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1.
Swiss Dent J ; 131(4): 349-352, 2021 Apr 06.
Artículo en Francés | MEDLINE | ID: mdl-33789418

RESUMEN

Bone resorption is a consequence of the loss of a tooth. Alveolar ridge resorption can restrict the volume of bone available for the positioning of a dental implant. Bone graft is a routinely performed procedure in order to increase this volume and provide an adequate situation for the replacement of the tooth. However, autogenous bone is the gold standard for this procedure, xenogenous bone is a good alternative. It presents reliable results and a low complication rate. In this article, we describe the case of an infection resulting in a facial skin fistula following a guided bone regeneration. A 52-year-old woman visited a maxillofacial unit with complaints of persistent swelling of the right cheek, associated to a facial skin fistula. She had a history of xenograft with OsteoBiol Gen-os©, performed at a dental office nine months earlier. Clinical examination and computed tomography suggested that there was a migration process of the bone substitute inside the cheek, which had led to the infection with a facial skin fistula. Loss of stability of the bone graft and particular anatomy of the posterior region of the mandible could explain the migration of the particles and the formation of the fistula.


Asunto(s)
Aumento de la Cresta Alveolar , Fístula Cutánea , Regeneración Ósea , Fístula Cutánea/diagnóstico por imagen , Fístula Cutánea/etiología , Fístula Cutánea/cirugía , Implantación Dental Endoósea , Femenino , Humanos , Mandíbula/cirugía , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/terapia
2.
Am J Orthod Dentofacial Orthop ; 159(4): 512-521, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33795092

RESUMEN

INTRODUCTION: This study aimed to evaluate the efficiency of a newly constructed computer-based decision support system (DSS) on the basis of artificial intelligence technology and designed to plan treatment for patients with a deep overbite. METHODS: With the help of information technology, a DSS was developed specifically for treatment planning of deepbite malocclusion. The program inputs were the components and the contributing factors used commonly by the orthodontic clinicians in deepbite diagnosis. The program outputs were the treatment planning options for deepbite treatment. A total of 357 decisions made by the algorithm were evaluated for accuracy by comparing them to the actual treatment changes of 51 patients with a well-treated deepbite. RESULTS: The decisions made by the algorithm were precise, with 94.4% having a very good agreement with actual treatment changes determined using Cohen's kappa coefficient. CONCLUSIONS: The constructed DSS was shown to be an efficient tool for planning treatment of deep overbite malocclusion in the permanent dentition; thus, the artificial intelligence could be used to formulate a customized plan for orthodontic clinicians.


Asunto(s)
Inteligencia Artificial , Maloclusión , Algoritmos , Cefalometría , Dentición Permanente , Humanos , Maloclusión/terapia , Mandíbula
3.
Wiad Lek ; 74(2): 263-267, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813483

RESUMEN

OBJECTIVE: The aim: The aim of our research is to study the features of toxic osteomyelitis in drug addicts, their diagnosis and comprehensive treatment, aimed at strengthening motivation for the suspension of the use of psychoactive substances and the elimination of the pathological process in the lower jaw. PATIENTS AND METHODS: Materials and methods: The features of toxic osteomyelitis, complicated by abuse, have been studied on 46 patients in the department of oral and maxillofacial surgery of Lviv regional clinical hospital during 2013-2019. Psychoactive substances, used by the patients, varied from homemade drugs "Screw" taken by 32 men (69.5%), synthetic drug amphetamine consumed by 10 men (21,7%) to Subutex used by 4 patients (8,7%) for their pleasure. All the patients underwent comprehensive examination, which included clinical, laboratory, radiological, pathohistological studies. Almost all patients - 41 ( 89.1% ) underwent sequestrectomy. RESULTS: Results: Clinical picture progressed quite rapidly in the form of diffuse destructive-necrotic osteomyelitis of the mandible, which was characterized by a severe, atypical course of the pathological process with permanent inclusion of other additional areas of the lesion of the mandible. The X-ray at this stage showed an increase in destructive processes in the bone. CONCLUSION: Conclusions: Appropriate surgical tactics and pathogenetic therapy are of great importance for toxic osteomyelitis in drug addicts. Due to the treatment, despite the total destruction of the mandible, it was possible to stop the destructive bone processes and to preserve life for such patients.


Asunto(s)
Consumidores de Drogas , Osteomielitis , Humanos , Masculino , Mandíbula , Osteomielitis/etiología
4.
Wiad Lek ; 74(2): 291-294, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813489

RESUMEN

OBJECTIVE: The aim: To determine the peculiarities of the morphometric parameters of suprahyoid region of the human prefetuses. PATIENTS AND METHODS: Materials and methods: Thirty specimens of human prefetuses of 14.0-80.0 mm parietococcygeal length (PCL) (7-12 weeks of IUD) were studied using a complex of modern methods of morphological research. RESULTS: Results: On the basis of obtained digital indicators of the main morphometric parameters of human SHR in the dynamics of the prenatal period of IUD the critical periods of development of the region were clarified and mathematical functions that describe the normal course of organogenesis of SHR were created, which can be useful for creating diagnostic algorithms for the norm when carrying out prenatal diagnostics and monitoring the state of the fetus. It has been established that the 9-10th week of IUD is a critical period in the development of SHR, since during this time, intensive growth processes occur, which are manifested by a sharp change in the size of the organ, and this can lead to the appearance of variants of the structure and possible congenital defects of the SHR and the dental-maxillary apparatus in general. CONCLUSION: Conclusions: 1.Age-depended dynamics of changes in the anterior angle of the SHR shows an almost linear decrease in the angle by the end of the 9th week of IUD almost to 76°, after which it increases to almost 90° by the end of the 10th week. From the 11th week of the IUD, the anterior angle decreases again to 77 °, but begins to increase at the 12th week and by the end of the prefeal period. 2.The lateral length of SHR increases almost uniformly until the 9th week of IUD, during which its growth rate slows down. Starting from the end of the 10th week of IUD, this morphometric parameter begins to grow rapidly until the end of the prenatal period of ontogenesis. The growth rate of the lateral length of the SHR is described by the function: L lat = 1.1025 + 0.0015 x + 0.001 x2. 3.The width of the SHR from the 10th week of IUD begins to grow rapidly until the end of the prenatal period of development. The growth rate of the width of SHR is described by the function: W = 1.1025 + 0.0015 x + 0.001 x2. 4.Analysis of the age dynamics of the area of SHR demonstrates the exponential dependence on the age of the prefetuses, which is described by a mathematical function: A = 1,2452exp(0,0424x). Meanwhile, there is a slight slowdown in its growth rate at the 10th week of IUD with subsequent recovery of growth by the end of the prenatal period of ontogenesis. 5.The 9-10th week of IUD is a critical period in the development of SHR, since during this time, intensive growth processes occur, which are manifested by a sharp change in the size of the mandible.


Asunto(s)
Feto , Mandíbula , Femenino , Humanos , Maxilar , Embarazo
5.
Br J Radiol ; 94(1120): 20200026, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33684314

RESUMEN

OBJECTIVES: Mandible osteoradionecrosis (ORN) is one of the most severe toxicities in patients with head and neck cancer (HNC) undergoing radiotherapy (RT). The existing literature focuses on the correlation of mandible ORN and clinical and dosimetric factors. This study proposes the use of machine learning (ML) methods as prediction models for mandible ORN incidence. METHODS: A total of 96 patients (ORN incidence ratio of 1:1) treated between 2011 and 2015 were selected from the local HNC toxicity database. Demographic, clinical and dosimetric data (based on the mandible dose-volume histogram) were considered as model variables. Prediction accuracy (measured using a stratified fivefold nested cross-validation), sensitivity, specificity, precision and negative predictive value were used to evaluate the prediction performance of a multivariate logistic regression (LR) model, a support vector machine (SVM) model, a random forest (RF) model, an adaptive boosting (AdaBoost) model and an artificial neural network (ANN) model. The different models were compared based on their prediction accuracy and using the McNemar's hypothesis test. RESULTS: The ANN model (77% accuracy), closely followed by the SVM (76%), AdaBoost (75%) and LR (75%) models, showed the highest overall prediction accuracy. The RF model (71%) showed the lowest prediction accuracy. However, based on the McNemar's test applied to all model pair combinations, no statistically significant difference between the models was found. CONCLUSION: Based on our results, we encourage the use of ML-based prediction models for ORN incidence as has already been done for other HNC toxicity end points. ADVANCES IN KNOWLEDGE: This research opens a new path towards personalised RT for HNC using ML to predict mandible ORN incidence.


Asunto(s)
Neoplasias de Cabeza y Cuello/radioterapia , Aprendizaje Automático , Mandíbula/efectos de la radiación , Osteorradionecrosis/diagnóstico , Interpretación de Imagen Radiográfica Asistida por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Femenino , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Humanos , Incidencia , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
6.
Medicine (Baltimore) ; 100(8): e24869, 2021 Feb 26.
Artículo en Inglés | MEDLINE | ID: mdl-33663114

RESUMEN

ABSTRACT: Techniques for enhancing the effective space of the mandibular arch are urgently needed. Therefore, this study aimed to perform mandibular expansion in combination with a fixed-appliance technique, with preliminary monitoring by finite element analysis and 3-dimensional cone-beam computed tomography (CBCT).Finite element models were structured according to CBCT images of a 14-year-old girl. The von Mises stress of the alveolar bone and tooth displacement were assessed in different models. The technique was also applied in an 11-year-old boy. CBCT was performed at post-expansion, post-retention, post-treatment and 2 years after treatment. Tooth movement and alveolar bone stress were assessed by the CAD software.Finite element analysis suggested that the teeth tended to stand upright in the buccal side in the expander model compared with the expander-remove model. However, minimum tooth change was observed in the normal model, indicating highest stability. The von Mises stress of the alveolar bone was decreased in the normal model compared with the expander model, suggesting that buccal-inclined teeth could more easily lead to alveolar bone stress than normal ones. Based on CBCT data and the 3D mandibular dentition model fitting, mandibular teeth tended to be upright in the buccal side after retention compared with the post-expansion condition, which somewhat differed from finite element analysis results. Furthermore, dehiscence and fenestration were not observed.This expansion technique is expected to increase the effective space after mandibular expansion and reduce buccal alveolar bone stress.


Asunto(s)
Mandíbula/diagnóstico por imagen , Aparatos Ortodóncicos Fijos , Técnica de Expansión Palatina/instrumentación , Técnicas de Movimiento Dental/métodos , Adolescente , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Masculino , Proyectos Piloto
7.
Braz Oral Res ; 35: e034, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33729279

RESUMEN

The objective of this study was to apply elliptic Fourier analysis (EFA) to find shape differences among skeletal growth patterns in both radiographic and tomographic panoramic views, controlling for asymmetry. Lateral and panoramic images were obtained from 350 patients. After screening patients with asymmetric linear and angular values and natural asymmetric hemimandibular shape, 240 patients were included in the study: 48 with tomographic information and 192 with radiographic information. The images were classified according to the mandibular plane angle and the ANB angle. Mandibular contours were digitized on the panoramic images and EFA was performed with 20 harmonics, filtering rotation, translation and size properties. As there were no differences between radiographic and tomographic panoramic mandibular contours and normal distribution was found in all groups, MANOVA was conducted to determine differences using a Hotelling's p-values with Bonferroni correction and an XY graph tool was applied to visualize these differences graphically. A 95% confidence level was used. Significative differences were found among hypodivergent, normodivergent, and hyperdivergent patterns in Class I, II, and III (p < 0.05), located mainly in the symphyseal region. The results of this study suggest that EFA is a useful tool to mathematically analyze mandibular contours and their morphological differences given by facial biotypes. This method could improve the precision of the mandibular prediction models.


Asunto(s)
Mandíbula , Cefalometría , Análisis de Fourier , Humanos , Mandíbula/diagnóstico por imagen
8.
Eur J Paediatr Dent ; 22(1): 26-30, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33719479

RESUMEN

AIM: The current study aimed to analyse the dentoskeletal effects of the Invisalign mandibular advancement (MA) device in the treatment of skeletal Class II malocclusions. MATERIALS AND METHODS: Pre-treatment and post-treatment lateral skull radiographs from patients treated with MA versus TB (Twin-Block Appliance) at the Department of Orthodontics of the University of L'Aquila, Italy, were traced. Eligibility criteria included SNB<78; ANB>4; no previous orthodontic treatments; and vertebral maturation stage (CVM) CS3. Radiographs from patients with craniofacial anomalies, or who underwent extraction treatments, were excluded. Totally, 20 patients were examined, 10 of whom treated with MA and 10 treated with TB. All the radiographs were traced by one expert operator, blind to the groups. A preliminary method error study was performed to exclude intra-operator differences. RESULTS: Baseline characteristics of the participants were similar between the groups. Both appliances demonstrated a reduction of SNB and ANB angle, and a decrease in overjet. TB demonstrated a higher efficacy in increasing mandibular dimensions. A significant retroinclination of the upper incisive was observed in the TB group, where a decrease of SNA angles was additionally observed. The resulting differences between the two groups could be attributed to the different design of the appliances. CONCLUSIONS: The present data show the effectiveness of both TB and MA in the management of skeletal Class II malocclusions due to mandibular retrusion. But some differences exist in the dentoalveolar effect of the two appliances. MA seems indicated in Class II cases where a control of the upper frontal teeth position is needed.


Asunto(s)
Maloclusión de Angle Clase II , Avance Mandibular , Aparatos Ortodóncicos Funcionales , Aparatos Ortodóncicos Removibles , Cefalometría , Humanos , Italia , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/terapia , Mandíbula , Estudios Retrospectivos , Resultado del Tratamiento
9.
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
11.
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
12.
Gen Dent ; 69(2): 48-50, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661114

RESUMEN

Tooth autotransplantation is the movement of a tooth from its socket into another socket within the same patient. This case report discusses the viability of tooth autotransplantation in a patient with diabetes mellitus. A 23-year-old woman presented with the chief complaint of pain from a carious mandibular right second molar, which was deemed nonrestorable. Autotransplantation of a viable third molar was therefore suggested as the treatment of choice. Six months after surgery, the patient was recalled for reevaluation of the reimplanted tooth. Pulpal sensitivity was assessed, revealing a normal pulpal response. The patient reported no pain or symptoms of infection. At the 1-year and 2-year follow-ups, clinical examinations confirmed that the transplanted tooth was vital, and the patient was able to chew food normally without experiencing pain on the mandibular right side. Dental autotransplantation may be considered a conservative approach to replacing a missing tooth, especially for young patients with growing jaws or patients with limited financial means who cannot afford other treatment options.


Asunto(s)
Diabetes Mellitus , Tercer Molar , Adulto , Femenino , Estudios de Seguimiento , Humanos , Mandíbula , Tercer Molar/cirugía , Trasplante Autólogo , Adulto Joven
13.
Gen Dent ; 69(2): 60-63, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661117

RESUMEN

Osteoblastoma is a rare benign osteoblastic tumor accounting for less than 1% of all bone tumors; approximately 10% to 12% of cases occur in the maxillofacial skeleton. This case report describes the clinical, imaging, and histopathologic findings of an atypical osteoblastoma occurring in the mandible of a 60-year-old man. The characteristics of the lesion and the differential diagnosis from other bone pathoses are reviewed.


Asunto(s)
Neoplasias Mandibulares , Osteoblastoma , Diagnóstico Diferencial , Humanos , Masculino , Mandíbula , Neoplasias Mandibulares/diagnóstico por imagen , Neoplasias Mandibulares/cirugía , Persona de Mediana Edad , Osteoblastoma/diagnóstico por imagen , Osteoblastoma/cirugía
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(3): 256-262, 2021 Mar 09.
Artículo en Chino | MEDLINE | ID: mdl-33663155

RESUMEN

Objective: To explore the effect of extraction on upper airway in skeletal class Ⅰ adolescents. Methods: According to random number table method, 30 skeletal class Ⅰteenagers who underwent orthodontic straight wire treatment were selected randomly in Department of Orthodontics, School of Stomatology, The Fourth Military Medical University between January 2016 and December 2019. There were 13 males and 17 females, aged (13.7±1.5) years (12.2-15.7 years). In all patients, four first premolars were removed and the upper and lower anterior teeth were retracted under non-maximal anchorage (non-implant anchorage or face bow). The cone-beam CT (CBCT) data before and after orthodontic extraction treatments were studied. The three-dimensional model of the upper airway was reconstructed and segmented, and the relevant indexes of oropharyngeal volume and cross-sectional area were measured. Cephalograms was generated to measure tooth-jaw indexes and hyoid position. The changes of each index before and after orthodontic treatment were compared. The correlation between the changes in the volume or sectional area of the oropharyngeal airway and the changes in the dental and maxillary indexes and the hyoid position was tested. Results: Compared with those before treatment, palatopharyngeal volume, glossopharyngeal volume, oropharyngeal total volume, and minimum transection area increased by 632 (558) mm3, 758 (549) mm3, 1 454 (955) mm3 and 14 (29) mm2 respectively, and statistically significant differences were found (P<0.05). The minimum oropharyngeal area was mostly located in the glossopharynx. The cross-sectional area and the maximum anterior-posterior diameter of uvula tip decreased by (4±10) mm2 and (0.4±0.8) mm respectively, and the difference was statistically significant (P<0.05). There was no significant difference in the maximum lateral diameter before and after treatment (P>0.05). The ratio of the maximum antero-posterior diameter to the maximum lateral diameter at the uvula tip decreased from 0.589 (0.034) before treatment to 0.535 (0.047) after treatment (P<0.05), indicating that its shape tends to be more elliptic after treatment. In addition, the change of cross-sectional area at the apex of uvula was positively correlated with the changes of mandibular central incisor lip inclination and the distances from the upper and lower central incisor points to the Frankfort plane perpendicular to the sella point (UI-FHp and LI-FHp) (P<0.05). Conclusions: The impact of orthodontic extraction treatment on oropharyngeal airway was generally small in skeletal class Ⅰ adolescents. However, it could change the shape of the airway to some extent. The change of airway cross-sectional area at the uvula tip was positively correlated with the retraction of anterior teeth.


Asunto(s)
Mandíbula , Maxilar , Adolescente , Diente Premolar , Cefalometría , Niño , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Hueso Hioides , Masculino , Maxilar/diagnóstico por imagen
15.
J Oral Sci ; 63(2): 179-183, 2021 Mar 31.
Artículo en Inglés | MEDLINE | ID: mdl-33731505

RESUMEN

PURPOSE: This study was conducted to investigate the incidence and predictors of hypercementosis in mandibular third molars using cone beam computed tomography. METHODS: Using a retrospective approach, 1,160 cone beam computed tomography image sets were analyzed. Two oral radiologists independently evaluated the image sets based on four severity grades: 0, no hypercementosis around the root; 1, hypercementosis surrounding less than half of the root surface; 2, hypercementosis surrounding more than half of the root surface; and 3, hypercementosis surrounding the entire root surface. Hypercementosis was identified as a dark or light layer. Statistical analyses of relationships between hypercementosis incidence and possible predictors (e.g. age, sex, impaction, and occlusion) were performed using chi-square test or Fisher's exact test; logistic regression was used for multivariate analysis. RESULTS: The severity of hypercementosis increased with age, and the incidences were as follows: ≤19 years, 0%; 20-24 years, 14.1%; 25-29 years, 57.7%; 30-39 years, 83.0%; 40-49 years, 92.7%; 50-59 years, 93.4%; and ≥60 years, 96.8%. CONCLUSION: The observed incidences of hypercementosis were relatively higher than in previous studies, and the incidence was significantly lower for occluded teeth than for non-occluded teeth.


Asunto(s)
Hipercementosis , Tomografía Computarizada de Haz Cónico , Humanos , Incidencia , Mandíbula , Tercer Molar/diagnóstico por imagen , Estudios Retrospectivos , Raíz del Diente
16.
J Prosthodont ; 30(S1): 61-63, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33783089

RESUMEN

PURPOSE: The objective of this Critically Appraised Topic was to determine the level of evidence relative to the usefulness of the Frankfort mandibular plane angle in prosthodontic treatment. MATERIALS AND METHODS: The Patient Intervention Comparison Outcome (PICO) mesh heading received zero PubMed references, as did Frankfort Mandibular Plane Angle (FMA) as a determinant for dental occlusion and Frankfort Mandibular Plane Angle as a determinant of the occlusal scheme. Frankfort Mandibular Plane Angle alone received 168 PubMed citations that highlighted 2 DiPietro articles and a third from the orthodontics literature which was a Randomized Controlled Trial not relevant to the PICO. Four others, three prosthodontic and one orthodontic publication, were related to the PICO. A Google search revealed one additional article, which was a narrative review. RESULTS: Nine articles were related to the search, 2 of which were clinical trials that revealed no evidence to support the use of FMA as a diagnostic test. CONCLUSION: Based on the limited data presented above, there is a lack of evidence to support the use of FMA as a diagnostic procedure to predict outcomes, or dictate prosthodontic treatment.


Asunto(s)
Maloclusión , Mandíbula , Prostodoncia , Cefalometría , Evaluación del Resultado de la Atención al Paciente
17.
J Prosthodont ; 30(S1): 64-66, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33783092

RESUMEN

PURPOSE: The purpose of this Critically Appraised Topic was to investigate the possible clinical relevance of recording the immediate mandibular lateral translation. MATERIALS AND METHODS: A literature search limited to Clinical trials, Randomized Controlled Trials, Systematic Reviews, Meta Analyses, and using the PICO headings revealed no citations. Using the key words dental, occlusion, immediate side shift, also received no citations. Expanding the search criteria to include Journal Articles revealed 17 citations. Using dental occlusion, Bennett movement, revealed 21 citations. RESULTS: The cited articles were reviewed for relevance and duplicates were eliminated. The resulting 10 English language in vivo studies pertinent to the question were included. Other articles were culled from the author's library and the reference list of the aforementioned articles. There is no evidence on the prevalence of IMLT in patients in need of occlusal rehabilitation. There is agreement that the recording of the IMLT is reference point and recording instrument dependent. There is agreement that IMLT is observable on some patients and is minimal in magnitude. There is no evidence of any adverse clinical events as a result of not including IMLT in a restorative occlusal scheme. CONCLUSIONS: It is justifiable to question the necessity of attempting both to record immediate mandibular lateral translation on the average patient and reproduce it on an articulator.


Asunto(s)
Articuladores Dentales , Mandíbula , Humanos , Movimiento
18.
J Prosthodont ; 30(S1): 12-19, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33783090

RESUMEN

PURPOSE: Patients in need of extensive prosthodontic treatment may need restoration of their occlusal vertical dimension (OVD) due to tooth wear, tooth loss, or changes that have occurred to existing prostheses over time. Prosthodontic treatment is based on the clinical application of the available evidence regarding interocclusal distance (IOD), the positional stability of rest vertical dimension (RVD), and the effect of altering the OVD. Hence, the purpose of this consensus document is to examine available data related to IOD, RVD, and alteration of the OVD. MATERIALS AND METHODS: The search was limited to Clinical trials, Randomized Controlled Trials, Systematic Reviews and Meta-analyses. Key words were healthy patient, mean, range, interocclusal rest distance; healthy patient, mean, range, freeway space; and dentistry, interocclusal gap, and no citations appeared. Dentistry, interocclusal distance, revealed 5 not relevant citations. Dentistry, inter occlusal rest space, and dentistry, interocclusal rest distance, both had the same single not relevant citation. Dentistry, freeway space revealed over 7,000 citations. Dentistry, occlusal vertical dimension, revealed 253 citations, 7 of which were related to the search question but only 1 which was different from the previous search. Mandible, rest vertical dimension, age changes, found 7 citations, none relative to the question. Expanding the search to include journal article found 260 citations with only one relevant to the question. Mandible, rest vertical dimension, alteration, harm revealed no citations; mandible, occlusal vertical dimension, alteration, revealed 15 citations, 1 of which was relevant; mandible, occlusal vertical dimension, changes, revealed 75 citations, none of which were relevant; mandible, occlusal vertical dimension, rehabilitation revealed 10 citations, none of which were relevant. Expanding the search strategy to include Journal article, mandible, occlusal vertical dimension, alteration, received 159 citations, 4 of which were relevant; mandible, occlusal vertical dimension, restoration revealed 208 citations, 1 of which was relevant. Numerous other articles were culled by going through the reference lists of the aforementioned articles. RESULTS: For IOD, 27 articles were found relevant to the search question, which confirmed a mean of 3.0 mm with ranges from 1 to 9 mm. Five articles revealed little evidence as to whether the RVD changes during life. For OVD, 20 articles, including 4 systematic reviews, revealed some evidence that skeletal growth continues from mid adolescence into mid adulthood; strong anecdotal evidence that some unopposed teeth will continue to erupt; no clinical evidence to support the concept that abraded teeth in occlusion in a patient with bruxism will undergo continuous eruption; and some evidence from clinical case reports that restoring OVD in patients with severe abrasion is a successful treatment. CONCLUSIONS: There is a range of dimensions for the interocclusal distance (IOD) with many normal dental patients functioning with a higher or lower IOD than the commonly used 3.0 mm average dimension. The resting vertical dimension (RVD) is a 3-dimensional range with little evidence related to changes in the RVD during life. However, aging can cause a decrease in muscle tone which could affect the RVD. The restoration of the OVD can be successfully accomplished if proper diagnosis and treatment planning are performed.


Asunto(s)
Oclusión Dental , Mandíbula , Adulto , Consenso , Humanos , Prostodoncia , Dimensión Vertical
19.
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
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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