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1.
J Prosthet Dent ; 112(2): 267-75, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24795262

RESUMO

STATEMENT OF PROBLEM: The detection of cracks and fractures in natural teeth is a diagnostic challenge. Cracks are often not visible clinically nor detectable in radiographs. PURPOSE: The purpose of this study was to evaluate the diagnostic parity of quantitative percussion diagnostics, transillumination, clinical microscopy, and dye penetration. MATERIAL AND METHODS: Three independent examiners provided blind testing for the study. Examiner 1 transilluminated 30 extracted teeth and 23 three-dimensional copy replica control teeth and documented any visible cracks. Each tooth was then mounted in acrylic resin with a periodontal ligament substitute. Examiner 2 examined each specimen aided by the clinical microscope and transillumination and documented visible tooth cracks and fractures. Examiners 1 and 3 then independently tested all specimens with a device developed for quantitative percussion diagnostics. All visible cracks/fractures were removed with a water-cooled fine diamond rotary instrument. Crack visibility was enhanced by the use of a clinical microscope, dye penetrant, and accessory transillumination. This disassembly process was video documented/photographed for each specimen. One more quantitative percussion diagnostics testing was administered when the disassembly was complete. RESULTS: Quantitative percussion diagnostics crack detection agreed with the gold standard microscope and transillumination method in 52 of 53 comparisons (98% agreement). Moreover, the method achieved 96% specificity and 100% sensitivity for detecting cracks and fractures in natural teeth. When all tooth cracks were removed, quantitative percussion diagnostics indicated no further structural instability. CONCLUSIONS: Quantitative percussion diagnostics can nondestructively detect cracks and fractures in natural teeth with accuracy similar to that of the clinical microscope, transillumination, and dye penetrant. In addition, the method was able to reveal the presence of many cracks that were not detected by conventional transillumination.


Assuntos
Síndrome de Dente Quebrado/diagnóstico , Percussão/métodos , Fraturas dos Dentes/diagnóstico , Corantes , Humanos , Técnicas In Vitro , Microscopia/métodos , Percussão/instrumentação , Percussão/estatística & dados numéricos , Fotografação , Valor Preditivo dos Testes , Técnicas de Réplica , Sensibilidade e Especificidade , Cloreto de Tolônio , Transiluminação/métodos , Gravação em Vídeo
2.
J Prosthet Dent ; 106(6): 350-4, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22133390

RESUMO

Osteonecrosis of the jaw has been identified in recent years as an unfortunate potential side effect for patients taking nitrogen-containing bisphosphonates. Many authors have attempted unsuccessfully to elucidate the mechanism behind this drug-induced malady, leaving dentists with unclear guidelines on how to treat these patients. Recent literature suggests a threshold-related impairment of epithelial cell migration over bone. A conservative, non-invasive approach aimed at preserving the epithelial attachment in a patient on a long-term oral alendronate protocol is described. The advantage of this approach is to prevent a highly destructive bone degenerative process that does not have a clear and predictable treatment protocol.


Assuntos
Alendronato/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Planejamento de Dentadura , Prótese Parcial Fixa , Inserção Epitelial/patologia , Idoso , Dente Pré-Molar/lesões , Dente Pré-Molar/cirurgia , Dente Suporte , Prótese Dentária Fixada por Implante , Feminino , Seguimentos , Humanos , Coroa do Dente/cirurgia , Fraturas dos Dentes/cirurgia , Dente não Vital/cirurgia
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