment groups.


Asunto(s)
Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía , Coronas , Implantación Dental Endoósea , Femenino , Humanos , Masculino , Proyectos Piloto
10.
Oral Maxillofac Surg Clin North Am ; 32(4): 519-559, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32919832

RESUMEN

Impacted third molars occur in a significant number of patients and often require treatment because of presence of symptoms and/or disease. Management of these teeth typically involves referral to oral and maxillofacial surgeons for diagnosis, treatment planning, and ultimate removal if indicated. Proper diagnosis and treatment planning helps optimize surgical results at each stage of the procedure, and ultimately patient outcomes. Adherence to proper surgical techniques helps minimize risks and complications associated with the procedure. Multiple alternative surgical techniques also exist for uncommon, but potentially complicated, situations that arise with some impacted third molars.


Asunto(s)
Tercer Molar/cirugía , Diente Impactado/cirugía , Humanos , Planificación de Atención al Paciente , Derivación y Consulta , Extracción Dental
11.
Am J Orthod Dentofacial Orthop ; 158(4): e17-e27, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32863088

RESUMEN

INTRODUCTION: The objective of this research was to evaluate the treatment outcomes, long-term occlusal changes, and patient satisfaction after 37 years of nonextraction and extraction treatments. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term posttreatment (T3) ages of 13.2, 15.0, and 50.3 years, respectively. Mean treatment time (T2 - T1) and long-term follow-up time (T3 - T2) were 1.8 and 35.2 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with mean ages at T1, T2, and T3 of 13.3, 15.6, and 53.6 years, respectively. Mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 2.3 and 37.9 years, respectively. The Peer Assessment Rating (PAR) index and Objective Grading System (OGS) indexes were evaluated at T1, T2, and T3 stages. The subjects also answered an online questionnaire regarding esthetic and occlusal self-perception at T3. Intergroup comparison was performed with t tests. RESULTS: The PAR index improved with treatment and similarly worsened at T3 for both groups. OGS scores were close to the passing score at T2 for both groups. The nonextraction group presented worse OGS scores at T3 than the extraction group. Nonextraction patients perceived more changes in alignment over time, but overall satisfaction was similar. CONCLUSIONS: The PAR index improved with treatment, and the PAR and OGS scores showed a significant increase, indicating great occlusal changes in the long-term stage. The nonextraction group showed more occlusal changes and perceived more changes in their alignment over time, but overall patient satisfaction was similar in both groups.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Satisfacción del Paciente , Diente Premolar , Estética Dental , Humanos , Persona de Mediana Edad , Ortodoncia Correctiva , Extracción Dental , Resultado del Tratamiento
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(6): 907-910, 2020 Jun 30.
Artículo en Chino | MEDLINE | ID: mdl-32895197

RESUMEN

OBJECTIVE: To explore the application of digital positioning guide plate in extraction of impacted supernumerary teeth and evaluate its clinical efficacy. METHODS: From March to August, 2019, 30 patients with labial impacted supernumerary teeth treated in the Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University were enrolled in this study. Fifteen of the patients were treated with digital positioning guide plate to remove the impacted supernumerary teeth (test group). According to the CBCT data and the dentition model of the patients, the positioning guide plate was positioned by avoiding the important anatomical structure with the tooth-bone surface as the support to design the soft tissue incision line and bone tissue exposure range. The other 15 patients who were treated without the use of the guide plate for operation served as the control group. The design time, tooth searching time, operation time and complications were compared between the two groups. RESULTS: The positioning guide plate was well attached during the operation and allowed quick location of the supernumerary teeth while helping to expose the supernumerary teeth and avoid the damage of the adjacent important anatomical structures. The pre-operative design time was 50 ± 5 min in the test group and 0 min in the control group. The average time of tooth finding in the test group was 5±2 min, as compared with 10±3 min in the control group (t=15.40, P < 0.01); the average time of operation was significantly shorter in the test group than in the control group (25±4 min vs 45±6 min; t=35.50, P < 0.01). No intraoperative complications occurred in the test group, and slight deviation occurred in one case in the control group. CONCLUSIONS: The application of digital positioning guide plate in extraction of embedded supernumerary teeth can significantly shorten the time of tooth finding, reduce the difficulty of operation, and improve the quality of operation.


Asunto(s)
Diente Impactado , Diente Supernumerario , Placas Óseas , Huesos , Humanos , Tempo Operativo , Extracción Dental
13.
Rev. Odontol. Araçatuba (Impr.) ; 41(2): 45-51, maio-ago.2020. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1102698

RESUMEN

Dentes impactados são caracterizados pela falha na erupção dentro do tempo cronológico. O termo ''dente invertido'' se refere ao mau posicionamento do dente, caracterizando-se pelo dente na direção contrária à usual. A inversão de dente impactado é considerada um fenômeno raro. Em casos mais complexos de impacção dentária, há a necessidade de um tratamento conservador, específico e procura-se prevenir possíveis danos às estruturas anatômicas adjacentes. Por essa razão, a técnica cirúrgica denominada coronectomia, também conhecida como odontectomia parcial intencional, tem, em alguns casos, indicação de uso, pois realiza-se a exérese da porção coronária do dente, sepultando as suas raízes, quando estas se encontram em contato com estruturas nobres. Dessa forma, este trabalho tem como objetivo apresentar um caso raro da utilização da técnica de coronectomia para um terceiro molar superior invertido em paciente do sexo feminino, 26 anos, que compareceu ao serviço de Cirurgia Buco-Maxilo-Facial apresentando um terceiro molar superior, assintomático, impactado em posição invertida no lado esquerdo. Ao exame tomográfico, apresentou íntimo contato do dente 28 com as raízes do 27. A porção coronária se encontrava em posição superior, em direção a parte posterior do seio maxilar. A técnica da coronectomia foi escolhida como planejamento cirúrgico, a fim de proteger o dente 27 das possíveis consequências traumáticas que a luxação e extração completa do dente 28 poderia ocasionar. O acompanhamento clínico demonstrou que a técnica foi bem indicada, com evolução de neoformação óssea completa na região da coroa removida e o dente adjacente com vitalidade e em função mastigatória(AU)


Impacted teeth are characterized by eruption failure within chronological time. The term 'inverted tooth' refers to the mispositioning of the tooth, characterized by the tooth in the opposite direction to the usual one. Impacted tooth inversion is considered a rare phenomenon. In more complex cases of dental impaction, there is a need for conservative and specific treatment, and attempts are made to prevent possible damage to adjacent anatomical structures. For this reason, the surgical technique called coronectomy, also known as intentional partial odontectomy, has, in some cases, indication of use, where the coronary portion of the tooth is excised, burying its roots when they are in contact with noble structures. Thus, this paper aims to present a rare case of the use of the inverted upper third molar coronectomy technique in a 26-year-old female patient, who attended the Buccomaxillofacial Surgery Service presenting a superior third molar, asymptomatic, impacted in inverted position on the left side. At tomographic examination, the patient presented close contact of tooth #16 with the roots of tooth #15. The coronary portion was in the superior position, towards the posterior part of the maxillary sinus. The coronectomy technique has been chosen as a surgical planning in order to protect tooth #15 from the possible traumatic consequences that dislocation and complete extraction of tooth #16 could cause. Clinical follow-up showed that the technique was successfully indicated, with complete bone neoformation in the removed crown area and the adjacent tooth with vitality and masticatory function(AU)


Asunto(s)
Humanos , Femenino , Adulto , Diente Impactado/cirugía , Tercer Molar/cirugía , Extracción Dental , Diente Impactado , Tercer Molar
14.
Rev. Asoc. Odontol. Argent ; 108(2): 57-62, mayo-ago. 2020. ilus
Artículo en Español | LILACS | ID: biblio-1121186

RESUMEN

Objetivo: Describir la importancia del reconocimiento oportuno del trauma crónico de la mucosa bucal producido por un elemento dentario que generó una lesión erróneamente diagnosticada como neoplasia maligna. Caso clínico: Una paciente de sexo femenino, de 79 años de edad, realizó una consulta estomatológica por una lesión lingual con un diagnóstico presuntivo de cáncer. Tras la inspección de la cavidad bucal y el estudio anatomopatológico se diagnosticó úlcera asociada a trauma dentario. La intervención terapéutica odontológica (eliminación del trauma) resolvió el cuadro cínico. Conclusión: El trauma crónico en la mucosa bucal puede generar lesiones sobre mucosa sana o bien complicar una patología preexistente. En el presente caso, la inspección de la cavidad bucal con la identificación y la eliminación del trauma lograron la reparación de la lesión. El estudio anatomopatológico precisó el diagnóstico de ulceración asociada a trauma dentario (AU)


Aim: The aim of this case report is to show the importance of the early diagnosis of a traumatic lesion of the oral mucosa arising from a posterior broken tooth that was initially misdiagnosed as oral cancer. Case report: A 79-year-old female attends an appointment with the oral medicine specialist for a lesion on the lateral side of the tongue with a presumptive diagnosis of oral cancer. The examination of the oral cavity and the anatomopathological diagnosis confirmed the presence of an ulcer associated with dental trauma. The lesion healed completely with the elimination of the trauma. Conclusion: Chronic trauma in the oral cavity can produce lesions in the oral mucosa or exacerbate preexisting lesions. In this case report a thorough oral examination showed a broken tooth as the cause of trauma and after its removal the lesion healed completely. The result of the biopsy confirmed the diagnosis of an oral ulcer associated with dental trauma (AU)


Asunto(s)
Humanos , Femenino , Anciano , Enfermedades de la Lengua/diagnóstico , Úlceras Bucales/diagnóstico , Diagnóstico Diferencial , Errores Diagnósticos , Extracción Dental , Raíz del Diente/patología , Biopsia
15.
J Dent Child (Chic) ; 87(2): 60-68, 2020 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-32787998

RESUMEN

Purpose: Although rapid maxillary expansion (RME), transpalatal arch (TPA) and cervical-pull headgear (HG) have been suggested for the interception of palatally displaced permanent canines (PDCs), existing knowledge remains inconclusive. The purpose of this study was to assess these practices in an evidence-based manner.
Methods: Randomized controlled trials (RCTs) investigating the prevalence of physiologic PDC eruption after using RME, TPA and HG, with or without the extraction of the primary canines, were searched, and the risk of bias was assessed.
Results: Data from five RCTs were included. RME, TPA and HG, with or without extracting primary canines, can significantly increase the rate of normal eruption of PDCs compared to no intervention (risk ratio [RR] = 2.5 to 4.5). In comparison to extraction, no difference was observed, except for HG combined with primary canine extraction (RR = 1.413; 95 percent confidence interval = 1.062 to 1.880).
Conclusion: RME, TPA and HG can significantly increase the rate of normal eruption of PDC compared to no intervention. However, when compared to extraction, no differences were noted, except for HG combined with primary canine extraction.


Asunto(s)
Erupción Ectópica de Dientes , Diente Canino , Humanos , Maxilar , Ortodoncia Interceptiva , Extracción Dental , Diente Primario
16.
Ned Tijdschr Tandheelkd ; 127(7-08): 409-416, 2020.
Artículo en Holandés | MEDLINE | ID: mdl-32840496

RESUMEN

Three adult patients, ages 28 (female), 36 (male) and 53 (male), respectively, were referred by their dentists to an orofacial surgeon concerning problems with their third molars. With the woman, teeth 38 and 48 were removed. After the removal of tooth 38, a permanent periodontal attachment loss of the adjoining second molar occurred. With the second patient, retention of tooth 48 caused serious damage to the adjoining second molar, resulting in the loss of the tooth. At the time of removal, there was a question of increased risk of inflammatory complications and nerve damage. With the third patient, removal of his impacted tooth 38 led to osteomyelitis and a fracture of the angle of the mandible. According to the newly published 'Third molar' in the Dutch Clinical Guidelines, the advice is to consider the removal of asymptomatic third molars in 17-year-old patients. In the case of impacted third molars with mesial or horizontal angulation and partial eruption, the risk of pathology is such that preventive removal is advised. An intraoral radiograph (periapical or bitewing) as a first screening is recommended here.


Asunto(s)
Tercer Molar , Diente Impactado , Adolescente , Adulto , Femenino , Humanos , Masculino , Mandíbula , Diente Molar , Extracción Dental
17.
Int J Esthet Dent ; 15(3): 288-305, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32760924

RESUMEN

The socket-shield technique, first published in 2010, has gained worldwide scientific and clinical acceptance. To address possible complications with this innovative approach in esthetic implant dentistry, we provide a comprehensive step-by-step protocol incorporating what we have learnt in the past decade. After initial decoronation of the tooth, the implant bed is prepared through the root of the tooth to be extracted. Following extraction of the palatal root fragments, the shield is prepared according to either a mechanical or biologic 'locking' principle. The mechanical 'locking' comprises a direct contact between the implant and the shield, whereas the biologic approach facilitates ankylosis of the shield, preventing its coronal displacement. The coronal part of the shield is brought into a concave shape, ending up 0.5 mm coronal to the buccal bone. The implant is consequently inserted, and an individualized healing cap fabricated. When performed according to the underlying biologic and mechanical principles, the socket-shield technique can provide highly esthetic and predictable outcomes.


Asunto(s)
Implantes Dentales de Diente Único , Carga Inmediata del Implante Dental , Estética Dental , Extracción Dental , Alveolo Dental/cirugía
18.
Clin Oral Investig ; 24(10): 3325-3334, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32776170

RESUMEN

BACKGROUND: The aim of this study was to evaluate through a systematic review the extraction of third molars as a risk factor for temporomandibular disorders (TMDs). TYPES OF STUDIES REVIEWED: Randomized and nonrandomized controlled clinical trials where patients underwent third molar extraction and with qualitative evaluation of TMDs before and after extraction were included. RESULTS: After applying the inclusion criteria, seven nonrandomized clinical studies were included. QUIPS tool showed that four articles presented a moderate and three a high risk of bias (RoB). Six studies reported that TMDs presented higher level after removal of third molars ranging from OR, 1.81 to 2.15/RR, 2.1. However, one study showed no significant association. GRADE showed heterogeneity in relation to general results, which means that confidence in the estimated effects varied from low to moderate GRADE. The quality of clinical recommendations decreased especially due to the risk of bias in some of the included studies evaluated with the QUIPS tool. CONCLUSIONS AND PRACTICAL IMPLICATIONS: Third molar extraction can be associated with the development of TMD signs and symptoms. Furthermore, TMD can be aggravated according to the third molar location, the degree of impaction and surgical difficulty, age, and gender. This systematic review highlights the need to perform randomized clinical trials with diagnostic criteria and standardized surgical procedures.


Asunto(s)
Trastornos de la Articulación Temporomandibular , Diente Impactado , Humanos , Tercer Molar , Factores de Riesgo , Extracción Dental
19.
Oral Maxillofac Surg Clin North Am ; 32(4): 511-517, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32839095

RESUMEN

Exodontia services comprise the largest portion of clinical practice for most oral and maxillofacial surgeons in the United States. This article is an overview of the principles of exodontia including the physics principles underlying the appropriate use of dental elevators and forceps. Failure to understand the instrumentation and the physics principles being used can cause prolonged operative time, iatrogenic injury to the patient, and unnecessary fatigue and/or injury to the provider. Advances in materials, technology, and innovative design have produced interesting new instruments for exodontia. New instruments including periotomes, piezosurgery, physics forceps, and vertical extraction systems are introduced and reviewed.


Asunto(s)
Extracción Dental , Humanos
20.
Anaesth Intensive Care ; 48(4): 306-313, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32819166

RESUMEN

The aim of this prospective cohort study was to describe the anaesthetic practices, rates of postoperative pain and the recovery trajectory of children having urgent dental extractions at our institution. Demographic, anaesthetic and surgical details of children undergoing dental extractions were obtained by case note review. Parent-proxy pain scores were collected via telephone on the day of surgery and on postoperative days, as well as details of analgesia given, behavioural disturbance, and nausea and vomiting. Follow-up was continued until each child no longer had pain. Datasets were analysed for 143 patients. Fasting times were prolonged, with 81 children (56.6%) fasted for over four hours from fluids. Moderate or severe pain was recorded in 14 children (9.8%) postoperatively on the day of surgery, with higher rates in children who had a greater number of teeth extracted. Low rates of moderate to severe pain were observed during follow-up, affecting six children (4.2%) on postoperative day 1 and three children (2.1%) on postoperative day 2 with primarily simple analgesia administered at home. Only eight children (5.6%) had nausea and/or vomiting on the day of surgery. Rates of reported behavioural disturbance at home were low, extending beyond the second postoperative day in only two children (1.4%), and only four children (2.8%) attended a dentist during the follow-up period. In conclusion, the low rates of pain and nausea and vomiting reported in the days following surgery for urgent dental procedures suggest that children can be cared for at home with simple analgesia.


Asunto(s)
Analgesia , Anestesia , Dolor Postoperatorio , Extracción Dental , Niño , Humanos , Estudios Prospectivos
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