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1.
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
2.
Am J Orthod Dentofacial Orthop ; 156(2): 178-185, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375227

RESUMEN

INTRODUCTION: This study aimed to identify significant factors affecting the spontaneous angular changes of impacted mandibular third molars as a result of second molar protraction. Temporary skeletal anchorage devices in the missing mandibular first molar (ML-6) or missing deciduous mandibular second molar (ML-E) with missing succedaneous premolar spaces provided traction. METHODS: Forty-one mandibular third molars of 34 patients (10 male and 24 female; mean age 18.3 ± 3.7 years) that erupted after second molar protraction were included in this study. They were classified into upright (U) and tilted (T) groups. Linear and angular measurements were performed at the time of treatment initiation (T1) and of ML-6 or ML-E space closure (T2). Regression analyses were used to identify significant factors related to third molar uprighting. RESULTS: Nolla stage (odds ratio [OR] 4.1), sex (OR 0.003 for male), third molar angulation at T1 (OR 1.1), missing tooth space (OR 0.006), rate of third molar eruption (OR 23.3), and rate of second molar protraction (OR 0.2) significantly affected third molar uprighting. Age, third molar angulation at T1, rate of third molar eruption, and rate of second molar protraction were significant factors for predicting third molar angulation at T2. CONCLUSIONS: Available space for third molar eruption before and after second molar protraction is not associated with uprighting of erupting third molars. Older patients whose third molars are in greater Nolla stage, are in a more upright position at T1, and have a greater eruption rate have a greater chance for third molar uprighting. Alternatively, an increase in second molar protraction rate results in mesial tipping of the third molars.


Asunto(s)
Maloclusión/prevención & control , Maloclusión/fisiopatología , Mandíbula/fisiopatología , Tercer Molar/fisiopatología , Diente Impactado/fisiopatología , Adolescente , Adulto , Puntos Anatómicos de Referencia , Diente Premolar , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Diente Molar/fisiopatología , Tercer Molar/anatomía & histología , Tercer Molar/diagnóstico por imagen , Aparatos Ortodóncicos , Cierre del Espacio Ortodóncico , Ortodoncia Correctiva , Erupción Dental , Diente Primario , Diente Impactado/complicaciones , Diente Impactado/diagnóstico por imagen , Adulto Joven
3.
Medicina (Kaunas) ; 55(6)2019 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-31238599

RESUMEN

BACKGROUND AND OBJECTIVES: Impacted third molars (ITM) are the most commonly-impacted teeth. There is a risk for ITM to cause a number of pathological conditions, and external root resorption (ERR) of adjacent teeth is one of the most prevalent. Retaining or prophylactic extraction of ITM is a polemic topic. External root resorption of adjacent teeth is one of possible indications for prophylactic removal of ITM. The aim of this study was to assess the relationship between external root resorption (ERR) on the distal aspect of second molars' roots and positional parameters of ITM. Methods: Cone beam computed tomography scans of 109 patients (41 males, 68 females; mean age 26.4 ± 7.9 years) with 254 ITM (131 in the maxilla and 123 in the mandible) were retrospectively analyzed. Positional parameters of ITM (mesio-distal position, angulation, impaction depth, and available eruption space) were evaluated. The presence, location, and depth of ERR of adjacent second molars were assessed. Results: Analysis showed a relationship between ITM impaction depth, mesial inclination angle, and the presence of ERR. Mesial inclination angle of more than 13.6° increased the odds of ERR occurrence by 5.439 (95% CI, 2.97-9.98). ITM presence at the level of ½ of roots of the adjacent second molar or more apically increased the odds of ERR occurrence by 2.218 (95% CI, 1.215-4.048). No significant correlation was detected between the occurrence of ERR and patient age, gender, or the available eruption space in the mandible. Depth of ERR did not depend on its location. Conclusions: Incidence of ERR in second molars is significantly associated with mesial inclination and a deep position of ITM.


Asunto(s)
Tercer Molar/lesiones , Resorción Radicular/etiología , Diente Impactado/complicaciones , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico/métodos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Tercer Molar/fisiopatología , Curva ROC , Estudios Retrospectivos , Resorción Radicular/fisiopatología , Diente Impactado/fisiopatología
4.
Anat Rec (Hoboken) ; 302(8): 1419-1433, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-30315641

RESUMEN

A growing body of literature demonstrates that genetic patterning mechanisms underlie the relative proportions of the mammalian postcanine dentition with the third molar being key to understanding variation within the molar row. With this relatively recent insight, there has been renewed interest in mammalian taxa that have lost the third molars. Within platyrrhines, the marmosets and tamarins (Callitrichidae family) are characterized by small body size, claw-like nails, twinning, and reduced molar number. Small body size is hypothesized to have resulted in the third molar being crowded out of the jaws leading to its evolutionary loss in this family. To further explore this hypothesis, we measured the cranium and dentition of 142 individuals spanning all five platyrrhine families. These data reveal that callitrichids have a significantly smaller proportion of mandibular postcanine tooth row length relative to other platyrrhines, refuting the "crowding out" hypothesis. However, postcanine tooth row length is significantly correlated with mandibular length and cranial length (P < 0.01) across all platyrrhines providing evidence for a strong allometric association between postcanine tooth row length and body size more generally. The small body size that characterizes callitrichids results in part from slower prenatal growth rates. Given the allometric relationship between postcanine tooth row length and body size, reported here and in previous studies, we hypothesize that the evolutionary loss of the third molars in callitrichids results from the inhibition of third molar development as a consequence of the slower prenatal growth rates associated with small body size in this family. Anat Rec, 302:1419-1433, 2019. © 2018 Wiley Periodicals, Inc.


Asunto(s)
Evolución Biológica , Desarrollo Fetal/fisiología , Tercer Molar/fisiopatología , Cráneo/anatomía & histología , Cráneo/crecimiento & desarrollo , Diente/anatomía & histología , Diente/crecimiento & desarrollo , Animales , Odontometría , Platirrinos
5.
Comput Methods Biomech Biomed Engin ; 21(7): 488-497, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29969292

RESUMEN

The relationship between mandibular third molar (M3) angulation and mandibular angle fragility is not well established. The aim of this study was to evaluate the impact of M3 angulation on the mandibular angle fragility when submitted to a trauma to the mandibular body region. A three-dimensional (3D) mandibular model without M3 (Model 0) was obtained by means of finite-element analysis (FEA). Four models were generated from the initial model, representing distoangular (Model D), horizontal (Model H), mesioangular (Model M) and vertical (Model V) angulations. A blunt trauma with a magnitude of 2000 N was applied perpendicularly to the sagittal plane in the mandibular body. Maximum principal stress (Pmax) (tensile stress) values were calculated in the bone. The lowest Pmax stress values were noted in Model 0. When the M3 was present extra stress fields were found around marginal bone of second molar and M3. Comparative analysis of the models with M3 revealed that the highest level of stress was found in Model V, whereas Model D showed the lowest stress values. The angulation of M3 affects the stress levels in the mandibular angle and has an impact on mandibular fragility. The mandibular angle becomes more fragile in case of vertical impaction when submitted to a trauma to the mandibular body region.


Asunto(s)
Análisis de Elementos Finitos , Imagenología Tridimensional , Mandíbula/fisiopatología , Tercer Molar/fisiopatología , Heridas y Traumatismos/fisiopatología , Humanos , Estrés Mecánico , Soporte de Peso
6.
J Zhejiang Univ Sci B ; 19(1): 38-48, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29308606

RESUMEN

OBJECTIVE: To investigate the stress distribution to the mandible, with and without impacted third molars (IM3s) at various orientations, resulting from a 2000-Newton impact force either from the anterior midline or from the body of the mandible. MATERIALS AND METHODS: A 3D mandibular virtual model from a healthy dentate patient was created and the mechanical properties of the mandible were categorized to 9 levels based on the Hounsfield unit measured from computed tomography (CT) images. Von Mises stress distributions to the mandibular angle and condylar areas from static impact forces (Load I-front blow and Load II left blow) were evaluated using finite element analysis (FEA). Six groups with IM3 were included: full horizontal bony, full vertical bony, full 450 mesioangular bony, partial horizontal bony, partial vertical, and partial 450 mesioangular bony impaction, and a baseline group with no third molars. RESULTS: Von Mises stresses in the condyle and angle areas were higher for partially than for fully impacted third molars under both loading conditions, with partial horizontal IM3 showing the highest fracture risk. Stresses were higher on the contralateral than on the ipsilateral side. Under Load II, the angle area had the highest stress for various orientations of IM3s. The condylar region had the highest stress when IM3s were absent. CONCLUSIONS: High-impact forces are more likely to cause condylar rather than angular fracture when IM3s are missing. The risk of mandibular fracture is higher for partially than fully impacted third molars, with the angulation of impaction having little effect on facture risk.


Asunto(s)
Análisis del Estrés Dental , Mandíbula/fisiopatología , Fracturas Mandibulares/diagnóstico por imagen , Fracturas Mandibulares/fisiopatología , Tercer Molar/fisiopatología , Adulto , Algoritmos , Fenómenos Biomecánicos , Simulación por Computador , Módulo de Elasticidad , Femenino , Análisis de Elementos Finitos , Humanos , Imagenología Tridimensional , Modelos Biológicos , Estrés Mecánico , Tomografía Computarizada por Rayos X
7.
J Oral Maxillofac Surg ; 76(1): 34-45, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28688821

RESUMEN

PURPOSE: The current data suggest that the presence of lower third molars predisposes the patient to a greater risk of mandibular angle fracture. Thus, the present review sought to determine whether an association exists between the presence of a lower third molar and the occurrence of a mandibular angle fracture in adults and to assess the influence of third molar position according to the Pell and Gregory classification. MATERIALS AND METHODS: The present study was a systematic review and meta-analysis of analytical observational studies. The present review included all reports of the relationship between mandibular angle fractures and lower third molars. No restriction regarding year, language, or publication status was used. The review protocol was registered at the PROSPERO database (registration no. CRD42016047057). Electronic searches unrestricted for publication period and language were performed in the PubMed, Scopus, SciELO, and Latin American and Caribbean Health Sciences databases. Google Scholar and OpenGrey databases were used to search the "gray literature," avoiding selection and publication biases. The entire search was performed by 2 eligibility reviewers. Association and proportion meta-analyses were planned for the studies with sufficient data. The primary predictor variable was the relationship between the presence of a lower third molar and the development of mandibular angle fractures. The secondary outcome variables were the vertical and horizontal positions of the lower third molar, according to the Pell and Gregory classification and their relationship to the susceptibility to developing a mandibular angle fracture. RESULTS: The search strategies resulted in 411 studies, from which 16 were selected for qualitative and quantitative review. The association meta-analysis included all the selected studies and showed that patients with lower third molars are 3.16 times more likely to develop mandibular angle fractures. The proportion meta-analysis included 5 studies and showed that the overall rate of mandibular angle fractures was 51.58% and that positions III and C are more likely to result in fracture, with a rate of 59.84 and 63.67%, respectively. CONCLUSIONS: The results of the present study have shown that the presence of impacted third molars increases by 3.16 times the risk of mandibular angle fractures in adults, with the greatest risk present when third molars are classified as IIIC according to Pell and Gregory. The available evidence is not sufficiently robust to determine whether third molar presence or the level of impaction is the main causative factor for the occurrence of mandibular angle fractures.


Asunto(s)
Fracturas Mandibulares , Tercer Molar/fisiopatología , Humanos , Factores de Riesgo , Diente Impactado/fisiopatología
8.
Sci Rep ; 7(1): 12602, 2017 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-28974709

RESUMEN

Food impaction after impacted mandibular third molar extraction is a serious problem that should not be ignored. Incomplete suturing of the distal incision in the conventional method is the main cause of food impaction and delayed wound healing. The present study introduces a novel suture and drainage technology that requires hermetic suturing of the distal incision and rubber drainage for buccal drainage. 76 patients with horizontally/mesially impacted third molars (bilateral) were enrolled in this prospective study. An impacted tooth on one side of each patient was extracted by occlusal drainage using the conventional method, whereas the other side tooth was extracted by buccal drainage using the novel method. The differences in wound healing, facial swelling, bleeding and dry socket between the two sides of each patient were compared postoperatively, and the trends for patient selection of the surgical method were also compared. The results indicated that buccal drainage had obvious advantages in wound healing and reduced the risk of postoperative bleeding, and most patients preferred this technique; there were no significant differences in postoperative facial swelling or pain. Thus, buccal drainage can solve the problem of long-term food impaction induced by traditional incision postoperatively and is worthy of clinical promotion.


Asunto(s)
Mandíbula/cirugía , Tercer Molar/cirugía , Extracción Dental/métodos , Diente Impactado/cirugía , Adulto , Drenaje/métodos , Femenino , Hemorragia/complicaciones , Hemorragia/fisiopatología , Humanos , Masculino , Mandíbula/fisiopatología , Tercer Molar/fisiopatología , Diente Impactado/complicaciones , Diente Impactado/fisiopatología , Adulto Joven
9.
J Am Dent Assoc ; 148(12): 903-912, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28965988

RESUMEN

BACKGROUND: Through a systematic literature review, the authors assess the effect of premolar extractions on third-molar (M3) eruption considering eruption rate, retromolar space, and molar angulation. TYPES OF STUDIES REVIEWED: The authors performed a systematic search using MEDLINE and Web of Science databases up through April 2017 to identify quality studies available comparing M3 eruption between a group with premolar extraction and a group without premolar extraction. RESULTS: Twelve comparative retrospective cohort studies met all the inclusion criteria. The authors found in 5 studies comparing the rate of M3 eruption that there were significantly higher results in the group with extractions. They found in 5 studies comparing the evolution of the retromolar space significantly higher results in the group with extractions. Lastly, concerning the uprighting of the M3 during treatment, the authors found only 2 studies showing significant differences between the 2 groups, each time in favor of the group with extractions. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The dental literature on premolar extraction related to the eruption of the M3 is composed of average-quality retrospective studies. Premolar extraction significantly improves the chances of M3 eruption, but the level of evidence of comparative retrospective cohort studies is low. Clinicians must continue to rely on their judgment regarding premolar extraction on a case-by-case basis until the evidence is stronger. Retrospective studies with standardized protocols and more detailed methodologies are required to obtain higher levels of evidence.


Asunto(s)
Diente Premolar/cirugía , Tercer Molar/anatomía & histología , Tercer Molar/fisiopatología , Erupción Dental , Extracción Dental , Humanos , Ortodoncia Correctiva
10.
J Dent ; 61: 55-66, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28359700

RESUMEN

OBJECTIVES: To analyse the effect of first and second premolar extractions on eruption space for upper and lower third molars and on third molar position and angulation during orthodontic treatment. METHODS: The sample consisted of 296 patients of which 218 patients were orthodontically treated without extraction and 78 patients with extraction of first or second premolars. The eruption space for third molars was measured on pre- and posttreatment lateral cephalograms, whereas the angulation, vertical position, the relation with the mandibular canal and the mineralization status of third molars were evaluated using pre- and posttreatment panoramic radiographs. All data were statistically analyzed. RESULTS: The increase in eruption space and the change in vertical position of upper and lower third molars significantly differed between patients treated with and without premolar extractions, whereas the change in angulation, relationship with the mandibular canal and mineralization status of the third molars did not significantly differ between patients treated with and without premolar extractions. CONCLUSIONS: The retromolar space and the position of third molars significantly change during orthodontic treatment in growing patients. Premolar extractions have a positive influence on the eruption space and vertical position of third molars, whereas they do not influence the angular changes of third molars. Due to the retrospective character of the study, these conclusions should be carefully considered. Further prospective research is necessary for better insights into this complex topic. CLINICAL SIGNIFICANCE: This study stresses the importance of considering the possible effects of orthodontic treatment on third molars during treatment planning.


Asunto(s)
Diente Premolar/cirugía , Tercer Molar/anatomía & histología , Tercer Molar/fisiopatología , Extracción Seriada , Erupción Dental/fisiología , Adolescente , Cefalometría/métodos , Niño , Arco Dental/patología , Femenino , Humanos , Estudios Longitudinales , Masculino , Maloclusión/clasificación , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Maxilar/diagnóstico por imagen , Maxilar/patología , Tercer Molar/diagnóstico por imagen , Tercer Molar/crecimiento & desarrollo , Ortodoncia Correctiva/métodos , Radiografía Panorámica , Estudios Retrospectivos , Calcificación de Dientes , Técnicas de Movimiento Dental , Diente Impactado/prevención & control , Adulto Joven
11.
Int J Oral Maxillofac Surg ; 46(6): 716-729, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28291569

RESUMEN

The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars on angle fractures. An electronic search was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and VHL databases, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 35 studies were included in the systematic review and 28 in the meta-analysis. Twenty studies presented a score of ≤6 stars in the Newcastle-Ottawa scale assessment, indicating a risk of bias in the analysis. The presence of a mandibular third molar increases the chance of an angle fracture (case-control and cross-sectional studies: odds ratio (OR) 3.83, 95% confidence interval (CI) 3.02-4.85, I2=83.1%; case-control studies: OR 3.27, 95% CI 2.57-4.16, I2=81.3%). The third molar positions most favourable to angle fracture according to the Pell and Gregory classification are class B (OR 1.44, 95% CI 1.06-1.96, I2=87.2%) and class II (OR 1.67, 95% CI 1.36-2.04, I2=72.4%). Class A (OR 0.60, 95% CI 0.45-0.81, I2=87.1%) and class I (OR 0.51, 95% CI 0.37-0.71, I2=89.4%) act as protective factors for angle fracture. The results suggest that the presence of the third molar increases the chance of angle fracture by 3.27 times and that the most favourable positions of the third molar for angle fracture are classes B and II, whilst classes A and I act as protective factors.


Asunto(s)
Fracturas Mandibulares , Tercer Molar/fisiopatología , Humanos , Factores de Riesgo , Diente Impactado/fisiopatología
12.
Int J Oral Maxillofac Surg ; 46(6): 730-739, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28259600

RESUMEN

The aim of this systematic review was to investigate the influence of the presence and position of mandibular third molars in mandibular condyle fractures. An electronic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and VHL, through January 2016. The eligibility criteria included observational studies. The search strategy resulted in 704 articles. Following the selection process, 13 studies were included in the systematic review and 11 in the meta-analysis. In terms of the risk of bias analysis, six studies presented ≤6 stars in the Newcastle-Ottawa scale assessment. The presence of a mandibular third molar decreased the probability of condylar fracture (cross-sectional and case-control studies: odds ratio (OR) 0.26, 95% confidence interval (CI) 0.17-0.40, I2=87.8%; case-control studies: OR 0.30, 95% CI 0.16-0.58, I2=91.6%). The third molar positions most favourable to condylar fracture according to the Pell and Gregory classification are class A (OR 1.32, 95% CI 1.09-1.61, I2=0%) and class I (OR 1.37, 95% CI 1.05-1.77, I2=32.8%). Class B (OR 0.69, 95% CI 0.49-0.97, I2=56.0%) and class II (OR 0.71, 95% CI 0.57-0.87, I2=0%) act as protective factors for condylar fracture. The results suggest that the presence of a mandibular third molar decreases the chance of condylar fracture and that the positions of the third molar most favourable for condylar fracture are classes A and I, with classes B and II acting as protective factors.


Asunto(s)
Cóndilo Mandibular/lesiones , Fracturas Mandibulares , Tercer Molar/fisiopatología , Humanos , Factores de Riesgo , Diente Impactado/fisiopatología
13.
Am J Orthod Dentofacial Orthop ; 151(3): 572-582, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28257742

RESUMEN

A 22-year-old woman came with a unilateral missing mandibular first molar and buccal crossbite. The open space was closed by protraction of the mandibular left second molar and uprighting and protraction of the horizontally impacted third molar using temporary skeletal anchorage devices, and her buccal crossbite was corrected with modified palatal and lingual appliances. The total active treatment time was 36 months. Posttreatment records after 9 months showed excellent results with a stable occlusion.


Asunto(s)
Maloclusión/fisiopatología , Maloclusión/terapia , Tercer Molar/fisiopatología , Cierre del Espacio Ortodóncico/métodos , Diente Impactado/fisiopatología , Diente Impactado/terapia , Femenino , Humanos , Diente Molar/fisiopatología , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Radiografía Panorámica , Adulto Joven
14.
Eur J Orthod ; 39(4): 426-432, 2017 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-28160471

RESUMEN

Objectives: To investigate the effects of orthodontic non-extraction treatment with or without headgear on the position of and the space available for upper third molars in growing children with class II malocclusions. Materials and methods: The sample consisted of pre- and post-treatment panoramic radiographs and lateral cephalograms of 294 class II orthodontic patients; 160 were treated with headgear and 134 were treated without headgear. The space available for the upper third molar was measured on the lateral cephalogram as the distance from pterygoid vertical (PTV) to the distal surface of the upper first molar crown (PTV-M1). Angulation, vertical position and tooth development stage of the upper third molars were evaluated on panoramic radiographs. All measurements were evaluated statistically. Results: In both groups PTV-M1 increased, but the increase in PTV-M1 was significantly higher for patients treated without headgear. A linear model for repeated measures revealed that this difference was still significant after correction for age, gender and molar occlusion. Further, there is no evidence that the change in angulation, vertical position and development stage of the upper third molars during orthodontic treatment is influenced by headgear therapy. Conclusion: This study indicates that the use of headgear in growing patients significantly affects the space available for upper third molars. However, orthodontic treatment with headgear does not influence the angulation, vertical position and development stage of upper third molars. It is therefore important to always take into account third molars during treatment planning.


Asunto(s)
Aparatos de Tracción Extraoral , Maloclusión de Angle Clase II/terapia , Tercer Molar/fisiopatología , Adolescente , Cefalometría/métodos , Niño , Femenino , Humanos , Estudios Longitudinales , Masculino , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/fisiopatología , Tercer Molar/diagnóstico por imagen , Tercer Molar/patología , Variaciones Dependientes del Observador , Odontogénesis/fisiología , Radiografía Panorámica/métodos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Erupción Dental
15.
J Craniomaxillofac Surg ; 43(6): 870-8, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25939313

RESUMEN

The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side.


Asunto(s)
Análisis de Elementos Finitos , Imagenología Tridimensional/métodos , Mandíbula/fisiopatología , Cóndilo Mandibular/fisiopatología , Tercer Molar/fisiopatología , Diente Impactado/fisiopatología , Adulto , Fenómenos Biomecánicos , Fuerza Compresiva , Simulación por Computador , Hueso Cortical/fisiopatología , Módulo de Elasticidad , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Fracturas Mandibulares/fisiopatología , Modelos Biológicos , Estrés Mecánico , Resistencia a la Tracción , Tomografía Computarizada por Rayos X/métodos , Erupción Dental/fisiología , Interfaz Usuario-Computador
16.
Med. oral patol. oral cir. bucal (Internet) ; 20(3): 386-392, mayo 2015. ilus
Artículo en Inglés | IBECS | ID: ibc-139056

RESUMEN

BACKGROUND: This study investigated the efficacy of low level laser therapy (LLLT) for managing alveolar osteitis (AO).MATERIAL AND METHODS: Sixty patients with alveolar osteitis of mandibular third molars were randomly divided into three groups. In group 1, socket irrigation was followed by alvogyl placement, and the treatment was repeated 48 hours later. In group 2, socket was irradiated with a low power red laser for 3 consecutive days (200 mW, 30 seconds on each of the buccal and lingual surfaces and 30 seconds at the middle of the socket, 6 J per area). The subjects in group 3 underwent treatment with a low power infrared laser with the same parameters as group 2. A visual analogue scale (VAS) was used to record the degree of pain at the morning (T0, before intervention) and at 6 (T1) and 12 (T2) hours later for 3 days. RESULTS: Pain was significantly lower in the alvogyl group than the other groups at T1 and T2 points on day 1 and at T0 and T1 points on day 2 (p<0.05). At T2 point on day 2 and on day 3, VAS became significantly lower in the red laser group compared to the other groups (p<0.05). The infrared laser was not more efficacious than the other groups at any of the treatment intervals, but it reduced VAS to an acceptable level. CONCLUSIONS: LLLT displayed good results in this study for treatment of alveolar osteitis and should be further investigated as an alternative to alvogyl for AO management (AU)


Asunto(s)
Humanos , Terapia por Luz de Baja Intensidad/métodos , Alveolo Seco/terapia , Anestesia Dental , Tercer Molar/fisiopatología , Anestesia Local , Estudios de Casos y Controles
17.
Head Face Med ; 11: 9, 2015 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-25890111

RESUMEN

The aim of this systematic review was to evaluate the clinical effectiveness of the surgical technique of coronectomy for third molars extraction in close proximity with the inferior alveolar nerve.A literature survey carried out through PubMed, SCOPUS and the Cochrane Library from inceptions to the last access in January 31, 2014, was performed to intercept randomised clinical trials, controlled clinical trials, prospective cohort studies or retrospective studies (with or without control group) that examined the clinical outcomes after coronectomy. The following variable were evaluated: inferior alveolar nerve injury, lingual nerve injury, postoperative adverse effects, pulp disease, root migration and rate of reoperation. Ten articles qualified for the final analysis. The successful coronectomies varied from a minimum of 61.7% to a maximum of 100%. Coronectomy was associated with a low incidence of complications in terms of inferior alveolar nerve injury (0%-9.5%), lingual nerve injury (0%-2%), postoperative pain (1.1%-41.9%) and swelling (4.6%), dry socket infection (2%-12%), infection rate (1%-9.5%) and pulp disease (0.9%). Migration of the retained roots seems to be a frequent occurrence (2%-85.3%).Coronectomy appears to be a safe procedure at least in the short term, with a reduced incidence of postoperative complications. Therefore, a coronectomy can be indicated for teeth that are very close to the inferior alveolar nerve. If a second operation is needed for the remnant roots, they can be removed with a low risk of paresthesia, because the roots are generally receded from the mandubular nerve.


Asunto(s)
Traumatismos del Nervio Craneal/prevención & control , Tercer Molar/cirugía , Extracción Dental/métodos , Diente Impactado/cirugía , Tomografía Computarizada de Haz Cónico/métodos , Traumatismos del Nervio Craneal/etiología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Mandíbula/cirugía , Nervio Mandibular , Tercer Molar/diagnóstico por imagen , Tercer Molar/fisiopatología , Dolor Postoperatorio/fisiopatología , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Extracción Dental/efectos adversos , Diente Impactado/diagnóstico por imagen , Resultado del Tratamiento
18.
J Endod ; 41(8): 1371-4, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25777501

RESUMEN

Tooth autotransplantation is a viable treatment option for tooth replacement when a suitable donor tooth is available. These case reports described significant vertical bone growth after autotransplantation of a mature third molar. The left mandible third molars (n = 2) were transplanted to the missing tooth in the left mandible. The patient follow-up period was 10 years after transplantation. Clinical examination revealed no mobility of the transplanted tooth. Radiographic examination indicated that bone regeneration occurred around the transplanted tooth. Vertical bone growth was observed in the cervical area of the root surface and the recipient bone. In autotransplantation of mature teeth, long-term follow-up results indicate that vertical bone growth can be expected if viability of the periodontal ligament cells is maintained.


Asunto(s)
Maxilares/fisiopatología , Tercer Molar/fisiopatología , Tercer Molar/trasplante , Procedimientos Quirúrgicos Ortognáticos , Osteogénesis , Trasplante Autólogo , Adulto , Caries Dental/cirugía , Estudios de Seguimiento , Humanos , Maxilares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Tercer Molar/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Erupción Ectópica de Dientes/cirugía , Trasplante Autólogo/métodos
19.
J Craniomaxillofac Surg ; 43(1): 113-6, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25465485

RESUMEN

BACKGROUND: There is no consensus regarding the prophylactic removal of mandibular third molars (TM) in fracture lines to facilitate healing. Recent evidence suggests that poor healing is attributed to the limited use of antimicrobials, delayed care and semi-rigid fixation as a treatment method, favoring retention of TM. STUDY DESIGN: A retrospective cohort study of all patients presenting with mandibular angle fractures at the Hippokration General Hospital of Athens (2006-2011) was designed to examine the association between the presence versus absence of TMs in the line of mandibular fractures and the fracture healing process. Development of complications during the healing process was the outcome of interest. Additional factors considered were patient age, sex, and fracture etiology. MATERIALS AND METHODS: Data were extracted from a retrospective chart review, including information from clinical and radiological examinations. The analytical sample included 112 patients with 121 angle fractures. Bivariate methods including Fisher's exact and chi-square tests were used to test the association between TM presence in the fracture line and healing complications. CONCLUSION: This study found no association between the presence of mandibular TM in the fracture line and postoperative complications and the healing process when combined with light intermaxillary fixation for 15 days.


Asunto(s)
Curación de Fractura/fisiología , Fracturas Mandibulares/fisiopatología , Tercer Molar/fisiopatología , Adolescente , Adulto , Factores de Edad , Anciano de 80 o más Años , Placas Óseas , Tornillos Óseos , Niño , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Fijación Interna de Fracturas/instrumentación , Humanos , Técnicas de Fijación de Maxilares/instrumentación , Luxaciones Articulares/cirugía , Masculino , Fracturas Mandibulares/cirugía , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios Retrospectivos , Factores Sexuales , Diente Impactado/fisiopatología , Resultado del Tratamiento , Adulto Joven
20.
Rev. medica electron ; 36(supl 1)oct. 2014.
Artículo en Español | CUMED | ID: cum-58378

RESUMEN

Introducción: el objetivo de este trabajo es realizar una revisión bibliográfica sobre la información de estudios realizados y publicados en diferentes provincias de Cuba, en los que se abordan las complicaciones pre y posoperatorias de los terceros molares retenidos. Metodología: se desarrolló una estrategia de búsqueda con los términos: tercer molar retenido, meta-análisis, revisión sistemática, combinados con complicaciones pre y posoperatorias, utilizando las publicaciones encontradas desde enero de 1990 hasta junio de 2013. Discusión: se encontró en todos los estudios realizados en las diferentes provincias de Cuba, que los terceros molares son los dientes que presentan mayor posibilidades de retención, por lo que casi siempre tienen indicación de tratamiento quirúrgico, presentando diferentes complicaciones tanto pre como posoperatoria. Conclusiones: con esta revisión llegamos a la conclusión de que en los estudios realizados en las diferentes provincias de Cuba, la complicación preoperatoria más frecuente causada por terceros molares retenidos fue la pericoronaritis, la cual siempre viene acompañada de dolor y edema, y las complicaciones más frecuentes después de la cirugía son la celulitis facial posoperatoria, acompañada casi siempre de trismo y dolor(AU)


Background: the aim of this work is developing a bibliographic review on the studies carried out and published in several Cuban provinces, approaching pre-surgery and post-surgery complications of the third retained molars. Methodology: we developed a search strategy with the terms: third retained molar, meta-analyses, systematic review, combined with pre- and post-surgery complications, using literature published from January 1990 to June 2013. Discussion: in all the studies made in different Cuban provinces we found that the third molars are the teeth having greater retention possibilities, therefore their surgical treatment is almost always indicated; they present different pre- and post-surgery complications. Conclusions: with this review we arrived to the conclusion that in studies carried out in different Cuban provinces, the most frequent pre-surgery complication caused by the retained third molars was pericoronaritis, always accompanied by pain and edema, and the most frequent post-surgery complication was facial cellulites, almost always accompanied with trismus and pain(AU)


Asunto(s)
Humanos , Tercer Molar/fisiopatología , Tercer Molar/cirugía , Celulitis/complicaciones , Traumatismos Faciales/complicaciones , Cuba/epidemiología
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