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1.
Braz Oral Res ; 34: e016, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32130363

RESUMEN

Horizontal bone loss after tooth extraction is a common finding that demands bone reconstruction in various cases. The aim of this study was to assess the horizontal alveolar status in partially and completely edentulous patients using cone-beam computed tomography (CBCT). In total, 1516 CBCT scans of 1404 adult patients were analyzed. Assessment of the images was performed in accordance with the previously published horizontal alveolar change (HAC) classification, which categorizes horizontal bone defects into four classes: HAC 1, HAC 2, HAC 3 and HAC 4 (from the least severe to the most severe condition). Analysis of 1048 scans from partially edentulous patients presented a distribution of 63.55%, 22.14%, 13.36% and 0.95% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Analysis of 468 scans from completely edentulous patient images presented a distribution of 19.87%, 28.63%, 41.67% and 9.83% in HAC 1, HAC 2, HAC 3 and HAC 4, respectively. Based on these results, as in HAC 4, no cancellous bone was found between the cortical buccal and lingual/palatal bone plates, it seems reasonable to state that the absence of cancellous bone is higher in completely edentulous patients than in partially edentulous patients. Therefore, the absence of cancellous bone seems to be higher in completely edentulous than in partially edentulous patients.


Asunto(s)
Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/patología , Proceso Alveolar/patología , Boca Edéntula/epidemiología , Boca Edéntula/patología , Adolescente , Adulto , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Proceso Alveolar/diagnóstico por imagen , Aumento de la Cresta Alveolar , Brasil/epidemiología , Hueso Esponjoso/diagnóstico por imagen , Hueso Esponjoso/patología , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Boca Edéntula/diagnóstico por imagen , Prevalencia , Estudios Retrospectivos , Adulto Joven
2.
Sensors (Basel) ; 19(24)2019 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-31842494

RESUMEN

Periodontal diagnosis requires discovery of the relations among teeth, gingiva (i.e., gums), and alveolar bones, but alveolar bones are inside gingiva and not visible for inspection. Traditional probe examination causes pain, and X-ray based examination is not suited for frequent inspection. This work develops an automatic non-invasive periodontal inspection framework based on gum penetrative Optical Coherence Tomography (OCT), which can be frequently applied without high radiation. We sum up interference responses of all penetration depths for all shooting directions respectively to form the shooting amplitude projection. Because the reaching interference strength decays exponentially with tissues' penetration depth, this projection mainly reveals the responses of the top most gingiva or teeth. Since gingiva and teeth have different air-tissue responses, the gumline, revealing itself as an obvious boundary between teeth and gingiva, is the basis line for periodontal inspection. Our system can also automatically identify regions of gingiva, teeth, and alveolar bones from slices of the cross-sectional volume. Although deep networks can successfully and possibly segment noisy maps, reducing the number of manually labeled maps for training is critical for our framework. In order to enhance the effectiveness and efficiency of training and classification, we adjust Snake segmentation to consider neighboring slices in order to locate those regions possibly containing gingiva-teeth and gingiva-alveolar boundaries. Additionally, we also adapt a truncated direct logarithm based on the Snake-segmented region for intensity quantization to emphasize these boundaries for easier identification. Later, the alveolar-gingiva boundary point directly under the gumline is the desired alveolar sample, and we can measure the distance between the gumline and alveolar line for visualization and direct periodontal inspection. At the end, we experimentally verify our choice in intensity quantization and boundary identification against several other algorithms while applying the framework to locate gumline and alveolar line in vivo data successfully.


Asunto(s)
Encía/diagnóstico por imagen , Enfermedades Periodontales/diagnóstico , Tomografía de Coherencia Óptica , Diente/diagnóstico por imagen , Pérdida de Hueso Alveolar/diagnóstico , Pérdida de Hueso Alveolar/diagnóstico por imagen , Humanos , Enfermedades Periodontales/patología
3.
Biomed Res Int ; 2019: 1271492, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31662968

RESUMEN

Objectives: This study aimed to assess the effect of zoledronic acid on an immunocompromised mice model with periapical disease. Materials and Methods: Thirty C57BL/6N mice were randomly divided into three groups (N = 10). All animals were subjected to bilateral ovariectomy (OVX) and then treated with saline (Veh), zoledronic acid (ZA), or concomitant zoledronic acid and dexamethasone (ZA/Dx) for 12 weeks. Eight weeks after starting drug administration, pulpal exposure was conducted on the lower left first molar. Four weeks after pulpal exposure, all mice were sacrificed and the mandibles were collected for radiological and histological examinations. Results: Microcomputed tomography (µ-CT) examination showed significantly reduced periapical bone resorption in the ZA/Dx group and decreased periodontal bone resorption in both ZA and ZA/Dx groups. Higher bone mineral density (BMD) and strengthened microstructure were found in ZA and ZA/Dx groups. More empty lacunae were found in ZA and ZA/Dx groups. Conclusions: Apical periodontitis aggravates MRONJ under immunocompromised circumstances. Concurrent use of ZA and steroids inhibits alveolar bone resorption but increases the risk of developing MRONJ.


Asunto(s)
Conservadores de la Densidad Ósea/uso terapéutico , Enfermedades Periapicales/tratamiento farmacológico , Ácido Zoledrónico/uso terapéutico , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/tratamiento farmacológico , Pérdida de Hueso Alveolar/patología , Animales , Densidad Ósea/efectos de los fármacos , Dexametasona/farmacología , Modelos Animales de Enfermedad , Femenino , Mandíbula/efectos de los fármacos , Ratones , Ratones Endogámicos C57BL , Diente Molar/efectos de los fármacos , Osteonecrosis/tratamiento farmacológico , Ovariectomía , Enfermedades Periapicales/diagnóstico por imagen , Enfermedades Periapicales/patología , Microtomografía por Rayos X
4.
Cient. dent. (Ed. impr.) ; 16(2): 143-148, mayo-ago. 2019. ilus, tab
Artículo en Español | IBECS | ID: ibc-183726

RESUMEN

Introducción: La falta de volumen óseo en el maxilar es un hallazgo habitual en los pacientes que presentan pérdidas dentarias de larga duración. En la actualidad el uso de implantes es la opción más demandada para su rehabilitación, pero para ello son necesarias unas magnitudes mínimas y en los casos que no se presenten, habrá que realizar técnicas de regeneración ósea para que el tratamiento sea viable. Caso clínico: Paciente varón de 58 años de edad que acudió a Servicio de Cirugía Bucal e Implantología del Hospital Virgen de la Paloma de Madrid. Fue diagnosticado hace 7 años de enfermedad periodontal crónica del adulto; tras un periodo de abandono, regresó para la valoración de una rehabilitación completa superior. Se realizó una minuciosa exploración intraoral. Como pruebas complementarias se realizaron una radiografía panorámica y, posteriormente, un estudio tomográfico, donde se observó un insuficiente volumen óseo para el tratamiento implantológico, por lo que se planificó realizar una elevación sinusal bilateral mediante ventana con un injerto autógeno de calota combinado con plasma rico en plaquetas. Conclusiones: El tratamiento de elevación sinusal mediante ventana con injerto de calota es una opción a tener en cuenta para la rehabilitación impantológica de la arcada superior


Introduction: The lack of maxilla bone volume makes the implant treatment difficult. In order to make the implant rehabilitation possible a certain hight is required, which is not enough in this particular case. Therefore a regular sinus lift with lateral approach. Currently, the use of implants is the most demanded option for rehabilitation, but for this minimum magnitudes are necessary and in cases that do not occur, bone regeneration techniques must be performed in order for the treatment to be viable. Clinical case: Male 65 years old patient, arrived at the Oral Surgery service at the Virgen de la Paloma Hospital. No medical or family record of interest. Diagnosed seven years ago with a periodontal chronic disease. After a period of not taking care of it, he returned a few months ago with severe tooth mobility and bone loss, for a full rehabilitation valuation.A meticulous oral inspection was performed. As additional tests, a panoramic radiograph was performed as well as a tomographic test. As a result it was confirmed that the maxilla bone volume was not enough to develop any implant treatment. Therefore it was decided to perform a bilateral sinus lift via a calvarial graft mixed with plateletrich plasma at in hospital environment. Conclusion: The sinus lift treatment via craneal calvarial graft combined with platelet-rich plasma is an option to keep in mind for the full implant rehabilitation of the upper dental arch


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Pérdida de Hueso Alveolar/cirugía , Maxilar/cirugía , Atrofia , Cráneo/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Supervivencia de Injerto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Maxilar/diagnóstico por imagen , Maxilar/patología , Trasplante de Tejidos
5.
Artículo en Inglés | MEDLINE | ID: mdl-31323848

RESUMEN

OBJECTIVE: To describe remodeling of the mesial and distal marginal bone level around platform-switched (PS) and platform-matched (PM) dental implants that were sandblasted with large grit and etched with acid over a three-year period. MATERIALS AND METHODS: Digital periapical radiographs were obtained at the following time-points: during Stage I of the surgical placement of dental implants, before loading, immediately after loading (baseline), and one, three, six, 12, and 36 months after loading for measuring the horizontal and vertical marginal bone levels. RESULTS: Sixty implants were successfully osseointegrated during the overall observation period. Vertical marginal bone levels for the PS and PM dental implants were 0.78 ± 0.77 and 0.98 ± 0.81 mm, respectively, whereas the horizontal marginal bone levels for the PS and PM implants were 0.84 ± 0.45 and 0.98 ± 0.68 mm, respectively. During the time leading up to the procedure until 36 months after the procedure, the average vertical marginal bone level resulted in less bone loss for the PS and PM groups-0.96 ± 1.28 and 0.30 ± 1.15 mm, respectively (p < 0.05). The mean levels of the horizontal marginal bone also showed increases of 0.48 ± 1.01 mm in the PS and 0.37 ± 0.77 mm in the PM groups from the time before loading until 36 months after the procedure. However, these increases were not statistically significant (p > 0.05). CONCLUSION: PS dental implants appeared to be more effective than PM implants for minimizing the mean marginal vertical and horizontal marginal bone loss during the three-year period. Regardless of which abutment connection was used, the dental implant in the present retrospective investigation exhibited minimal marginal bone remodeling, thus indicating long-term stability.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Prótesis Anclada al Hueso/estadística & datos numéricos , Implantación Dental Endoósea/instrumentación , Implantes Dentales/estadística & datos numéricos , Oseointegración , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Hueso Alveolar/diagnóstico por imagen , Huesos , Prótesis Anclada al Hueso/efectos adversos , Implantación Dental Endoósea/estadística & datos numéricos , Implantes Dentales/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía Dental , Estudios Retrospectivos
6.
Am J Orthod Dentofacial Orthop ; 156(1): 75-86, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256844

RESUMEN

INTRODUCTION: Maintaining tooth anchorage during orthodontic treatment has challenged orthodontists and threatening the success of some orthodontic therapy. The objective of this study was to evaluate the effect of local administration of simvastatin on orthodontic tooth movement. METHODS: Nickel-titanium coil springs were used to induce orthodontic tooth movement in 10 white New Zealand rabbits for 21 days. A split-mouth design was implemented where one mandibular quadrant received local administration of simvastatin and the corresponding mandibular quadrant received control vehicle solution on a weekly basis. Magnitudes of tooth movement were measured on 3-dimensional models of the experimental teeth. Animals were killed at the end of the experimental period to allow histomorphometric analysis of alveolar bone modeling. RESULTS: The total magnitude of tooth movement in the quadrant receiving simvastatin was significantly less than that in the quadrant receiving control vehicle solution. Local administration of simvastatin resulted in a significant percentage of inhibition of tooth movement of 39.8 ± 22.6%. Histomorphometric analysis revealed a significant reduction in the numbers of osteoclasts and areas of active bone-resorptive lacunae hindering bone resorption processes in the quadrant receiving simvastatin. CONCLUSIONS: Local administration of simvastatin can reduce the rate and magnitude of orthodontic tooth movement. Moreover, local administration of simvastatin diminishes bone resorption processes associated with orthodontic tooth movement reducing the number of osteoclasts and the subsequent area of active bone resorption.


Asunto(s)
Resorción Ósea/patología , Osteoclastos/efectos de los fármacos , Simvastatina/administración & dosificación , Simvastatina/antagonistas & inhibidores , Técnicas de Movimiento Dental/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Animales , Remodelación Ósea/efectos de los fármacos , Resorción Ósea/diagnóstico por imagen , Masculino , Mandíbula/irrigación sanguínea , Mandíbula/efectos de los fármacos , Mandíbula/patología , Modelos Animales , Níquel/química , Aparatos Ortodóncicos , Alambres para Ortodoncia , Osteoclastos/patología , Conejos , Titanio/química , Técnicas de Movimiento Dental/instrumentación
7.
Osteoporos Int ; 30(9): 1873-1885, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31338519

RESUMEN

Our goal was to evaluate alveolar bone healing in OVX mice, and to assess the functional utility of a WNT-based treatment to accelerate healing in mice with an osteoporotic-like bony phenotype. INTRODUCTION: Is osteoporosis a risk factor for dental procedures? This relatively simple question is exceedingly difficult to answer in a clinical setting, for two reasons. First, as an age-related disease, osteoporosis is frequently accompanied by age-related co-morbidities that can contribute to slower tissue repair. Second, the intervals at which alveolar bone repair are assessed in a clinical study are often measured in months to years. This study aimed to evaluate alveolar bone repair in ovariectomized (OVX) mice and provide preclinical evidence to support a WNT-based treatment to accelerate alveolar bone formation. METHODS: OVX was performed in young mice to produce an osteoporotic-like bone phenotype. Thereafter, the rate of extraction socket healing and osteotomy repair was assessed. A liposomal WNT3A treatment was tested for its ability to promote alveolar bone formation in this OVX-induced model of bone loss. RESULTS: Bone loss was observed throughout the murine skeleton, including the maxilla, and mirrored the pattern of bone loss observed in aged mice. Injuries to the alveolar bone, including tooth extraction and osteotomy site preparation, both healed significantly slower than the same injuries produced in young controls. Given sufficient time, however, all injuries eventually healed. In OVX mice, osteotomies healed significantly faster if they were treated with L-WNT3A. CONCLUSIONS: Alveolar bone injuries heal slower in OVX mice that exhibit an osteoporotic-like phenotype. The rate of alveolar bone repair in OVX mice can be significantly promoted with local delivery of L-WNT3A.


Asunto(s)
Regeneración Ósea/efectos de los fármacos , Osteoporosis/fisiopatología , Alveolo Dental/efectos de los fármacos , Proteína Wnt3A/farmacología , Envejecimiento/fisiología , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/tratamiento farmacológico , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/fisiopatología , Animales , Resorción Ósea/fisiopatología , Modelos Animales de Enfermedad , Evaluación Preclínica de Medicamentos/métodos , Femenino , Maxilar/efectos de los fármacos , Maxilar/fisiología , Ratones Endogámicos BALB C , Diente Molar/cirugía , Osteogénesis/fisiología , Osteoporosis/complicaciones , Ovariectomía , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/fisiología , Cicatrización de Heridas/efectos de los fármacos , Microtomografía por Rayos X/métodos
8.
Trials ; 20(1): 461, 2019 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-31351492

RESUMEN

BACKGROUND: Periodontal intrabony defects are usually treated surgically with the aim of increasing attachment and bone levels and reducing risk of progression. However, recent studies have suggested that a minimally invasive non-surgical therapy (MINST) leads to considerable clinical and radiographic defect depth reductions in intrabony defects. The aim of this study is to compare the efficacy of a modified MINST approach with a surgical approach (modified minimally invasive surgical therapy, M-MIST) for the treatment of intrabony defects. METHODS: This is a parallel-group, single-centre, examiner-blind non-inferiority randomised controlled trial with a sample size of 66 patients. Inclusion criteria are age 25-70, diagnosis of periodontitis stage III or IV (grades A to C), presence of ≥ 1 'intrabony defect' with probing pocket depth (PPD) > 5 mm and intrabony defect depth ≥ 3 mm. Smokers and patients who received previous periodontal treatment to the study site within the last 12 months will be excluded. Patients will be randomly assigned to either the modified MINST or the M-MIST protocol and will be assessed up to 15 months following initial therapy. The primary outcome of the study is radiographic intrabony defect depth change at 15 months follow-up. Secondary outcomes are PPD and clinical attachment level change, inflammatory markers and growth factors in gingival crevicular fluid, bacterial detection, gingival inflammation and healing (as measured by geometric thermal camera imaging in a subset of 10 test and 10 control patients) and patient-reported outcomes. DISCUSSION: This study will produce evidence about the clinical efficacy and potential applicability of a modified MINST protocol for the treatment of periodontal intrabony defects, as a less invasive alternative to the use of surgical procedures. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03797807. Registered on 9 January 2019.


Asunto(s)
Pérdida de Hueso Alveolar/terapia , Raspado Dental , Regeneración Tisular Guiada Periodontal , Desbridamiento Periodontal , Periodontitis/complicaciones , Aplanamiento de la Raíz , Colgajos Quirúrgicos , Adulto , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/etiología , Raspado Dental/efectos adversos , Estudios de Equivalencia como Asunto , Femenino , Regeneración Tisular Guiada Periodontal/efectos adversos , Humanos , Londres , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Desbridamiento Periodontal/efectos adversos , Periodontitis/diagnóstico , Aplanamiento de la Raíz/efectos adversos , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
9.
BMC Oral Health ; 19(1): 128, 2019 06 26.
Artículo en Inglés | MEDLINE | ID: mdl-31242880

RESUMEN

BACKGROUND: This study aimed to examine radiologic microarchitectural changes in the mandibles of ovariectomized (OVX) rats through a systematic review and meta-analysis and to identify factors of the OVX rat model that influence on the bone microstructure. METHODS: Eligible articles were identified by searching electronic databases, including Embase, Medline, Web of Science, and KoreaMed, for articles published from January 1966 to November 2017. Two reviewers independently performed study selection, data extraction, and quality assessment. The pooled standardized mean difference (SMD) with 95% confidence intervals was calculated using a random-effects model. Subgroup analysis and meta-regression were performed to explore the effect of potential sources on the outcomes. The reliability of the results was assessed by sensitivity analysis and publication bias. RESULTS: Of 1160 studies, 16 studies (120 OVX and 120 control rats) were included in the meta-analysis. Compared to the control group, the OVX rats' trabecular bone volume fraction (SMD = - 2.41, P < 0.01, I2 = 81%), trabecular thickness (SMD = - 1.73, P < 0.01, I2 = 73%) and bone mineral density (SMD = - 0.95, P = 0.01, I2 = 71%) displayed the bone loss consistent with osteoporosis. The trabecular separation (SMD = 1.66, P < 0.01, I2 = 51%) has widen in the OVX mandibular bone in comparison to the control group. However, the trabecular number showed no indication to detect the osteoporosis (SMD = - 0.45, P = 0.38, I2 = 76%). The meta-regression indicated that longer post-OVX periods led to greater changes in bone mineral density (ß = - 0.104, P = 0.017). However, the rats' age at OVX was not linked to bone microstructure change. CONCLUSIONS: Using meta-regression and sensitivity analysis techniques, heterogeneity across the micro CT studies of OVX-induced osteoporosis was found. The major factors of heterogeneity were the region of interest and post-OVX period. Our assessment can assist in designing experiments to maximize the usefulness of OVX rat model.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Osteoporosis/diagnóstico por imagen , Ovariectomía , Pérdida de Hueso Alveolar/patología , Animales , Densidad Ósea , Femenino , Humanos , Mandíbula/patología , Osteoporosis/patología , Ratas , Ratas Sprague-Dawley , Reproducibilidad de los Resultados , Microtomografía por Rayos X
10.
Int J Oral Maxillofac Implants ; 34(6): 1493­1503, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31184639

RESUMEN

PURPOSE: The purpose of this study was the clinical and radiographic evaluation of four-implant-supported fixed prostheses and milled bar overdentures for rehabilitation of the edentulous mandible. MATERIALS AND METHODS: Thirty-six edentulous participants received four implants in the mandible (two vertical implants in the canine/lateral incisor area and two distally inclined implants anterior to the mental foramina) using flapless surgery. The implants were loaded with the mandibular dentures in the same day after necessary modifications. Three months after implant placement, participants were randomly allocated to one of two groups: (1) the overdenture group, where participants received milled bar overdentures; or (2) the fixed group, where participants received ceramo-metal fixed prostheses. Plaque and gingival indices, pocket depth, implant stability (using Osstell device), and marginal bone resorption (using standardized intraoral radiographs) were evaluated at the time of prosthesis insertion (T0), and 6 (T6) and 12 (T12) months after insertion. RESULTS: The implant survival rate was 100% for both groups. Plaque Index, Gingival Index, pocket depth, implant stability, and bone resorption significantly increased by time for anterior (P < .001) and posterior (P < .018) implants. Fixed prostheses showed significantly higher Plaque Index, Gingival Index, and pocket depth than milled bar for anterior (P < .001) and posterior (P < .037) implants. No significant differences in implant stability and bone resorption between groups were noted. For fixed prostheses, anterior implants showed significantly higher Plaque Index, Gingival Index, and pocket depth than posterior implants (P < .001) after 12 months. However, no significant differences in implant stability and bone resorption between anterior and posterior implants were noted for both groups. CONCLUSION: Both fixed prostheses and milled bar prostheses could be used successfully for immediately loaded four-implant rehabilitations of the edentulous mandible, as they were associated with favorable clinical and radiographic outcomes after 1 year. However, milled bar may be more advantageous than fixed prostheses in terms of reduced plaque/gingival indices and probing depth.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Prótesis Dental de Soporte Implantado , Arcada Edéntula , Pérdida de Hueso Alveolar/diagnóstico por imagen , Prótesis de Recubrimiento , Estudios de Seguimiento , Humanos , Arcada Edéntula/diagnóstico por imagen , Mandíbula , Resultado del Tratamiento
11.
Dent. press endod ; 9(1): 21-25, jan.-mar. 2019. tab, Ilus
Artículo en Portugués | LILACS, BBO - Odontología | ID: biblio-1000053

RESUMEN

Objetivo: avaliar, radiograficamente, a prevalência, extensão e severidade da reabsorção dentária em dentes adjacentes à área de fissura após enxerto ósseo alveolar. Métodos: radiografias de 200 indivíduos com fissura unilateral e bilateral, alveolar e palatina, foram analisadas para se investigar a presença de reabsorção dentária relacionada com o enxerto ósseo. No total, 1.315 radiografias foram analisadas (periapical, oclusal e radiografias panorâmicas), obtidas a partir de 200 indivíduos com fissura labiopalatina unilateral e bilateral completa ubmetidos a cirurgia de enxerto, disponíveis a partir dos arquivos da Seção de Radiologia do HRAC-USP. Resultados: entre os 200 indivíduos, 33 tinham reabsorções dentárias externas. Dessas, 15 estavam presentes nas radiografias pré-operatórias e 18 só depois do enxerto ósseo. No geral, 30 reabsorções localizaram- se no terço apical da raiz e 3 no terço cervical; o incisivo central esquerdo foi o mais afetado. Não foram observadas reabsorções dentárias no terço médio da raiz e nenhuma reabsorção afetou mais de um terço. Não existiu diferença estatisticamente significativa entre a idade do paciente durante a cirurgia de enxerto ósseo e a presença de reabsorção dentária externa. Conclusões: a prevalência da reabsorção dentária em dentes adjacentes à área da fissura em indivíduos submetidos a enxerto ósseo foi baixa (16,5%). O terço apical da raiz foi o local mais frequente de reabsorção radicular externa, e não houve reabsorções afetando mais de um terço da raiz. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Pérdida de Hueso Alveolar/diagnóstico por imagen , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Injerto de Hueso Alveolar/métodos , Resorción Dentaria , Distribución de Chi-Cuadrado
12.
Am J Orthod Dentofacial Orthop ; 155(5): 650-655.e2, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31053280

RESUMEN

INTRODUCTION: The goal of this study was to compare the outcomes and amount of change in periodontal health of anterior teeth in young versus middle-aged adults, who were treated to improve anterior alignment and occlusion. METHODS: Pre- and posttreatment records including orthodontic casts, cephalograms, and standardized periapical radiographs were retrospectively collected from young adults (aged 19-30 years; n = 12) and middle-aged adults (aged ≥40 years; n = 27). Following the American Board of Orthodontics criteria, discrepancy index (DI), cast-radiograph evaluation (CRE), treatment duration (TD), marginal bone loss (MBL), and tooth length (TL) were measured, and with the use of periapical radiographs, changes in the level of marginal bone (MBC) and the amount of root resorption (RR) after orthodontic treatment were calculated. RESULTS: DI, MBL, and TD were significantly higher in the middle-aged adults than in the young adults (P < 0.05). However, CRE and MBC after treatment were similar between the 2 groups (P > 0.05). The mean amount of RR following treatment was -0.6 ± 0.44 mm and -1.0 ± 0.61 mm in young and middle-aged adults, respectively. The degree of RR after compensating for treatment complexity and TD was similar between the 2 groups (P > 0.05). CONCLUSIONS: Although the initial malocclusion and periodontal conditions were unfavorable for the middle-aged adults, the overall treatment and periodontal outcomes after orthodontic treatment of the anterior teeth were similar to those for young adults. It appears that older adults tolerate orthodontics to improve the appearance of the anterior teeth as well as younger adults, with no additional burden because of their increased age.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Ortodoncia Correctiva , Resorción Radicular/diagnóstico por imagen , Adulto , Factores de Edad , Cefalometría , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
13.
PLoS One ; 14(4): e0215092, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30986268

RESUMEN

Recent improvements in additive manufacturing technologies may facilitate the use of customized 3D printed grafts for horizontal and vertical augmentation of the atrophic alveolar ridge. The accurate fit of such grafts could reduce the clinical treatment time and contribute optimal bone regeneration. The aim of this in vitro study was to evaluate the marginal and internal fit of 3D printed resin grafts as they could be used for alveolar ridge augmentation. Alveolar ridge morphologic data were derived from the Cone Beam Computed Tomography (CBCT) scans of six patients with alveolar bone defects. These data were transferred to a segmentation program to produce virtual 3D reconstructions of the alveolar ridge models. Using a Computer Aided Design (CAD) program, the alveolar bone defects were defined and customized grafts were designed and both the defects as well as the grafts generated (CAM) as 3D projects. These projects were imported into a 3D printer and were manufactured in resin. Hereafter, the grafts were fitted to the defect sites of the corresponding models and new CBCT scans were performed. Based on these scans, measurements were made at the marginal and internal part of the fitted grafts to evaluate the marginal and internal fit, respectively. The statistical analysis revealed that the mean marginal fit was significantly better (P < 0.05) than the mean internal fit. The fit of the grafts was dependent on the shape and on the size of the grafts. Specifically, the total void surface between the fitted graft and the corresponding defect site was significantly larger in the large-defect grafts than the small-defect grafts (P < 0.05). Within the limitations of the study, it could be demonstrated that it is possible to fabricate 3D printed resin grafts with acceptable fit in customized shapes, when combining CBCT scans and computer aided design and 3D printing techniques.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/instrumentación , Diseño Asistido por Computadora , Impresión Tridimensional/instrumentación , Pérdida de Hueso Alveolar/diagnóstico por imagen , Regeneración Ósea , Tomografía Computarizada de Haz Cónico , Diseño de Prótesis Dental , Humanos , Técnicas In Vitro , Proyectos Piloto
14.
Angle Orthod ; 89(5): 705-712, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30920874

RESUMEN

OBJECTIVES: To evaluate the effectiveness of platelet-rich plasma (PRP) with its growth factors in minimizing the side effects of rapid maxillary expansion (RME) on the periodontal tissue of anchoring teeth using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: A randomized, split-mouth clinical trial was conducted on 18 patients aged 12-16 years (14 ± 1.65) with a skeletal maxillary constriction who underwent RME using a Hyrax appliance. The sample was randomly divided into two groups: intervention and control sides. PRP was prepared and injected on the buccal aspect of supporting teeth in the intervention group. High-resolution CBCT imaging (H-CBCT) was carried out preoperatively (T0) and after 3 months of retention (T1) to study the buccal bone plate thickness (BBPT) and buccal bone crest level (BBCL) of anchoring teeth. Changes induced by expansion were evaluated using paired sample t-test (P < .05). RESULTS: Results showed that there was no significant difference in BBPT and BBCL between the two groups after RME (P > .05). The prevalence of dehiscence and fenestrations was increased at (T1) in both groups and the percentage was higher in the PRP group. CONCLUSIONS: RME induced vertical and horizontal bone loss. PRP did not minimize alveolar defects after RME.


Asunto(s)
Pérdida de Hueso Alveolar , Técnica de Expansión Palatina , Plasma Rico en Plaquetas , Adolescente , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/terapia , Niño , Tomografía Computarizada de Haz Cónico , Humanos , Maxilar
15.
PLoS One ; 14(3): e0212796, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30865648

RESUMEN

While there is a burgeoning interest in the effects of nutrition on systemic inflammatory diseases, how dietary macronutrient balance impacts local chronic inflammatory diseases in the mouth has been largely overlooked. Here, we used the Geometric Framework for Nutrition to test how the amounts of dietary macronutrients and their interactions, as well as carbohydrate type (starch vs sucrose vs resistant starch) influenced periodontitis-associated alveolar bone height in mice. Increasing intake of carbohydrates reduced alveolar bone height, while dietary protein had no effect. Whether carbohydrate came from sugar or starch did not influence the extent of alveolar bone height. In summary, the amount of carbohydrate in the diet modulated periodontitis-associated alveolar bone height independent of the source of carbohydrates.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Sacarosa en la Dieta/efectos adversos , Conducta Alimentaria , Periodontitis/etiología , Almidón/efectos adversos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/patología , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Animales , Proteínas en la Dieta/administración & dosificación , Proteínas en la Dieta/efectos adversos , Sacarosa en la Dieta/administración & dosificación , Modelos Animales de Enfermedad , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Tamaño de los Órganos , Almidón/administración & dosificación
16.
Med Oral Patol Oral Cir Bucal ; 24(2): e260-e264, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30818320

RESUMEN

BACKGROUND: The aim of the present prospective clinical study is to compare the stability of the implant-bone interface by the ISQ quotient and marginal bone loss (MBL) rate during one year of follow-up in four system implants with the same surface and different design. MATERIAL AND METHODS: Prospective randomized clinical trial of 21 patients in which four implant systems with the same surface and different design were placed. Patients were treated by the same operator following a similar surgical protocol with submerged technique. The second surgery to perform the prosthesis was performed at 3 months. All patients went to their review at 6 months and a year. A periapical radiograph for crestal bone analysis and an Implant stability quotient by resonance frequency analysis (ISQ) analysis were taken at baseline and the reviews. RESULTS: No statistically significant differences were found in the Implant stability quotient by resonance frequency analysis and Marginal Bone Loss in the four types of implants. The ISQ increased from the moment of insertion of the implant until the revision to the year, showing an increase of the stability implant, being this increasing less between the 6 months and the year. CONCLUSIONS: Differences in the design of the four implants tested in this study did not show statistically significant differences in any of the variables studied, so the implant design does not influence implant stability and marginal bone loss in the first year after placement.


Asunto(s)
Pérdida de Hueso Alveolar/rehabilitación , Pérdida de Hueso Alveolar/cirugía , Implantes Dentales , Oseointegración , Análisis de Frecuencia de Resonancia/métodos , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pilares Dentales , Implantación Dental Endoósea , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Mandíbula/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Persona de Mediana Edad , Estudios Prospectivos
17.
J Oral Sci ; 61(1): 61-66, 2019 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-30814388

RESUMEN

The present study aimed to evaluate the performance of cone-beam computed tomography (CBCT) in assessing periodontal bone loss. If effective, CBCT could potentially be a more comfortable and accurate way to evaluate this disease. One hundred and eighty tooth sites from 13 patients were included. Clinical attachment level (CAL) was measured, then CBCT images were acquired prior to periodontal surgery. Three periodontists measured the distance between the cemento-enamel junction and alveolar bone crest at the mesio-buccal, mid-buccal, disto-buccal, mesio-lingual/palatal, mid-lingual/palatal, and disto-lingual/palatal sites. Comparisons of measurements were made among three methods. Inter-observer and intra-observer variances were also analyzed. Statistically significant differences were found between CBCT and CAL + 2.04 mm (P = 0.000), as well as intra-surgical evaluation (P = 0.001). All sites showed differences in CBCT versus intra-surgical measurement and versus CAL + 2.04 comparisons, except the buccal sites (P = 0.187 and 0.147, respectively). This study indicates that the results of CBCT do not agree with results of intra-surgical measurement. As a result, CBCT should be used with caution and only when necessary, to avoid radiation hazards.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico/métodos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
18.
Med. oral patol. oral cir. bucal (Internet) ; 24(2): e260-e264, mar. 2019. tab
Artículo en Inglés | IBECS | ID: ibc-180651

RESUMEN

Background: The aim of the present prospective clinical study is to compare the stability of the implant-bone interface by the ISQ quotient and marginal bone loss (MBL) rate during one year of follow-up in four system implants with the same surface and different design. Material and Methods: Prospective randomized clinical trial of 21 patients in which four implant systems with the same surface and different design were placed. Patients were treated by the same operator following a similar surgical protocol with submerged technique. The second surgery to perform the prosthesis was performed at 3 months. All patients went to their review at 6 months and a year. A periapical radiograph for crestal bone analysis and an Implant stability quotient by resonance frequency analysis (ISQ) analysis were taken at baseline and the reviews. Results: No statistically significant differences were found in the Implant stability quotient by resonance frequency analysis and Marginal Bone Loss in the four types of implants. The ISQ increased from the moment of insertion of the implant until the revision to the year, showing an increase of the stability implant, being this increasing less between the 6 months and the year. Conclusions: Differences in the design of the four implants tested in this study did not show statistically significant differences in any of the variables studied, so the implant design does not influence implant stability and marginal bone loss in the first year after placement


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Pérdida de Hueso Alveolar/diagnóstico por imagen , Implantación Dental Endoósea/métodos , Retención de Dentadura/métodos , Adaptación Marginal Dental/clasificación , Estudios Prospectivos , Diseño de Implante Dental-Pilar/métodos , Oseointegración/fisiología
19.
Artículo en Inglés | MEDLINE | ID: mdl-30794252

RESUMEN

The aim of this randomized, prospective study was to compare clinical and radiographic outcomes of microtextured implants with two different collar designs at 1 year postplacement. A total of 69 implants were assessed in 58 patients for site, patient-specific, and clinician-experience variables. Overall implant survival was 94.9%. A statistically significant preservation of crestal bone was observed in the microgrooved-collar group. Narrow implant diameter was associated with a statistically significant increase in crestal bone loss. Collar design and implant diameter may be important in limiting adverse esthetic and bone loss outcomes during initial function.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea/métodos , Implantes Dentales/efectos adversos , Diseño de Prótesis Dental/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/prevención & control , Implantación Dental Endoósea/efectos adversos , Humanos , Estudios Prospectivos , Radiografía Dental , Factores de Tiempo
20.
Clin Implant Dent Relat Res ; 21(1): 85-93, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30618184

RESUMEN

BACKGROUND: Calvarial bone grafts have been one of the grafting options that provides predictable results for three-dimensional reconstruction of severely atrophied ridges owing to their low resorption and rapid revascularization, thus providing adequate volume for implant insertion. The aim of this study was to introduce a computer-guided technique for calvarial graft harvest to minimize the complications known with grafting from this donor site. MATERIALS AND METHODS: Eight patients, suffering from severely atrophied, completely edentulous maxillary ridges, with an age range (21-30 years) were operated on (six males and two females). A custom-made guide for each patient based on preoperative computed tomography (CT) was fabricated for harvesting the outer table cortical bone blocks from the parietal bone, then particulate bone was collected with an auto-chip maker. Bilateral sinus lifting was indicated in all cases. The bone blocks were fixed intraorally and the bone particulates filled the gaps and the volume created by sinus lifting, then the whole complex was covered with collagen membranes fixed with titanium tacks. Immediate and 6 months CT were requested for evaluation of the guide accuracy and the graft integration, respectively. RESULTS: In all cases, the guide was found to accurately fit into its preplanned position and to correctly locate the anticipated harvest site with the needed dimensions of the bone blocks. No intraoperative complications were encountered such as breakage through the inner table or cerebrospinal fluid leakage. Postoperatively, all the cases showed uneventual healing except one case that had an anterior dehiscence. CONCLUSION: The computer-guided calvarial bone blocks harvest from the parietal bone is safe and predictable technique for three-dimensional reconstruction of severely atrophic edentulous maxilla.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Maxilar/cirugía , Procedimientos Quirúrgicos Reconstructivos/métodos , Cráneo/trasplante , Cirugía Asistida por Computador/métodos , Adulto , Pérdida de Hueso Alveolar/diagnóstico por imagen , Trasplante Óseo/métodos , Femenino , Humanos , Imagenología Tridimensional , Masculino , Maxilar/diagnóstico por imagen , Radiografía Panorámica , Tomografía Computarizada por Rayos X , Adulto Joven
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