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2.
J Clin Pediatr Dent ; 48(3): 52-58, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755982

RESUMO

This study aimed to evaluate the performance of deep learning algorithms for the classification and segmentation of impacted mesiodens in pediatric panoramic radiographs. A total of 850 panoramic radiographs of pediatric patients (aged 3-9 years) was included in this study. The U-Net semantic segmentation algorithm was applied for the detection and segmentation of mesiodens in the upper anterior region. For enhancement of the algorithm, pre-trained ResNet models were applied to the encoding path. The segmentation performance of the algorithm was tested using the Jaccard index and Dice coefficient. The diagnostic accuracy, precision, recall, F1-score and time to diagnosis of the algorithms were compared with those of human expert groups using the test dataset. Cohen's kappa statistics were compared between the model and human groups. The segmentation model exhibited a high Jaccard index and Dice coefficient (>90%). In mesiodens diagnosis, the trained model achieved 91-92% accuracy and a 94-95% F1-score, which were comparable with human expert group results (96%). The diagnostic duration of the deep learning model was 7.5 seconds, which was significantly faster in mesiodens detection compared to human groups. The agreement between the deep learning model and human experts is moderate (Cohen's kappa = 0.767). The proposed deep learning algorithm showed good segmentation performance and approached the performance of human experts in the diagnosis of mesiodens, with a significantly faster diagnosis time.


Assuntos
Aprendizado Profundo , Radiografia Panorâmica , Dente Impactado , Humanos , Criança , Pré-Escolar , Dente Impactado/diagnóstico por imagem , Algoritmos , Feminino , Masculino , Processamento de Imagem Assistida por Computador/métodos
3.
J Clin Pediatr Dent ; 48(3): 120-130, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755990

RESUMO

The root of late-dental-age labial inversely impacted maxillary central incisors (LIIMCIs) typically develops to severe dilacerated morphology. Therefore, reliable posttreatment periodontal estimates of orthodontic treatment prognosis would be critical to the treatment value of impacted incisors. This study aims to analyze further changes in dimensions of the alveolar bone following the closed-eruption treatment of late-dental-age dilacerated LIIMCIs. Cone beam computed tomography (CBCT) scanning data of 16 patients with unilateral dilacerated late-dental-age LIIMCIs were collected, including the pretreatment (T1) and at the 2.23 ± 0.78 years follow-up stage (T2) respectively. Patients underwent closed-eruption treatments to bring the impacted incisor into the dental arch. Dolphin imaging software was used to measure alveolar bone height labially, palatally, and proximally to the site at T1 and T2, as well as alveolar bone thicknesses at 0, 2, 4, 6 and 8 mm below the initial measurement plane (IMP). The alveolar bone heights on the impacted and contralateral sides increased from T1 to T2 (p < 0.05). Alveolar bone growth on both sides had no significant difference. In T2, the mean values of labial and distal alveolar heights on the contralateral sides were greater than on the impacted sides (p < 0.05). The mean values of total alveolar bone thicknesses on the impacted sides in T1 were significantly smaller than those on the contralateral sides in IMP-0, 2, 4, 6, 8 (p < 0.05). The total thicknesses on the impacted sides in T2 increased and were significantly greater than on the contralateral sides (p < 0.05), except for the thickness in IMP-0. The closed-eruption treatment of dilacerated late-dental-age LIIMCIs results in no significant changes to alveolar bone height, except on the labial and distal sides, with increased alveolar bone thickness, suggesting that this approach may be viable first choice therapy for non-extraction orthodontic cases.


Assuntos
Processo Alveolar , Tomografia Computadorizada de Feixe Cônico , Incisivo , Maxila , Dente Impactado , Humanos , Incisivo/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/crescimento & desenvolvimento , Estudos Retrospectivos , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Impactado/terapia , Dente Impactado/diagnóstico por imagem , Feminino , Masculino , Criança , Pré-Escolar
4.
BMC Oral Health ; 24(1): 515, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38698359

RESUMO

OBJECTIVE: Low impacted third molars are usually asymptomatic and are often found by X-ray examination. The removal of asymptomatic low impacted third molars is one of the most controversial clinical issues in oral and maxillofacial surgery. METHODS: In this study, 806 patients with low impacted mandibular third molars (LIMTMs) (full bony impaction) were analyzed to determine the prevalence and risk factors for cystic lesions and adjacent tooth root resorption throughout the patients' entire life cycle. RESULTS: The results showed that the prevalence of adjacent tooth root resorption and cystic lesions was age-related, exhibiting a trend of first increasing and then decreasing; prevalence peaked at the age of 41 to 45 years old, the prevalence rates were 12.50% and 11.11% respectively. And the lowest prevalence rate was 2.86% and 2.44% in ≥ 61 group and 56- to 60-year age group respectively. Age was an independent risk factor for adjacent tooth root resorption of LIMTMs, whereas age and impaction type (especially inverted impaction) were independent risk factors for cystic lesions. CONCLUSIONS: The full life cycle management strategy for LIMTMs may need to be individualized. Surgical removal is recommended for LIMTMs in patients younger than 41 to 45 years, especially for inverted, mesioangular, and horizontally impacted LIMTMs. LIMTMs in patients older than 41 to 45 years may be treated conservatively with regular follow-up, but surgical removal of inverted impacted LIMTMs is still recommended to avoid cyst formation.


Assuntos
Dente Serotino , Reabsorção da Raiz , Dente Impactado , Humanos , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Feminino , Estudos Retrospectivos , Masculino , Adulto , Pessoa de Meia-Idade , Fatores de Risco , Mandíbula , Prevalência , Adulto Jovem , Adolescente , Fatores Etários , Idoso
6.
Orthod Fr ; 95(1): 79-103, 2024 05 03.
Artigo em Francês | MEDLINE | ID: mdl-38699916

RESUMO

Introduction: Impacted or transposed teeth present a common yet challenging issue in dentistry. These conditions occur when teeth fail to erupt properly or emerge in abnormal positions within the dental arch. Material and Method: This article explores the evolving landscape of therapeutic strategies for impacted or transposed teeth, emphasizing a multidisciplinary and patient-centered approach. Results: By adopting a multidisciplinary approach involving orthodontists, oral surgeons, and other dental specialists, clinicians can tailor treatment plans to address individual needs and optimize outcomes. Discussion: Therapeutic reassessment of impacted or transposed teeth represents a paradigm shift in modern dentistry, emphasizing personalized care, minimally invasive techniques, and interdisciplinary collaboration.


Introduction: Les dents incluses ou transposées présentent un problème courant, quoique difficile à gérer. Ces conditions surviennent lorsque les dents ne parviennent pas à faire leur éruption correctement ou émergent dans des positions anormales au sein de l'arcade dentaire. Matériel et méthode: Cet article explore le paysage évolutif des stratégies thérapeutiques proposées pour la prise en charge des dents incluses ou transposées, en mettant l'accent sur une approche multidisciplinaire centrée sur le patient. Résultats: En adoptant une approche multidisciplinaire réunissant des orthodontistes, des chirurgiens oraux et d'autres spécialistes dentaires, les cliniciens peuvent adapter les plans de traitement au mieux pour répondre aux besoins individuels de chaque patient et optimiser les résultats. Discussion: La réévaluation thérapeutique des dents incluses ou transposées représente un changement de paradigme en dentisterie moderne, mettant l'accent sur les soins personnalisés, les techniques mini-invasives et la collaboration interdisciplinaire.


Assuntos
Dente Impactado , Humanos , Dente Impactado/terapia , Dente Impactado/cirurgia , Erupção Ectópica de Dente/terapia
7.
Clin Oral Investig ; 28(6): 325, 2024 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-38762665

RESUMO

OBJECTIVE: With the increasing maturity of 3D printing technology, the application of digital guide template in the extraction of impacted teeth has become more sophisticated. However, for maxillary palatal deeply impacted teeth, there still exist significant clinical challenges. This experiment introduces a novel digital guide template and innovatively employs a flapless technique to explore a minimally invasive approach for the extraction of palatal deeply impacted teeth. METHODS: This experiment included 40 patients diagnosed with palatal completely impacted teeth, randomly divided into an experimental group and a control group. The experimental group used the new digital guide template for flapless extraction, while the control group employed the traditional freehand flap technique. RESULTS: The experimental group can significantly reduce the localization time of palatally impacted teeth (P < 0.001), with total surgery times of 18.15 ± 4.88 min and 22.00 ± 7.71 min for the experimental and control groups, respectively (P = 0.067). Although there were no significant statistical differences between the two groups in terms of intraoperative bleeding, adjacent tooth damage, infection, or damage to nearby important anatomical structures, the experimental group showed significant improvements in postoperative pain (P < 0.05), swelling (P < 0.001), and patient satisfaction (P < 0.001) compared to the control group. CONCLUSION: Compared to traditional freehand flap surgery, flapless extraction of palatally impacted teeth guided by digital templates significantly reduces the localization time of impacted teeth and demonstrates notable advantages in some postoperative complications. Future studies with larger sample sizes are needed to substantiate the feasibility of this technique.


Assuntos
Estudos de Viabilidade , Extração Dentária , Dente Impactado , Adolescente , Adulto , Feminino , Humanos , Masculino , Maxila/cirurgia , Satisfação do Paciente , Impressão Tridimensional , Cirurgia Assistida por Computador/métodos , Extração Dentária/métodos , Dente Impactado/cirurgia , Resultado do Tratamento
8.
BMC Oral Health ; 24(1): 482, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38643143

RESUMO

BACKGROUND: Root resorption of adjacent teeth due to impacted canines is common, and orthodontic treatment often leads to secondary resorption or even loss of adjacent roots. Clinical reports of long-term stability after treatment are rare. CASE PRESENTATION: This study reports two cases of maxillary impacted canines resulting in severe root resorption of the adjacent lateral incisors. Surgical exposure, orthodontic retraction, and alignment of the impacted canines were successful in both cases, and the resorbed lateral incisors were stable with no significant loosening and normal pulp vitality after treatment and at the 5- and 10-year follow-up appointments. CONCLUSIONS: Light orthodontic force may be used to move adjacent teeth with root resorption due to tooth obstruction. The path and direction in which the teeth are moved must be specifically designed so that the adjacent roots are not resorbed and so long-term stability can be achieved.


Assuntos
Reabsorção da Raiz , Dente Impactado , Humanos , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Reabsorção da Raiz/terapia , Seguimentos , Incisivo , Maxila , Dente Impactado/complicações , Dente Impactado/diagnóstico por imagem , Dente Canino
9.
Compend Contin Educ Dent ; 45(4): e1-e4, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38622085

RESUMO

The presence of impacted and/or supernumerary teeth in the maxillary anterior region can cause complications when attempting to perform restorations with implants. Extracting these structures can lead to adverse issues related to the adjacent dentition and require osseous grafting to provide a base to house the planned implant, but such an approach increases treatment time and cost. In this case report, a patient presented with an impacted permanent canine oriented on the horizontal plane with several supernumerary teeth coronal to the impacted canine. CBCT analysis revealed a very thin buccal plate over the impacted supernumerary teeth. The proposed treatment followed the principles of partial extraction therapy (PET) whereby the impacted structures were treated like bone, and implants were placed in contact with them or through them to achieve the desired osseointegration and provide long-term survival of the restored implants.


Assuntos
Implantes Dentários , Dente Impactado , Dente Supranumerário , Humanos , Dente Supranumerário/complicações , Dente Supranumerário/diagnóstico por imagem , Dente Supranumerário/cirurgia , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Maxila/cirurgia , Implantação Dentária Endóssea , Extração Dentária
10.
J Hist Dent ; 72(1): 48-51, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38642380

RESUMO

The evolution of 20-year-old dental museum-like showcases located in the lobby and the main hallway of the School of Dental Medicine, Puerto Rico (PR) are described along with important professionals who impacted on this development.


Assuntos
Faculdades de Medicina , Dente Impactado , Humanos , Adulto Jovem , Adulto , Porto Rico , Manobras Políticas , Museus
11.
BMC Oral Health ; 24(1): 456, 2024 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-38622566

RESUMO

PURPOSE: To assess the impact of endoscope-assisted fractured roots or fragments extraction within the mandibular canal, along with quantitative sensory testing (QST) alterations in the inferior alveolar nerve (IAN). METHODS: Six patients with lower lip numbness following mandibular third molar extraction were selected. All patients had broken roots or fragments within the mandibular canal that were extracted under real-time endoscopic assistance. Follow-up assessments were conducted on postoperative days 1, 7, and 35, including a standardized QST of the lower lip skin. RESULTS: The average surgical duration was 32.5 min, with the IAN exposed in all cases. Two of the patient exhibited complete recovery of lower lip numbness, three experienced symptom improvement, and one patient remained unaffected 35 days after the surgery. Preoperative QST results showed that the mechanical detection and pain thresholds on the affected side were significantly higher than those on the healthy side, but improved significantly by postoperative day 7 in five patients, and returned to baseline in two patients on day 35. There were no significant differences in the remaining QST parameters. CONCLUSIONS: All endoscopic surgical procedures were successfully completed without any additional postoperative complications. There were no cases of deterioration of IAN injury, and lower lip numbness recovered in the majority of cases. Endoscopy allowed direct visualization and examination of the affected nerve, facilitating a comprehensive analysis of the IAN.


Assuntos
Dente Impactado , Traumatismos do Nervo Trigêmeo , Humanos , Estudos Retrospectivos , Hipestesia/complicações , Hipestesia/cirurgia , Canal Mandibular , Traumatismos do Nervo Trigêmeo/etiologia , Mandíbula/cirurgia , Nervo Mandibular , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Dente Serotino/cirurgia , Dente Impactado/cirurgia , Radiografia Panorâmica/métodos
12.
Sci Rep ; 14(1): 8952, 2024 04 18.
Artigo em Inglês | MEDLINE | ID: mdl-38637677

RESUMO

Tooth impaction is a condition in which a tooth does not reach its normal position and is often observed in the third mandibular molar due to inadequate space. This study aimed to investigate the prevalence and configuration of the impacted third molars with an emphasis on angular orientations in a sample of the Ethiopian population. This cross-sectional study included a retrospective analysis of 291 patient records and orthopantomography data from the archives of a private dental clinic in Addis Ababa, during the study period from December 2020 to November 2022. Demographic details and data on the position and level of the impacted third molars were evaluated using the Winter classification. Data were analyzed for frequency distribution. The prevalence of impacted third molars was 22% (n = 64), with a greater incidence on the right side (60.9%) and a higher frequency in the mandible (67.2%). Vertical angulation (32.8%), followed by mesioangular angulation (31.2%), was the most common impaction pattern. The results highlight the need for improved treatment protocols for third molar impaction, emphasizing the prevalence in the mandible and the importance of addressing vertical impaction. Regular dental check-ups are essential for assessing third molar impaction and planning appropriate management. These data can inform policymaking and treatment considerations for impacted third molars in the Ethiopian population.


Assuntos
População da África Oriental , Dente Serotino , Dente Impactado , Humanos , Dente Serotino/diagnóstico por imagem , Projetos Piloto , Estudos Retrospectivos , Prevalência , Estudos Transversais , Etiópia/epidemiologia , Mandíbula/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Impactado/epidemiologia
14.
Shanghai Kou Qiang Yi Xue ; 33(1): 97-100, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38583033

RESUMO

PURPOSE: To explore the effect of extracting the completely impacted teeth by minimally invasive surgery with preserving the buccal bone plate. METHODS: Eighty-six cases were selected and randomly divided into 2 groups. In the experimental group, a fenestration was made with a ball drill to expose the buccal and lingual margin of crown, and the buccal bone plate was preserved. T-shaped crown cuttings were performed, minimally invasive extraction was conducted.In the control group, the distal and buccal bone plates were removed with a ball drill, the distal and buccal crowns were exposed, and T-shaped crown was cut. The other procedures were the same. The degree of swelling, restricted mouth opening and VAS pain score after operation were observed, the levels of C-reactive protein and anti-hemolytic streptoglobulin were detected by laboratory tests, and the periodontal probing depth(PD), bleeding index (BI), and clinical attachment loss(CAL) of the adjacent second molar were examined 1 month after surgery. SPSS 25.0 software package was used for data analysis. RESULTS: The swelling degree of the two groups was significantly relieved in the experimental group than in the control group (P<0.05), and there was no significant difference in the degree of mouth opening limitation and pain (P>0.05). The level of C-reactive protein in the control group was significantly higher than that in the observation group (P<0.05). There was no significantly difference in the level of anti-hemolytic streptococcus between the 2 groups (P>0.05). One month after operation, the PD and CAL in the control group were significantly higher than those in the experimental group(P<0.05). There was no significant difference between the 2 groups in BI(P>0.05). CONCLUSIONS: The patients who preserve the buccal bone plate by minimally invasive extraction of impacted mandibular teeth have less reaction and better wound healing.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Dente Serotino/cirurgia , Placas Ósseas , Proteína C-Reativa , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Dente Impactado/cirurgia , Mandíbula/cirurgia , Dor
15.
Shanghai Kou Qiang Yi Xue ; 33(1): 71-75, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38583028

RESUMO

PURPOSE: To evaluation the effect of modified triangular flap-secondary healing (MTF-S) on the treatment of mandibular impacted wisdom teeth with full or partial bone impaction. METHODS: A total of 207 patients with mandibular impacted wisdom teeth were selected in Shaoxing Stomatological Hospital from June 2022 to June 2023. Among them, 86 patients had completely impacted wisdom teeth (group A), and 121 patients had partially impacted wisdom teeth (group B). All patients had bilateral impacted wisdom teeth. One of the wisdom teeth was removed first and was sutured with triangular flap-primary healing (TF-P). The other wisdom tooth was removed two weeks later and was sutured with MTF-S. Patients in groups A and B were divided into two subgroups based on suture methods, with TF-P used for group A1 and B1, and MTF-S used for groups A2 and B2. Perioperative indicators, including surgical time, root loss rate, and completeness of extraction sockets were recorded; Postoperative complications of four groups, including pain, swelling, and limited mouth opening were compared. SPSS 22.0 software package was used for statistical analysis. RESULTS: The surgical time of group A1, A2, B1 and B2 was (17.69±3.28), (18.22±3.06), (12.37±3.72) and (12.64±4.13) minutes, respectively. The surgical time of group A1 and A2 was significantly longer than that of group B1 and B2 (P<0.05). Seven days after surgery, the VAS scores of group A1, A2, B1 and B2 were (1.17±0.34), (0.93±0.29), (0.48±0.15) and (0.76±0.21), respectively. The VAS scores of group B1 and B2 were lower than those of group A1 and A2, and group A2 was lower than group A1 and B2 was higher than group B1 group(P<0.05). On the 1st day, 3rd day, and 7th day after surgery, the swelling degree in group A1 was greater than that in group B1, and the swelling degree in group B1 was greater than that in group A2 and B2(P<0.05); while the limitation of mouth opening mouth in group A2 and B2 was lower than that in group A1 and B1, and the limitation of opening mouth in group B2 was lower than that in group A2(P<0.05). CONCLUSIONS: Compared with partially impacted wisdom teeth, the extraction of completely impacted wisdom teeth has a longer surgical time. For completely impacted wisdom teeth, MTF-S is beneficial for reducing postoperative pain, swelling and mouth opening limitations. For partially impacted wisdom teeth, MTF-S is beneficial for reducing postoperative swelling and mouth opening limitations, but the effect is not significant in reducing patient pain.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Dente Serotino/cirurgia , Extração Dentária/efeitos adversos , Extração Dentária/métodos , Dente Molar , Dente Impactado/cirurgia , Coroas , Dor Pós-Operatória
16.
Int Orthod ; 22(2): 100867, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38457898

RESUMO

INTRODUCTION: Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. MATERIAL AND METHODS: This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). RESULTS: The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (ß=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (ß=0.97, P=0.001) and the probability of transmigration increased (ß=1.05, P<0.001). CONCLUSIONS: One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.


Assuntos
Dente Canino , Mandíbula , Radiografia Panorâmica , Dente Impactado , Humanos , Dente Impactado/diagnóstico por imagem , Estudos Retrospectivos , Masculino , Feminino , Criança , Dente Canino/diagnóstico por imagem , Dente Canino/anatomia & histologia , Mandíbula/diagnóstico por imagem , Mandíbula/anatomia & histologia , Estudos Transversais , Adolescente , Colômbia , América Latina
17.
Clin Oral Investig ; 28(4): 218, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38489136

RESUMO

OBJECTIVES: This study aimed to compare the impact of pre- and postoperative etoricoxib administration versus only postoperative on third molar extraction sequelae and oral health quality of life. MATERIALS AND METHODS: This prospective quasi experimental study involved 56 patients, divided into a study group receiving preemptive etoricoxib 120 mg before surgery and postoperative etoricoxib 120 mg (n = 28), and a control group receiving preemptive placebo before surgery and postoperative etoricoxib 120 mg (n = 28). Follow-up assessments were conducted at 3- and 7-days post-surgery, recording swelling, trismus, and adverse events. Patients rated perceived pain using the visual analog scale (VAS) and completed an oral health-related quality of life (OHRQoL) questionnaire at specified intervals. Statistical analysis employed non-parametric tests (i.e., the Mann-Whitney test, Friedman test, and Wilcoxon sign test) with P < 0.05. RESULTS: Significantly lower VAS scores were reported in the study group throughout the follow-up period (P < 0.05). Pharmacological protocol did not have a significant impact on postoperative edema and trismus (P > 0.05). However, double etoricoxib intake significantly improved postoperative quality of life on day 3 after surgery (P < 0.05). CONCLUSIONS: Pre- and postoperative etoricoxib 120 mg intake in third molar surgery reduced postoperative pain and enhanced postoperative quality of life on day 3 after surgery. Importantly, it was equally effective in managing swelling and trismus compared to exclusive postoperative intake. CLINICAL RELEVANCE: Preemptive etoricoxib use may decrease patient discomfort following impacted mandibular third molar extraction.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Etoricoxib/uso terapêutico , Dente Serotino/cirurgia , Trismo/prevenção & controle , Trismo/etiologia , Qualidade de Vida , Estudos Prospectivos , Saúde Bucal , Extração Dentária/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Dente Impactado/cirurgia , Edema/etiologia
18.
Tunis Med ; 102(1): 32-37, 2024 Jan 05.
Artigo em Francês | MEDLINE | ID: mdl-38545727

RESUMO

INTRODUCTION: Third molars are the most commonly concerned teeth with the impaction. Impacted third molar (ITM) can be associated to various clinical pathologies Aim: To determine the prevalence of ITM, its pattern and associated affections in Tunisian patients. METHODS: The study reviewed panoramic radiographs of patients consulting the Fattouma Bourguiba University Hospital, Monastir (Tunisia). Orthopantomograms were analyzed to define the prevalence of ITM; its angulation, depth and relation with the anterior border of mandibular ramus. Associated pathologies were also assessed. RESULTS: Seven hundred and thirty patients were included (286 men and 444 women). The age ranged from 19 to 89 years. Half of the patients (50.3%) showed at least one ITM. The total number of ITM was 881 with a statistical difference between arches (respectively 34.3% and 65.7% in the maxilla and in the mandible). The most common number of ITM was two (35.4%). Level C of impaction was observed more frequently in the maxilla and level A in the mandible. The most common angulation was the vertical one for both arches. Seventy six percent of ITM were presented with class II in relation with the anterior border of mandibular ramus. There was no significant difference in the frequency of impaction between gender and sides. The number of ITM associated with pathological conditions was 199 (22.6%). The most frequently observed pathology was the distal caries on the second molars (11.7%) followed by the caries of the third molars (5.2%). CONCLUSION: The prevalence of ITM among Tunisian patients was high.


Assuntos
Dente Serotino , Dente Impactado , Masculino , Humanos , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Dente Serotino/diagnóstico por imagem , Dente Serotino/patologia , Prevalência , População do Norte da África , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Dente Impactado/diagnóstico por imagem , Dente Impactado/epidemiologia , Dente Impactado/complicações
19.
BMC Oral Health ; 24(1): 371, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519914

RESUMO

BACKGROUND: The most severe complication that can occur after mandibular third molar (MM3) surgery is inferior alveolar nerve (IAN) damage. It is crucial to have a comprehensive radiographic evaluation to reduce the possibility of nerve damage. The objective of this study is to assess the diagnostic accuracy of panoramic radiographs (PR) and posteroanterior (PA) radiographs in identifying the association between impacted MM3 roots and IAN. METHODS: This study included individuals who had PR, PA radiographs, and cone beam computed tomography (CBCT) and who had at least one impacted MM3. A total of 141 impacted MM3s were evaluated on CBCT images, and the findings were considered gold standard. The relationship between impacted MM3 roots and IAN was also evaluated on PR and PA radiographies. The data was analyzed using the McNemar and Chi-squared tests. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of PR and PA radiographies were determined. RESULTS: Considering CBCT the gold standard, the relationship between MM3 roots and IAN was found to be statistically significant between PR and CBCT (p = 0.00). However, there was no statistically significant relationship between PA radiography and CBCT (0.227). The study revealed that the most prevalent limitation of the PR in assessing the relationship between MM3 roots and IAN was the identification of false-positive relationship. CONCLUSIONS: PA radiography may be a good alternative in developing countries to find out if there is a contact between MM3 roots and IAN because it is easier to get to, cheaper, and uses less radiation.


Assuntos
Dente Serotino , Dente Impactado , Humanos , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Projetos Piloto , Extração Dentária/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Nervo Mandibular/diagnóstico por imagem , Radiografia Panorâmica/métodos , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Mandíbula/diagnóstico por imagem
20.
Medicina (Kaunas) ; 60(3)2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38541199

RESUMO

Third molar extraction is the most common procedure in oral and maxillofacial surgery. Third molars are considered less functional than other teeth and are often extracted. Sometimes, they are also used for auto-transplantation for the benefit of oral rehabilitation. Since many biological factors are involved in this surgical approach, herein, we outline a review of the biological characteristics of medico-legal/forensic interest, in addition to presenting a successful clinical case. A scoping review of currently available research data (following the principles of PRISMA-ScR or the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) on third molar auto-transplantation was conducted by drawing upon the main databases (Scopus, PubMed, Google Scholar and LILACS) to evaluate biological and clinical characteristics possibly relatable to forensic issues. All the collected data were summarized and elaborated on for the purpose of this article. A patient underwent extraction of the right upper first molar and auto-transplantation of the unerupted ipsilateral third molar. Many biologic and clinical factors are involved in the success of this clinical procedure. Knowledge of third molar anatomy, of its development and viable surgical approaches are all essential elements; just as important are the treatment of the tooth before and after transplantation and the integrity of the periodontal ligament. Follow-up of the clinical case for 5 years made it possible to verify the stability of the procedure over time. Third molar auto-transplantation is feasible and cost-effective. However, the use of third molars as donor teeth in auto-transplantation may have medico-legal implications. The lack of official protocols and consistent evidence-based guidelines for operators still prevent such a procedure from becoming mainstream; therefore, it is viewed with suspicion by clinicians and patients, even though the biological factors herein detected point to a reasonably high degree of safety. The understanding of many specific biological and clinical factors involved in the stability of third molar auto-transplantation allows for a thorough understanding of the forensic implications relevant to clinical practice. Effective communication and information provision are therefore of utmost importance, in the interest of both patients and doctors.


Assuntos
Dente Impactado , Humanos , Dente Impactado/cirurgia , Dente Serotino/cirurgia , Extração Dentária , Fatores Biológicos
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