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1.
Artículo en Inglés | MEDLINE | ID: mdl-33819324

RESUMEN

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


Asunto(s)
Recesión Gingival , Procedimientos Quirúrgicos Orales , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Incisivo/cirugía , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
2.
Artículo en Inglés | MEDLINE | ID: mdl-33819329

RESUMEN

This randomized controlled clinical trial with a 1-year follow-up evaluated gingival thickness changes around teeth after use of dermal allograft and xenograft matrix. A total of 116 teeth (19 patients) were separated into two groups. One group received xenogeneic collagen matrix (n = 48), while the other received allogeneic acellular dermal matrix (n = 68) via a coronally advanced flap (CAF). Gingival thickness (GT), keratinized gingival width (KGW), pocket depth (PD), and clinical attachment loss (CAL) were measured on the day of surgery (baseline) and at 3 weeks, 2 months, 6 months, and 1 year postoperative. The two groups were compared using repeated-measures ANOVA (P < .05). The mean GT at 1 year was 1.59 ± 0.31 mm in the xenogeneic group and 1.63 ± 0.33 mm in the allogeneic group (P = .60). The mean change in GT was 1.08 mm in the xenogeneic group and 1.13 mm in the allogeneic group, which was clinically relevant and statistically significant compared to baseline values (P < .001). However, changes in GT were not significantly different between the two groups at any time point (P > .05). The GT increased in all cases treated with allogeneic and xenogeneic enriched collagen matrix. Both soft tissue substitutes were equally effective in acheiving optimal GT.


Asunto(s)
Recesión Gingival , Trasplante de Células Madre Hematopoyéticas , Colágeno , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Raíz del Diente , Resultado del Tratamiento
3.
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
4.
Artículo en Inglés | MEDLINE | ID: mdl-33819336

RESUMEN

This randomized split-mouth preliminary clinical trial aimed to evaluate periodontal parameters and gingival blood flowmetry, comparing sites that received subepithelial connective tissue graft from the palate after deepithelialization (DE) or obtained with parallel incision (PI). Periodontal parameters were evaluated at baseline and 6 months postoperative. Gingival blood flows were analyzed by laser Doppler flowmetry (LDF) at baseline and 2, 7, and 14 days postoperative. Statistical and LDF analyses were performed with R version 3.5.1 and MATLAB software, and clinical parameters through ANOVA and Wilcoxon signed-rank tests. LDF showed superior decrease in power spectral density (PSD) for DE after 2 days. After 7 days, PSD returned to initial values only for PI, and DE had not returned to the initial values by day 14. Despite major initial revascularization challenges for DE sites, both grafts promoted satisfactory root coverage in the treatment of multiple gingival recessions.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Humanos , Reología , Raíz del Diente/cirugía , Resultado del Tratamiento
6.
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
7.
Niger J Clin Pract ; 24(3): 435-442, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33723120

RESUMEN

Aims: To investigate the root canal anatomy and the incidence of fused roots in maxillary first molar (MFM) and maxillary second molar (MSM) teeth in the Turkish population and compare them to teeth with separate roots using cone-beam computed tomography (CBCT). Methods: CBCT images of 616 MFMs and 703 MSMs were analyzed from 402 patients for the number of roots and the presence of fusion. The canal configuration of teeth with separate and fused roots was compared. Type of fusion and canal merging positions were determined. A P value of less than 0.05 was considered significant. Results: Five hundred and seventy-one (92.69%) MFMs had three separate roots, one (0.16%) had four roots and the incidence of root fusion was 7.14%. An additional mesiobuccal (MB) canal was present in 79.34% of the teeth with three separate roots. There was no merging of canals in 36 of 44 teeth with fused roots. The prevalence of fusion was higher in the MSMs (23.47%). The incidence of three and four separate roots in MSM teeth was 74.68% and 1.85%, respectively. The prevalence of additional MB canals in teeth with three separate roots was 53.14%. There was no canal merging in 60% of the fused rooted teeth. There were two-merged canals in 31.52% and multiple merged canals in 8.48% of the MSMs. Conclusions: In the Turkish population, the incidence of root fusion in the MFMs and MSMs was 7.14% and 23.47%, respectively, with more canal merging in the MSMs.


Asunto(s)
Homosexualidad Masculina , Minorías Sexuales y de Género , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar/diagnóstico por imagen , Humanos , Masculino , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
8.
Quintessence Int ; 52(4): 284-291, 2021 Mar 03.
Artículo en Inglés | MEDLINE | ID: mdl-33655740

RESUMEN

OBJECTIVE: The objective of this study was to systematically review the literature regarding the effect of root coverage procedures on tooth survival and periodontal outcomes. DATA SOURCES: A systematic search of the literature was performed according to the PRISMA guidelines. A PICO-based search strategy was performed in six databases. Eligibility criteria included studies comparing tooth survival and periodontal outcomes of teeth treated with root coverage procedures versus teeth that had no treatment. The search resulted in 3,646 articles; 212 articles were downloaded for review, and six articles (three studies) were included. Only a single study reported on tooth survival and found no difference between teeth that underwent root coverage procedures versus those that did not. Although the surgeries described in each study were mostly successful in reducing recession and increasing keratinized gingiva, teeth which did not undergo surgery did not seem to have a clinically significant change in recession. The study with the longest follow-up (18 to 35 years) showed an average increase in recession of 0.5 ± 0.9 mm and a decrease in keratinized tissue of 0.3 ± 0.8 mm in the control group. CONCLUSION: This systematic review highlights the need for randomized controlled trials to assess the influence of root coverage surgeries on tooth longevity in order to better inform evidence-based practice. When compared to no surgical intervention, there is presently no evidence to suggest that root coverage surgeries increase tooth longevity. Furthermore, the amount of recession does not appear to increase a clinically significant amount over time without surgical intervention in the presence of proper maintenance and home care.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Estudios de Seguimiento , Encía , Recesión Gingival/cirugía , Humanos , Colgajos Quirúrgicos , Raíz del Diente/cirugía , Resultado del Tratamiento
9.
Am J Orthod Dentofacial Orthop ; 159(4): 460-469, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33526299

RESUMEN

INTRODUCTION: To investigate the anatomy of the posterior palatal alveolar process, which is often used for placement of the orthodontic mini-implant (OMI), and to suggest simple guidelines for safe placement of OMI. METHODS: Cone-beam computed tomography (CBCT) scans of 60 patients (30 men, 30 women; age range, 18-39 years; average age, 25.8 years) was used to measure the palatal interradicular distance, the palatal bone thickness, and the palatal soft-tissue thickness. Measurements were performed on the area from the maxillary canine to the maxillary second molar based on the vertical distance apical from the cementoenamel junction. The CBCT data were analyzed by Bonferroni correction for multiple testing and the multivariable mixed linear model. RESULTS: The palatal interradicular distance was the widest between the second premolar and the first molar and the narrowest between the first and second premolars. The palatal bone thickness at interdental sites was the thickest between the first and second premolars and the thinnest between the first and second molars. The interdental palatal soft-tissue thickness from the canine to the second premolar was thicker than any other area. There were minor measurement differences between genders and positive correlations between vertical distance from the cementoenamel junction plane and all of the parameters. CONCLUSION: In this study, we evaluated the anatomy of the posterior palatal area using CBCT scans of adult patients. The data will provide guidelines to the clinicians before OMI placement in the posterior palatal alveolar process.


Asunto(s)
Implantes Dentales , Métodos de Anclaje en Ortodoncia , Adolescente , Adulto , Proceso Alveolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Maxilar , Raíz del Diente , Adulto Joven
10.
Am J Orthod Dentofacial Orthop ; 159(4): 426-434.e5, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33568273

RESUMEN

INTRODUCTION: This study aimed to build an experimental immature tooth movement model and verify less resorption of incompletely developed roots than those fully developed during the same orthodontic treatment, followed by investigating the cellular and molecular mechanism. METHODS: The development of Wistar rat tooth was investigated using in vivo microcomputed tomography and hematoxylin and eosin staining to decide the optimal ages of rats for immature tooth and mature tooth groups. The rats in the immature tooth and mature tooth groups were divided into experimental, sham control, and blank control groups. After orthodontic treatment for 3 weeks, the mesial root volume, crown movement distance, neck movement distance, root inclination, and apical distance were measured by microcomputed tomography. The expressions of TRAP, Jagged1, Notch2, IL-6, and RANKL were analyzed by immunohistochemical staining and real-time polymerase chain reaction. The repair of root resorption was also investigated after removing orthodontic force for 3 and 6 weeks. RESULTS: The root achieved the development stage around 10 weeks, so 4-week-old rats and 10-week-old rats were used in the immature tooth group and mature tooth group, respectively. The volume of root resorption in the experimental immature tooth group was 0.0869 ± 0.0244 mm3, which was less than that in the mature tooth group (0.1218 ± 0.0123 mm3) (P <0.001). Immature tooth movement decreased TRAP-positive odontoclasts on the compression side while having no statistically significant effect on osteoclasts. The protein expression of Jagged1, Notch2, IL-6, and RANKL in the mature tooth group increased significantly compared with the immature tooth group, not only on the compression side but also on the tension sides. The mRNA expression of Jagged1, Notch2, and RANKL was significantly lower in the immature tooth group, whereas the expression of IL-6 had no significance but a strong tendency. The root volume after repairing for 3 weeks was still less than that of blank control, whereas after repairing for 6 weeks, the difference was not statistically significant. CONCLUSIONS: The experimental immature tooth movement model for the Wistar rat was achieved for the first time. The immature tooth will suffer less root resorption than the mature tooth, which may be due to odontoclastogenesis inhibition by decreased expression of Jagged1/Notch2/IL-6/RANKL signaling.


Asunto(s)
Resorción Radicular , Animales , Osteoclastos , Ratas , Ratas Wistar , Resorción Radicular/etiología , Resorción Radicular/prevención & control , Técnicas de Movimiento Dental , Raíz del Diente , Microtomografía por Rayos X
11.
Am J Orthod Dentofacial Orthop ; 159(4): 536-544, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33568277

RESUMEN

Treatment of an impacted incisor with a dilacerated root is challenging for clinicians because of the position of the impacted incisor, the abnormality of the root, unfavorable prognosis, and, especially, the long treatment duration. We report on 2 young patients who had inversely impacted maxillary central incisors with developing labially dilacerated roots. Both patients were treated by a novel surgical approach, in situ rotation, by which the crowns of the inversely impacted incisors were carefully rotated to a relatively normal position, whereas the apical location remained relatively unchanged. About 2 weeks after surgery, spontaneous eruption of the treated incisors was observed. Three months later, the postoperative central incisors were further aligned into the maxillary arch with a fixed orthodontic appliance. Follow-up visits 2 or 3 years after surgery indicated that the positions of the dilacerated incisors maintained stability with good gingival esthetics, and the pulpal vitality was favorable. The roots grew further in a relatively normal direction of the incisor's longitudinal axis, which was different from the initial curvature angle. Moreover, with the in situ rotation surgery, treatment time was greatly reduced and resulted in a favorable prognosis compared with conventional treatment.


Asunto(s)
Incisivo , Diente Impactado , Estética Dental , Humanos , Incisivo/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Rotación , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/cirugía , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(2): 204-206, 2021 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-33557507
13.
Head Face Med ; 17(1): 3, 2021 Feb 03.
Artículo en Inglés | MEDLINE | ID: mdl-33531044

RESUMEN

BACKGROUND: Orthodontic root resorptions are frequently investigated in small animals, and micro-computed tomography (µCT) enables volumetric comparison. Despite, due to overlapping histograms from dentine and bone, accurate quantification of root resorption is challenging. The present study aims at (i) validating a novel automated approach for tooth segmentation (ATS), (ii) to indicate that matching of contralateral teeth is eligible to assess orthodontic tooth movement (OTM) and root resorption (RR), (iii) and to apply the novel approach in an animal trial performing orthodontic tooth movement. METHODS: The oral apparatus of three female mice were scanned with a µCT. The first molars of each jaw and animal were segmented using ATS (test) and manually (control), and contralateral volumes were compared. Agreement in root volumes and time efficiency were assessed for method validation. In another n = 14 animals, the left first upper molar was protracted for 11 days at 0.5 N, whereas the contralateral molar served as control. Following ATS, OTM and RR were estimated. RESULTS: ATS was significantly more time efficient compared to the manual approach (81% faster, P < 0.01), accurate (volume differences: - 0.01 ± 0.04 mm3), and contralateral roots had comparable volumes. Protracted molars had significantly lower root volumes (P = 0.03), whereas the amount of OTM failed to reveal linear association with RR (P > 0.05). CONCLUSIONS: Within the limits of the study, it was demonstrated that the combination of ATS and registration of contralateral jaws enables measurements of OTS and associated RR in µCT scans.


Asunto(s)
Resorción Radicular , Animales , Femenino , Ratones , Diente Molar/diagnóstico por imagen , Roedores , Resorción Radicular/diagnóstico por imagen , Técnicas de Movimiento Dental , Raíz del Diente , Microtomografía por Rayos X
15.
Braz Oral Res ; 35: e022, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33605353

RESUMEN

This study aimed to determine the mean distances between apexes of the maxillary posterior teeth and the maxillary sinus, between apexes of the mandibular posterior teeth and the mandibular canal, and between the root apexes of all teeth and the adjacent cortical plates. A total of 800 cone-beam computed tomography (CBCT) scans (400 maxillary and 400 mandibular) were obtained from patients indicated for several treatments. The proximity between apexes and anatomical structures, and the relationship between apexes and adjacent cortical plates were assessed together with the risk of over-instrumentation. Paired-sample comparisons were performed by using the paired t-test. The means were compared by ANOVA, Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests. a) Most of the apexes classified as A (high-risk proximity) were observed in maxillary first and second molars, in mandibular first and second molars, and in second premolars in relation to near anatomical structures. b) A predominance of class A (86.42%) was noticed in the first premolars, between apexes of maxillary teeth and adjacent cortical plates. c) The distance between apexes of mandibular teeth and buccal cortical plates showed a predominance of medium-risk proximity (B) in all the groups, except the first premolars, with the highest risk (82.22%), and the second molars, with low-risk proximity (C) to distal and mesiobuccal apexes (91.77% and 89.62%). CBCT images are important for endodontic diagnosis and treatment, since many teeth have high risk proximity to near anatomical structures and adjacent cortical plates.


Asunto(s)
Seno Maxilar , Raíz del Diente , Corteza Cerebral , Tomografía Computarizada de Haz Cónico , Humanos , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
16.
Braz Oral Res ; 35: e29, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33605359

RESUMEN

This study evaluated how Er,Cr:YSGG laser, associated or not with 5% fluoride varnish, influences the surface roughness and volume loss of bovine root dentin submitted to erosive and/or abrasive wear. One hundred and twenty dentin specimens were divided into the groups: without preventive treatment (WPT), 5% fluoride varnish (FV); Er,Cr:YSGG laser irradiation (L), and varnish combined with laser (FV + L). The specimens (n = 10) were subdivided into: 1 = erosion (E); 2 = abrasion (A); and 3 = erosion followed by abrasion (E + A). The erosive solution used was a soft-drink (pH = 2.42 at 4ºC) applied in 5-min cycles twice a day for 10d. Abrasive wear involved brushing for 60s with an electric brush (1,600-oscillations/s) at a load of 2.0N. Surface roughness and volume loss were evaluated using a laser scanning confocal microscope. Roughness data were submitted to one-way ANOVA and Tukey post-hoc test. For volume loss, the Kruskal-Wallis and Dunn's post-hoc tests were used (α = 5%). The lowest values of roughness were found in the control areas of all subgroups (p > 0.05). In the experimental area, the [(WPT) + (E+A)] subgroup had a significantly higher roughness (5.712 ± 0.163 µm 2 ) than the other subgroups (p < 0.05). The L and (FV + L) groups had statistically similar roughness, regardless of the type of wear. The (FV + L) group had the lowest volume loss, regardless of the type of wear performed: [(FV + L) + (E)] = 7.5%, [(FV + L) + (A) = 7.3%, and [(FV + L) + (E + A)] = 8.1%. The subgroup [(WPT) + (E + A)] had the highest volume loss (52.3%). The proposed treatments were effective in controlling dentin roughness. Laser irradiation can be an effective method to increase root dentin resistance after challenges and limit problems related to non-carious lesions.


Asunto(s)
Láseres de Estado Sólido , Erosión de los Dientes , Animales , Bovinos , Dentina , Fluoruros , Láseres de Estado Sólido/uso terapéutico , Erosión de los Dientes/etiología , Raíz del Diente , Cepillado Dental
17.
J Oral Maxillofac Surg ; 79(4): 748-755.e1, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33434519

RESUMEN

PURPOSE: The purpose of this study was to introduce the method and first results of a modified tooth sectioning technique for the extraction of horizontally impacted mandibular third molars (M3Ms) with large root bifurcation. PATIENTS AND METHODS: A total of 300 horizontally impacted M3Ms with large root bifurcation in medically healthy patients were included in this prospective study. Patients were divided into 2 groups: the modified method group (test group), in which the M3M was sectioned between the distal root and the remainder of the tooth at the point of root bifurcation; and the conventional method group (control group), in which the M3M was sectioned between the crown and the root at the cementoenamel junction. Operation duration, postoperative reactions, complications, and patient satisfaction were analyzed and compared between the 2 groups. RESULTS: Each group included 150 M3Ms which were all successfully extracted. Operation durations in the test and control group were 10.48 ± 3.78 and 15.09 ± 4.24 minutes, respectively (P < .05). The test group had significantly better results than the control group with regard to postoperative reactions and complications (P < .05). Patients in the test group had higher satisfaction ratings regarding operation duration and the healing process than those in the control group (P < .05). CONCLUSIONS: The modified method of tooth sectioning between the distal root and the remainder of the tooth can efficiently eliminate resistance from the bone and adjacent mandibular second molar and allow for just 1 sectioning of the M3M in most cases, which could make the operation straightforward and safe.


Asunto(s)
Tercer Molar , Diente Impactado , Humanos , Mandíbula/cirugía , Diente Molar , Tercer Molar/cirugía , Estudios Prospectivos , Extracción Dental , Raíz del Diente/cirugía , Diente Impactado/cirugía
18.
Clin Oral Investig ; 25(4): 1613-1626, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33474623

RESUMEN

OBJECTIVE: This review aimed to evaluate the effects of enamel matrix derivative (EMD) in association with coronally advanced flap (CAF) or CAF + connective tissue graft (CTG) when compared with CAF alone or CAF + CTG for the treatment of gingival recessions (GR) in maxillary teeth. METHODS: Five databases and gray literature were searched up to April 2020, to find randomized clinical trials comparing the clinical effects of CAF + EMD versus CAF alone (first group) or CAF + CTG + EMD versus CAF + CTG (second group) in the treatment of Miller class I and II or Cairo type I gingival recessions (GR). Random effects model of mean differences was used to determine the GR reduction, gain in keratinized tissue width (KTW), and gain in clinical attachment level (CAL). The trial sequential analysis (TSA) was implemented to determine the optimal information size (OIS) and imprecision using the GRADE approach. Bayes factors were calculated as complementary statistical evidence of p value. RESULTS: From 1349 titles identified, 9 trials representing 336 GR were included. The meta-analysis showed a statistically significant difference for GR reduction and CAL gain in favor CAF + EMD (p ≤ 0.05). The additional effect of EMD showed a statistically significant difference in GR reduction in favor CAF + CTG + EMD (p ≤ 0.05). The differences in KTW gain proved to be not statistically significant in both comparison groups. The OIS were not met among meta-analyses. Evidence certainty according the GRADE approach proved to be moderate for GR reduction and gain in CAL, but very low for gain in KTW. CONCLUSION: The adjunctive application of EMD in the treatment of GR in maxillary teeth either with CAF or CTG provided moderate certainty evidence in favor of their use for reduction in GR and gain in CAL at 6 and 12 months. However, their effect on the increase in keratinized tissue band height showed very low evidence certainty for its use. CLINICAL RELEVANCE: To know if EMD could improve the results for root coverage.


Asunto(s)
Proteínas del Esmalte Dental , Recesión Gingival , Teorema de Bayes , Tejido Conectivo , Encía , Recesión Gingival/cirugía , Gingivoplastia , Humanos , Raíz del Diente , Resultado del Tratamiento
19.
Arch Oral Biol ; 123: 105040, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33454421

RESUMEN

OBJECTIVE: To evaluate cone-beam computed tomography images in an Argentine population in order to determine the presence of mandibular premolars with C-shaped canal system and classify them. METHODS: 697 images were observed, 170 of them fulfilling the selection criteria. Once established the presence of a C-shaped canal system, premolars were classified using Fan's criteria. Data description was made by frequencies and percentages rates, with a 95% confidence interval according to the score method. Comparisons were assessed by means of the Chi-square test with a significance level equal to 5%. RESULTS: Of 269 first premolars, 27 teeth showed C-shaped canal system, i.e. 10%, and of 231 second premolars, 4 presented C-shaped canal system, i.e. 2%. Out of 17 patients presenting first premolars in both sides, 6 showed a bilateral C-shaped canal system pattern and 11 did not present this condition. When the condition was unilateral (n = 15), 7 patients showed C-shaped canal in the tooth 3.4 and 8 patients showed C-shaped canal in the tooth 4.4. The second premolars showed C-shaped canals unilaterally. Along the canal, configuration variations at the three-thirds have been observed for the first and second mandibular premolars. CONCLUSION: The C-shaped canal system pattern prevalence in mandibular first and second premolars was estimated for the first time in an Argentine population, in vivo. The present report contributes to the epidemiological understanding of the anatomical variable of the inner dental configuration and its extrapolation to the clinical practice.


Asunto(s)
Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar , Raíz del Diente , Argentina , Cavidad Pulpar/diagnóstico por imagen , Humanos , Mandíbula/diagnóstico por imagen
20.
Am J Orthod Dentofacial Orthop ; 159(3): 271-280, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33485718

RESUMEN

INTRODUCTION: This study was aimed at investigating the reliability and accuracy of cone-beam computed tomography (CBCT) diagnosis of contact between a temporary anchorage device (TAD) and tooth root and assessing any effect produced by metal brackets, imaging software program, and image segmentation or color enhancement tools. METHODS: Eighteen fresh pig mandibles were used. TADs (Vector, 1.4 × 8 mm) were placed at the buccal intermolar alveolar bone on both sides of the mandibles. With soft tissue kept intact, each mandible underwent CBCT scans (voxel size, 400 µm) before and after placing TADs, and after placing metal brackets on involved molars. Alveolar bone specimens containing the TADs were then exposed to microcomputed tomography (microCT) scans (voxel size, 27 µm) after TAD removal. Two independent raters, blinded of image identity, diagnosed TAD-root contact using ImageJ (National Institutes of Health and the Laboratory for Optical and Computational Instrumentation, University of Wisconsin, Madison, Wis) for microCT; Dolphin (Dolphin Imaging and Management Solutions, Chatsworth, Calif) and Anatomage software programs (Anatomage, Santa Clara, Calif) for CBCT images. Intrarater and interrater reliability and diagnostic accuracy were statistically assessed using Cohen kappa and McNemar tests. RESULTS: Intrarater and interrater reliability of TAD-root contact diagnoses were perfect for microCT diagnoses (κ = 1), generally moderate to good (κ >0.5) for CBCT diagnoses except for the use of color enhancement tools (κ <0.25). For diagnostic accuracy, there was generally a low agreement (κ <0.45) between CBCT and microCT (gold standard). The percent accuracy ranged from 68.1% to 79.2% and was not different among raters, bracket presence/absence, or software choices (chi-square tests, P >0.05). Overall, diagnostic sensitivity was above 80%, whereas specificity was below 55%. CONCLUSIONS: Despite good reliability, diagnoses of TAD-root contact using 400 µm voxel size CBCT imaging tend to be inaccurate, with a likelihood of high false-positive diagnoses.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Diente Molar , Animales , Diente Molar/diagnóstico por imagen , Reproducibilidad de los Resultados , Porcinos , Raíz del Diente/diagnóstico por imagen , Microtomografía por Rayos X
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