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1.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(5): 990-994, 2021 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-34650307

RESUMO

OBJECTIVE: To measure the three-dimensional morphology of the labial supraosseous gingiva (SOG) and the thickness of related labial bone in maxillary anterior teeth of periodontally healthy Han nationality youth using soft tissue indirect imaging cone-beam computed tomography (CBCT). METHODS: Twenty-five periodontally healthy subjects (11 males and 14 females) with 150 maxillary anterior teeth were involved in this study. A special impression with radiopaque material including the maxillary teeth was made, then a CBCT scan with the elastomeric matrix in position was taken for each subject. The imaging data were generated and transferred to a volumetric imaging software in which three-dimensional reconstruction was conducted and the image analyses were carried out. Measurements were made at the site of labial center of the maxillary anterior teeth. The height of the SOG, the distance between cemento-enamel junction (CEJ) and bone crest, the gingival thickness at the CEJ, and the thickness of bone 2 mm below the labial bone crest were measured and the correlation analysis between the parameters was made. All the data analyses were performed using SPSS 22.0. The data were analyzed with ANVOA and Pearson correlation tests with the significance level at α=0.05. RESULTS: The mean SOG values were (3.49±0.70) mm, (3.48±0.81) mm, and (3.54±0.67) mm for central incisors, lateral incisors and canines, respectively. There were no statistically significant differences among the different sites (P > 0.05). The mean gingival thickness values were (1.45±0.23) mm, (1.13±0.24) mm, (1.14±0.22) mm for central incisors, lateral incisors and canines, respectively. The gingival thickness of the central incisors was the largest among the maxillary anterior teeth with statistically significant difference (P < 0.05). No correlation was found between the SOG and gingival thickness among the maxillary anterior teeth (P > 0.05). CONCLUSION: The gingival thickness of central incisors was the largest and the supraosseous gingival height had no correlation with gingival thickness among the periodontally healthy maxillary anterior teeth.


Assuntos
Gengiva , Maxila , Adolescente , Tomografia Computadorizada de Feixe Cônico , Feminino , Gengiva/diagnóstico por imagem , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Colo do Dente
2.
J Adhes Dent ; 23(5): 379-387, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34549921

RESUMO

PURPOSE: To evaluate the 24-month clinical performance of Adhese Universal (ADH) (Ivoclar Vivadent) using two different application modes (etch-and-rinse vs self-etch) when restoring non-carious cervical lesions. MATERIALS AND METHODS: Twenty-six patients participated in this study. A total of 117 non-carious cervical lesion restorations (N = 117) were assigned to two groups: 1) ADH in the etch-and-rinse mode (n = 59) and 2) ADH in the self-etch mode (n = 58). The same resin composite (Tetric EvoCeram, Ivoclar Vivadent) was used for all restorations. The restorations were evaluated at baseline and at 24 months using the World Dental Federation (FDI) criteria. The results were analyzed statistically using the McNemar test (α = 0.05) and a generalized estimating equation. RESULTS: In self-etch mode, significant differences were found for marginal coloring (p = 0.002), marginal adaptation (p = 0.031), and hypersensitivity (p = 0.031) between baseline and the end of the 24-month period. In the etch-and-rinse mode, significant differences were found for marginal coloring (p = 0.004), fractures/retention (p = 0.002), marginal adaptation (p = 0.002), and hypersensitivity (p = 0.000). Significant differences were also detected between groups at 24 months for fractures/retention (p = 0.001). At 24 months, 10 restorations of the etch-and-rinse group were lost and 2 restorations of the self-etch group were lost. CONCLUSION: In terms of fractures and retention criteria, this universal adhesive obtained better results when applied in self-etch mode than in etch-and-rinse mode.


Assuntos
Restauração Dentária Permanente , Colo do Dente , Cimentos Dentários , Humanos , Cimentos de Resina
3.
Braz Oral Res ; 35(Supp 2): e096, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34586210

RESUMO

The presence of a tooth-surface defect, such as a non-carious cervical lesion (NCCL), associated with sites of gingival recession (GR) defects creates a combined soft tissue/tooth defect (CD) that requires a different treatment plan. This study aimed to critically review the literature regarding the available treatment protocols for CDs and suggest a new decision-making process. NCCLs were classified as Class A-: the cementoenamel junction (CEJ) was visible and the root surface discrepancy was < 0.5 mm (no step); Class A+: CEJ was visible and the root surface discrepancy was > 0.5 mm (with a step); Class B-: unidentifiable CEJ without a step; Class B+: unidentifiable CEJ with a step. NCCLs affecting both root and crown surfaces (Class B) lead to CEJ destruction and consequently eliminate an important landmark used before and after root coverage procedures. The depth of the root surface discrepancy is vital owing to its possible impact on soft tissue adaptation after healing, which, in turn, may influence the treatment options, namely the use of graft and/or composites to compensate for the discrepancy. Clinically, a step with horizontal depth greater than 0.5 mm should be recognized as the minimum threshold value to define this condition. Extremely deep defects tend to assume a V-shaped topography. Therefore, extremely deep V-shaped defects were classified into subclasses A+V, a V-shaped defect, and B+V, a V-shaped defect with loss of CEJ, for management considerations. The treatment options, supported by the literature, and a decision-making process to deal with each condition are presented.


Assuntos
Retração Gengival , Diagnóstico Bucal , Gengiva , Retração Gengival/terapia , Humanos , Colo do Dente , Coroa do Dente , Raiz Dentária , Resultado do Tratamento
4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(4): 764-769, 2021 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-34393242

RESUMO

OBJECTIVE: To evaluate the influence of base materials on stress distribution in endodontically treated maxillary premolars restored with endocrowns using three-dimensional finite element analysis. METHODS: A maxillary second premolar was scanned by Micro-CT and a three-dimensional finite element model of ceramic endocrown with 1 mm thickness of base was established. A model without base was also established as a negative control. Four kinds of conventional base materials with different elastic modulus were adopted: light cure glass ionomer(3M Vitrebond, 3 657 MPa), flowable composite resin(3M Filtek Z350XT Flowable Restorative, 7 300 MPa), high strength glass ionomer(GC Fuji Ⅸ, 13 130 MPa), and posterior composite resin(3M Filtek P60, 19 700 MPa). With a 200 N force loaded vertically and obliquely, the distribution and magnitude of stress in the tooth tissue and adhesive layer were investigated by three-dimensional finite element analysis. RESULTS: The maximum von Mises stress values(vertical/oblique) in dentin and adhesive layer were measured as follows: (1) no base material: 19.39/70.49 MPa in dentin and 6.97/17.97 MPa in adhesive layer; (2) light cure glass ionomer: 19.00/69.75 MPa in dentin and 6.87/16.30 MPa in adhesive layer; (3) flowable composite resin: 18.78/69.33 MPa in dentin and 6.79/16.17 MPa in adhesive layer; (4) high strength glass ionomer: 18.71/69.20 MPa in dentin and 6.74/16.07 MPa in adhesive layer; (5) posterior composite resin: 18.61/69.03 MPa in dentin and 6.70/16.01 MPa in adhesive layer. Under the same loading condition, models with different elastic moduli of base materials had similar stress distribution patterns. The von Mises stress of tooth tissue was mainly concentrated in the tooth cervix. Under oblique load, the regions where von Mises stress concentrated in were similar to those under a vertical load, but the values increased. The stress concentration in the tooth cervix was alleviated in models with base materials compared with the model without base material. The maximum von Mises stress in the tooth tissue and adhesive layer decreased when the elastic modulus of base materials increased and got close to that of dentin. CONCLUSION: The posterior composite resin of which the elastic moduli is high and close to that of dentin is recommended as base material for premolar endocrowns to alleviate the concentration of stress in tooth cervix and adhesive layer.


Assuntos
Resinas Compostas , Colo do Dente , Dente Pré-Molar , Cerâmica , Análise do Estresse Dentário , Dentina , Análise de Elementos Finitos , Humanos , Teste de Materiais , Estresse Mecânico , Microtomografia por Raio-X
5.
Artigo em Inglês | MEDLINE | ID: mdl-34328482

RESUMO

Gingival recession accounts for apical migration of the gingival margin, resulting in exposure of the cementoenamel junction and root surface, with exposure of the root surface linked to deteriorated esthetic appearance and increased dentinal hypersensitivity. Various surgical techniques have been used to correct labial gingival recession defects. The present study evaluated and compared the results of semilunar coronally positioned flap (SCPF) alone and in conjunction with free gingival graft (FGG) for the treatment of Miller Class I and II gingival recession defects in maxillary anterior teeth. A total of 20 bilateral Miller Class I and II gingival recession sites were included and randomly allocated (n = 10 sites/group) to either the semilunar coronally positioned flap technique alone (SCPF group; control) or with FGG (SCPF+FGG group; test). Longitudinal alterations in probing depth (PD), recession width (RW), recession height (RH), width of keratinized tissue (WKT), and clinical attachment level (CAL) were measured and analyzed for both groups at 1-, 3-, 6-, and 12-month follow-ups. Both groups saw a significant decrease in RH, RW, and CAL and a significant increase in WKT. No statistically significant difference was observed in the final root coverage outcome between both groups in terms of RH, RW, and CAL, but a significant increase in WKT was seen with SCPF+FGG. Both techniques demonstrated optimal results without significant differences in the final root coverage outcomes except for WKT, which had a statistically significant increase in the SCPF+FGG group.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Bucais , Assistência Odontológica , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Colo do Dente
6.
Int J Oral Sci ; 13(1): 19, 2021 06 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112752

RESUMO

External cervical resorption (ECR) refers to a pathological state in which resorption tissues penetrate into the dentin at the cervical aspect of the root. Despite being latent in its initial phase, ECR could cause severe damage to mineralized dental tissue and even involve the pulp if not given timely diagnosis and treatment. Nevertheless, the etiology of ECR is still poorly understood, which adds to the difficulty in early diagnosis. ECR has received growing attention in recent years due to the increasing number of clinical cases. Several potential predisposing factors have been recognized in cross-sectional studies as well as case reports. In the meantime, studies on histopathology and pathogenesis have shed light on possible mechanisms of ECR. This review aims to summarize the latest findings in the pathogenesis and potential predisposing factors of ECR, so as to provide pragmatic reference for clinical practice.


Assuntos
Reabsorção da Raiz , Colo do Dente , Causalidade , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Humanos , Reabsorção da Raiz/etiologia
7.
J Adhes Dent ; 23(3): 201-215, 2021 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-34060300

RESUMO

PURPOSE: Mild and intermediately strong 2-step self-etch adhesives (2SEa) have been shown to bond efficiently to dentin. In general, their bonding efficiency to enamel is inferior to that of etch & rinse adhesives (E&Ra). On the other hand, their application procedure is less elaborate, and consequently leaves less room for application mistakes. The aim of this randomized controlled trial was to evaluate the clinical performance of an intermediately strong 2SEa, as compared with that of a 3-step E&Ra after 6 years of clinical functioning. MATERIALS AND METHODS: 239 non-carious cervical lesions in 50 patients were restored with the nanohybrid composite Herculite XRV (Kerr), bonded in random order either with the 2SEa Optibond XTR ('O-XTR', Kerr) or the gold-standard control 3E&Ra Optibond FL ('O-FL', Kerr). The restorations were recalled after 1, 2 and 6 years of clinical service and examined for retention, marginal adaptation, marginal discoloration, caries occurrence, and postoperative sensitivity. Statistical analysis was performed using a logistic regression model with generalized estimating equations (2-way GEE model). RESULTS: The patient recall rate at 6 years was 94%. The overall clinical success rate was 81.9% and 80.9% for O-XTR and O-FL, respectively. In total, 42 restorations (21 O-XTR, 21 O-FL) failed because of retention loss, severe abfraction/abrasion/erosion, severe marginal defects and/or discoloration, and/or caries. A retention rate of 92.9% and 88.9% was recorded for O-XTR and O-FL, respectively. Progressive marginal deterioration was observed over the 6-year period. Small clinically acceptable marginal defects were recorded in about 70% of the restorations (O-XTR: 69.9%; O-FL: 74.1%). Regarding marginal discoloration, 37% of the O-XTR and 30.2% of the O-FL restorations showed superficial clinically acceptable marginal discoloration. Six O-XTR and 4 O-FL restorations exhibited caries at the restoration margin. No significant difference was observed between the two groups for any of the evaluated parameters (p > 0.05). CONCLUSION: After 6 years of clinical service, Class-V restorations bonded with the 2SEa performed clinically equally well as those bonded with the 3E&Ra.


Assuntos
Restauração Dentária Permanente , Colo do Dente , Cimentos Dentários , Esmalte Dentário , Adaptação Marginal Dentária , Humanos
8.
Int Endod J ; 54(9): 1647-1652, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33932037

RESUMO

AIM: To assess the impact of mechanical overinstrumentation of root canals in extracted teeth on the development of dentinal microcracks in the apical portion of the root by means of micro-computed tomographic (micro-CT) analysis. Root canal preparation short of the canal terminus and at the apical foramen (AF) were used as controls. METHODOLOGY: Twenty 2-rooted maxillary premolars with two canals were selected, scanned in a micro-CT device and the root canals prepared sequentially using Reciproc M-Wire R25 instruments to working lengths: 1 mm short of the AF (AF - 1 mm), at the AF (AF), and overinstrumentation (AF + 1 mm). A micro-CT scan of each specimen was performed after each time point. After reconstruction and co-registration procedures, the images were screened from the cementoenamel junction to the apex (n = 55 352) to identify the presence of dentinal microcracks in the apical third of the root. RESULTS: After the analyses of 55 352 slices, dentinal microcracks were visualized in 12.45% of the images (6892 slices), with 5.73% (3174 slices) in the cervical, 3.57% (1976 slices) in the middle and 3.15% (1740 slices) in the apical third. All dentinal microcracks observed at all time points (AF - 1 mm, AF and AF + 1 mm) were already present in the corresponding images before canal instrumentation. Therefore, no new microcracks were detected, regardless of the working length used for canal instrumentation. CONCLUSION: Reciprocating root canal preparation either short, at or beyond the AF (overinstrumentation) did not create dentinal microcracks in the roots of extracted 2-rooted maxillary premolars.


Assuntos
Preparo de Canal Radicular , Ápice Dentário , Cavidade Pulpar , Humanos , Ápice Dentário/diagnóstico por imagem , Colo do Dente , Extração Dentária , Microtomografia por Raio-X
9.
Dent Mater J ; 40(5): 1151-1159, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34024886

RESUMO

The purpose of this multicenter clinical study was to compare the mid-term clinical effectiveness of direct resin composite restorations using one-step or two-step self-etch adhesives (1-SEAs or 2-SEAs). In total, 352 restorations of class I-V cavities and non-carious cervical lesions in vital teeth (1-SEAs; 52 cases, 2-SEAs; 300 cases) were placed at nine university hospitals and evaluated according to the modified USPHS criteria at baseline, and after 1, 2, and 3 years. The recall rates were 86.6% (1 year), 80.1% (2 years), and 62.2% (3 years). Two restorations failed due to fracture during the follow-up, and there was no significant difference in survival rates between 1-SEAs (97.6%) and 2-SEAs (99.4%). However, 2-SEAs exhibited significantly lower occurrences of discoloration, marginal discoloration, fracture, and plaque retention. Moreover, the subjects reported a significantly lower postoperative hypersensitivity and higher overall satisfaction at all evaluation periods if 2-SEAs were used.


Assuntos
Restauração Dentária Permanente , Colo do Dente , Resinas Compostas , Cimentos Dentários , Adaptação Marginal Dentária , Adesivos Dentinários , Humanos , Cimentos de Resina , Resultado do Tratamento
10.
Anat Sci Int ; 96(4): 509-516, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33821420

RESUMO

Cementoenamel junction is an anatomical landmark which indicates the meeting point of enamel of the crown and the cementum of the root. It is an important reference point in clinical dentistry as well as in dental radiography. The present study is done to describe the distribution of the mineralized tissue at the cementoenamel junction in relation to various surfaces of the premolars. The study sample consisted of 89 permanent maxillary and mandibular premolars from both males and females extracted for orthodontic reasons. They were stained with carbol fuchsin and observed under a dissecting microscope to identify the following tissue interrelationships at the cementoenamel junction: cementum overlapping the enamel; edge-to-edge relationship between enamel and cementum; gap between the enamel and cementum and enamel overlapping the cementum. The cementum overlapping the enamel interrelationship was predominant in the buccal and lingual surfaces of both first and second maxillary premolars, while the edge-to-edge relationship and the presence of a gap between the enamel and the cementum relationship were abundant in distal and mesial sides. Enamel overlapping the cementum was recorded only in a very small proportion of the sample. A good understanding about the morphological variations at the cementoenamel junction area is very important and this area should be handled carefully during routine dental procedures such as dental bleaching, orthodontic treatment, placement of rubber dam and placement of dental materials.


Assuntos
Dente Pré-Molar/anatomia & histologia , Colo do Dente/anatomia & histologia , Adolescente , Criança , Feminino , Humanos , Masculino , Sri Lanka
11.
J Clin Periodontol ; 48(8): 1111-1125, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33899259

RESUMO

AIM: To assess the safety/efficacy of a tissue-engineered biocomplex in periodontal reconstruction. METHODS: Twenty-seven intrabony defects were block-randomized across three treatment groups: Group-A (NA  = 9) received autologous clinical-grade alveolar bone marrow mesenchymal stem cells (a-BMMSCs), seeded into collagen scaffolds, enriched with autologous fibrin/platelet lysate (aFPL). In Group-B (NB  = 10), the collagen scaffold/aFPL devoid of a-BMMSCs filled the osseous defect. Group-C (NC  = 8) received Minimal Access Flap surgery retaining the soft tissue wall of defects identically with Groups-A/-B. Subjects were clinically/radiographically assessed before anaesthesia (baseline) and repeatedly over 12 months. RESULTS: Quality controls were satisfied before biocomplex transplantation. There were no adverse healing events. All approaches led to significant clinical improvements (p < .001) with no inter-group differences. At 12 months, the estimated marginal means for all groups were as follows: 3.0 (95% CI: 1.9-4.1) mm for attachment gain; 3.7 (2.7-4.8) mm for probing pocket depth reduction; 0.7 (0.2-1.3) mm increase in recession. An overall greater mean reduction in the radiographic Cemento-Enamel Junction to Bottom Defect (CEJ-BD) distance was found for Groups-A/-C over Group-B (p < .023). CONCLUSION: Radiographic evidence of bone fill was less pronounced in Group-B, although clinical improvements were similar across groups. All approaches aimed to trigger the innate healing potential of tissues. Cell-based therapy is justified for periodontal reconstruction and remains promising in selected cases.


Assuntos
Perda do Osso Alveolar , Regeneração Tecidual Guiada Periodontal , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Humanos , Perda da Inserção Periodontal/cirurgia , Colo do Dente , Cicatrização
12.
J Oral Sci ; 63(2): 191-194, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33790090

RESUMO

PURPOSE: To investigate the effect of slurry abrasive levels and acidic challenges on the development of non-carious cervical lesions. METHODS: Ninety-six extracted upper premolars were affixed in pairs to acrylic blocks and had their root surfaces covered by acrylic resin except for 2 mm from the cemento-enamel junction. The specimens were distributed into six groups (n = 8 pairs) based on two experimental factors: (1) slurry abrasivity level [low/medium/high] and (2) citric acid challenge [yes/no]. Specimens were brushed for 5,000, 15,000, 35,000, and 65,000 strokes. Volume loss (VL) was determined based on optical profilometry scans of specimens impressions at the baseline and at subsequent brushing levels. Data were analyzed using repeated measures analysis of variance and Bonferroni pairwise comparison (α = 0.05). RESULTS: Higher VL values were associated with high-abrasivity slurries relative to low- and medium-abrasivity slurries (P < 0.001). Increasing the slurry abrasivity level increased the VL regardless of the acidic challenge, which did not have a significant effect (P = 0.184). After 65,000 strokes, significant VL was recorded in all groups relative to preceding brushing levels (P < 0.001). CONCLUSION: Higher values of time-dependent surface loss were associated with increased dentifrice slurry abrasivity, regardless of the citric acid challenge.


Assuntos
Dentifrícios , Abrasão Dentária , Erosão Dentária , Humanos , Abrasão Dentária/etiologia , Colo do Dente , Erosão Dentária/etiologia , Escovação Dentária , Cremes Dentais
13.
J Endod ; 47(6): 883-894, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33745945

RESUMO

External cervical resorption (ECR) is a relatively uncommon yet aggressive form of dental hard tissue destruction. It is initiated at the cervical aspect of the root surface and extends apicocoronally and circumferentially inside the dentin. Despite the large number of case reports and clinical studies that have investigated ECR, its etiology remains unclear. Recent advancements in clinical assessment measures, such as the use of cone-beam computed tomographic imaging, have provided additional insights into the nature of this lesion. This has facilitated the continued development and improvement of treatment methods for this condition. In this article, we provide an overview of the latest research pertaining to the etiology, histopathology, predisposing factors, diagnosis, classification, and treatment of ECR. Furthermore, we provide a summary of the different classification schemes for ECR and highlight the relevant therapeutic principles.


Assuntos
Reabsorção da Raiz , Tomografia Computadorizada de Feixe Cônico , Humanos , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Colo do Dente/diagnóstico por imagem
14.
BMC Oral Health ; 21(1): 143, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33752651

RESUMO

BACKGROUND: Understanding the anatomy of the facial alveolar bone (FAB), provides a prognostic tool for estimating the degree of dimensional ridge alterations after tooth extraction. This systematic review and meta-analysis aims to determine the FAB thickness and modifying factors of anterior maxillary teeth measured by CBCT scans. A secondary objective was to assess the facial distance from the cementoenamel junction (CEJ) to the bone crest. METHODS: An electronic search was made of Medline, Embase, Web of Science, Cochrane Library and Google Scholar up to December 2019. Studies that analyze and quantitatively compare FAB thickness at maxillary teeth by CBCT scans were included. The methodological quality of the included studies was appraised using the ROBINS-I tool and the overall meta-evidence certainty using the GRADE approach. A single means random-effects meta-analysis was performed to obtain the weighted mean for 95% confidence interval. A meta-regression of covariates and subgroup analysis was conducted. The nullity Qh test and I2 index for heterogeneity was estimated. RESULTS: 2560 potentially relevant articles were recorded from which 29 studies were selected for the qualitative analysis, including 17,321 teeth. Seventeen studies considered the facial bone crest, and 12 the CEJ as a reference point for their measurements. Mean FAB thickness was ≤ 1 mm in maxillary incisors and canines (0.75-1.05 mm) and 1-2 mm in premolars. Patients over 50 years of age, females and thin gingival phenotype was associated with thinner FAB at some apico-coronal locations of maxillary incisors and canines. The geographical setting was an effect modifier that could explain up to 87% of the heterogeneity in FAB thickness, being Asian populations that showed the lowest FAB thickness values. The CEJ-bone crest distance was 2-2.5 mm in all teeth analyzed. Population over 50 years of age exhibited greater CEJ-bone crest distances, and males also showed a trend for greater distance. Evidence certainty has shown moderate quality in most analysis subsets. CONCLUSIONS: Facial alveolar bone at anterior maxillary teeth is thin, heterogeneous in width along its apico-coronal dimensions, and increases in thickness in maxillary premolars. The CEJ-bone crest distance presented homogeneous and similar values in all teeth analyzed.


Assuntos
Processo Alveolar , Maxila , Processo Alveolar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Colo do Dente
15.
Oper Dent ; 46(1): E34-E59, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33529313

RESUMO

CLINICAL RELEVANCE: The use of filled adhesive systems does not influence the clinical performance of the adhesive restoration in noncarious cervical lesions.


Assuntos
Cimentos Dentários , Restauração Dentária Permanente , Resinas Compostas , Cimentos Dentários/uso terapêutico , Colo do Dente
16.
Biomed Res Int ; 2021: 8822804, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33490278

RESUMO

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG.


Assuntos
Implantação Dentária , Transplantes/transplante , Adulto , Colágeno/uso terapêutico , Tecido Conjuntivo/transplante , Implantação Dentária/efeitos adversos , Implantação Dentária/métodos , Implantação Dentária/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Palato Duro/transplante , Estudos Retrospectivos , Colo do Dente/patologia , Colo do Dente/cirurgia
17.
J Dent ; 106: 103571, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33385534

RESUMO

OBJECTIVE: This study evaluated the effect of resin composite restorations of non-carious cervical lesions (NCCLs) on the occurrence/progression of gingival recession (GR), considering different tooth isolation techniques. METHODS: A randomized controlled split-mouth and blinded trial was carried out. Patients (n = 38) with at least two NCCLs were included. Before the cervical restoration placement, the NCCLs (181 teeth) were randomly allocated into two treatment groups according to the tooth isolation techniques: cotton roll or rubber dam. Experienced, trained, blinded, and calibrated examiners performed periodontal evaluations at baseline and 5-year follow-up, using a periodontal probe. Restorations were assessed with the FDI criteria. Thirty-two patients (154 teeth) were evaluated at 5 years. The occurrence/progression of GR between baseline and follow-up was considered the primary outcome. The relative risk (RR) and 95 % confidence interval (95 %CI) were calculated by Poisson regression (α < 0.05). RESULTS: After 5 year, 31 teeth (13.6 %) presented occurrence/progression of GR. In the multivariate analyses, the occurrence/progression of GR was associated with the use of rubber dam isolation (RR; 95 %CI: 2.65; 1.01-7.00) and a lack of marginal adaptation of the restoration (RR; 95 %CI: 10.98; 2.31-52.30). Toothbrush stiffness, use of abrasive dentifrice, tooth type, and the presence of biofilm or gingivitis did not present a statistically significant higher risk for occurrence/progression of GR. CONCLUSION: The use of rubber dam isolation associated with retraction clamp and the lack of a proper marginal adaptation of the composite restorations are risk indicators for the occurrence/progression of GR in individuals who received a restoration for an NCCL. CLINICAL SIGNIFICANCE: Isolation with a rubber dam and dental clamps may promote GR in sites with restored NCCLs. Moreover, clinical examinations for lack of marginal adaptations of the restorations may be included in a clinical setting.


Assuntos
Restauração Dentária Permanente , Retração Gengival , Resinas Compostas , Adaptação Marginal Dentária , Seguimentos , Humanos , Diques de Borracha , Colo do Dente
18.
J Periodontol ; 92(3): 327-335, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32738056

RESUMO

Gingival recession defect (GRD) may be defined as an apical migration of the gingival margin respective to the cementoenamel junction resulting in partial exposure of the root surface to the oral cavity, which may have important esthetic, functional, and periodontal health implications. A novel system for the classification and management of non-proximal GRDs is proposed in this article. This evidence-based system consists of two essential components: (1) Establishment of the GRD type based on the midbuccal/midlingual attachment level respective to the interproximal bone level, and (2) Assessment of the gingival phenotype according to the width of attached gingiva and gingival thickness. Each category of this new classification system is linked with treatment recommendations substantiated by relevant literature pertaining to the outcomes of validated root coverage procedures in specific scenarios, which can be used as a guide for clinical decision-making in daily practice.


Assuntos
Retração Gengival , Tecido Conjuntivo , Estética Dentária , Gengiva , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Colo do Dente , Raiz Dentária/cirurgia , Resultado do Tratamento
19.
Clin Oral Investig ; 25(5): 2999-3006, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33025146

RESUMO

OBJECTIVE: To explore and evaluate the application of a surgical guide in the extraction of impacted mesiodentes. MATERIALS AND METHODS: Patients with impacted mesiodentes approachable from the labial side of the maxilla were randomly divided into three groups. The surgical guide for group I was made using cone beam computed tomography (CBCT) and dental cast, whereas the surgical guide for group II was only made using CBCT data. Group I and group II were first evaluated to determine whether guide use could accurately locate the cementoenamel junction (CEJ) of the mesiodentes, and the impacted mesiodentes were extracted with the help of the surgical guide. Group III underwent an operation without a guide. For all patients, the preoperative design time, tooth searching time, operation time, complications, and costs were measured. RESULTS: The guides for group I and group II could locate the CEJ of the mesiodentes accurately, with good application effect during the operation. Group I and group II required additional preoperative design time compared with group III. However, the tooth searching time and operation time in groups I and II were significantly reduced compared with those in group III. Group I and group II showed no intraoperative complications, and two cases in group III showed imprecision during localization. The overall cost for group III was higher than that of group I or group II. But group I and group II required extra visits and costs. CONCLUSIONS: Despite some limitations, the surgical guide assisted with mesiodentes extraction and can improve the quality of the operation quality as well as reducing its economic burden, difficulty, and duration. Through proper design, we can create a high-quality surgical guide using only CBCT data. CLINICAL RELEVANCE: The surgical guide can be used as an important assistive tool in alveolar surgery.


Assuntos
Dente Impactado , Dente Supranumerário , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila , Colo do Dente , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Dente Supranumerário/diagnóstico por imagem , Dente Supranumerário/cirurgia
20.
Spec Care Dentist ; 41(1): 98-102, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33150634

RESUMO

Idiopathic cervical root resorption (ICRR) is a rare condition involving the cemento-enamel junction of the teeth. Multiple idiopathic cervical root resorption (MICRR) involves several teeth with an unknown prevalence and aetiology. The resorptive lesions are often detected on routine radiographs or during clinical examination. The defects are often painless, hence they are usually diagnosed late and in an advanced stage when diagnosed clinically. The restoration of MICRR can be demanding with subsequent loss of the teeth affected. In this report, we describe the case of a 16-year-old female with MICRR, the therapeutic challenges and clinical burden for this young patient over a period of approximately 5 years.


Assuntos
Reabsorção da Raiz , Adolescente , Feminino , Humanos , Reabsorção da Raiz/diagnóstico por imagem , Colo do Dente/diagnóstico por imagem
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