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1.
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
2.
Orthod Craniofac Res ; 24 Suppl 1: 31-38, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33652500

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate the long-term position of erupted third molars after maxillary total arch distalization using modified C-palatal plates (MCPPs) in adolescents and to identify factors associated with these positions. SETTING AND SAMPLE POPULATION: Sixty-two third molars (male: 20, female: 42) in Class II patients treated with MCPPs and thirty-nine teeth for the Control group (male: 22, female: 17). MATERIALS AND METHODS: Samples were analyzed using panoramic radiographs taken initially (T0), after treatment (T1) and after >3 years retention (T2). Third molars were classified as downward (Group A, N = 31; males: 12, females: 19) and upward (Group B, N = 31; males: 8, females: 23) based on their vertical position after treatment. Analysis of variance and multiple logistic regression analysis were performed. RESULTS: The vertical position of the third molars of Group A, Group B, and the Control showed a 2.2, 3.5 and 2.7 mm downward movement at T2. However, there was no difference in the amount of third molar eruption among the groups. Regarding factors affecting the vertical distance of the third molar, Age, C8-OP, ∠8-OP and D7-T at the initial affected vertical position of the third molars after molar distalization (P < .05). CONCLUSIONS: Group A and B showed no difference in the third molar eruption during retention after total arch distalization. This study suggests that it might be unnecessary to extract the developing third molar before molar distalization in Class II adolescents.


Asunto(s)
Maloclusión de Angle Clase II , Tercer Molar , Adolescente , Cefalometría , Femenino , Humanos , Masculino , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Técnicas de Movimiento Dental
3.
Dental Press J Orthod ; 26(1): e21ins1, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33729293

RESUMEN

INTRODUCTION: The third molars are forgotten because they are the last in the dental arch, they do not directly influence the smile and they appear only in adolescence, when they do. OBJECTIVES: 1) to provide the clinician with a "checklist" to assess and diagnose changes to be screened in the third molar region in new patients; 2) to reveal the importance of not discharging the patient submitted to any dental treatment without first analyzing the third molars region clinically and on imaging examinations, since many diseases are associated to them. RESULT: A list of 10 situations that cover all diagnostic possibilities involving the third molars is presented. CONCLUSION: Adopting this protocol is a matter of habit, since the need is fundamental. The next professional assisting your patient may ask: "Did he not request examinations for the third molars?".


Asunto(s)
Mandíbula , Tercer Molar , Adolescente , Humanos , Masculino , Tercer Molar/diagnóstico por imagen
5.
J Oral Maxillofac Surg ; 79(4): 756-762, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33359105

RESUMEN

PURPOSE: This retrospective study examined distal bone healing on the adjacent second molar between the demineralized bone matrix incorporated with recombinant human bone morphogenetic protein-2 (DBM/rhBMP-2) and a collagen sponge in the mandibular third molar extraction socket. MATERIALS AND METHODS: From 2018 to 2020, 26 extraction patients (male, average 21.5 years), who received a graft (each of 13 using DBM/rhBMP-2 and collagen plug, respectively) on the extraction socket without primary closure, were enrolled in this study. The bony defect was measured by computed tomography before and 6 months after the extraction. The difference in the bone healing was analyzed between the DBM/rhBMP-2 and collagen plug groups using a Mann-Whitney U test. RESULTS: No complications, such as infection and food packing, were encountered. The DBM/rhBMP-2 and collagen plug groups showed a similar distribution of preoperative bony defect (median 5.8 and 5.0 mm, respectively). After 6 months, more bone healing was observed in the DBM/rhBMP-2 group than in the collagen plug group (median 3.85 and 2.37 mm, respectively, P = .029) CONCLUSIONS: A DBM/rhBMP-2 graft after a third molar extraction does significantly alter the bony defect on the distal aspect of the second molar compared with a collagen plug.


Asunto(s)
Mandíbula , Tercer Molar , Proteína Morfogenética Ósea 2/uso terapéutico , Humanos , Masculino , Mandíbula/cirugía , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Proteínas Recombinantes , Estudios Retrospectivos , Extracción Dental , Factor de Crecimiento Transformador beta
6.
J Oral Maxillofac Surg ; 79(3): 520-531, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33338418

RESUMEN

PURPOSE: The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal. PATIENTS AND METHODS: Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05. RESULTS: From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P < .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P < .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes. CONCLUSIONS: Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction.


Asunto(s)
Tercer Molar , Diente Impactado , Adulto , Femenino , Humanos , Mandíbula , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Estudios Prospectivos , Extracción Dental , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Adulto Joven
7.
J Oral Maxillofac Surg ; 79(3): 537.e1-537.e7, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33358721

RESUMEN

Surgical removal of third molars is a common procedure undertaken by both general dentists and oral and maxillofacial surgeons. Although rare, iatrogenic displacement of the tooth or root fragments into adjacent fascial spaces is a known complication. This case report details the retrieval of displaced root tips from a mandibular third molar into the sublingual space using intraoperative navigation to minimize surgical exploration. Oral-maxillofacial surgeons should consider using 3-dimensional navigation during scheduled retrieval of displaced teeth, fragments, or foreign objects to minimize the risk of surgical complications.


Asunto(s)
Cuerpos Extraños , Diente Impactado , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , Diente Molar , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Suelo de la Boca , Extracción Dental
8.
Cient. dent. (Ed. impr.) ; 17(3): 225-231, sept.-dic. 2020. tab
Artículo en Español | IBECS | ID: ibc-198606

RESUMEN

La extracción del tercer molar inferior es el procedimiento más frecuente dentro del campo de la cirugía bucal, siendo el daño del nervio dentario inferior una de las complicaciones más frecuentes en la extracción. Como alternativa para disminuir el riesgo de aparición de esta complicación surge la coronectomía, técnica que consiste en la eliminación de la corona dentaria manteniendo intactas las raíces dentro del hueso alveolar. El objetivo del presente artículo fue realizar una puesta al día sobre la coronectomía en terceros molares inferiores, analizando indicaciones, contraindicaciones, complicaciones y éxito de esta técnica. La coronectomía parece ser una alternativa eficaz a la extracción para la prevención de trastornos neurosensoriales en terceros molares impactados en estrecha relación con el NDI. Sin embargo, es necesaria la realización de más estudios comparando la extracción convencional con la coronectomía, con un mayor seguimiento, para conocer el éxito y las complicaciones a largo plazo de este tratamiento


The lower third molar extraction is one of the most common procedures in the field of oral surgery. Furthermore, the damage of the inferior alveolar nerve is one of the most frequent complications related to this procedure. The coronectomy was introduced in 1984, as an alternative approach that tended to reduce the occurrence of this complication. The main objective of this article is to review current evidence of coronectomy applied to mandibular third molars, analyzing indications, contraindications, complications and success of the technique. The coronectomy seems to be an effective alternative to conventional third molar extraction, for the prevention of neurosensorial disorders in impacted third molars in direct relation with inferior alveolar nerve. However, further studies are needed which compare conventional approach with coronectomy with a greater follow-up to understand the long-term morbidities and success of the technique


Asunto(s)
Humanos , Adulto , Tercer Molar/cirugía , Tercer Molar/diagnóstico por imagen , Mandíbula , Corona del Diente/diagnóstico por imagen , Corona del Diente/cirugía , Osteogénesis , Complicaciones Posoperatorias/prevención & control , Nervio Mandibular , Regeneración Ósea , Inflamación/prevención & control
9.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33370928

RESUMEN

We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a 'jelly like' brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.


Asunto(s)
Antineoplásicos Inmunológicos/administración & dosificación , Linfoma de Células B Grandes Difuso , Tercer Molar , Radioterapia/métodos , Movilidad Dentaria , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Biopsia/métodos , Diagnóstico Diferencial , Humanos , Linfoma de Células B Grandes Difuso/complicaciones , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/terapia , Masculino , Tercer Molar/diagnóstico por imagen , Tercer Molar/fisiopatología , Tercer Molar/cirugía , Radiografía Panorámica/métodos , Extracción Dental/métodos , Movilidad Dentaria/diagnóstico , Movilidad Dentaria/etiología , Resultado del Tratamiento
10.
Dental Press J Orthod ; 25(4): 68-74, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32965389

RESUMEN

OBJECTIVE: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. METHODS: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). RESULTS: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). CONCLUSIONS: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


Asunto(s)
Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Diente Impactado/diagnóstico por imagen , Humanos , Mandíbula/diagnóstico por imagen , Diente Molar , Cirujanos Oromaxilofaciales , Ortodoncistas , Radiografía Panorámica , Erupción Dental , Extracción Dental
11.
Artículo en Inglés | MEDLINE | ID: mdl-32981872

RESUMEN

OBJECTIVE: The aim of this cross-sectional accuracy study was to compare panoramic reconstruction (PR) and multiplanar reconstruction (MPR) images, which are used to establish the prognosis for impacted mandibular third molars in relation to professional decision making. STUDY DESIGN: Images of 10 patients who had undergone cone beam computed tomography (CBCT) examination were selected, resulting in 2 distinct groups of images, with 10 in each group: PR and MPR. To check prognostic accuracy, 2 images from each group were randomly selected and reinserted into the sample, totaling 24 images. A questionnaire was completed by 54 professionals: 27 orthodontists and 27 oral and maxillofacial surgeons (OMFSs). Data were evaluated by using the χ2 and McNemar's tests and Kappa statistics at P < .05. RESULTS: There were no statistically significant differences when isolated PR images were compared with MPR images by orthodontists (P = .72) or OMFSs (P = .45). However, there were significant differences in the professional decision regarding the prognosis for impacted teeth, where OMFSs indicated the need for more extractions compared with orthodontists (P < .0001). CONCLUSIONS: There are no differences between PR and multiplanar CBCT images with regard to the determination of the prognosis for impacted mandibular third molars. However, there was a difference in the decision making between the different specialties.


Asunto(s)
Diente Impactado , Tomografía Computarizada de Haz Cónico , Estudios Transversales , Humanos , Mandíbula/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Pronóstico , Radiografía Panorámica , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
12.
Am J Orthod Dentofacial Orthop ; 158(4): 495-504, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32741561

RESUMEN

INTRODUCTION: The mesio-angulated impaction of mandibular third molars makes them unsuitable as donor teeth for tooth autotransplantation. However, uprighted molars may be applicable for autotransplantation. This study aimed to determine the amount of periodontal ligament (PDL) on the root surfaces of extracted third molars after an application of uprighting force and to examine the amount of PDL at the tension and compression sites. METHODS: In this prospective cohort study, 15 mesio-angulated mandibular third molars (iM8s) from 15 patients planned for orthodontic extraction, were uprighted using springs connected to miniscrews, whereas 15 nonopposing and fully erupted mandibular third molars from 15 other patients served as controls. The altered angulation was monitored and assessed from panoramic radiographs. All 30 molars, removed by simple extraction, were stained with 0.04% (w/v) toluidine blue to analyze the percentages of stained PDL on the root surfaces. RESULTS: An average period of 3.4 months was necessary to upright the iM8s at a mean rate of 8.3° per month. The mean percentage of stained PDL on the loaded iM8s was significantly greater than that on the unloaded molars (P <0.05). The mean percentages of stained PDL were significantly increased at the cervical and middle thirds and the buccal, mesial, and distal surfaces of the loaded iM8s compared with those of the unloaded molars (P <0.05), whereas the apical third and the lingual surface, corresponding to the compression sites, showed no significant increases. CONCLUSIONS: Orthodontic uprighting leads to significantly increased proliferative PDL on certain radicular portions and surfaces of iM8s, which might be useful for tooth autotransplantation.


Asunto(s)
Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Diente Impactado/diagnóstico por imagen , Humanos , Mandíbula/diagnóstico por imagen , Ligamento Periodontal/diagnóstico por imagen , Estudios Prospectivos , Técnicas de Movimiento Dental
13.
Oral Dis ; 26 Suppl 1: 145-148, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32862525

RESUMEN

BACKGROUND: Third molar surgery is a common procedure performed by oral and maxillofacial surgeons. This kind of surgery is predictable, and complications are infrequent. Immune deficiency is one of the considerations for the prevention of complications. HIV patients may be immune deficient. Third molar surgical procedures are associated with bleeding and increased risk of infection. Improvement in oral hygiene must be encouraged, such as pre-operative scaling. Prophylactic antibiotics and history of anti-retroviral therapy should be considered. CASE REPORT: 7 cases of third molar surgery in HIV patients were handled at the oral and maxillofacial surgery department. Intraoral examination showed typical lesions of HIV patients such as oral candidiasis, hairy leucoplakia, necrotizing ulcerative periodontitis, oral ulcers and also pericoronitis of third molars. Radiological examination showed impacted teeth in the upper and lower the third molar region. Third molar treatment was carried out as elective surgery under general anaesthesia. Prophylactic antibiotics were given to the patients as standard of care. CONCLUSION: Treatment planning for HIV-positive patients follows the same sequence as with other patients, and the priorities are to remove local infection and prevent further dental disease. Third molar surgery in HIV-positive patients can improve dental health which can affect the quality of life. Prophylactic antibiotic should be used to prevent infections. Bleeding control also needed to avoid complications.


Asunto(s)
Infecciones por VIH , Tercer Molar , Extracción Dental , Diente Impactado , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Humanos , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Calidad de Vida , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
14.
J Oral Maxillofac Surg ; 78(11): 1886-1891, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32640205

RESUMEN

PURPOSE: Coronectomy is performed to avoid injury to the inferior alveolar nerve when mandibular third molars (M3s) in close proximity to the inferior alveolar nerve are indicated for extraction. Concern has been raised regarding the fate of submerged roots with exposed pulp tissue and whether this will serve as a nidus for infection. The study purpose was to answer the following clinical question: Among patients undergoing coronectomy, do those treated with concurrent root canal treatment (RCT), when compared with those not treated with RCT, have a decreased frequency of postoperative infections? The specific aims of this study were to 1) perform a comprehensive review to compare postoperative infection rates in M3 coronectomies with and without concurrent RCT and 2) review relevant animal and human studies pertaining to pulpal physiology as it relates to coronectomy. MATERIALS AND METHODS: The study was designed as a comprehensive review to identify controlled studies that compared outcomes of M3 coronectomies with and without concurrent RCT published through January 2020. Studies included in the sample needed to meet the following criteria: 1) studies published in English, 2) human studies, and 3) studies that reported the postoperative infection outcomes. The predictor variable was concurrent RCT at the time of coronectomy. The outcome variable was postoperative infection. RESULTS: The database search identified 107 publications for initial review. After application of the inclusion and exclusion criteria, the final sample included only 1 publication. The frequencies of postoperative infection with and without concurrent RCT were 87.5% and 12.5%, respectively. CONCLUSIONS: The one study identified for detailed review showed that RCT at the time of coronectomy does not decrease the frequency of postoperative infections. This result supports the recommendation that it is unnecessary to perform concurrent RCT on M3 roots that are retained. The finding that intentional submersion of roots does not require RCT also is supported by multiple animal and human studies.


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Cavidad Pulpar , Humanos , Mandíbula/cirugía , Nervio Mandibular , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Corona del Diente/cirugía , Extracción Dental , Raíz del Diente/cirugía , Diente Impactado/cirugía
15.
Oral Maxillofac Surg ; 24(4): 447-453, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32617697

RESUMEN

PURPOSE: The teeth positioning may be an important associated factor for the pericoronitis' clinical signs. Our objective was to verify the association between lower third molar position according to the Pell and Gregory classification and clinical variables in patients with pericoronitis. METHODS: Cross-sectional analysis of panoramic radiographs and medical records of patients with pericoronitis. Primary outcomes: pain and oral health-related quality of life (OHRQoL); secondary outcomes: mouth opening, edema/erythema extension, visible plaque index, bleeding on probing index, periodontal pocket probing depth, and distal alveolar bone crest height of the adjacent second molar. RESULTS: The edema/erythema extension was higher in the IIA position compared with the IA position (p = 0.03). Regarding the OHRQoL, the OHIP-14 score was 21.0 (± 9.26, range from 4 to 44). The most scored domain was physical pain (5.24), followed by psychological discomfort (4.43). Third molars in IIA position are associated with worse OHRQoL than IB and IIB positions (p = 0.03). CONCLUSIONS: There was a higher extension of edema/erythema and worse OHRQoL when the third molar was in IIA position. Prophylactic removal of mandibular third molar in position IIA may avoid the onset of mucosal edema/erythema and prevent pericoronitis from promoting impairment of individuals' quality of life.


Asunto(s)
Pericoronitis , Diente Impactado , Estudios Transversales , Humanos , Mandíbula/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Calidad de Vida , Diente Impactado/diagnóstico por imagen
16.
J Biol Regul Homeost Agents ; 34(3 Suppl. 1): 155-163, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32618173

RESUMEN

Auto transplantation of immature donor teeth can be a strategic therapeutic solution in young patients. It is preferable to choose this approach instead of prosthetic restorations because it offers a unique and definitive solution. Orthodontic space closure is not always deemed desirable, especially in non-extraction cases (53,54). Successful auto transplantations allow alveolar growth through eruption of donor teeth together with the adjacent dentition when skeletal and dental development is not yet completed. Auto transplantation of third molars is less well-recognised and less documented. The available literature shows promising success rates. Immature donor teeth are reportedly associated with better outcomes than mature donor teeth. Aim of this case report was to analyse the short-term outcomes of auto transplantation of immature maxillary third molars to replace the missing mandibular second premolars in a 17-year-old healthy female with oligodontia. The surgical procedure was performed as a single step. Left and right lower second deciduous molars (7.5-8.5), close to exfoliation, were extracted. Donor upper third molars with developing root were extracted as a traumatically as possible and immediately placed into the surgically modified recipient sites. They were stabilized by a sectional wire. One year after surgery, the survival of both transplanted teeth was achieved. They showed periodontal health, normal mobility and continuation of root development during the follow-up period. The upper left third molar responded to all success criteria, no signs of ankylosis, root resorption (infection or inflammatory), and pulp necrosis. The upper right third molar had long-standing evidence of not progressive cervical external inflammatory root resorption without any clinical signs. Further research is needed to determine their long-term survival and success rates.


Asunto(s)
Anodoncia , Tercer Molar , Adolescente , Anodoncia/terapia , Diente Premolar , Femenino , Humanos , Diente Molar , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Erupción Dental
17.
Orv Hetil ; 161(28): 1166-1174, 2020 07.
Artículo en Húngaro | MEDLINE | ID: mdl-32609624

RESUMEN

INTRODUCTION AND AIM: The aim of our study was to investigate the influence of the occlusal support, and mandibular third molars on mandibular angle and condylar fractures. METHOD AND RESULTS: Patients with unilateral and isolated angle or condylar fractures were included in this retrospective, cross-sectional study. Data was collected from patient records and panoramic x-rays. The predictor variables included the type of occlusal support and the presence or absence of third molars. The outcome variable was angle or condylar fracture, while other predictor variables included demographic factors. Bivariate (χ2 test) and logistic regression analyses were conducted to investigate the associations between variables and the outcome. 43 angle (mean age: 29.9 ± 12.8 years; 98.4% male) and 37 condylar (mean age: 46.8 ± 20.2 years; 62.2% male) fracture cases were included in this study. Bilateral occlusal support was present in 81.4% of angle fracture group and in 51.3% of condylar fracture group (p<0.001). In the case of bilateral occlusal support, an odds ratio (OR) of 4.2 was found for angle fractures (p<0.006). A third molar was present in 86% of the angle fracture group and in 43.2% of the condylar fracture group (p<0.001). The presence of a third molar exhibited an odds ratio of 8.1 for the angle fractures (p<0.001). When bilateral occlusal support and third molar were present simultaneously, the risk was 15.9 times higher for an angle fracture (p<0.001). CONCLUSION: The presence of occlusal support and/or third molars was significantly associated with angle fractures, however, the absence of occlusal support and/or third molars significantly correlated with condylar fractures. Orv Hetil. 2020; 161(28): 1166-1174.


Asunto(s)
Oclusión Dental , Mandíbula , Cóndilo Mandibular/lesiones , Fracturas Mandibulares/etiología , Tercer Molar/anatomía & histología , Diente Impactado/complicaciones , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Incidencia , Masculino , Fracturas Mandibulares/epidemiología , Persona de Mediana Edad , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica , Estudios Retrospectivos , Factores de Riesgo , Corona del Diente/diagnóstico por imagen , Adulto Joven
18.
Oral Maxillofac Surg ; 24(4): 417-422, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32556618

RESUMEN

PURPOSE: The coronectomy technique is an alternative to conventional impacted tooth removal which aims to reduce the risk of damage to the inferior alveolar nerve (IAN). The technique is usually performed by senior oral surgeons or residents in training. Herein, patients were treated in a single service, in which coronectomy was performed by an undergraduate dental student on partially erupted lower third molars. METHODS: A prospective analysis was performed on 21 individuals submitted to a total of 35 coronectomies. Clinical and radiographic follow-up was performed for at least 12 months. RESULTS: Overall, healing was within normal limits, without major complications and without permanent IAN injury. However, one case showed temporary IAN paraesthesia resolved within a month and two required repetitions of coronectomy due to the remaining enamel, but with a good final result. Root migration was observed in all cases, but no other surgery was required. CONCLUSION: Coronectomy may be an important option for treating partially erupted teeth in close nerve relationships, which could also be performed by trained undergraduate dental students. This series is interesting because it can encourage oral and maxillofacial surgeons to train undergraduate students and to stimulate their attraction and passion for surgery.


Asunto(s)
Diente Impactado , Traumatismos del Nervio Trigémino , Humanos , Mandíbula , Nervio Mandibular/cirugía , Tercer Molar/diagnóstico por imagen , Tercer Molar/cirugía , Estudios Prospectivos , Estudiantes , Corona del Diente/diagnóstico por imagen , Corona del Diente/cirugía , Extracción Dental , Raíz del Diente , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
19.
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
20.
BMC Oral Health ; 20(1): 159, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32487188

RESUMEN

BACKGROUND: Pericoronal radiolucent lesions are a common radiographic finding, but it is rare that they occur in multiple forms. Multiple calcifying hyperplastic dental follicles (MCHDF) are entities with few cases described to date; nevertheless, they appear to have a very particular phenotypic pattern. CASES PRESENTATION: Case 1: A 10-year-old male was evaluated radiographically, revealing four impacted canines, each accompanied by unilocular pericoronal radiolucency. Case 2: A 16-year-old male was planning orthodontic treatment; following his radiological evaluation all third molars were found to be accompanied with pericoronal radiolucencies. Enucleation, and third molar removal along with the pericoronal tissue were the respective treatments. Microscopically, in both cases, the specimens shown odontogenic epithelium, and type I and II calcifications in the hyperplastic follicles, all these characteristics were consistent with MCHDF. CONCLUSION: Although MCHDF are a rare entity, they must be considered in the differential diagnosis of multiple pericoronal lesions. Under the light of the current evidence, the histological findings may be relatively heterogeneous, but their integration with both the clinical data, which are apparently particular, and with the radiographic characteristics, can lead to a definitive diagnosis.


Asunto(s)
Saco Dental/diagnóstico por imagen , Tercer Molar/diagnóstico por imagen , Radiografía Panorámica/métodos , Diente Impactado/diagnóstico por imagen , Adolescente , Niño , Saco Dental/cirugía , Quiste Dentígero/diagnóstico por imagen , Humanos , Masculino , Enfermedades Mandibulares/diagnóstico por imagen , Diente Molar , Tercer Molar/cirugía , Diente Impactado/patología , Diente Impactado/cirugía
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