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1.
Am J Orthod Dentofacial Orthop ; 157(2): 212-217, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32005473

RESUMEN

INTRODUCTION: This study aimed to investigate the association between root morphology of maxillary incisors and nonsyndromic tooth agenesis in patients compared with a control group without agenesis. METHODS: This controlled cross-sectional pilot study (1:4) was performed with a random sample of 335 records from Brazilian applicants for orthodontic treatment, paired by sex and age. Panoramic and periapical radiographs were analyzed to diagnose tooth agenesis and to assess root morphology. The agenesis group (n = 67) included patients with nonsyndromic tooth agenesis, and the control group (n = 268) included patients without tooth agenesis. The statistical analysis included the Student t test and z test, conditional logistic regression, and odds ratio estimates. RESULTS: Occurrence of root morphological changes was significantly higher among patients with agenesis (P <0.05). Significant morphological changes (short, blunt, apically bent, and pipette-shaped roots) were found in the roots of remaining teeth when comparing agenesis and control groups (P <0.05). Patients with agenesis were more likely to show root morphological changes (odds ratio, 74.23; 95% confidence interval, 16.93-325.46; P <0.001). CONCLUSION: Patients with agenesis are more likely to present root morphological changes, which should be considered to minimize problems during orthodontic treatments.


Asunto(s)
Anodoncia , Incisivo , Raíz del Diente , Anodoncia/diagnóstico por imagen , Brasil , Estudios Transversales , Humanos , Incisivo/diagnóstico por imagen , Maxilar , Proyectos Piloto , Radiografía Panorámica , Raíz del Diente/diagnóstico por imagen
2.
Gen Dent ; 68(1): 66-71, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31859666

RESUMEN

Knowledge of the anatomical relationships between the maxillary sinus (MS) and posterior teeth is important to prevent complications when endodontic or oral surgical procedures are performed. The aim of this study was to evaluate the relationships between the root apices of maxillary posterior teeth and the MS floor. Three oral radiologists evaluated 851 posterior teeth (1969 roots) imaged with cone beam computed tomography. The roots were analyzed individually in parasagittal sections, on which the most superior point of the apex was observed. A qualitative evaluation was performed, and each root was assigned a proximity score: 1, root invaginating the MS; 2, root in close contact with the MS floor; 3, root with no relationship with the MS; and 4, root with a measurable proximity to the MS. For roots classified as score 4, the distance to the MS floor was measured (quantitative analysis). Student t tests, 1-way analysis of variance, and simple linear regression analysis were performed (P < 0.05). The qualitative analysis revealed that the mesiobuccal root of the second molar had a pronounced proximity to the MS. The quantitative analysis revealed no differences in distance to the MS between right and left posterior teeth or between the different roots of the same tooth. In relation to the MS, the second molar was positioned closest, followed by the first molar, second premolar, and first premolar. Except for the comparison between mean distances of the second premolar and first molar (P = 0.11), the differences between groups of teeth were statistically significant (P < 0.05). Simple linear regression analysis showed that the more posterior the tooth was in relation to the midline, the shorter the mean distance from the root apex to the MS floor (P < 0.05). The mesiobuccal roots of second molars were closest to the MS. Second molars exhibited the shortest distances between their root apices and the MS and the greatest number of roots that were invaginating or in close contact with the MS. Therefore, second molars require special attention when endodontic or oral surgical approaches involve those regions.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Maxilar , Seno Maxilar , Humanos , Procesamiento de Imagen Asistida por Computador , Maxilar/anatomía & histología , Seno Maxilar/anatomía & histología , Seno Maxilar/diagnóstico por imagen , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen
3.
J Endod ; 46(1): 40-43, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31843127

RESUMEN

INTRODUCTION: This study evaluated the presence of midmesial canals (MMCs) in a random sample of mandibular molars and the relationship of the intracanal distance between mesiobuccal (MB) and mesiolingual (ML) canal orifices. METHODS: Fifty-one extracted mandibular molars were divided into samples of 3 to 4 teeth, mounted in plaster and boxing wax, and immersed in water before cone-beam computed tomographic (CBCT) imaging. Two endodontic residents completed the access openings. The teeth and the CBCT images were interpreted for the presence of MMCs and the mesial intracanal distance. CBCT software measured the distance between the buccal of the MB canal to the lingual of the ML canal at the pulpal floor to determine the average length between the canals. RESULTS: Seven distinct MMCs were seen both clinically (incidence of 13.725%) and on the CBCT images. Twenty-seven teeth (52.94%) had ambiguous broad isthmi between the MB and the ML orifices. MMCs were present at the furcation level but merged with the MB or ML canal toward the apex in 6 of 7 teeth (85.71%). The mean distance between the mesial canals in teeth with MMCs was 3.643 mm, and it was 3.818 mm for teeth without MMCs. According to independent sample t testing, the P value was >.05. CONCLUSIONS: The incidence of MMCs in mandibular molars appears consistent with the literature. However, there does not appear to be a statistically significant difference in the mesial intracanal distance in teeth with and without MMCs. Visualization of MMCs on CBCTs may be subjective. There does not appear to be a correlation between the presence of MMCs and an increased or decreased mesial intracanal distance.


Asunto(s)
Cavidad Pulpar , Mandíbula , Raíz del Diente , Tomografía Computarizada de Haz Cónico , Cavidad Pulpar/diagnóstico por imagen , Humanos , Incidencia , Mandíbula/diagnóstico por imagen , Diente Molar , Raíz del Diente/diagnóstico por imagen
4.
Am J Orthod Dentofacial Orthop ; 156(5): 593-602, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31677667

RESUMEN

INTRODUCTION: The aim of this research was to evaluate the influence of x-ray projection geometry on interradicular space of the posterior maxillary arch. METHODS: Cone-beam computed tomography (CBCT) scans of 32 patients (16.85 ± 4.93 years) who met the selection criteria were enrolled. One hundred ninety-two interradicular sites of the posterior maxillary arch were evaluated. Before measurements, each side of the maxillary arch was orientated in all 3 planes of space to obtain CBCT synthesized periapical radiographs with 0° projection geometry (orthogonal x-ray beam-orthogonal X-ray angulation [OX]). Standardized CBCT axial rotations (10°, 20°, -10°, and -20°) were used to simulate periapical radiographs taken with mesial and distal angulation of the x-ray beam (mesial x-ray angulation [MX] and distal x-ray angulation [DX]). Interradicular space widths were measured on OX, MX, and DX CBCT synthesized periapical radiographs. Measurements were performed parallel to the occlusal plane at 3 mm and 6 mm apical to the midpoint of the alveolar crest. Interradicular distances were statistically compared (P <0.05). RESULTS: Interradicular distances measured on MX and DX CBCT synthesized periapical radiographs were significantly smaller than those measured on OX. Interradicular distance was significantly correlated with the horizontal angulation of the x-ray beam. X-ray projection angle was the most influential variable on interradicular distance. About 30% reduction in interradicular space was observed for every 10° of deviation from orthogonal x-ray. CONCLUSION: Two-dimensional radiographs obtained away from the 0° projection geometry can reduce the actual interradicular space for mini-implants, inducing misdiagnosis.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Implantes Dentales , Raíz del Diente , Proceso Alveolar , Humanos , Raíz del Diente/diagnóstico por imagen
5.
Acta Odontol Latinoam ; 32(2): 51-56, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31664293

RESUMEN

The aim of this study was to evaluate the degree of penetration of obturation cement in artificial lateral canals after Passive Ultrasonic Irrigation (PUI) with ethylenediaminetetraacetic acid (EDTA) for different times. Fifty upper molar palatine roots were used, in which two artificial lateral canals were made at distances of 7 and 3 millimeters from the root apex. After instrumentation and drying the canal, the final toilet stage was performed on five groups (n = 10), as follows: G1 - EDTA 17% + PUI for 10 seconds; G2 - EDTA 17% + PUI for 20 seconds; G3 - EDTA 17% + PUI for 30 seconds; G4 - EDTA 17% + PUI for 60 seconds; G5 - EDTA 17% + activation by instrument R50 for 5 minutes (Control). The canals were sealed by the single cone technique, and after 72 hours, sectioned in two planes transverse to the artificial canal, to see the degree of penetration of the sealing cement. In the radiographic analysis, there was no statistical difference (p> 0.05) between groups in the two artificial lateral canals. However, PUI of EDTA for 60 seconds produced a significant difference in the degree of penetration of the sealing cement (p <0.05) at 7 mm from the apex. Therefore, PUI with EDTA for 60 seconds promoted a higher degree of penetration of the obturator cement in the artificial lateral canal.


Asunto(s)
Dentina/metabolismo , Materiales de Obturación del Conducto Radicular/farmacología , Irrigantes del Conducto Radicular/farmacología , Irrigación Terapéutica/métodos , Terapia por Ultrasonido , Cavidad Pulpar/cirugía , Ácido Edético/farmacología , Humanos , Preparación del Conducto Radicular , Hipoclorito de Sodio/farmacología , Raíz del Diente/diagnóstico por imagen
6.
J Appl Oral Sci ; 27: e20180693, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31596370

RESUMEN

OBJECTIVES: To compare the sealing ability and biocompatibility of Biodentine with mineral trioxide aggregate (MTA) when used as root-end filling materials. METHODOLOGY: The Cell Counting Kit-8 (CCK-8) assay was used to compare the cytotoxicity of MTA and Biodentine. Twenty-one extracted teeth with a single canal were immersed in an acidic silver nitrate solution after root-end filling. Then, the volume and depth of silver nitrate that infiltrated the apical portion of the teeth were analyzed using micro-computed tomography (micro-CT). Seventy-two roots from 3 female beagle dogs were randomly distributed into 3 groups and apical surgery was performed. After six months, the volume of the bone defect surrounding these roots was analyzed using micro-CT. RESULTS: Based on the results of the CCK-8 assay, MTA and Biodentine did not show statistically significant differences in cytotoxicity (P>0.05). The volume and the depth of the infiltrated nitrate solution were greater in the MTA group than in the Biodentine group (P<0.05). The volume of the bone defect was larger in the MTA group than in the Biodentine group. However, the difference was not significant (P>0.05). The volumes of the bone defects in the MTA and Biodentine groups were smaller than the group without any filling materials (P<0.05). CONCLUSIONS: MTA and Biodentine exhibited comparable cellular biocompatibility. Biodentine showed a superior sealing ability to MTA in root-end filling. Both Biodentine and MTA promoted periradicular bone healing in beagle dog periradicular surgery models.


Asunto(s)
Compuestos de Aluminio/farmacología , Compuestos de Calcio/farmacología , Óxidos/farmacología , Tejido Periapical/efectos de los fármacos , Ligamento Periodontal/efectos de los fármacos , Materiales de Obturación del Conducto Radicular/farmacología , Tratamiento del Conducto Radicular/métodos , Silicatos/farmacología , Cicatrización de Heridas/efectos de los fármacos , Adolescente , Animales , Regeneración Ósea/efectos de los fármacos , Recuento de Células , Células Cultivadas , Perros , Combinación de Medicamentos , Humanos , Masculino , Ensayo de Materiales , Osteogénesis/efectos de los fármacos , Tejido Periapical/citología , Tejido Periapical/diagnóstico por imagen , Ligamento Periodontal/diagnóstico por imagen , Reproducibilidad de los Resultados , Factores de Tiempo , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/efectos de los fármacos , Raíz del Diente/cirugía , Resultado del Tratamiento , Microtomografía por Rayos X , Adulto Joven
7.
Am J Orthod Dentofacial Orthop ; 156(4): 566-573, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582128

RESUMEN

INTRODUCTION: Accurate root position is imperative for successful orthodontic treatment that is stable and functional. Current methods to monitor root position are either inaccurate or use relatively high levels of radiation. A method to generate an expected root position (ERP) setup has been reported to have the potential to accurately evaluate root position with minimal radiation. The purpose of this study was to determine the accuracy and reliability of the clinical decisions made on root position using the ERP setup. METHODS: This retrospective study included 10 subjects who had pretreatment and midtreatment cone-beam computed tomography (CBCT) scans and study models. An ERP setup was generated for all patients at midtreatment. Four examiners assessed both the CBCT scan and ERP setup and made clinical decisions regarding the root position with each method. Cohen's kappa was determined to assess intraoperator and intermethod reliability. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to determine the accuracy of the ERP setup. RESULTS: The kappa values for intraoperator reliability for both the CBCT scan and ERP setup fell within the 0.61-0.80 range. The kappa values for intermethod reliability between the CBCT scan and ERP setup fell within the 0.61-0.80 range for all tooth groups. The sensitivity of the ERP setup ranged from 0.72 to 0.90, specificity ranged from 0.89 to 0.97, positive predictive value ranged from 0.57 to 0.85, and negative predictive value ranged from 0.93 to 0.99. CONCLUSIONS: This study demonstrated that the ERP setup, when compared with the gold standard CBCT scan, was accurate and reliable in making clinical decisions regarding root position at midtreatment.


Asunto(s)
Toma de Decisiones Clínicas , Tomografía Computarizada de Haz Cónico/métodos , Imagen Tridimensional/métodos , Técnicas de Movimiento Dental , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Modelos Dentales , Humanos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Sensibilidad y Especificidad
8.
Medicine (Baltimore) ; 98(40): e17356, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577730

RESUMEN

Molar-incisor malformation (MIM) is a recently defined dental abnormality of molar root and incisors, and introduced as one of the causes of periapical and periodontal abscess. The purpose of this study was to investigate the clinical and radiological features of MIM, with special emphasis on various medical history. A total of 38 patients with MIM were included in this study. Radiographic features and clinical data, including medical history, chief complaint, associated complications, treatment, and prognosis, were retrospectively investigated. On radiographs, the affected molars showed short, slender, underdeveloped roots and constricted pulp chambers. All affected incisors and canines exhibited dilacerated short roots, wedge-shaped defect on the cervical part of the crown. Complications included periodontal bone loss (52.6%), endodontic lesion (50.0%), and endodontic-periodontal lesion (28.9%). The medical histories of the patients with MIM indicate that almost all (94.7%) were hospitalized due to problems during the neonatal period. MIM may cause various dental problems, such as periapical and periodontal abscess and early loss of the affected teeth. The early diagnosis of MIM on radiographs and appropriate treatment will contribute to a favorable prognosis, especially for young and adolescent patients.


Asunto(s)
Incisivo/diagnóstico por imagen , Incisivo/patología , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/patología , Adolescente , Pérdida de Hueso Alveolar/etiología , Niño , Preescolar , Cavidad Pulpar/diagnóstico por imagen , Cavidad Pulpar/patología , Femenino , Humanos , Masculino , Radiografía Dental , Estudios Retrospectivos , Anomalías Dentarias/complicaciones , Anomalías Dentarias/diagnóstico , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/patología , Adulto Joven
9.
BMC Oral Health ; 19(1): 206, 2019 09 04.
Artículo en Inglés | MEDLINE | ID: mdl-31484529

RESUMEN

BACKGROUND: To determine the accuracy of volumetric measurements of the mandible in vitro by cone-beam computed tomography (CBCT) and to analyze the influence of voxel sizes and segmentation threshold settings on it. METHODS: The samples were obtained from pig mandibles and scanned with 4 voxel sizes: .125 mm, .20 mm, .30 mm, and .40 mm. The minimum segmentation thresholds in Hounsfield units (HU) were set as 0, 100, 200, 300, and 400, respectively, for each voxel size for 3D reconstruction. Laser scanning as the reference, the volumes of each CBCT scanning, the mean iterative distances of superimposition and total positive and negative deviations were recorded and compared. RESULTS: The volumes of CBCT-scan deviated from those of laser-scan by + 7.67% to - 3.05% with different HU and voxel sizes. The deviation increased with the voxel size. There was a more suitable minimum HU threshold of segmentation (HU100 for .125 mm, 200 for .20 mm, 300 for .30 mm, and 400 for .40 mm) for each voxel size. CONCLUSIONS: Voxel sizes and Hounsfield unit thresholds influence the accuracy of volumetric measurements in CBCT scanning. The volume increase with the voxel size, and different voxel sizes correspond to different optimal Hounsfield unit thresholds.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Procesamiento de Imagen Asistida por Computador/métodos , Imagen Tridimensional/métodos , Mandíbula/diagnóstico por imagen , Radiografía Dental Digital/métodos , Animales , Simulación por Computador , Rayos Láser , Odontometría , Intensificación de Imagen Radiográfica/métodos , Porcinos , Corona del Diente/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
10.
Am J Orthod Dentofacial Orthop ; 156(3): 391-400, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474269

RESUMEN

INTRODUCTION: Orthodontic traction of a maxillary impacted canine (MIC) increases the orthodontic treatment time. Therefore, the objective of this study was to evaluate the influence of MIC characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. METHODS: This follow-up and retrospective study included 45 MICs orthodontically tractioned into the occlusal plane with the use of a standardized protocol. MIC characteristics, including type, sector, side, location, height, and complexity of impaction, as well as α and ß angles and canine root length and area were measured. Likewise, factors associated with orthodontic treatment, including sex, age, malocclusion, premolar extractions, previous incisor root resorption, ANB, APDI, and SNA angles, and PNS-ANS distance were also evaluated. The statistical analysis included multiple linear regressions to estimate the influence of all variables on the duration of traction (α = 0.05). RESULTS: Sex had significant influence (P = 0.027) on the time of traction; in female patients, the time was 2.05 months more than in male patients. Bilateral impaction treatment increased the time by 2.74 months compared with unilateral cases (P = 0.001). Traction of bicortically centered impacted canines increased the duration of traction by 2.85 months (P = 0.001). Finally, the traction time increased in 2.35 months (P = 0.046) when the impaction sectors were 4 or 5 (close to the midline). CONCLUSIONS: The duration of active orthodontic traction of MIC is mainly influenced by sex, bilateral type, bicortically centered location, or when MIC is located in sector 4 or 5 close to midline, increasing the traction time by some months.


Asunto(s)
Diente Canino/cirugía , Maxilar/cirugía , Ortodoncia Correctiva/métodos , Diente Impactado/complicaciones , Diente Impactado/terapia , Adolescente , Diente Canino/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incisivo , Masculino , Maloclusión/clasificación , Maloclusión/terapia , Maxilar/diagnóstico por imagen , Procedimientos Quirúrgicos Orales , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Planificación de Atención al Paciente , Radiografía Dental , Estudios Retrospectivos , Resorción Radicular/complicaciones , Factores Sexuales , Factores de Tiempo , Erupción Dental , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Tracción , Resultado del Tratamiento
11.
Niger J Clin Pract ; 22(8): 1126-1131, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31417057

RESUMEN

Objective: The aim of this cross-sectional study was to assess the prevalence of apical periodontitis in root canal treated teeth in Turkish subpopulation and to evaluate the effects of both coronal restoration quality and root canal treatment (RCT) quality on apical periodontitis. Materials and Methods: Panoramic images of individuals who applied to our department for different diagnostic reasons were randomly and retrospectively scanned. Total RCT number, RCT quality, type of coronal restoration, restoration quality, periapical status, and total number of teeth were recorded. The criteria used for coronal restorations quality and RCT quality were defined by De Moor et al. and slightly modified by Gunduz et al. Periapical status was assessed by the periapical index developed by Orstavik et al. Pearson's Chi-square test was used for statistical analysis, and the intraobserver agreements were assessed by Kappa coefficients. Values of P < 0.05 were accepted to be meaningful. Results: The total examined teeth number was 6064, of which had 541 (8.9%) RCT. The prevelance of apical periodontitis was 40.5%. The number of adequate RCT was 178 (32.9%), and 138 (77.5%) of them were healthy. The number of adequate coronal restoration was 334, and 62.3% of them were healthy. For the cases that have adequate coronal restorations, there was statistically significant relationship between adequate RCT and periapical status (P < 0.001). Conclusion: The prevelance of apical periodontitis was 40.5% and there was statistically significant relationship between adequate RCT and periapical status.


Asunto(s)
Cavidad Pulpar/diagnóstico por imagen , Restauración Dental Permanente/efectos adversos , Periodontitis Periapical/diagnóstico por imagen , Radiografía Panorámica/métodos , Tratamiento del Conducto Radicular/efectos adversos , Corona del Diente/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen , Adulto , Distribución de Chi-Cuadrado , Estudios Transversales , Restauración Dental Permanente/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodontitis Periapical/epidemiología , Prevalencia , Estudios Retrospectivos , Tratamiento del Conducto Radicular/normas , Turquia/epidemiología
12.
J Endod ; 45(10): 1209-1218, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31378339

RESUMEN

INTRODUCTION: The aims of this in vivo cone-beam computed tomographic (CBCT) study were to evaluate the prevalence, characteristics, and correlations between the fused rooted maxillary first and second molars as well as their consequent merged and C-shaped canals in a Saudi Arabian population. METHODS: CBCT imaging of 726 maxillary first and second molars from 208 subjects of Saudi origin were evaluated in the present study. The prevalence of fused rooted maxillary molars, merged canals, C-shaped configurations, and correlations between the presence of fused rooted teeth between first and second molars were examined as the primary outcome. Differences by sex, location in the jaw, and bilateral symmetry (similarity between right- and left-side teeth in the same patient) were evaluated as the secondary outcome. The Z test was used for differences in the independent proportions, the chi-square test was used for differences between sex and locations, and the Cohen kappa test was used for bilateral symmetry. The kappa test was also used for intrarater reliability. A value of P < .05 was considered significant. RESULTS: The prevalence of fused rooted maxillary first and second molars was 7% and 21%, respectively. Within fused rooted teeth, the presence of merged canals was 8.3% and 32.1%, whereas the prevalence of C-shaped canals was 8.3% and 5.1% in first and second maxillary molars, respectively. Among 57 subjects who had fused rooted maxillary molars, 19.3% showed a correlation between first and second molars. In fused rooted maxillary molars, 3.8% first molars and 13% second molars were bilaterally symmetrical. There were no statistically significant differences between sexes and right- and left-sided fused rooted maxillary molars, merged canals, or C-shaped canals. CONCLUSIONS: Maxillary second molars presented more complex external and internal morphology compared with maxillary first molars, with an overall prevalence of 14% of fused rooted maxillary molars and 3.7% merged and 0.8% C-shaped canal configurations for all maxillary molars. The clinician should be aware of such challenges, and for a better treatment outcome, the use of CBCT imaging (small field of view) and an operative dental microscope can be considered when a preoperative periapical radiograph shows signs of fused rooted maxillary molars.


Asunto(s)
Cavidad Pulpar , Raíz del Diente , Tomografía Computarizada de Haz Cónico , Humanos , Diente Molar , Prevalencia , Reproducibilidad de los Resultados , Arabia Saudita , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/patología
13.
J Med Case Rep ; 13(1): 261, 2019 Aug 07.
Artículo en Inglés | MEDLINE | ID: mdl-31387625

RESUMEN

BACKGROUND: Anomalies in primary teeth are comparatively fewer than in the permanent teeth. The presence of a primary canine with two roots is very rare. An unusual anomaly like this may lead to problems during extraction or exfoliation. Emphasis on the importance of anomalies is required for proper diagnosis and to facilitate a better treatment outcome. CASE PRESENTATION: The present case report describes a case of a bilateral bi-rooted primary maxillary canines diagnosed during a radiographic examination in a 9-year-old Saudi boy. To the best of our knowledge, this is the first case of bi-rooted primary maxillary canine reported from the region of Saudi Arabia. CONCLUSION: This case report aims to increase awareness of the morphological alterations in primary canines and to emphasize the importance of diagnosis and radiographic examination using different angles. Clinicians should consider all the possible tooth variations during routine intra-oral and radiographic examinations to facilitate a better treatment outcome and to avoid unwanted complications.


Asunto(s)
Incisivo/anomalías , Raíz del Diente/anomalías , Preescolar , Humanos , Incisivo/diagnóstico por imagen , Masculino , Maxilar/diagnóstico por imagen , Radiografía , Raíz del Diente/diagnóstico por imagen
14.
Microsc Res Tech ; 82(10): 1748-1755, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31313438

RESUMEN

The aim of the study was to compare different imaging methods in the diagnosis of microcracks on root dentin and to evaluate the frequency of dentinal microcracks observed after root canal preparation using the ProTaper Universal (PTU) system of different sizes. A total of 30 mandibular molars' mesial roots were scanned with microcomputed tomography (micro-CT) and cone beam computed tomography (CBCT) imaging methods before instrumentation. Root canal instrumentation was performed up to PTU F2 and F4 files. After instrumentation stages, the roots were scanned again with micro-CT and then with CBCT in same parameters. All roots were sectioned horizontally at 2, 4, 6, 8, and 10 mm from the apices of the specimens. The sections were imaged under a stereomicroscope. Finally, imaging of the sections was done by scanning electron microscopy (SEM). Statistical data analysis of instrumentation steps was performed using Friedman and Wilcoxon tests, and the data of imaging methods were analyzed using Kruskal-Wallis and Mann-Whitney U tests (p = .05). Instrumentation with the PTU system up to F2 and F4 files significantly increased the number of microcracks compared with preoperative samples according to micro-CT imaging (p < .05). For detecting microcracks on the root dentin, there were no statistically significant differences between micro-CT (43.9%) and stereomicroscopy (45.8%) (p < .05). SEM showed significantly higher percentage of microcracks (88.3%) (p > .05). No microcrack was observed using the CBCT method. There were no statistically differences between micro-CT and stereomicroscopy. SEM showed more dentinal microcracks while no microcrack was observed with CBCT.


Asunto(s)
Dentina/diagnóstico por imagen , Dentina/lesiones , Diagnóstico por Imagen/métodos , Raíz del Diente/diagnóstico por imagen , Raíz del Diente/lesiones , Humanos , Diente Molar/diagnóstico por imagen , Diente Molar/lesiones , Preparación del Conducto Radicular/efectos adversos
15.
BMC Med Genet ; 20(1): 126, 2019 07 16.
Artículo en Inglés | MEDLINE | ID: mdl-31311520

RESUMEN

BACKGROUND: Osteodysplasia of the oral and maxillofacial bone is generally accompanied by systemic bone abnormalities (such as short stature, joint contracture) or other systemic abnormalities (such as renal, dermatological, cardiovascular, optic, or hearing disorders). However, it does not always present this way. Recent reports have suggested that genome-wide sequencing is an effective method for identifying rare or new disorders. Here, we performed whole-exome sequencing (WES) in a patient with a unique form of acquired, local osteodysplasia of the oral and maxillofacial region. CASE PRESENTATION: A 46-year-old woman presented to our hospital with the complaint of gradually moving mandibular teeth (for 6 months), changing facial appearance, and acquired osteolysis of the oral and maxillofacial bones, showing mandibular hypoplasia without family history. Upon skeletal examination, there were no abnormal findings outside of the oral and maxillofacial area; the patient had a height of 157 cm and bone mineral density (according to dual energy x-ray absorptiometry) of 90%. Results of blood and urine tests, including evaluation of bone metabolism markers and neurological and cardiovascular examinations, were normal. We performed WES of genomic DNA extracted from the blood of this patient and her mother, who did not have the disease, as a negative control. We identified 83 new missense variants in the patient, not detected in her mother, including a candidate single nucleotide variant in exon 14 of PCNT (pericentrin). Critical homozygous or compound heterozygous variants in PCNT are a known cause of microcephalic osteodysplastic primordial dwarfism type II accompanied by mandibular hypoplasia, which is similar to the maxillofacial phenotype in this patient. CONCLUSIONS: Protein simulations performed using Polymorphism Phenotyping v2 and Combined Annotation Dependent Depletion software indicated that this missense variant is likely to disrupt the PCNT protein structure. These results suggest that this is a new form of osteolysis related to this PCNT variant.


Asunto(s)
Antígenos/genética , Enanismo/genética , Retardo del Crecimiento Fetal/genética , Predisposición Genética a la Enfermedad/genética , Variación Genética/genética , Microcefalia/genética , Osteocondrodisplasias/genética , Antígenos/química , Secuencia de Bases , Densidad Ósea , Enanismo/diagnóstico por imagen , Enanismo/fisiopatología , Exones , Femenino , Retardo del Crecimiento Fetal/diagnóstico por imagen , Retardo del Crecimiento Fetal/fisiopatología , Heterocigoto , Homocigoto , Humanos , Mandíbula/patología , Microcefalia/diagnóstico por imagen , Microcefalia/fisiopatología , Persona de Mediana Edad , Osteocondrodisplasias/diagnóstico por imagen , Osteocondrodisplasias/fisiopatología , Osteólisis , Fenotipo , Tomógrafos Computarizados por Rayos X , Odontopatías/congénito , Odontopatías/diagnóstico por imagen , Odontopatías/genética , Raíz del Diente/anomalías , Raíz del Diente/diagnóstico por imagen , Secuenciación del Exoma Completo
16.
Am J Orthod Dentofacial Orthop ; 156(1): 44-52, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256835

RESUMEN

INTRODUCTION: The objective of this study was to investigate the location, orientation and root development of maxillary lateral incisors in patients with palatally impacted central incisors. Comparison was made between the lateral incisor on the affected side and that on the normally erupted side. METHODS: Cone-beam computed tomographic images from 20 patients (10 boys, 10 girls, mean age (9.01 ± 1.52 years old) with unilateral palatally impacted maxillary central incisors were imported into Dolphin imaging software 11.8 for 3-dimensional reconstruction and reorientation. Software measurement tools were used to measure the root length, crown distance, angle to palatal plane, distance to midline, and angle to midsagittal plane of the maxillary lateral incisors on both the impacted and unaffected sides. RESULTS: The Wilcoxon signed rank test indicated that lateral incisors on the impacted side were more proclined, at a mean angle difference of 29.47° in the sagittal plane (P < 0.001). The mean length of the roots of the lateral incisors was 1.21 mm shorter (P < 0.05) on the affected side compared with the normal side, and the lateral incisor crowns on the impacted side were located at an average of 4.57 mm closer to the palatal plane than on the normally erupted side (P < 0.001). The angle of long axis of the lateral incisors on the affected side had a greater angulation to the midsagittal plane compared with the unaffected side, with a mean difference of 30.27° (P < 0.001). CONCLUSIONS: Maxillary lateral incisors adjacent to palatally impacted maxillary central incisors side had abnormal root development and demonstrated angulation and position change compared with those adjacent to normally erupted central incisors.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Incisivo/anomalías , Incisivo/anatomía & histología , Maxilar/anatomía & histología , Paladar (Hueso)/anatomía & histología , Diente Impactado/diagnóstico por imagen , Niño , Femenino , Humanos , Procesamiento de Imagen Asistida por Computador/métodos , Imagen Tridimensional , Incisivo/diagnóstico por imagen , Masculino , Maxilar/diagnóstico por imagen , Paladar (Hueso)/diagnóstico por imagen , Estudios Retrospectivos , Corona del Diente/anatomía & histología , Erupción Dental , Raíz del Diente/anomalías , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen
17.
Oral Maxillofac Surg Clin North Am ; 31(3): 489-496, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31164269

RESUMEN

This article summarizes the accomplishments and knowledge gained over the past 2 decades with respect to immediate dental root analogue implants (RAIs). It discusses how the artificial nature of the present dental implant materials and unnatural shapes cause complications, posing a threat to long-term biointegration, and how RAIs will influence the way that implants are produced. Will an osseointegrated RAI be the optimal immediate replacement for extracted teeth in the future? How will three-dimensional printing be involved in these more biomimetic RAI systems? The present research and developments seem promising and will continue to shape the future of implant prosthodontics.


Asunto(s)
Biomimética , Implantes Dentales , Diseño de Prótesis Dental/métodos , Impresión Tridimensional , Raíz del Diente/diagnóstico por imagen , Materiales Dentales , Humanos , Imagen Tridimensional , Oseointegración , Raíz del Diente/cirugía
18.
Forensic Sci Int ; 301: 76-81, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31132549

RESUMEN

The Kvaal method as a non-invasive method for age estimation based on the changes of pulpal size caused by secondary dentin deposition has been applied to different ethnics. However, its results are often conflicting and its accuracy is relatively poor. This study aimed to verify the applicability of the Kvaal method to estimate the ages of the Chinese population using digital panoramic radiographs and to formulate specific regression equations for use in Chinese subjects. A sample of 360 digital panoramic radiographs from northern Chinese population were selected, from which the pulpal size and width of six tooth types (maxillary central incisor, lateral incisor, second premolar, mandibular lateral incisor, canine, and first premolar) were measured using Kvaal's method. Then, inter- and intra-observer reliabilities were calculated to evaluate the reproducibility of those measurements. The correlation between chronological age and measurements was also examined and the Chinese-specific equations for age estimation were conducted. After comparing the accuracy of the Chinese-specific equation with the original Kvaal equation, the age of the Chinese population was clearly overestimated by Kvaal's equation, and a Chinese-specific equation could ameliorate age prediction accuracy. In addition, the residuals of the Chinese-specific equation were significantly lower than that of the original Kvaal's method. Thus, we concluded that the original Kvaal equation cannot accurately estimate age in the Chinese population. Although accuracy improved using the Chinese-specific equation that was based on Kvaal's methodology, the standard deviation remained large. In view of the lack of accurate age estimation methods for adults, we propose finding more correlated variables or combining other age estimation methods to increase the accuracy for adult age estimation.


Asunto(s)
Determinación de la Edad por los Dientes/métodos , Pulpa Dental/diagnóstico por imagen , Radiografía Dental Digital , Radiografía Panorámica , Ápice del Diente/diagnóstico por imagen , Diente/diagnóstico por imagen , Adulto , Anciano , Grupo de Ascendencia Continental Asiática , China , Pulpa Dental/anatomía & histología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Reproducibilidad de los Resultados , Programas Informáticos , Diente/anatomía & histología , Ápice del Diente/anatomía & histología , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Adulto Joven
19.
Morphologie ; 103(341 Pt 2): 65-71, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31036461

RESUMEN

PURPOSE: To investigate the position of the mental foramen based on its relation with the roots of the mandibular teeth and quantify the prevalence of anterior loop and satellite foramina in the mandible in cone beam computed tomography (CBCT) scans. METHODS: The sample consisted of 400 CBCT scans of males (n=190) and females (n=210) from Moscow, Russia. Using the system proposed by Tebo and Telford (1950), the position of the mental foramen was classified into: I) mesial to the mandibular first premolar; II) at the apex of the mandibular first premolar; III) between the roots of the mandibular first and second premolars; IV) at the apex of the mandibular second premolar; V) between the roots of the mandibular second premolar and first molar; and VI) at the apex of the roots of the mandibular first molar. Additionally, the images were assessed to investigate the prevalence of the anterior loop of the mandibular canal and the presence of satellite foramina. RESULTS: Mental foramen position class III was the most prevalent (61%) followed by class IV (27%), II (8%), I, V and VI (together <4%). Statistically significant differences were not detected between males and females (P<0.05). In Russian males and females, the anterior loop of the mandibular canal was found in 15.78% and 3%, respectively; while satellite foramina were found in 31.58% and 19.62%, respectively. CONCLUSION: The spatial position of the mental foramen and the morphological alterations of the mandibular canal and adjacent foramina must be known prior to surgical interventions in the mandible.


Asunto(s)
Mandíbula/anatomía & histología , Raíz del Diente/anatomía & histología , Adulto , Diente Premolar/anatomía & histología , Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Factores Sexuales , Raíz del Diente/diagnóstico por imagen
20.
J Endod ; 45(6): 724-728, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31056296

RESUMEN

INTRODUCTION: The morphology of the palatal root of maxillary first and second molars was analyzed and compared using micro-computed tomographic scanning. METHODS: Forty-seven extracted maxillary molars were scanned with a micro-computed tomographic device to analyze the palatal radicular dentin dimensions, canal working width, root length, canal curvature, lateral canals, and apical constriction anatomy. Quantitative data were analyzed with mean and standard deviation for first and second molars, respectively. Comparison was made between first and second molars using an unpaired t test. RESULTS: The palatal root of maxillary first molars was found to have statistically significantly thinner dentin than second molars on the palatal aspect of the root 8-11 mm from the apex, correlating to the coronal and middle thirds of the root. First molar palatal roots also had a statistically significantly wider canal mesiodistally than second molars at 13-15 mm from the apex, correlating approximately to the level of the cementoenamel junction and pulpal floor. Significant canal curvature was present. These findings suggest the need for conservative coronal flaring and instrumentation. CONCLUSIONS: The absence of an apical constriction in 76.6% of the specimens highlights the importance of creating an apical seat through instrumentation to maintain obturation materials. A minimum master apical file size of 40 is recommended based on preoperative working widths in the apical 0.5-1.0 mm. A root-end resection of 3.5 mm would remove a greater majority of lateral canals.


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