Radiographic differences observed following apexification vs revascularization in necrotic immature molars and incisors: a follow-up study of 18 teeth.

PURPOSE: To evaluate the effectiveness of apexification versus revascularization in the treatment of necrotic immature teeth and determine which strategy affords the greatest radiological success rate. METHODS: An analysis was made of 18 teeth subjected to mineral trioxide aggregate (MTA) apical plugging and regenerative endodontic treatment, assessing healing of the apical lesions and the changes in root dimensions. RESULTS: Significantly greater root growth was observed with revascularization in terms of the percentage change in length (12.75% at 6 months) and dentin thickness (34.57% at 6 months) (p < 0.05). There were no significant differences between the two treatments in terms of the apical healing scores after 6 months of follow-up (p > 0.05). CONCLUSION: Apexification with an MTA apical plug and pulp regeneration are reliable treatments for non-vital immature teeth. The radiographic outcomes are comparable between the immature teeth subjected to MTA apexification versus those subjected to revascularization. The results of the present study indicate a greater increase in root length and width with regenerative endodontic treatment.

Are there any differences between first and second primary molar pulpectomy prognoses? A retrospective clinical study.

AIM: To determine if there are any significant differences between the prognoses of pulpectomies done on first and second primary molars of the upper and lower dental arch. MATERIALS AND METHODS: Study Design: The clinical study included 55 children who had undergone 86 pulpectomy treatments, 41 on the first molars and 45 on the second molars. The root canal filling material consisted of a paste based on Walkhoff formula, containing Kri-1, calcium hydroxide and meta-cresol formaldehyde. The same clinician carried out all pulpectomies. RESULTS: After the analysis there were a total of 7 treatment failures (3 in the upper arch and 4 in the lower). Four of the 7 failures were first primary molars and three were second primary molars. STATISTICS: There were no significant differences in the prognoses of the different kinds of primary molars. CONCLUSION: The anatomy of the primary molars changes considerably. Significant differences were not observed in the prognosis of different types of primary molars after pulpectomy.

How effective is the Invisalign® system in expansion movement with Ex30' aligners?

OBJECTIVES: The aims of this study are to validate a new method for quantifying the predictability of expansion movement with the Invisalign® system and to determine whether there are statistically significant differences between planned expansion with ClinCheck® and actual clinical quantification using upper post-treatment model comparisons. MATERIALS AND METHODS: A sample of 116 patients subjected to expansion with Invisalign® was studied. The following variables were measured at T1 and T2 on 3D models and ClinCheck®: canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, canine depth, arch depth, first molar rotation, first right and left molar rotation, and first molar inclination. RESULTS: Measurement error was tested, showing good precision for all variables. The paired test showed non-significant differences between the 3D model and ClinCheck® at T1 for all variables except first molar cuspid width and arch depth. Statistically significant differences were found for canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, and canine depth when the 3D model and ClinCheck® were compared at T2. CONCLUSIONS: Differences between the 3D model and ClinCheck® at T2 showed that planned expansion at the end of treatment is not predictable. CLINICAL RELEVANCE: This is the first in vivo human study to quantify the predictability of expansion in patients with Invisalign® Ex30 material.

Maxillary protraction at early ages. The revolution of new bone anchorage appliances.

PURPOSE: An update is provided on the different types of early treatment for class III malocclusions of maxillary origin. There is an increasing tendency to prescribe maxillary orthopedic treatment with skeletal anchorage, with the purpose of enhancing the skeletal and reducing the dentoalveolar effects--offering a management option for children with important deformations that otherwise would have to wait until adult age to receive surgical treatment. METHOD: A literature review has been made of maxillary bone orthopedic traction appliances in growing children with class III malocclusions. A Medline (PubMed) search was made using the following MeSH terms: Cephalometric, Child, Malocclusion class III/therapy, Extraoral traction appliances, Palatal expansion, Bone plates, Skeletal anchorage, Orthodontic anchorage. RESULTS: Many articles show that the greatest maxillary advances are obtained at very early ages, though with a greater tendency towards relapse. However skeletal anchorage has been seen to afford a lesser relapse rate and greater dentofacial orthopedic efficiency due to its low dentoalveolar impact. In any case, further randomized clinical studies are needed to firmly establish the quantifiable differences in terms of maxillary advance, optimum traction age, optimum traction appliance and potential side effects. At present, the incorporation of surgically inserted bone anchorage appliances (miniplates and miniscrews) offers a purely orthopedic approach to treatment, with minimization of the undesirable side effects of traditional dentofacial orthopedic compensation based on dentoalveolar anchorage. Nevertheless, further studies are needed to consolidate the supporting scientific evidence in this field.

Artículo de revisión: Sistemas y tipos de retención / No disponible

El manejo del tiempo posterior a la finalización de caso resulta de extremada importancia, tanto como el propio tratamiento en sí. Son muchas y variadas las formas de ejercerla contención del mismo. Existen diferentes corrientes acerca de estos métodos. Existen sistemas fijos o removibles, utilizados de forma temporal o permanente, así también la necesidad de retención según la calidad y estabilidad de los resultados obtenidos. En este artículo realizamos una revisión de la literatura, para intentar exponer las diferentes alternativas en los sistemas y tipos de retención y poder establecer unas pautas consensuadas sobre la actuación en la etapa siguiente al tratamiento activo (AU)

The management of the retention period after comprehensive orthodontic treatment is of paramount importance, as treatment itself. There are many retention protocols in the orthodontic literature. Different schools regarding retention needs and methods also are described in this review paper. Fixed and removable, semi-permanent and permanent retainers are found among the clinical preferences of different authors, depending on the quality and stability of treatment results. In this paper, a review of the literature was conducted to present the different approaches to orthodontic retention systems and to establish consensus clinical guidelines (AU)