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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 9-17, maio-ago. 2021. ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1252898

RESUMEN

As reabsorções radiculares são classificadas em interna e externa e um correto diagnóstico é fundamental para o sucesso no tratamento e é de suma importância que a resolução clínica seja feita precocemente para que se tenha um prognóstico clínico favorável. Reabsorção interna não é comum em dentes permanentes, e seu processo se caracteriza por um aumento do canal radicular de forma oval. O presente estudo teve como objetivos demonstrar e descrever através de um relato de prontuário o tratamento de reabsorção radicular interna de incisivos superiores permanentes. Através da seleção de uma paciente pela disciplina de Triagem da clínica odontológica do Centro Universitário da Serra Gaúcha, a qual apresentou alterações radiográficas compatíveis com reabsorção radicular interna inflamatória na região de dois incisivos superiores permanentes, com lesão periapical estabelecida em ambos, concluiu-se o tratamento para então gerar este estudo do tipo retrospectivo observacional. A reabsorção quando não tratada pode avançar e envolver estruturas além do tecido conjuntivo inflamado e a lesão pode avançar em direção apical. Após estabelecido o diagnóstico, iniciou-se os tratamentos endodônticos dos elementos utilizando hidróxido de cálcio como medicação intracanal, após as trocas de medicações as reabsorções foram controladas e então, as obturações dos canais foram realizadas, buscando um preenchimento adequado para o caso. A reabsorção radicular interna inflamatória causa danos irreversíveis, mas seu processo foi controlado através de terapia endodôntica. Este desempenho é considerado uma patologia, e pode comprometer qualquer extensão da raiz, é comum que os casos permaneçam assintomáticos, portanto, deve ser tratado o mais breve possível assim que descobertos para evitar sua progressão, e consequentemente danos maiores(AU)


Root resorption is classified as either internal or external, and a correct diagnosis is essential for successful treatment. Internal resorption is not common in permanent teeth, and its process is characterized by an enlarged oval root canal. The present study aims to demonstrate and describe, through a medical record, the treatment of internal root resorption of permanent upper incisors. A patient was selected from the Triage Course of the Dental Clinic (Centro Universitário da Serra Gaúcha) who presented radiographic changes associated with inflammatory internal root resorption in two permanente upper incisors, with a periapical lesion established in both and a treatment was then carried out in order to generate this retrospective observational study. Resorption when left untreated can progress and involve structures beyond the inflamed connective tissue and the lesion can advance in the apical direction. After the diagnosis was confirmed, endodontic treatments were initiated using calcium hydroxide as an intracanal medication. After changing the medication, the resorption was controlled and then the canal fillings were performed, seeking an adequate filling for the case. Inflammatory internal root resorption causes irreversible damage, but its process has been controlled through endodontic therapy. This performance is considered a pathology, and can compromise any extension of the root, it is common for the cases to remain asymptomatic, therefore, it should be treated as soon as it's discovered to prevent its progression, and consequently greater damage(AU)


Asunto(s)
Humanos , Femenino , Adulto , Tratamiento del Conducto Radicular , Resorción Radicular , Resorción Radicular/terapia , Incisivo , Hidróxido de Calcio , Dentición Permanente , Diente no Vital , Cavidad Pulpar
2.
Medicina (Kaunas) ; 57(5)2021 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-34068934

RESUMEN

Background and Objectives: Periapical cystic lesions are a pathology frequently addressed to endodontic specialists. Although their therapy is still not standardized, the treatment should be as conservative as possible and by endodontic means, as they are lesions of endodontic origin. The present case report describes two cases of upper central incisors with large cyst-like periapical lesions, and their one-year follow up. Materials and Methods: Endodontic orthograde treatment was performed under copious irrigation with sodium hypochlorite, in association with calcium hydroxide as an intra-canal medication for both teeth. Root canal filling was achieved in a separate appointment using the continuous wave of condensation technique. A decompression procedure was used in association with endodontic therapy in the second case to reduce the pressure inside the cystic lesion and to allow its drainage, and only because the root canal could not be dried three weeks after medication. Initial cone beam computed tomography (CBCT) investigations, as well as at the one-year follow up, were used to compare the evolution of the lesion. Results: Both cases had a favorable outcome. New bone formation in the periapical region and complete resolution of the lesion was observed at the one-year control in the first case. In the second case, although the lesion was still not completely healed at 12 months, a significant reduction in its size could be observed, showing active signs of healing. Conclusions: Endodontic treatment is the first choice option in the management of teeth with pulpal necrosis and large periapical cystic-like lesions. Decompression is the only surgical procedure recommended when the canals cannot be dried and obturated. Large surgical interventions are unnecessary in cases where endodontic treatment can be performed.


Asunto(s)
Periodontitis Periapical , Quiste Radicular , Hidróxido de Calcio/uso terapéutico , Humanos , Incisivo , Quiste Radicular/diagnóstico por imagen , Quiste Radicular/cirugía , Tratamiento del Conducto Radicular
3.
Artículo en Inglés | MEDLINE | ID: mdl-34076629

RESUMEN

Treatment of gingival recessions affecting mandibular incisors is scarcely documented. Despite a shallow vestibule depth being considered a poor anatomical condition, it has never been measured nor deemed a clinical parameter affecting the outcome of root coverage procedures. This study describes a vertically and coronally advanced flap (V-CAF) + connective tissue graft (CTG) technique to obtain root coverage and increased vestibule depth in the treatment of gingival recessions affecting mandibular incisors. Twenty patients with single gingival recessions were treated. The results showed that V-CAF+CTG is effective in increasing residual vestibule depth and in reducing recession depth. Immediately after surgery, a vestibule-depth increase of 5.9 ± 1.2 mm was reported, which was statistically significant compared to baseline, and it remained stable after 12 months (4.8 ± 1.1 mm). The mean percentage of root coverage was 98.3% ± 5.2% for all treated recessions, and complete root coverage (CRC) was achieved in 90% of cases (18 of 20). V-CAF+CTG could be considered a successful technique in terms of vestibule depth increase and CRC for the treatment of single gingival recessions in the mandibular incisors.


Asunto(s)
Recesión Gingival , Incisivo , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Incisivo/cirugía , Raíz del Diente , Resultado del Tratamiento
4.
J Pak Med Assoc ; 71(6): 1561-1565, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34111072

RESUMEN

OBJECTIVE: To assess the gingival biotypes in smokeless tobacco (Gutka and Paan) users and compare it with non-tobacco users in Karachi sub-population using trans-gingival probing method (TRAN). METHODS: This in-vivo, cross sectional study was conducted in the department of Operative Dentistry from 20th February 2019 to 25th June 2019 Dow University of Health Sciences, Karachi after obtaining ethical approval from the Institutional review board of DUHS (Ref: IRB-1207/DUHS/Approval/2019/21). A total of 70 participants, 35 subjects currently using smokeless tobacco (Gutka and Paan) and 35 non-tobacco users from both genders were included in the study after taking informed consent. Gingival biotype was recorded using probe transparency method. Probing of the gingival sulcus was performed at the mid-buccal aspect of both maxillary incisors. Depending on the visibility of the underlying probe gingiva was categorized as thin or thick. RESULTS: Statistically significant differences in gingival biotype was observed of both groups (p=0.005). Males were recorded with a higher percentage of thick gingiva in both groups (81% in smokeless tobacco and 65% in non-tobacco) while in females thick gingiva was more prevalent in smokeless tobacco group (85.7%) whereas thin gingiva was noted in non-tobacco group (66.7%); although the results between genders was statistically insignificant. The comparison between different age groups, genders and both groups was statistically insignificant. CONCLUSIONS: Significant difference was observed between gingival biotype of smokeless tobacco and non-tobacco user groups. No statistically significant results were observed between genders and age groups.


Asunto(s)
Tabaco sin Humo , Estudios Transversales , Femenino , Encía , Humanos , Incisivo , Masculino
5.
Shanghai Kou Qiang Yi Xue ; 30(2): 129-134, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109349

RESUMEN

PURPOSE: The goal of this investigation was to measure and analyze the root position of palatally malposed maxillary lateral incisor based on cone-beam CT(CBCT)images, in order to provide references for orthodontists to move this kind of teeth scientifically. METHODS: CBCT data from 200 patients meeting the selection criteria with palatally malposed maxillary lateral incisor were investigated in this study. The root was divided into eight equal parts by length, then T1 to T8 were orderly pointed from root apex to alveolar ridge crest. The labial and palatal bone thickness at each point was measured; meanwhile, the angle between the long axis of the tooth and that of the alveolar bone was measured.The data was analyzed using SPSS 19.0 software package. RESULTS: The mean labial bone thicknesses at all researched points were less than 1.00 mm, except for point T1,T7 and T8. The mean labial bone thicknesses at point T3, T4 and T5 were the thinnest, which were all less than 0.5 mm(P<0.05). The mean thicknesses of labial bone gradually increased from T4 to T8(P<0.05). The mean palatal bone thicknesses were all more than 1.00 mm at the eight points,the mean thicknesses of palatal bone gradually increased from T8 to T1(P<0.05). All the angulations between the long axes of teeth and those of the alveolar bone were negative, indicating the root was close to the labial alveolar wall. The average angulation was minus 31.06 degrees. CONCLUSIONS: Results suggest that the root of palatally malposed maxillary lateral incisor is close to the labial wall of the alveolar bone, its labial alveolar bone is frequently quite thin or even deficient, especially in the zone between 1/4 root length to the root apex and the mid-root. If we move the palatally malposed maxillary lateral incisor labially, it is better to choose tipping movement, instead of bodily movement, in order to avoid serious bone fenestration and dehiscence or root absorption.


Asunto(s)
Incisivo , Maxilar , Proceso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Paladar (Hueso)
6.
Shanghai Kou Qiang Yi Xue ; 30(2): 162-166, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109355

RESUMEN

PURPOSE: To investigate the effect of root development on root and periodontal tissues of maxillary impacted anterior teeth after orthodontic traction based on cone-beam CT (CBCT). METHODS: Thirty-four patients (34 teeth) requiring orthodontic traction for maxillary impacted anterior teeth in Southwest Medical University Affiliated Stomatological Hospital from July 2018 to March 2019 were selected. The patients were divided into incomplete development group and complete development group according to root development, each with 17 cases. All patients received orthodontic traction treatment. Root length, thickness of root canal wall, pulp vitality, width of the attachment ridge, bone mineral density around root and orthodontic traction time were compared between the two groups. Statistic analysis was completed by SPSS 20.0 software package. RESULTS: Root length of complete development group was significantly longer than that of incomplete development group before treatment(P<0.05). After treatment, the root length of incomplete development group was significantly longer than that of the complete development group(P<0.05). The thickness of root canal wall was significantly greater in complete development group than in incomplete development group before treatment (P<0.05), which had no significant difference between groups after treatment(P>0.05). The pulp vitality and width of the attachment ridge had no significant difference between two groups after treatment(P>0.05). Bone mineral density around root was significantly decreased in both groups after treatment(P<0.05), and was lower in complete development group than in incomplete development group(P<0.05). The orthodontic traction time in the complete development group was significantly longer than that in incomplete development group(P<0.05). CONCLUSIONS: In orthodontic traction treatment, the impacted anterior teeth with undeveloped roots have advantages of mild root absorption, rapid periodontal tissue reconstruction, short orthodontic traction time with the root, thickness of root canal wall and pulp vitality in the normal range.


Asunto(s)
Diente Impactado , Tracción , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo , Maxilar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen
7.
Shanghai Kou Qiang Yi Xue ; 30(2): 187-190, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109360

RESUMEN

PURPOSE: To compare apical root resorption of maxillary incisors between adolescents and adults after orthodontic treatment. METHODS: Patients receiving orthodontic treatment in Affiliated Hospital of Chifeng University from May 2014 to August 2016 were enrolled, and divided into two age groups: adolescent group (32) and adult group (36). The included subjects received orthodontic fixed appliance treatment with straight-wire technique combined with Hawley type retainer for one year. After treatment, all patients were followed up for one year. Then the apical root resorption of maxillary incisors was evaluated by cone-beam CT (CBCT) at 4 time points, including pre-treatment (T1), end of treatment (T2), 6 months after treatment (T3), and 12 months after treatment (T4). Data were processed by SPSS 20.0 software package. RESULTS: The external root volume of maxillary central incisor, lateral incisors, mandibular central incisors and mandibular lateral incisors of both sides at T2-T4 was significantly lower than that at T1(P<0.05). There was partial increase in root volume of both groups at T3 and T4, while no significant difference from that at T2 (P>0.05). △root volume T3-T2 and △root volume T4-T3 had no significant difference between the two groups (P>0.05). △root volume T3-T2 in the adolescent group was significantly smaller than that in the adult group (P<0.05). Correlation analysis showed that the △root volumeT1-T2 was significantly positively correlated with age (P<0.05), meanwhile △root volume T3-T2 and △root volume T4-T3 were negatively correlated with age (P<0.05). CONCLUSIONS: Age is an important factor affecting the volume of root after orthodontic treatment. Adolescent patients with Class II division 1 malocclusion have a strong ability of self-healing after orthodontic treatment.


Asunto(s)
Maloclusión Clase II de Angle , Resorción Radicular , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Humanos , Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Resorción Radicular/diagnóstico por imagen , Ápice del Diente
8.
Artículo en Inglés | MEDLINE | ID: mdl-34066772

RESUMEN

The number of patients diagnosed with temporomandibular joint (TMJ) internal derangements, who are seeking orthodontic treatment, is increasing. The aim of the study was to assess the relationship between the presence of TMJ reciprocal clicking and the morphology and position of the mandible, and position of lower incisors, examined on the lateral cephalograms. Fifty patients diagnosed with reciprocal clicking in at least one of the TMJs and 55 patients with no symptoms of TMJ dysfunction were included in the study. Cephalometric analysis was used for the assessment of: skeletal class, sagittal and vertical position of the mandible, angle of the mandible, inclination of the mandibular ramus and the mandibular corpus, as well as for the assessment of the position of the mandibular incisors. The statistical significance level was set at p = 0.05. There were no statistically significant differences between the examined groups regarding the sagittal and vertical position of the mandible, as well as regarding the sagittal position of the mandibular incisors. Presence of TMJ reciprocal clicking is not associated with the position and the morphology of the mandible, as well as with the sagittal position of the mandibular incisors. Patients with early stages of TMJ internal derangements do not present any significant changes in Cephalometrics. Patients diagnosed with TMJ internal derangements before orthodontic treatment require an interdisciplinary approach to the treatment, including physiotherapy.


Asunto(s)
Luxaciones Articulares , Disco de la Articulación Temporomandibular , Estudios de Casos y Controles , Humanos , Incisivo , Imagen por Resonancia Magnética , Mandíbula
9.
Dental Press J Orthod ; 26(2): e2119378, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33950082

RESUMEN

OBJECTIVE: To determine whether separating the alignment and leveling phases can reduce proclination of the mandibular incisors. METHODS: Eligibility criteria included Class I subjects with an irregularity index of 3-5 mm, 3-4 mm curve-of-Spee (COS), and non-extraction treatment. Thirty adults were randomly allocated into two groups: (1) Control group was leveled and aligned simultaneously with flat archwires progressively to 0.016x0.022-in stainless-steel; (2) Experimental group was aligned first with 0.014-in-superelastic NiTi with mild accentuated COS, then leveled using 0.016x0.022-in beta-titanium accentuated COS archwires and gradually reduced the curve until flat. Mandibular incisor position and inclination were evaluated by cephalometric analysis. COS and irregularity index were evaluated in study models. Assessment was conducted twice after 0.016-in NiTi and after 0.016x0.022-in stainless-steel archwire placements. Dental changes from cephalograms and models were compared within group using paired t-test and between groups using independent t-test. RESULTS: Control group: Round-wire-phase, mandibular incisors tipped labially (4.38° and 1 mm) with intrusion (-1.13 mm); Rectangular-wire-phase, mandibular incisors further intruded and proclined (-0.63 mm and 1.38°). Experimental group: During aligning with round accentuated COS archwires, mandibular incisors tipped very slightly labially (0.75° and 0.50 mm) with no significant intrusion; during leveling with rectangular archwires, incisors majorly intruded (1.75 mm) with slight proclination (1.81°). The experimental group had significant less incisor proclination (control: 5.76°, experimental: 2.56°) with more incisor intrusion (control: -1.75 mm, experimental: -2.13 mm). The COS in experimental group showed significant greater reduction (-2.88 mm) than that of the control group (-1.69 mm). CONCLUSION: In control group, mandibular incisor proclination was markedly observed in round archwires, with further proclination caused by rectangular archwires. In experimental group, minimal proclination was exhibited when accentuated COS round archwires were used for aligning. Leveling with rectangular archwires caused less proclination with more COS reduction.


Asunto(s)
Incisivo , Técnicas de Movimiento Dental , Cefalometría , Mandíbula , Alambres para Ortodoncia , Acero Inoxidable
10.
Int J Esthet Dent ; 16(2): 216-230, 2021 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-33969976

RESUMEN

AIM: The altered size, shape or position of the teeth affect their proper alignment, the harmony of the smile, and the dentofacial composition. The aim of this article is to describe a minimally invasive approach to improve the esthetics of a patient through the golden proportion (GP) concept with the use of direct composite resin stratification. MATERIALS AND METHODS: A 26-year-old female complained about the appearance of her smile due to the existing spaces between her anterior teeth; her small, peg-shaped lateral incisors; the wear of her canines; and the color of her teeth. The clinical examination confirmed diastemas in the anterior teeth, peg-shaped maxillary lateral incisors, and incisal wear of the canines. Treatment with dental whitening followed by composite restorations was performed in line with the current conservative approach in dentistry. The patient was followed up for 18 months. CONCLUSION: The use of the additive technique with composite for the closure of diastemas under the GP concept illustrates an example of viable management to restore esthetic harmony through a minimally invasive approach, with reliability over time and the advantages of being less laborious, less time consuming, and less expensive than other approaches. The treatment plan was acceptable to the patient.


Asunto(s)
Estética Dental , Incisivo , Adulto , Femenino , Estudios de Seguimiento , Humanos , Reproducibilidad de los Resultados , Sonrisa
11.
Compend Contin Educ Dent ; 42(5): 220-226; quiz 228, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33980019

RESUMEN

In this study of orthodontic and surgical management of impacted maxillary canines, the current literature is reviewed and a decision tree is presented to assist clinicians in determining the optimal treatment based on available evidence. Impacted canines have a prevalence of 2% and are more common in females. Palatal impactions are present in around 75% of cases. These trends are observed worldwide with small variations in different populations. Diagnosis through clinical examination and conventional imaging can be complemented with cone-beam computed tomography imaging when necessary. Early intervention by extraction of deciduous canines is indicated when the canine is impacted in sectors 2 or 3 and has an angle of 20 to 30 degrees in relation to the vertical line. Other early management approaches involve rapid palatal expansion or distalization of posterior teeth, when possible. Surgical orthodontic treatment is required when early intervention is unsuccessful. For buccal impactions, the canine position relative to the mucogingival junction determines the choice of surgical procedure; for palatal impactions, the open surgical procedure seems to be preferred. In some situations, however, a closed eruption has precise indications. Use of efficient orthodontic mechanics reduces treatment complications and may be complemented with the use of nitinol piggybacks, swinging gates, modified transpalatal arches, and temporary anchorage devices. Frequent complications with impactions include canine ankylosis, root resorption of the neighboring lateral or central incisor, and gingival esthetic differences between the impacted canine and the contralateral canine upon treatment completion.


Asunto(s)
Resorción Radicular , Diente Impactado , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Diente Canino/cirugía , Estética Dental , Femenino , Humanos , Incisivo , Maxilar/cirugía , Técnica de Expansión Palatina , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
12.
J Clin Pediatr Dent ; 45(2): 83-89, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33951162

RESUMEN

OBJECTIVES: To address a literature gap by evaluating, in a larger set of samples, the clinical and radiographic outcomes of pulpectomy in primary maxillary incisors using ZOE and calcium hydroxide/iodoform paste. To also identify the predisposing factors for treatment outcomes. STUDY DESIGN: Medical charts of 124 patients (aged 16 to 60 months) and radiographs of their incisors (309 incisors) were reviewed (128 with ZOE and 181 with Metapex). All incisors were restored with composite resin crowns. RESULTS: The radiographic success rates for ZOE and Metapex were: 85.9% and 82.9% at the 12-month recall, and 69.2% and 64% at the 24-month recall, with no statistically significant difference between the two groups. Clinical failures occurred more frequently in the Metapex group (P = 0.006), as clinical signs of pain and soft tissue pathosis were found in 6.2% of the Metapex cases at 24 months but none in the ZOE group. Significant predisposing factors for radiographic success were type of tooth, degree of obturation at recalls, and preoperative root resorption. CONCLUSIONS: The radiographic success rates are comparable between the ZOE and Metapex groups. Clinical pathological manifestations such as pain and soft tissue pathosis are seen in the Metapex group at recalls, but none in the ZOE group. Predisposing factors such as type of incisor, preoperative root resorption, and extent of filling at recalls are associated with the radiographic success rate.


Asunto(s)
Pulpectomía , Materiales de Obturación del Conducto Radicular , Preescolar , Humanos , Incisivo , Lactante , Estudios Retrospectivos , Materiales de Obturación del Conducto Radicular/uso terapéutico , Aceites de Silicona , Diente Primario , Resultado del Tratamiento , Cemento de Óxido de Zinc-Eugenol
13.
J Clin Pediatr Dent ; 45(2): 67-73, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33951173

RESUMEN

OBJECTIVES: This pilot study compared hemostatic pack (HP) application with no intervention following extraction of maxillary primary incisors in healthy children for effect on bleeding time and influence of patient or tooth variables utilizing a novel scale for assessment of bleeding following extraction. STUDY DESIGN: A novel scale was created to assess bleeding after extraction. This scale was utilized in a randomized, split mouth study of healthy children ages 2-7 years old requiring extraction of at least 2 primary maxillary incisors under general anesthesia. One extraction site was randomly assigned to receive HP and the other had no hemostatic measures. Post-operative bleeding was rated at 2, 10, and 15 minutes post-extraction. Other variables recorded included age, sex, periapical radiolucency, presence of fistula, swelling, discoloration, intraoral stabilization device used, and vital signs at two time intervals. Pre-operative radiographs were reviewed for root resorption and periapical radiolucency. RESULTS AND CONCLUSIONS: Twenty-five patients provided 50 teeth. Hemostatic pack had a significant effect on reducing bleeding at each time point and that effect did not change over time. Age, sex, tooth pain, post-extraction heart rate, blood pressure, discoloration, amount of resorption, and presence of a periapical radiolucency had no significant effect on bleeding. The proposed bleeding scale had good intra-rater reliability and could be useful in future studies, once validated.


Asunto(s)
Hemostáticos , Resorción Radicular , Niño , Preescolar , Hemostáticos/uso terapéutico , Humanos , Incisivo , Proyectos Piloto , Reproducibilidad de los Resultados , Extracción Dental
14.
J Endod ; 47(6): 865-872, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33975756

RESUMEN

The etiology of surface and inflammatory root resorption after the replantation of incisors was examined in green vervet monkeys. The teeth were examined histologically and histobacteriologically for pulpal healing and root resorption 2 and 8 weeks after replantation. In contrast to surface resorption, inflammatory resorption was related to infected necrotic tissue or an infected leukocyte zone in the root canal. The following theory for surface and inflammatory resorption is presented. Damaged periodontal ligament areas and damaged parts of the root surface are attacked by a resorption process whereby resorption of cementum and dentin may occur. Inflammatory resorption or surface resorption will then occur depending on the pulpal status and the depth of the resorption cavity. If the resorption cavity penetrates the intermediate layer of cementum and contacts dentinal tubules that are in communication with infected necrotic pulp tissue or an infected leukocyte zone, then inflammatory resorption will take place as a result of the diffusion of toxic elements from the pulp canal to the resorption cavity. However, if the resorption cavity is shallow and does not penetrate the intermediate layer of cementum, a tooth that displays similar pulpal changes will elicit only surface resorption because the intermediate layer of cementum will tend to arrest the diffusion of toxic elements. Finally, if the pulp contains vital, inflamed, or noninflamed tissue or if root canal treatment has been performed, surface resorption will occur regardless of the depth of the cavity.


Asunto(s)
Incisivo , Resorción Radicular , Animales , Chlorocebus aethiops , Pulpa Dental , Haplorrinos , Ligamento Periodontal , Resorción Radicular/etiología , Reimplante Dental , Raíz del Diente
15.
J Forensic Odontostomatol ; 1(39): 2-8, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-34057152

RESUMEN

OBJECTIVES: To propose a formula for determining reduced mouth opening due to oral and maxillofacial trauma, based on the normal standard of the Brazilian population. MATERIALS AND METHODS: First, the maximum mouth opening was established, in millimeters, using a digital pachymeter, in patients between 22 and 60 years of age. The opening was measured from the upper to the lower incisor, at maximum amplitude, without pain and overbite. Second, the facial profile type and height were determined. A formula was developed to calculate the percentage of reduced mouth opening based on the normal average. RESULTS: The average mouth opening was found to be 51.71 mm in men and 47.94 mm in women, thus establishing a statistically significant difference in mouth opening between sexes. However, there was no statistically significant difference between age and profile type with mouth opening. The following formulas were developed to calculate the reduced mouth opening, based on the averages found, by using RA= [100-(A.1.93)].0.3 for males and RA= [100-(A.2,08)] .0.3 for female patients. CONCLUSION: Considering that mouth opening tends to be larger in men than in women, valid formulas can be used to determine the correct percentage of reduced mouth opening.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos , Brasil , Femenino , Medicina Legal , Humanos , Incisivo , Masculino , Rango del Movimiento Articular
16.
J Forensic Odontostomatol ; 1(39): 9-15, 2021 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-34057153

RESUMEN

Dental radiographs, endodontic treatment and materials are a source of useful forensic data. The response of dental materials to death-related events are widely studied and provide forensic evidence for experts. This study aimed to analyze the radiographic images of endodontically treated teeth submitted to burial and drowning simulation, verifying its forensic feasibility, applicability and usefulness. MATERIAL AND METHOD: n=20 bovine incisor teeth were endodontically treated then divided into two groups: burial and drowning scenarios. Teeth were radiographed two times (before and after scenario) with an aluminium stepwedge, and optical density (OD) was assessed in each root third, in both radiographs, and then compared (ANOVA and Tukey test) for each scenario. RESULTS: Burial scenario did not significantly alter radiopacity. As for the drowning scenario, there was no difference in radiopacity between the root thirds before the test. After drowning, the apical third demonstrated lower OD (p<.05) than the other two thirds. Comparing the OD before and after drowning, medium third presented lower and cervical third demonstrated higher means (p<.05) after drowning. CONCLUSION: We concluded that drowning conditions could alter the radiopacity of endodontically treated teeth, more specifically in the medium and cervical thirds. There is no evidence that this also occurs in burial situations. This has the potential to be useful in forensic casework as an initial sign of the type of ambient in which the body was supposedly exposed or set.


Asunto(s)
Ahogamiento , Diente no Vital , Animales , Entierro , Bovinos , Ahogamiento/diagnóstico por imagen , Humanos , Incisivo
17.
J Contemp Dent Pract ; 22(1): 18-22, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34002703

RESUMEN

AIM: The aim of this retrospective study is to assess potential correlation between the width of the keratinized gingiva (KG), and the dimensions of the supracrestal gingival tissue (SGT) components. MATERIALS AND METHODS: On the sample of 259 teeth of 79 patients, the following measurements were collected: width of KG, sulcus depth (SD), SGT, and biological width (BW) dimensions; separate correlations between measured elements were computed for males and females, for anterior and posterior, and for maxillary and mandibular teeth separately. RESULTS: Correlations between buccal KG and BW were present only for the upper anterior teeth and were nonsignificant in the female subsample, whereas the correlation between lingual KG and SGT were present only in females. Additionally, correlations between buccal KG and SD were present in upper anterior teeth only and were absent in the male subgroup. CONCLUSION: The width of the KG cannot routinely be used as an indicator for the dimensions of the SGT components. CLINICAL SIGNIFICANCE: While the width of the KG can hardly be a useful indicator in upper anterior teeth, probing depth and bone sounding prior to prosthetic rehabilitation remains an essential tool to ensure tissue preservation.


Asunto(s)
Encía , Maxilar , Femenino , Humanos , Incisivo , Masculino , Estudios Retrospectivos
18.
Int J Comput Dent ; 24(1): 41-51, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-34006062

RESUMEN

AIM: To evaluate the fracture resistance and failure pattern of endodontically treated teeth with post and cores made of different CAD/CAM materials in comparison with cast post and cores. MATERIALS AND METHODS: A total of 40 maxillary central incisors were divided into four groups. Post and cores were fabricated using the following materials: fiber-reinforced composite, high-density polymer, polymer-infiltrated ceramic network, and nonprecious metal alloy as a control group. Specimens were covered with lithium disilicate crowns and subjected to thermomechanical cyclic loading followed by fracture resistance testing until failure. One-way ANOVA followed by Bonferroni multiple comparison tests were used to determine significant differences between the four groups. The significance level was set at 0.05. 3D finite element analysis was then performed, and results were analyzed based on the von Mises stress distribution criteria and the maximum principal stress for the possible failure areas. RESULTS: No statistically significant differences were found in the fracture resistance between the four groups. In terms of unrestorable failures, no significant differences were found among the tested groups. CONCLUSION: The tested post and cores have comparable fracture resistance to that of metallic cast post and cores in the anterior region. CLINICAL SIGNIFICANCE: Post and cores made of CAD/CAM materials offer an acceptable alternative for the restoration of anterior teeth.


Asunto(s)
Técnica de Perno Muñón , Diente no Vital , Cerámica , Diseño Asistido por Computadora , Coronas , Fracaso de la Restauración Dental , Análisis del Estrés Dental , Humanos , Incisivo , Ensayo de Materiales
19.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(2): 384-389, 2021 Mar 03.
Artículo en Chino | MEDLINE | ID: mdl-33879915

RESUMEN

OBJECTIVE: To analyze the etiological and clinical characteristics of oral emergency patients under 18 years with dental trauma, and to provide guidance on the prevention and treatment in children and adolescents. METHODS: A retrospective study on the intact data of the dental trauma patients under 18 years from January 2016 to December 2018 in the Department of Oral Emergency in Peking University School of Stomatology was conducted, and the distribution of the patients' gender, age and visiting time, as well as the number and position of traumatic teeth, diagnostic classification, and multiple injury with dental trauma were analyzed. RESULTS: During the period, 54.2% of the first visit dental trauma patients (10 164) were children or adolescents (5 506). The two peak ages were 3-4 and 7-9 years. The incidence of the male was higher than the female in every age group (Wilcoxon test, P < 0.001). From May to June and September to November, there were more cases of dental trauma. The peak time of daily dental trauma cases was from 19:00 to 20:00 (Jonckheere-Terpstra test, P < 0.001). The positions of traumatic teeth in both sides were approximate symmetrical, and maxillary central incisors were the most affected. 52.3% of the patients suffered multiple teeth injuries. Among the permanent teeth trauma, enamel and dentin fracture was the most common (24.7%), followed by concussion (20.5%), sub-luxation (17.9%) and complicated crown fracture (14.4%). And among the primary teeth trauma, subluxation was the most common (31.1%), followed by concussion (14.5%) and lateral luxation (9.5%). 19.7% of the children and adolescent dental trauma patients were also suffered maxillofacial soft or hard tissue injury. CONCLUSION: The incidence of dental trauma in children and adolescents is higher than that in adults. There were two age peaks among the children and adolescents patients. Primary teeth and young permanent teeth were usually suffered. Clinical treatment should be considered along with the characteristics of child tooth growth. In order to prevent the occurrence of dental trauma, early orthodontic intervention should be carried out in children with severe overjet. Families, schools and nursery institutions should strengthen the protection against dental trauma.


Asunto(s)
Sobremordida , Avulsión de Diente , Fracturas de los Dientes , Traumatismos de los Dientes , Adolescente , Adulto , Niño , Femenino , Humanos , Incisivo , Masculino , Estudios Retrospectivos , Fracturas de los Dientes/epidemiología , Traumatismos de los Dientes/epidemiología
20.
Artículo en Inglés | MEDLINE | ID: mdl-33819324

RESUMEN

Numerous surgical techniques for root coverage have been suggested with different degrees of success, as assessed by the proportion of complete root coverage. Mandibular incisors, teeth with a high frequency of gingival recession defects (GRDs), were associated with the least favorable outcomes due to unfavorable anatomical conditions. In the present series of three cases, a modified version of the free gingival graft technique for the purpose of root coverage at mandibular incisors is illustrated. The purpose of the modification of the original technique was to achieve improved blood supply from the recipient site to the graft, with the ultimate aim of enhancing predictability and outcomes of the procedure. In all included cases, complete or almost complete root coverage was achieved at challenging GRDs in the mandibular incisor area.


Asunto(s)
Recesión Gingival , Procedimientos Quirúrgicos Orales , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Incisivo/cirugía , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
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