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1.
Compend Contin Educ Dent ; 42(4): 158-162, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33960801

RESUMEN

Over time, patients treated in developmental stages of implantology may need additional treatment,as teeth adjacent to implants may fail and require replacement themselves with new implants. Blending newer implant rehabilitations into a dentition with existing implant-supported restorations can be challenging. The use of implants with a subcrestal angle correction (SAC) enables predictable screw-retained anchorage of temporary and definitive restorations. An SAC implant often can be placed into the palatal bone of an extraction socket, along the incisal angle of the crown, allowing screw retention of the prosthesis. This case report demonstrates the use of both straight and SAC implants combined with hard- and soft-tissue augmentation and serial provisionalization to replace hopeless teeth adjacent to pre-existing implants and improve esthetics in the anterior maxilla.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Coronas , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
2.
Compend Contin Educ Dent ; 42(4): g1-g4, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33961750

RESUMEN

Fixed prostheses offer various advantages over conventional removable devices for immediate restoration of a fractured tooth in the esthetic zone. In this case report, a fixed solution is employed through the use of a same-day provisional restoration attached to an immediately placed dental implant. Utilizing biologics and an implant system that allows for excellent primary stability, this treatment modality offers a predictable method for achieving immediate implant placement and provisionalization. The minimally invasive technique facilitates the development and maintenance of soft- and hard-tissue contours to enable an optimal result in the final restoration.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Restauración Dental Provisional , Estética Dental , Humanos , Maxilar/cirugía , Satisfacción del Paciente , Resultado del Tratamiento
3.
Prog Orthod ; 22(1): 12, 2021 May 03.
Artículo en Inglés | MEDLINE | ID: mdl-33937947

RESUMEN

BACKGROUND: The purpose of this study was to compare the stress distribution and displacement patterns of the one versus two maxillary molars distalization with iPanda and to evaluate the biomechanical effect of distalization on the iPanda using the finite element method. METHODS: The finite element models of a maxillary arch with complete dentition, periodontal ligament, palatal and alveolar bone, and an iPanda connected to a pair of midpalatal miniscrews were created. Two models were created to simulate maxillary molar distalization. In the first model, the iPanda was connected to the second molar to simulate a single molar distalization. In the second model, the iPanda was connected to the first molar to simulate "en-masse" first and second molar distalization. A varying force from 50 to 200 g was applied. The stress distribution and displacement patterns were analyzed. RESULTS: For one molar, the stress was concentrated at the furcation and along the distal surface in all roots with a large amount of distalization and distobuccal crown tipping. For two molars, the stress in the first molar was 10 times higher than in the second molar with a great tendency for buccal tipping and a minimal amount of distalization. Moreover, the stress concentration on the distal miniscrew was six times higher than in the mesial miniscrew with an extrusive and intrusive vector, respectively. CONCLUSIONS: Individual molar distalization provides the most effective stress distribution and displacement patterns with reduced force levels. In contrast, the en-masse distalization of two molars results in increased force levels with undesirable effects in the transverse and vertical direction.


Asunto(s)
Maloclusión de Angle Clase II , Diseño de Aparato Ortodóncico , Cefalometría , Análisis de Elementos Finitos , Humanos , Maxilar , Diente Molar , Técnicas de Movimiento Dental
4.
J Clin Pediatr Dent ; 45(2): 140-145, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33951166

RESUMEN

AIM: To compare maxillary development of individuals with unilateral cleft lip and palate (CLP) to individuals with skeletal Class I and Class III malocclusions. STUDY DESIGN: Cephalometric X-ray films from 90 patients (mean age: 13 ± 2.3 years) were used. The number of samples was determined by Power analysis and three groups consisting of 30 patients (Group 1: Skeletal Class I, Group 2: Skeletal Class III, Group 3: CLP) were formed. A total of 13 cephalometric measurements were performed using Dolphin imaging software 11.7. The Kruskal-Wallis and ANOVA tests were used to calculate the differences. The Dunn test and Bonferroni correction were used in paired group comparisons. RESULTS: SNA, Co-A, A-PTV Horizontal, Na-APog, A-Na-Pog, FH-NA, Sn'-Mx1, MxOP-TVL (p<0.001***), U6-PTV Vertical (p<0.01**), and NaBa PTV-Gn (p<0.05*) values were significantly different between the three groups. There was no significant difference in Na-ANS, FH-NPog, or Mx1 labial-ULA. SNA, Co-A, A-PTV Horizontal, Na-APog, and A-Na-Pog values between the 1st and 2nd groups and between the 1st and 3rd groups (p<0.001***) were significantly different. FH-Na-A, Sn'-Mx1, MxOP-TVL (p<0.001***), and U6-PTV vertical were different between groups 1 and 3 (p<0.01**), while FH-Na-A (p<0.001***), Sn'-Mx1, MxOP-TVL (p<0.01**), A-PTV Horizontal, and A-Na-Pog (p<0.05*) were significantly different between groups 2 and 3. CONCLUSION: Maxillary development in CLP differs from skeletal Class I but is similar to skeletal Class III. Considering the delay in maxillary development in the CLP patient, maxillary protraction and maxillary expansion are important treatment protocols in the early period.


Asunto(s)
Labio Leporino , Fisura del Paladar , Maloclusión de Angle Clase III , Cefalometría , Labio Leporino/diagnóstico por imagen , Fisura del Paladar/diagnóstico por imagen , Humanos , Maloclusión de Angle Clase III/diagnóstico por imagen , Maxilar/diagnóstico por imagen
5.
Quintessence Int ; 52(6): 488-495, 2021 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-33880909

RESUMEN

OBJECTIVE: This study aimed to compare the accuracy performance of five different intraoral scanning systems for a full-arch scan on an edentulous cadaver maxilla. METHOD AND MATERIALS: Five digital intraoral impression systems were used to scan a fully edentulous cadaver maxilla. A master scan obtained with an ATOS Capsule industrial grade scanner provided the point of comparison. Experimental scans were compared to the master scan using a metrology software that allows images to be overlayed on one another and deviations interpreted. Once aligned, three comparisons were made between the experimental scans and the reference: the entire maxilla, the ridge area only, and the palate area only. RESULTS: Trueness deviations between the experimental scans and the master digital model were up to 0.1 mm in the 75th percentile. For the whole maxilla, only the Medit scanner had statistically significantly inferior trueness compared to other scanners. When only the palate was considered, Medit was significantly different from Element (P = .0025) and Trios 4 (P = .0040), with no differences found between other scanners. For the ridge region the results replicate the trend observed for the whole maxilla. In regard to precision, differences were found only in the whole maxilla and the ridge area. In both areas, only Medit's precision was significantly different compared to other scanners, with the exception of Element. However, Element performance was similar to all other scanners. CONCLUSION: Most intraoral scanners exhibited similar performance. Although several statistically significant differences were identified, the clinical impact of these variances is probably not meaningful. (Quintessence Int 2021;52:488-495; doi: 10.3290/j.qi.b1244373).


Asunto(s)
Técnica de Impresión Dental , Maxilar , Diseño Asistido por Computadora , Arco Dental , Modelos Dentales , Humanos , Imagenología Tridimensional , Maxilar/diagnóstico por imagen
6.
BMJ Case Rep ; 14(4)2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888482

RESUMEN

We report the case of a 25-year-old man with a maxillary ghost cell odontogenic carcinoma (GCOC). The patient presented to the maxillofacial and head and neck surgery clinic with a growing lump in the left maxilla. Initial workup with CT revealed a cystic lesion in the left upper jaw with associated bone erosion and an enhancing soft-tissue component. Enucleation showed a GCOC associated with a calcifying odontogenic cyst. After the diagnosis was obtained, the patient underwent widening of the first surgical resection. GCOCs are rare odontogenic neoplasms with unspecific clinical and imaging presentation, whose definitive characterisation is based on pathology. Current treatment approaches mainly involve surgical excision, but the prognosis is highly unpredictable due to intertumoral heterogeneity. As tumour recurrences occur in 73% of cases, radical surgery with negative margins is highly recommended. Therefore, it is essential to recognise this entity to offer patients adequate management.


Asunto(s)
Carcinoma , Neoplasias Maxilares , Quiste Odontogénico Calcificado , Tumores Odontogénicos , Adulto , Humanos , Masculino , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Neoplasias Maxilares/diagnóstico por imagen , Neoplasias Maxilares/cirugía , Recurrencia Local de Neoplasia , Tumores Odontogénicos/diagnóstico por imagen , Tumores Odontogénicos/cirugía
7.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(2): 170-174, 2021 Apr 01.
Artículo en Chino | MEDLINE | ID: mdl-33834671

RESUMEN

OBJECTIVES: The present study aimed to explore the innervation of the anterior hard palatine and its relationship with individual development stage. Specifically, the effects of anesthesia on patients of different ages were observed, and neurodevelopment in the maxillofacial region was invesitgated. References that are helpful in selecting local anesthesia were provided. METHODS: A total of 182 patients with mixed dentition were randomly divided into the nasopalatine nerve block and greater palatine nerve block groups. Then, 219 patients with permanent dentition were divided into an adolescent group (13-18 years old) and adult group (over 19 years old), all of whom underwent bilateral greater palatine nerve block. Palatal mucosal pain sensation was tested pre- and post-anesthesia with Von Frey hairs. RESULTS: Among the children with mixed dentition, bilateral greater palatine nerve block tended to result in better anesthetic effects than nasopalatine nerve block (P<0.05), except in the incisive papilla. No difference in anesthetic effect was observed between adolescents and adults (P>0.05). The bilateral greater palatine nerve block was more effective in inducing an anesthestic effect in the anterior hard palatine in mixed dentition than in permanent dentition (over 13 years old; P<0.05). CONCLUSIONS: The sensation of the anterior hard palatine seems mainly dominated by the greater palatine nerve until mixed dentition and gradually shifted to the nasopalatine nerve in conjunction with maxillary development and tooth replacement. Hence, the innervation of the anterior hard palatine induce a secondary development during the development of the maxilla.


Asunto(s)
Bloqueo Nervioso , Paladar Duro , Adolescente , Adulto , Niño , Dentición Mixta , Humanos , Maxilar , Nervio Maxilar , Paladar (Hueso) , Adulto Joven
8.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(2): 203-208, 2021 Apr 01.
Artículo en Chino | MEDLINE | ID: mdl-33834676

RESUMEN

OBJECTIVES: To investigate the differences in the temporomandibular joints (TMJs) between patients with anterior disc displacement with reduction (ADDwR) and asymptomatic subjects by using 3D morphometric measurements. METHODS: A total of 15 patients with ADDwR and 10 asymptomatic subjects were enrolled. Then, 3D models of the maxilla and mandible were reconstructed using MIMICS 20.0. Nine morphologic parameters of TMJs on both sides were measured on the 3D solid model. The differences in the parameters were analyzed between the patients and the asymptomatic subjects and between the left and right sides of each group. RESULTS: The horizontal and coronal condylar angles on the ipsilateral side of the patients were significantly greater than those of the asymptomatic subjects (P<0.01). Meanwhile, the sagittal ramus angle (SRA), medial joint space, lateral joint space, superior joint space, anterior joint space, and posterior joint space in the patients were significantly lower than those in the asymptomatic subjects (P<0.01). CONCLUSIONS: ADDwR will increase the condylar angles to be significantly greater than the normal level and decrease SRA and articular spaces to be significantly smaller than the normal level. The condyles will be displaced upward, closer to the fossa.


Asunto(s)
Luxaciones Articulares , Trastornos de la Articulación Temporomandibular , Diente , Humanos , Imagen por Resonancia Magnética , Mandíbula , Cóndilo Mandibular , Maxilar , Articulación Temporomandibular
9.
BMC Oral Health ; 21(1): 199, 2021 04 19.
Artículo en Inglés | MEDLINE | ID: mdl-33874922

RESUMEN

BACKGROUND: The aim of the study was to compare the amount of interproximal enamel reduction (IPR) provided on ClinCheck software with the amount of IPR carried out by the orthodontist during treatment with clear aligners. METHODS: 30 subjects (14 males, 16 females; mean age of 24.53 ± 13.41 years) randomly recruited from the Invisalign account of the Department of Orthodontics at the University of Rome "Tor Vergata" from November 2018 to October 2019, were collected according to the following inclusion criteria: mild to moderate dento-alveolar discrepancy (1.5-6.5 mm); Class I canine and molar relationship; full permanent dentition (excluding third molars); both arches treated only using Comprehensive Package by Invisalign system; treatment plan including IPR. Pre- (T0) and post-treatment (T1) digital models (.stl files), created from an iTero scan, were collected from all selected patients. The OrthoCAD digital software was used to measure tooth mesiodistal width in upper and lower arches before (T0) and at the end of treatment (T1) before any refinement. The widest mesio-distal diameter was measured for each tooth excluding molars by "Diagnostic" OrthoCAD tool. The total amount of IPR performed during treatment was obtained comparing the sum of mesio-distal widths of all measured teeth at T0 and T1. Significant T1-T0 differences were tested with dependent sample t-test (P < 0.05). RESULTS: In the upper arch, IPR was digitally planned on average for 0.62 mm while in the lower arch was on average for 1.92 mm. As for the amount of enamel actually removed after IPR performing, it was on average 0.62 mm in the maxillary arch. In the mandibular arch, the mean of IPR carried out was 1.93 mm. The difference between planned IPR and performed IPR is described: this difference was on average 0.00 mm in the upper arch and 0.01 in the lower arch. CONCLUSIONS: The amount of enamel removed in vivo corresponded with the amount of IPR planned by the Orthodontist using ClinCheck software.


Asunto(s)
Aparatos Ortodóncicos Removibles , Adolescente , Adulto , Niño , Arco Dental , Esmalte Dental , Dentición Permanente , Femenino , Humanos , Masculino , Maxilar , Diente Molar , Adulto Joven
10.
Head Face Med ; 17(1): 14, 2021 Apr 22.
Artículo en Inglés | MEDLINE | ID: mdl-33888144

RESUMEN

BACKGROUND: Estrogen is a well-known and important hormone involved in skeletal homeostasis, which regulates genes involved in bone biology. Some studies support that estrogen is important for craniofacial growth and development. Therefore this in vivo animal study aimed to investigate, whether and in which way low estrogen levels in the prepubertal period affect craniofacial development in the postpubertal stage and to quantify the gene expression of RANK, RANKL and OPG in cranial growth sites in ovariectomized estrogen-deficient rats during puberty. METHODS: Control (sham-operated, n = 18) and ovariectomy (OVX, n = 18) surgeries were performed on 21-days-old female Wistar rats. Animals euthanized at an age of 45 days (pubertal stage) were used for gene expression analyses (n = 6 per group) and immunohistochemistry of RANK, RANKL and OPG. Animals euthanized at 63 days of age (post-pubertal stage) were used for craniofacial two-dimensional and three-dimensional craniofacial measurements using µCT imaging (n = 12 per group). RESULTS: In the µCT analysis of the mandible and maxilla many statistically significant differences between sham-operated and OVX groups were observed, such as increased maxillary and mandibular bone length in OVX animals (p < 0.05). Condylar volume was also significantly different between groups (p < 0.05). The sham-operated group showed a higher level of RANK expression in the midpalatal suture (p = 0.036) and the RANKL:OPG ratio levels were higher in the OVX group (p = 0.015). CONCLUSIONS: Our results suggest that estrogen deficiency during the prepubertal period is associated with alterations in the maxillary and mandibular bone length and condylar growth.


Asunto(s)
Mandíbula , Maxilar , Animales , Densidad Ósea , Estrógenos , Femenino , Expresión Génica , Humanos , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Pubertad , Ratas , Ratas Wistar
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(4): 324-328, 2021 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-33832032

RESUMEN

Objective: To test the reproducibility of the visual analogue scale (VAS) used in the evaluation of the esthetic effect of anterior dental implants, and to explore the factors that affect the correlation between VAS and pink esthetic score/white esthetic score (PES/WES). Methods: From January 2018 to August 2019, a total of 108 doctors and patients were recruited in the Department of Prosthodontics, Implantology and Fourth Clinical Division of Peking University School and Hospital of Stomatology. Among them, there were 35 dental implant specialists who were familiar with PES/WES [implant specialist group, 25 males, 10 females, (37.3±4.5) years old], 34 dentists who were not familiar with PES/WES [dentist group, specialized in Prosthodontics, Periodontology, Orthodontics, and Oral Maxillofacial Surgery, 24 males, 10 females, (36.1±4.2) years old], 39 patients [patient group, 28 males, 11 females, (45.4±8.3) years old]. Twenty oral pictures of patients [12 males, 8 females, (43.7±6.4) years old] treated in the Department of Prosthodontics, Peking University School and Hospital of Stomatology from December 2016 to December 2017 were taken for single implant restoration for esthetic evaluation with VAS. Score 0 for evaluation of not beautiful and score 10 for very beautiful. Re-evaluation of the same 20 pictures with VAS after 1 month, and perform repeatability evaluation of VAS using chi-square test were conducted. At the same time, 13 implant specialists were randomly selected, to score the same photos with PES/WES. The PES scoring elements were the fullness of the mesial gingival papilla, the fullness of the distal gingival papilla, the curvature of the gingival margin, the protrusion of the root surface, the color and the texture of the soft tissue. The scoring elements of WES were crown shape, crown contour, crown color, surface texture, transparency and individual characteristics in order. Pearson correlation analysis was used to evaluate the correlation between the score of VAS and PES/WES. And the influence of the group on the correlation between PES/WES and VAS was analyzed. Results: The PES score was 7.5±1.8, and the WES score was 7.6±1.9 and the total score was 15.1±3.4. The VAS score of the implant specialist group was 6.8±1.8. The repeatability test of the two VAS results in the patient group was not statistically significant (Kappa=0.012, P>0.05); the two VAS results of the implant specialist group and the dentist group both had good repeatability (Kappa=0.727 and 0.556, P<0.01). The VAS score was weakly correlated with the total PES/WES score (r=0.27, P<0.01). The VAS score was correlated with the score elements in PES/WES (P<0.01), and the color (r=0.20) and shape (r=0.22) of the crown were the larger correlation coefficients. The correlation coefficients between the VAS score and the PES/WES scoring system decreased among the implant specialist group (r=0.49, moderate correlation), the dentist group (r=0.25, weak correlation) and the patient group (r=0.12, P>0.05). Conclusions: The consistency of VAS and PES/WES is affected by the cognition of the scorer. The combination of the two scoring systems is feasible and necessary for physicians to evaluate the overall esthetic effect of implant restoration.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Adulto , Coronas , Prótesis Dental de Soporte Implantado , Estética Dental , Estudios de Factibilidad , Femenino , Humanos , Masculino , Maxilar , Persona de Mediana Edad , Reproducibilidad de los Resultados , Resultado del Tratamiento , Escala Visual Analógica
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(4): 374-376, 2021 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-33832040

Asunto(s)
Anodoncia , Incisivo , Humanos , Maxilar
13.
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
14.
Georgian Med News ; (311): 58-62, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33814392

RESUMEN

Surgically assisted rapid maxillary expansion (SARME) is a common technique developed to treat skeletally mature patients with transverse maxillary deficiency. Although SARME is supposed to be a relatively safe procedure, it is not completely free of complications. The purpose of this study was to reveal the most typical postoperative SARME complications. Retrospective evaluation of the clinical cases of 665 patients (247 males and 418 females, mean age 25,3 years) with the diagnosis of maxillary transverse deficiency, who underwent SARME in period between 2012 and 2017 at the Clinical Center of Maxillofacial, Plastic Surgery and Dentistry, Moscow. According to the results of the research, the most typical complications of SARME are paresthesia of the infraorbital nerve branches and nasopalatine nerve (198/665), distraction device dislocation (61/665), inflammation in the distraction device area (57/665), insufficient expansion of the maxilla (42/665), asymmetric expansion (27/665). The number of complications revealed indicates that SARME is an operation associated with the risks of postoperative complications. Careful treatment planning, following the operation protocol and performing the minimally invasive access can help to avoid the majority of complications.


Asunto(s)
Técnica de Expansión Palatina , Diente , Adulto , Femenino , Humanos , Masculino , Maxilar/cirugía , Estudios Retrospectivos
15.
Artículo en Inglés | MEDLINE | ID: mdl-33819319

RESUMEN

Implant-related esthetic demands have increased tremendously in recent years. The presence of shallow papillae or open interproximal spaces (black triangles) are some of the most troubling dilemmas in dentistry. Among the many factors associated with the presence of papilla or papilla height, the interproximal bone is one of the main factors dictating the presence of an adequate papilla between implants. The present case report describes a patient with severe hard and soft tissue deficiencies with a high smile line in the esthetic zone, requiring multiple implants. The step-by-step process of the utilized techniques for achieving inter-implant papilla reconstruction through a multidisciplinary approach using both hard and soft tissue augmentation procedures, as well as soft tissue conditioning with customized abutments, is delineated.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Estética Dental , Estudios de Seguimiento , Encía , Humanos , Maxilar
16.
Artículo en Inglés | MEDLINE | ID: mdl-33819331

RESUMEN

This study aimed to assess how frequently the maxilla anatomy allows for lingualized immediate implants in the central incisor region with a screw channel that has an ideal distance of 1.5 mm from the incisal margin. The effect of abutments with angle correction on case selection will also be verified. A retrospective cross-sectional study of 181 CBCT scans was carried out. Using an implant-planning software, implant placement was simulated in the lingual aspect of the socket. The location of the prospective screw channel was registered as incisal, lingual, or facial. The angle between the actual screw channel and the position of the ideal one was calculated. The effect of angle correction on allowing an ideal screw channel configuration was computed. Out of 161 eligible cases, 144 presented favorable anatomy for an immediate implant. The screw channel had an incisal position in 40 cases (28%), a lingual position in 60 cases (42%), and a facial position in 44 cases (30%). The screw channel could be placed at the planned distance from the incisal edge in 35 cases (24%). The position was unfavorable in the remaining 109 cases. In 103 of these cases, an abutment with an angled screw channel could make the conditions feasible. Within the simulated conditions, a majority of maxillary central incisors present favorable ridge anatomy for lingualized immediate implant placement. Achieving a proper location of the screw channel requires abutments with angle correction in a majority of cases.


Asunto(s)
Implantes Dentales , Tomografía Computarizada de Haz Cónico Espiral , Tornillos Óseos , Estudios Transversales , Estudios de Factibilidad , Humanos , Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Prospectivos , Estudios Retrospectivos
17.
Artículo en Inglés | MEDLINE | ID: mdl-33819332

RESUMEN

The aim of the present case series was to evaluate the outcomes of the modified coronally advanced tunnel technique (MCAT) using the width of keratinized tissue (KTW) as an indicator to apply the connective tissue graft (CTG) specifically. Seven patients requiring treatment for the presence of multiple gingival RT1 recession defects in the maxilla were enrolled in the study. A total of 36 recessions were treated with MCAT, and the CTG was applied in 16 sites presenting < 2 mm of KTW at baseline. The mean root coverage from baseline to 1 year postsurgery was 90% for the sites treated with MCAT alone and 93.7% for those treated with MCAT+CTG. The increase of KTW was higher in the sites treated with CTG than in the sites treated without it. Within the limitations of the present case series, it can be concluded that the proposed surgical technique is extremely effective in gaining root coverage and reducing the amount of connective tissue harvested from the donor site.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Maxilar/cirugía , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
18.
Artículo en Inglés | MEDLINE | ID: mdl-33819333

RESUMEN

This study aimed to rehabilitate shortened maxillary dental arch with splinted crowns by connecting ultra-short implants with longer ones. In the posterior maxilla of 11 patients, one 10-mm (n = 11) and one or two ultra-short 4-mm (n = 17) dental implants were inserted. The insertion torque was lower than 20 Ncm in 55% of the 10-mm implants and in 94% of the 4-mm implants (P > .05). Median (range) implant stability quotients at the time of insertion and after 6 months were 61 (14 to 72) and 68 (51 to 79), respectively, for 4-mm implants, and 66 (52 to 78) and 78 (60 to 83), respectively, for 10-mm implants (P < .05). One 4-mm implant failed to integrate. All patients were restored with splinted metal-ceramic crowns connecting 4- and 10-mm implants. Median (range) clinical crown/implant ratios of 4-mm and 10-mm implants were 2.79 (1 to 3.66) and 1.06 (0.85 to 1.46), respectively (P < .05). Six months after prosthetic rehabilitation, the median (range) crestal bone loss was 0.3 mm (-0.7 to 1.7 mm) for 4-mm implants and was 0.5 mm (-0.8 to 3.5 mm) for 10-mm implants (P > .05). Splinted crowns combining 4- and 10-mm implants may contribute to a better force distribution in the treatment with ultra-short implant-supported prosthesis in the posterior maxilla.


Asunto(s)
Implantes Dentales , Maxilar , Coronas , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Seno Maxilar/cirugía
19.
Int J Oral Maxillofac Implants ; 36(2): 371-378, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909730

RESUMEN

PURPOSE: The aim of this study was to evaluate the survival and success rates of oral rehabilitations in a shortened maxillary dental arch and expanded maxillary sinus with 4-mm extrashort implants splinted to longer ones. MATERIALS AND METHODS: One 10-mm and one/two extrashort 4-mm titanium-zirconium SLActive tissue-level dental implants were inserted into 11 patients with limited vertical bone availability due to an expanded maxillary sinus antrum. Immediately and 6 months after insertion, implant stability resonance frequency analysis (RFA) values were assessed with an Osstell device. Splinted crowns combining 4- and 10-mm implants were supplied to all 11 cases. RESULTS: In 10 cases, the bone quality was type III, and in one case, type IV. Among 17 4-mm and 11 10-mm implants, the median RFA values were 61 (interquartile ranges [IQR]: 59 to 64) and 66 (IQR: 64 to 72). One 4-mm implant failed to osseointegrate and was removed. After 6 months of healing, secondary-stability measurements of 16 of the remaining 4-mm implants increased to 68 (IQR: 62 to 72) and of 10-mm implants to 78 (IQR: 77 to 80). After 1 year, all (11/11) oral rehabilitations supported by 10-mm (11/11) and 4-mm (16/16) implants were functional. The medians and IQRs of the probing depths (median: 2.8 mm, IQR: 2.3 to 3.1 mm vs median: 2.9 mm, IQR: 2.4 to 3.1 mm) and the crestal bone loss (median: 0.75 mm, IQR: 0 to 0.9 mm vs median: 0.22 mm, IQR: 0 to 0.4 mm) for the 10-mm and 4-mm implants, respectively, were similar. CONCLUSION: Rehabilitations with splinted crowns combining 4- and 10-mm implants demonstrated a favorable 1-year performance in a shortened maxillary dental arch.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estudios Prospectivos
20.
Braz Oral Res ; 35: e060, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33909867

RESUMEN

This study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of mesiobuccal second canal (MB2) in the maxillary first molars and other aspects of its internal anatomy. Sixty-two maxillary first molars were scanned by micro-CT. The presence of the MB2 canal was verified. The distance between the center points of the MB1, MB2, distobuccal (DB), and palatal (P) canal orifices on the pulp floor were measured (MB1-MB2, MB1-DB, MB2-DB, MB1-P, and DB-P). The MB1-P to DB-P ratio was calculated. The distances between the anatomic apex and the MB1 and MB2 apical foramina were measured. The length of the band-shaped isthmus was also measured. Student's t-test was applied to verify the association between the presence of an MB2 canal, the interorifice distances, and the ratio of the MB1-P to DB-P distance (α = 5%). The MB2 canal was present in 43 roots (69.35%). Statistics showed significant differences when MB2 was present for the largest MB1-P distance (p < 0.05) and higher values for the MB1-P to DB-P ratio (p < 0.05). A band-shaped isthmus was detected in 25.8% of MB roots. The mean distance from the apical foramen to the isthmus floor ranged from 1.74 for MB1 canals to 1.42 for MB2 canals. Canal orifice distances on the pulp floor may predict the presence of MB2 canals. There was a high incidence of isthmus, accessory canals, and apical delta in the critical apical zone in MB roots of maxillary first molars.


Asunto(s)
Maxilar , Raíz del Diente , Cavidad Pulpar/diagnóstico por imagen , Humanos , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Microtomografía por Rayos X
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