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1.
Prog Orthod ; 22(1): 8, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33718992

RESUMEN

BACKGROUND: This review synthesizes the available evidence about the predisposition of individuals with asthma or allergies to orthodontically induced inflammatory root resorption (OIIRR) and possible factors related to root resorption that were investigated in the included studies, such as the type of malocclusion, duration of orthodontic treatment, and tooth units. MATERIAL AND METHODS: Six electronic databases and partial gray literature were searched without date or language restrictions until September 2020. Prospective and retrospective observational cohort and case-control studies were included. The risk of bias (RoB) was assessed using the checklists from the Joanna Briggs Institute and the certainty of the evidence using the GRADE tool. To complement the case-control studies, the odds ratio (OR) of the individuals with allergies/asthma to develop root resorption was calculated. RESULTS: Six studies were included. One study with low RoB, one with moderate, and one with high RoB stated that allergic patients did not report a greater chance of developing OIIRR (OR = 1.17 to 2.10, p = 0.1 to 1), while only one study with low RoB reported that individuals with allergies tend to develop root resorption (OR = 2.4, 95% CI = 1.08-5.37). Three studies with low RoB and one with moderate showed no significant association between asthma and OIIRR (OR = 1.05 to 3.42, p = 0.12 to 0.94). No association was identified between the type of malocclusion and the degree of OIIRR. Uniradicular dental units and a prolonged treatment time seem to be associated with an increased risk of resorption. The certainty of the evidence was considered low for both exposure factors. CONCLUSION: Evidence with a low level of certainty indicates that individuals with allergies or asthma are not more predisposed to OIIRR. Uniradicular teeth and long-term orthodontic treatments are associated with a higher risk of OIIRR. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020188463.


Asunto(s)
Asma , Maloclusión , Resorción Radicular , Asma/complicaciones , Humanos , Estudios Prospectivos , Estudios Retrospectivos , Resorción Radicular/etiología , Técnicas de Movimiento Dental
2.
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
3.
Am J Orthod Dentofacial Orthop ; 159(3): e245-e251, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33518440

RESUMEN

INTRODUCTION: The objective of this research was to investigate the effects of different wavelengths low-level laser therapies on orthodontically induced inflammatory root resorption (OIIRR) during orthodontic tooth movement in rats by micro-computerized tomography. METHODS: Forty Wistar albino rats were divided into 5 groups: control group (A), 405-nm laser group (B), 532-nm laser group (C), 650-nm laser group (D), and 940-nm laser group (E). The left side of group A was used as a positive control (A-PC), and the right side of group A was used as a negative control (A-NC) group. In all groups, the maxillary left first molars were moved mesially by 50 g of force for 14 days. The lasers were performed for 9 minutes on the maxillary left first molar tooth. At the end of the experimental period, OIIRR measurements were performed at the mesial and the distal sides along the mesial root of the maxillary first molars. RESULTS: The root resorption volume was significantly lower in group A-NC than in groups A-PC, B, and D. The percentage of root resorption was significantly lower in group A-NC than in all other groups. The root resorption volume and the percentage of root resorption in groups C, D, and E were significantly lower than group A-PC. The depth and the width of the lacuna and even the number of mesial lacunae were similar between groups. The distal and the total lacunae were significantly lower in group A-NC than in all other groups except group C. CONCLUSIONS: The 532-nm, 650-nm, and 940-nm lasers significantly reduced the volume of OIIRR. In addition, the 532-nm laser reduced the number of lacunae both distally and totally than all the other groups.


Asunto(s)
Terapia por Luz de Baja Intensidad , Resorción Radicular , Animales , Ratas , Ratas Wistar , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Tomografía , Técnicas de Movimiento Dental
4.
Am J Orthod Dentofacial Orthop ; 159(3): e217-e232, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33487501

RESUMEN

INTRODUCTION: This study aimed to investigate the effect of EphB4/ephrinB2 signaling on orthodontically-induced root resorption repair and the possible molecular mechanism behind it. METHODS: Seventy-two 6-week-old male Wistar rats were randomly divided into 3 groups: blank control group, physiological regeneration group (PHY), and EphB4 inhibitor local injection group (INH). A root repair model was built on experimental rats of the PHY and INH groups. The animals in the INH groups received a daily periodontal local injection of EphB4 inhibitor NVP-BHG712, whereas the blank control group and PHY groups received only the vehicle. RESULTS: Histologic staining and microcomputed tomography analysis showed that root regeneration was inhibited in the INH group compared with the PHY group with a greater number of osteoclasts. Immunohistochemical staining showed active EphB4/ephrinB2 signaling activities during root regeneration. The cementogenesis-related factors cementum attachment protein, alkaline phosphatase, osteopontin, and runt-related transcription factor 2, and osteoclastic-related factors RANKL and osteoprotegerin were affected by regulated EphB4/ephrinB2 signaling. CONCLUSIONS: These findings demonstrated that the EphB4/ephrinB2 signaling might be a promising therapeutic target for novel therapeutic approaches to reduce orthodontically-induced root resorption through enhancement of cementogenesis.


Asunto(s)
Efrina-B2 , Resorción Radicular , Animales , Masculino , Osteoclastos , Ratas , Ratas Wistar , Resorción Radicular/etiología , Microtomografía por Rayos X
5.
Cient. dent. (Ed. impr.) ; 17(3): 233-237, sept.-dic. 2020. ilus
Artículo en Español | IBECS | ID: ibc-198607

RESUMEN

Atendiendo a la localización de la reabsorción radicular, ésta puede ser clasificada en externa o interna. La reabsorción interna es relativamente poco frecuente, y su etiología y patogénesis no está todavía del todo clara. Este artículo muestra la complejidad de un incisivo central superior con una reabsorción interna inflamatoria perforante. El diagnóstico definitivo lo hallamos a través del examen tridimensional, que confirmó la extensión y comunicación con la superficie externa radicular. Aunque como podremos ver a lo largo de la exposición del caso clínico, la ayuda del microscopio nos permitió abordar el caso con mayor seguridad. En todo momento pudimos eliminar el tejido inflamatorio y preparar el conducto de manera adecuada. La obturación en este tipo de casos supone un reto para el endodoncista, siendo éste, mayor cuando se realiza únicamente de manera ortógrada. Para la obturación realizamos una técnica descrita en la literatura, sellando la zona apical a la reabsorción con gutapercha adaptada mediante condensación vertical; la zona reabsortiva con material biocerámico y, por último, la zona coronal con guta-percha inyectada. Se realizó un 3D a los 26 meses para una nueva evaluación de la zona reabsortiva, y así evaluar el estado óseo alrededor de la misma. La paciente se presenta totalmente asintomática sin signos clínicos y con buena salud de los tejidos periapicales


Based on the location of the root resorption, it can be classified as external or internal. Internal resorption is relatively rare, and its etiology and pathogenesis is not yet entirely clear. This article shows the complexity of a superior central incisor with a perforating inflammatory internal resorption. The definitive diagnosis is found through the three-dimensional examination, which confirmed the extension and communication with the external root surface. Although as we can see throughout the presentation of the clinical case, the help of the microscope allowed us to address the case with greater certainty. At all times we were able to remove the inflammatory tissue and prepare the duct properly. The obturation in this type of cases supposes a challenge for the endodontist, being this one, greater when it is done only in an ortograde way. For the filling, we performed a technique described in the literature, filling the apical area with resorption with gutta-percha adapted by vertical condensation; the resorptive zone with bioceramic material and finally the coronal zone with injected gutta-percha. A 3D was performed at 26 months for a new evaluation of the resorptive zone, and thus evaluate the bone state around it. The patient presents totally asymptomatic without clinical signs and with good health of the periapical tissues


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Resorción Ósea/cirugía , Enfermedades Periapicales/diagnóstico por imagen , Corona del Diente/diagnóstico por imagen , Corona del Diente/cirugía , Resorción Radicular/etiología , Tomografía Computarizada de Haz Cónico , Imagenología Tridimensional , Cavidad Pulpar/ultraestructura
6.
Angle Orthod ; 90(4): 524-531, 2020 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378490

RESUMEN

OBJECTIVE: To determine the effect of alveolar decortication on orthodontically induced root resorption. MATERIALS AND METHODS: A total of 24 male Wistar rats (14 week old) were used. The rats were randomly divided into one of the following three groups: group 1 (control group), orthodontic tooth movement (OTM) for 2 weeks; group 2, OTM for 2 weeks + two alveolar decortications (2AD); group 3, OTM for 2 weeks + four alveolar decortications (4AD). The first molar was moved mesially for 2 weeks. Micro computed tomography was used to analyze root volume. In addition, histological sections were stained with Tartrate Resistant Acid Phosphatase (TRAP) to quantify the osteoclast number. RESULTS: The buccal root volume in OTM + 4AD group was decreased by 8.92% and 6.11% when compared with the OTM-only group and OTM + 2AD group, respectively. Similarly, the other four root volumes in the OTM + 4AD group was decreased by 8.99% and 5.24% when compared with the OTM-only group and OTM + 2AD group, respectively. There was a decrease in buccal root density in the OTM + 4AD group by 4.66% and 3.56% when compared with the OTM-only group and the OTM + 2AD group, respectively. In addition, there was an increase in the number of osteoclasts by 195.73% and 98.74% in OTM + 4AD group in comparison with the OTM and OTM + 2AD group. CONCLUSIONS: The amount of orthodontically induced root resorption was positively correlated with the extent of surgical injury used to accelerate orthodontic tooth movement.


Asunto(s)
Resorción Radicular , Animales , Masculino , Osteoclastos , Ratas , Ratas Wistar , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Técnicas de Movimiento Dental/efectos adversos , Raíz del Diente/diagnóstico por imagen , Microtomografía por Rayos X
7.
Ned Tijdschr Tandheelkd ; 127(12): 691-698, 2020 Dec.
Artículo en Holandés | MEDLINE | ID: mdl-33367296

RESUMEN

Apical root resorption is a biological process induced when orthodontic force is exerted on a tooth and local necrosis of the periodontal ligament occurs. Macrophages remove the necrotic tissue. In this way, differentiating osteoclasts can both attach to the now available dental surface and can then provoke root resorption. There is considerable uncertainty among dental practitioners on how to deal with clinically relevant apical root resorption (bigger/equal 2 mm) during or after orthodontic treatment. To increase understanding and to improve the quality of care, the Dutch Association of Orthodontists has developed a clinical practice guideline. Recommendations have been formulated for the diagnosis of apical root resorption, possible risk factors and treatment management in order to respond adequately to this problem in practice.


Asunto(s)
Resorción Radicular , Odontólogos , Humanos , Ligamento Periodontal , Rol Profesional , Resorción Radicular/etiología , Técnicas de Movimiento Dental , Raíz del Diente
8.
Angle Orthod ; 90(5): 648-654, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-33378476

RESUMEN

OBJECTIVES: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. MATERIALS AND METHODS: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. RESULTS: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P < .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P < .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P < .001); however, it became similar between the groups after 24 hours. CONCLUSIONS: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Resorción Radicular , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Humanos , Incisivo , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Técnicas de Movimiento Dental
9.
Dental Press J Orthod ; 25(5): 24-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33206825

RESUMEN

OBJECTIVE: The present study aimed at comparing the external lateral root resorption (ELRR) and external apical root resorption (EARR) between teeth moved through the atrophic edentulous ridge and those undergoing the usual orthodontic movement. METHODS: Fifty-four premolars were evaluated, where 27 of them had been moved toward the edentulous ridge (Group 1) and 27 from the same patient, had not been translated, which comprised the control group (Group 2). ELRR was evaluated by 0-3 scores and EARR was evaluated by 0-4 scores, before and after movement. Measurements were compared by Kruskal-Wallis and Student-Newman-Keuls tests. RESULTS: ELRR increased statistically only in the Group 1 (p< 0.05). After orthodontic treatment, it was observed that almost 56% (n = 15) of teeth in Group 1 presented scores 2 and 3, while Group 2 presented scores 2 and 3 in about 11% (n= 3) of the teeth. EARR increased in both groups after orthodontic movement, however, statistically analyses showed no significant differences between groups (p> 0.05). CONCLUSIONS: Orthodontic movement into the atrophic edentulous ridge is subject to a greater lateral external root resorption.


Asunto(s)
Resorción Radicular , Diente Premolar , Humanos , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Técnicas de Movimiento Dental
10.
Am J Orthod Dentofacial Orthop ; 158(5): 700-709, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32950335

RESUMEN

INTRODUCTION: External apical root resorption is nearly ubiquitous in people treated orthodontically. This study predicted the extent of external apical root resorption by the vector of the incisor movement. METHODS: Cone-beam computed tomography scans of 93 white American adolescents (45 boys, 48 girls) with a Class I malocclusion who received comprehensive orthodontics were analyzed. Half were treated with 4 first-premolar extractions, and the others were treated without extractions. An x, y, z coordinate system was registered on the maxillae, superimposing on foramina, to quantify vectors of maxillary incisor movements. Multiple linear regression identified significant predictors of resorption for each incisor. RESULTS: Strongly predictive models (R2 = 77%-86%) were obtained. All directions of incisor movement tested (anteroposterior, mediolateral, craniocaudal, torquing) increased the risk of resorption in a dose-response fashion. Intrusion was most damaging. The patient's sex, age, and duration of treatment were not predictive. CONCLUSIONS: Root resorption is a very frequent consequence of tooth movement, especially intrusion and torquing, though no direction is harmless, and most corrections occur in combination. Incisor apical resorption was significantly greater in the extraction sample (ca 0.5 mm).


Asunto(s)
Resorción Radicular , Técnicas de Movimiento Dental , Adolescente , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Incisivo/diagnóstico por imagen , Masculino , Maxilar/diagnóstico por imagen , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Ápice del Diente , Técnicas de Movimiento Dental/efectos adversos , Raíz del Diente
12.
Dental Press J Orthod ; 25(4): 16-22, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965382

RESUMEN

INTRODUCTION: When miniplates are used as anchoring for orthodontic mechanics for anterior open bite correction by retraction of anterior teeth and posterior teeth intrusion and retraction, orthodontically induced inflammatory external apical root resorption is clinically negligible. METHODS: A homogeneous sample of 32 patients was used, and the roots of the teeth were compared on CT scans performed before and after orthodontic treatment. RESULTS: The observed root resorption was minimal, and this can be explained by the uniform distribution of forces in several teeth, simultaneously, in the set of the dental arch and in the bone that supports the teeth. CONCLUSION: The most important thing to prevent root resorption in orthodontic practice, besides being concerned with the intensity of the applied forces, is to be careful with its distribution along the roots of each tooth, in the dental arch and in the bone that supports the teeth.


Asunto(s)
Mordida Abierta/diagnóstico por imagen , Mordida Abierta/terapia , Métodos de Anclaje en Ortodoncia , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Resorción Dentaria , Humanos , Técnicas de Movimiento Dental/efectos adversos
14.
J Endod ; 46(10): 1420-1427, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32525057

RESUMEN

INTRODUCTION: The current retrospective case-control study examined the potential systemic and local risk factors in relationship to external cervical resorption (ECR). The study hypothesis stated that both local and systemic risks are associated with higher ECR rates. METHODS: The ECR group included data about 76 patients (98 teeth) diagnosed with ECR at the university graduate endodontics clinic from 2008-2018. An equivalent comparative control group without ECR was composed of the same pool of patients and matched with cases by sex and age. Information about dental and medical history, including potential local risk factors (bruxism, trauma, eruption disorders, extraction of an adjacent tooth, orthodontics, and restorations) and systemic risk factors (medical conditions, medication, and allergies), was collected for both groups. Data were analyzed at tooth and patient levels. The chi-square test or Fisher exact test compared proportions between the 2 study groups. RESULTS: The overall ECR prevalence among endodontic patients during the 10-year follow-up was 2.3%. ECR was most frequent in maxillary anterior teeth (31.6%), and the Heithersay class 2 was the most frequent (38.8%) ECR diagnosis. Diabetes was the only significant systemic risk factor (P < .05). Trauma, as a local risk factor, was significantly (P < .05) more frequently reported in cases than in controls. CONCLUSIONS: The study hypothesis stating that both systemic and local risk factors were associated with higher ECR rates was partly confirmed, as one systemic (diabetes) and one local (trauma) risk factor were associated with higher ECR rates.


Asunto(s)
Resorción Radicular/epidemiología , Resorción Radicular/etiología , Diente , Estudios de Casos y Controles , Humanos , Estudios Retrospectivos , Cuello del Diente
15.
J Oral Maxillofac Surg ; 78(9): 1467-1477, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32504563

RESUMEN

PURPOSE: Impacted third molars (M3s) may lead to external root resorption (ERR) and dental caries (DC) in the adjacent second molars (M2s). The aim of this study was to identify the risk factors for ERR and DC in M2s associated with impacted M3s. MATERIALS AND METHODS: We implemented a cross-sectional study and enrolled a sample composed of patients with M3s and M2s present and cone-beam computed tomography (CBCT) scans available for review. If there was contact between the M2 and the adjacent M3 and the border of radiolucency was more distinct, the case was considered ERR. Apart from that, the case was considered DC. Potential predictor variables were defined as age, gender, tooth location, M2-M3 contact, root development in M3, M3 inclination, M3 impaction type, and M3 follicular diameter. Outcomes of the study were DC and ERR in M2s. CBCT was used to detect the presence of DC and ERR in M2s. RESULTS: A total of 250 eligible images of M3s in the upper and lower jaws of 167 patients were included. The mean age of the patients with CBCT images available was 26.08 ± 4 years (range, 18 to 40), and 43.6% of the patients were men. Factors associated with a significantly increased frequency of ERR in M2s included maxillary location, presence of M2-M3 contact, and mesioangular inclination (P < .005). DC in M2s was significantly more likely to occur in those with absence of contact between M2 and M3 (P < .005). CONCLUSIONS: The results of this study showed an increased risk of ERR to be associated with maxillary molars, mesioangular inclination, and presence of M2-M3 contact. The variable associated with an increased risk of DC was the absence of M2-M3 contact.


Asunto(s)
Caries Dental , Resorción Radicular , Diente Impactado , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Estudios Transversales , Caries Dental/diagnóstico por imagen , Humanos , Masculino , Diente Molar/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Estudios Retrospectivos , Factores de Riesgo , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/etiología , Diente Impactado/diagnóstico por imagen , Adulto Joven
17.
Niger J Clin Pract ; 23(5): 631-637, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32367869

RESUMEN

Background: Replantation of avulsed teeth is an invasive treatment approach where patient cooperation is required after the risks are explained to the patient or family. Although replantation of an avulsed permanent teeth is an accepted treatment approach, the long-term prognosis of the replanted teeth is still controversial. This report describes the survival of delayed replanted 15 incisors that was stored in unfavorable conditions after avulsion. Materials and Methods: Nine patients, aged 8-12 years, were referred to the Inonu University, Pediatric Dentistry Department with traumatically avulsed incisors. The parents were informed about the possible complications of a delayed replantation. Results: Forty percent of the teeth were splinted with flexible orthodontic wire and composite. The follow-up periods were varied from 24 to 48 months. The mean follow-up periods were 33.3 ± 8 months. 40% of the teeth were retained in the mouth for at least 3 years and contributed to alveolar bone development. In these cases, the most common complication (9 teeth, 60%) was replacement root resorption. Two of the 15 teeth which had wide open apices, continued to the root development. Conclusion: In this study, replanted teeth were retained in the mouth for at least 2 years and contributed to the patient's development. Therefore, this study has shown that delayed replantation of an avulsed tooth for a child is still worthwhile, even in cases of poor prognosis where the tooth had extended extra-alveolar dry storage. We believe that delayed replantation should be done because of its importance for the child's jaw and facial development.


Asunto(s)
Incisivo/lesiones , Avulsión de Diente/cirugía , Reimplante Dental , Niño , Dentición Permanente , Femenino , Humanos , Incisivo/diagnóstico por imagen , Incisivo/cirugía , Masculino , Padres , Radiografía Dental , Resorción Radicular/etiología , Resorción Radicular/prevención & control , Conservación de Tejido/métodos , Anquilosis del Diente , Avulsión de Diente/diagnóstico por imagen , Avulsión de Diente/fisiopatología , Resultado del Tratamiento
18.
Dent Traumatol ; 36(2): 174-184, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31638331

RESUMEN

BACKGROUND/AIM: Data on the clinical outcomes of traumatically intruded, young, permanent teeth in Chinese children and adolescents are absent. The aim of this study was to examine the probability of spontaneous re-eruption of injured teeth, to investigate the incidence of pulp necrosis with infection of the root canal system and replacement root resorption and to analyse possible factors related to healing complications after injury. MATERIALS AND METHODS: Clinical data from 6- to 18-year-old patients who sustained intrusive luxation from 2007 to 2016 were reviewed. Teeth were treated by awaiting re-eruption, orthodontic repositioning or surgical repositioning. The incidences of spontaneous re-eruption, pulp necrosis with infection, replacement resorption and marginal bone loss were calculated, and factors related to these complications were analysed using Cox regression and Kaplan-Meier analyses. RESULTS: Data from 79 teeth in 58 patients (mean age 9.19 ± 2.34 years) were examined over follow-up periods from 7 to 87 months (median 18 months). Of the 50 teeth awaiting re-eruption, the incidences of complete re-eruption and partial re-eruption were 40.0% and 34.0%, respectively. Teeth intruded <3 mm had a higher complete re-eruption rate (57.1%) than those with a 3-7 mm of intrusion (18.2%) (hazard ratio [HR] = 4.15). Of the 52 teeth observed for more than 12 months, pulp necrosis with infection, replacement resorption and marginal bone loss occurred in 57.4%, 15.4% and 61.5% of the teeth, respectively. Teeth with 3-7 mm (60.9%, HR = 2.97) or >7 mm (100%, HR = 6.44) of intrusion and teeth with uncomplicated crown fracture (85.7%, HR = 5.19) were more likely to develop pulp necrosis with infection. Teeth that received orthodontic or surgical repositioning showed higher incidences of replacement resorption (23.1%, HR = 5.72; 25.0%, HR = 11.68, respectively). CONCLUSIONS: Spontaneous re-eruption of intruded teeth was significantly related to intrusion depth. Intrusion depth and crown fracture had strong relationships with pulp necrosis with infection, whereas the choice of treatment influenced the development of replacement resorption.


Asunto(s)
Resorción Radicular/etiología , Avulsión de Diente , Adolescente , Niño , Necrosis de la Pulpa Dental/etiología , Dentición Permanente , Humanos , Incisivo , Estudios Retrospectivos
19.
Eur J Orthod ; 42(4): 407-414, 2020 09 11.
Artículo en Inglés | MEDLINE | ID: mdl-31421637

RESUMEN

BACKGROUND: Recently, the potential impact of different medications on the rate of orthodontic tooth movement and the associated root resorption has been systematically reviewed in animal studies and various effects have been shown. However, animal data cannot be extrapolated to human clinical situations directly. OBJECTIVES: To systematically investigate the most up to date available evidence from controlled human studies regarding the effect of medication administration on the rate of orthodontic tooth movement and associated root resorption development. SEARCH METHODS: We searched eight databases (covering also grey literature) without restrictions and we performed hand searching up until October 2018. SELECTION CRITERIA: Controlled studies in humans assessing the effect of various medications on the rate of orthodontic tooth movement and root resorption development. DATA COLLECTION AND ANALYSIS: Study selection was followed by data extraction and risk of bias assessment using the ROBINS-I tool for non-randomized and the Cochrane Risk of Bias Tool for randomized studies. RESULTS: Eight studies, at various risk of bias, were finally identified. With regard to the rate of orthodontic tooth movement, local injections of prostaglandin E1 were found to exert an increasing effect, whereas systemic intake of nabumetone decreased it. Following tenoxicam administration, drinking water with fluoride or local injections of calcitriol (vitamin D metabolite), no significant effects were demonstrated. Concerning root resorption development, nabumetone administration was shown to reduce it, whereas fluoride, overall, was not observed to exert any effect. Only in individuals subjected to heavy orthodontic forces, did fluoride show a protective effect for the period of force application, but not in the longer term during retention. CONCLUSIONS: The aforementioned substances may show varying effects on the rate of orthodontic tooth movement and root resorption development in human subjects. Despite the observed limitations, the orthodontist should be able to identify patients taking pharmaceuticals and consider any implications related to orthodontic treatment. REGISTRATION: PROSPERO (CRD42017078208).


Asunto(s)
Preparaciones Farmacéuticas , Resorción Radicular/etiología , Resorción Radicular/prevención & control , Animales , Manejo de Datos , Fluoruros , Humanos , Técnicas de Movimiento Dental/efectos adversos , Raíz del Diente
20.
Eur J Orthod ; 42(2): 115-124, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-31087032

RESUMEN

OBJECTIVES: To develop a clinical practice guideline on orthodontically induced external apical root resorption (EARR), with evidence-based and, when needed, consensus-based recommendations concerning diagnosis, risk factors, management during treatment, and after-treatment care. MATERIALS AND METHODS: The Appraisal of Guidelines for Research and Evaluation II instrument and the Dutch Method for Evidence-Based Guideline Development were used to develop the guideline. Based on a survey of all Dutch orthodontists, we formulated four clinical questions regarding EARR. To address these questions, we conducted systematic literature searches in MEDLINE and Embase, and we performed a systematic literature review. The quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. After discussing the evidence, a Task Force formulated considerations and recommendations. The drafted guideline was sent for comments to all relevant stakeholders. RESULTS: Eight studies were included. The quality of evidence (GRADE) was rated as low or very low. Only the patient-related risk factors, 'gender' and 'age', showed a moderate quality of evidence. The Task Force formulated 13 final recommendations concerning the detection of EARR, risk factors, EARR management during treatment, and after-treatment care when EARR has occurred. Stakeholder consultation resulted in 51 comments on the drafted guideline. After processing the comments, the final guideline was authorized by the Dutch Association of Orthodontists. The entire process took 3 years. LIMITATIONS: The quality of the available evidence was mainly low, and patient-reported outcome measures were lacking. CONCLUSIONS/IMPLICATIONS: This clinical practice guideline allows clinicians to respond to EARR based on current knowledge, although the recommendations are weak due to low-quality evidence. It may reduce variation between practices and aid in providing patients appropriate information.


Asunto(s)
Resorción Radicular/diagnóstico , Resorción Radicular/etiología , Resorción Radicular/terapia , Humanos , Factores de Riesgo
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