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1.
Shanghai Kou Qiang Yi Xue ; 29(1): 55-59, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32524122

RESUMO

PURPOSE: To observe the effect of bone grafting during the extraction of mandibular third molar on repair of distal alveolar bone defect distal to the second molar. METHODS: The risks of the distal alveolar bone defect in the second molar were estimated after removal of the impacted teeth according to the position of the third molar and second molar before operation. It was divided into three groups: low risk group, medium risk group and high risk group. The medium risk group and high risk group were further divided into bone graft subgroup (group A) and non-bone graft subgroup (group B). There were 36 cases in group A and 45 cases in group B. Postoperative re-examination indicators included subjective perception of the patients, depth of probing and height of alveolar bone in the distal molar of the second molar by X-ray examination. The data were analyzed with SPSS 19.0 software package. RESULTS: Six months after operation, in mediun risk group, 0 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 6 cases, the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (2.93±0.34) mm in group A and (2.95±0.50) mm in group B. There was no significant difference between 2 groups (P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (3.31±1.02) mm in group A, (3.10±1.72) mm in group B, the difference was not significant (P=0.794). In high risk group, 4 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 10 cases,the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (3.08±0.37) mm in group A and (3.24±0.41) mm in group B. There was no significant difference between 2 groups(P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (5.21±1.79) mm in group A, (2.99±2.42) mm in group B, the difference was significant (P<0.05). CONCLUSIONS: Risk classification of the second molar distal bone defects after extraction of the impacted teeth is essential, which is helpful to determine whether bone grafting is needed during operation. Autologous bone mixed with Bio-Oss artificial bone powder can promote recovery of the alveolar bone height of the second molar, especially in high risk group, and discomfort caused by exposure can be reduced.


Assuntos
Dente Impactado , Transplante Ósseo , Humanos , Mandíbula , Dente Molar , Dente Serotino , Extração Dentária
2.
J Contemp Dent Pract ; 21(3): 326-336, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32434983

RESUMO

AIM: This study aimed to overview and collect the current trends and techniques in managing maxillary impacted canines by retrieving recent literature, in a chronological manner from the prevention to the very late stages of treatment in adults. BACKGROUND: We performed a review on the recent literature regarding the current trends on the management of impacted canines. We have researched various types of available articles such as clinical trials and case presentations, meta- and systematic analyses, and literature reviews focusing on clinical management of impacted canines and their outcome evaluations. We adhered to those articles published within the last decade with a focus on treatment planning for impacted and displaced canines. REVIEW RESULTS: Depending on the diagnosis and its timing of it, a maxillary impacted canine can be managed by either prevention or interception, surgical opening followed by autonomous eruption or orthodontically traction, autotransplantation, and at last by removal and space closure. These techniques are elaborated one by one according to the age and severity of the diagnosis. CONCLUSION: Impaction of the canines is a manageable abnormality which is highly dependent on the timing and localization of the displaced tooth. Early detection will give the upper hand to orthodontists to engage by either prevention through extraction of deciduous canines or intercepting via assistant devices to create more space. According to the clinical situation, open or closed surgical uncovering might be required to bond an attachment. However, generally, those techniques did not show any significant clinical distinction in the outcome assessments. CLINICAL SIGNIFICANCE: These approaches are highly technique sensitive and require collaborations with other specialties. Proper diagnosis and prognosis assessment are necessary before making any decision to bring an impacted canine in alignment.


Assuntos
Maxila , Dente Impactado , Adulto , Dente Canino , Humanos , Ortodontistas , Erupção Dentária
3.
Indian J Dent Res ; 31(2): 312-314, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32436914

RESUMO

Identification and management of ectopic supplemental tooth in anatomically complex areas such as the floor of orbit are challenging. This arises from the rarity and lack of consensus over management. The situation gets complex when there is an evidence of follicular pathology such as dentigerous cyst. In this report, a case of maxillary third molar associated with maxillary sinus and a distomolar in association with the floor of orbit medially to the inferior-orbital canal is presented. The surgical management of the condition is presented.


Assuntos
Cisto Dentígero , Dente Impactado , Humanos , Seio Maxilar , Dente Serotino , Órbita
4.
J Contemp Dent Pract ; 21(1): 2-10, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32381793

RESUMO

AIM: The photobiomodulation (PBM) effect of 660 nm diode laser in reducing pain, edema, trismus and promote healing subsequently to the transalveolar extraction of mandibular third molars in female patients taking contraceptive pills were evaluated. MATERIALS AND METHODS: Fifty female patients participated in our study. The 660 nm diode laser was applied immediately on randomly selected patients of the study group (n = 25) over the surgical site for 1 minute with continuous laser beam application. For the control group (n = 25), the same extraction procedure was performed without the application of 660 nm diode laser. Pain intensity, swelling, trismus, and healing was evaluated before extraction and during recall visits 24 hours, 48 hours, and 7 days postoperatively. RESULTS: The values of pain, swelling, and trismus were significantly inferior in the study group compared to the control group (p < 0.05) at T2 and T3; while the values of the healing index were significantly superior in the study group compared to the control group (p < 0.001) at T1, T2, and T3. CONCLUSION: Using 660 nm diode laser reduced the postsurgical discomforts (pain, edema, and trismus) and promote healing associated following transalveolar extraction of the lower third molar. CLINICAL SIGNIFICANCE: To develop a framework based on the results regarding the PBM effect of 660 nm diode laser following transalveolar extraction of lower third molar in a female patient taking oral contraceptive pills, which may help to improve the treatment services provided to the community.


Assuntos
Terapia com Luz de Baixa Intensidade , Dente Impactado , Anticoncepcionais , Feminino , Humanos , Lasers Semicondutores , Dor Pós-Operatória
5.
Int J Esthet Dent ; 15(2): 196-210, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32467948

RESUMO

The permanent maxillary canine is the second most frequently impacted or displaced tooth. The standard treatment for an impacted canine includes, among other things, surgical exposure and orthodontic alignment. Surgical techniques for this procedure vary depending on whether the tooth is labially or palatally impacted, while orthodontic techniques vary according to clinical judgment and experience. Autotransplantation is a treatment alternative for impacted canines with complete root formation. The success of tooth transplantation depends on the vitality of the periodontal ligament (PDL) attached to the donor tooth, and its viability decreases when it is exposed extraorally. This article reports on maxillary canine autotransplantations combined with connective tissue grafts (CTGs) and orthodontics. The recipient mesiodistal space was created orthodontically and the recipient socket was prepared using dental implant drills. Following transplantation, bone defects were grafted using guided bone regeneration (GBR). At 4 years post-transplantation, the soft tissue level was stable and periapical radiographs showed a practically normal contour of the alveolar crest around teeth 13 and 23. The two permanent canines presented no root resorption and ankylosis, and no signs of inflammation or bleeding were observed. The procedure used in this case report demonstrates that canine transplantation combined with GBR, plastic surgery procedures, and orthodontic treatment may yield acceptable and predictable esthetic results.


Assuntos
Ligamento Periodontal , Dente Impactado , Dente Canino , Estética Dentária , Seguimentos , Humanos , Maxila , Transplante Autólogo
6.
Med Oral Patol Oral Cir Bucal ; 25(3): e395-e402, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32271319

RESUMO

BACKGROUND: Deciding whether or not to extract third molars remains a controversial situation in dental practice. Image exams support this decision by enabling a close view of the third molar, its adjacent bone and its relationship with the second molar. This study aimed to assess and compare second molar bone loss adjacent to impacted mandibular third molar in panoramic radiographs (PAN) and cone beam computed tomography (CBCT) scans. MATERIAL AND METHODS: A sample of 70 patients was selected (n=124 teeth). Each patient had a set of a panoramic radiograph and CBCT scans consecutively taken for dental treatment purposes. In PAN and CBCT, mandibular third molars were classified based on their position and bone loss of the adjacent second molar. Agreement between PAN and CBCT scans was assessed and quantified. RESULTS: Outcomes of bone loss assessment were different between PAN and CBCT scans (p<0.05). Bone loss was found in 62.9% of the PAN, while in CBCT scans it was found in 80%. In particular, nearly 29% (n=27) of the teeth that were classified without bone loss in PAN were classified with bone loss in CBCT scans. Mesioangular and horizontal third molars had a statistically significant association with bone loss of the adjacent second molars (p<0.05). In general, PAN underestimated the severity of bone loss compared to CBCT scans (p<0.05). CONCLUSIONS: Diagnosing second molar bone loss due to impaction of adjacent third molar in PAN may be challenging because of false negatives. Impacted third molars justify preoperative CBCT scans if second molar bone loss needs to be precisely assessed for a more detailed and reliable treatment plan.


Assuntos
Dente Serotino , Dente Impactado , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula , Dente Molar , Radiografia Panorâmica
7.
Artigo em Inglês | MEDLINE | ID: mdl-32233194

RESUMO

Missing canines compromise function and esthetics and therefore should be restored. In case of a retained canine, there can be a conservative approach of classic orthodontic eruption. If that is not effective, an alternative treatment method is to remove the retained tooth, followed by implant placement or transalveolar autotransplantation of the retained canine. En bloc autotransplantation of a retained canine, with surrounding bone, preserves canine periodontium and increases chances for revascularization and vitality of the transplanted tooth. This paper presents an en bloc autotransplantation of retained canines in the mandible in two female patients resulting in canine vitality after 1.5 years with proper pocket depth, physiologic tooth mobility, and positive reaction to ethyl chloride.


Assuntos
Dente Canino , Dente Impactado , Feminino , Humanos , Mandíbula , Transplante Autólogo
8.
Indian J Dent Res ; 31(1): 91-102, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246689

RESUMO

Objectives: This study was aimed at determining the specific signs of close relationship between impacted mandibular third molar (IMTM) root and inferior alveolar nerve (IAN) canal as visualised on digital panoramic radiograph or orthopantomograph (OPG) which should indicate as well as contraindicate the need for cone beam computed tomography (CBCT) imaging based on hierarchical model of Fryback and Thornbury. Materials and Methods: The sample consisted of 120 individuals (200 IMTM) who had undergone OPG as well as CBCT imaging as preoperative radiographic evaluation before surgical extraction. On panoramic radiographs; Rood and Sheehab's radiographic signs of IMTM root and IAN canal, impacted third molar position based on Winter's classification and depth of impaction based on Pell and Gregory's classification were evaluated. On CBCT; presence/absence of corticalization and the status of the buccal and lingual cortices (thinning/perforation) were evaluated. These findings of OPG were compared to CBCT findings to determine the better modality based on hierarchical model of Fryback and Thornbury. Results: Statistically significant association was found between radiographic signs of Rood and Sheehab such as 'no relation' and 'superimposition' on OPG and presence of corticalization between IMTM root and IAN canal on CBCT. Statistically significant association was also found between 'mesioangular' and 'vertical' positions of Winter's classification as well as 'class 1A' of Pell and Gregory's classification of IMTM on OPG and presence of corticalization on CBCT. CBCT was found to be having lesser variance and greater F value as compared to OPG for evaluation of IMTM. Conclusions: On OPG; Rood and Sheehab's radiographic signs such as 'no relation' and 'superimposition', Winter's 'mesioangular' and 'vertical' and Pell and Gregory's 'Class 1A' are not indicative for CBCT examination before surgical extraction is attempted. On OPG; Rood and Sheehab's radiographic signs such as interruption of white line, darkening of root, darkening of canal, deflection of root, narrowing of canal as well as diversion of canal are all frequently associated with absence of corticalization between IMTM root and IAN canal and hence require CBCT examination before surgical extraction is attempted so that post-operative neurological complications can be minimised. Also, Winter's horizontal, distoangular and others as well Pell and Gregory's classes 1B,1C,2A,2B,2C,3A,3B,3C are indicative for CBCT examination before surgical extraction is attempted. Fryback and Thornbury model-based comparison proves that CBCT is a better radiographic modality as compared to OPG for evaluation of IMTM relation with IAN canal.


Assuntos
Dente Serotino , Dente Impactado , Tomografia Computadorizada de Feixe Cônico , Humanos , Mandíbula , Nervo Mandibular , Radiografia Panorâmica , Extração Dentária
9.
Quintessence Int ; 51(5): 406-414, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32253392

RESUMO

OBJECTIVE: The aim of this randomized controlled clinical study was to evaluate the efficacy of a new technique fully based on the use of a piezoelectric device for third molar root extraction versus the conventional technique based on the use of manual and rotary instruments. METHOD AND MATERIALS: Patients referred to the hospital of Bolzano for third molar extraction were randomly divided into two groups and treated by two experienced oral surgeons. In the test group all the procedures were performed using piezoelectric instruments and a specially designed piezoelectric lever, whereas in the control group conventional manual and rotary instruments were used. The main outcome measure was patient's pain perception, and the secondary outcome measures were complications, duration of the surgical treatment, and soft tissue healing. The study had a 1-week follow-up. RESULTS: Fifty patients (23 females and 27 males) out of 90 were included in the study, and 100 third molars (50 maxillary and 50 mandibular) were extracted. All patients completed the expected follow-up. No differences were found between the two groups regarding patient's pain perception, complications, and soft tissue healing. However, the new piezoelectric extraction technique took less than half the time when compared to the conventional technique (4.6 ± 4.5 minutes versus 10.2 ± 13.1 minutes; P = .049). CONCLUSIONS: The new piezoelectric third molar root extraction technique allowed third molar extraction in less than one half the surgical time required by the traditional technique. The advantages seem to be more pronounced in difficult cases. However, both surgeons who performed the procedures were very experienced and all the patients were young. Therefore, caution should be given to the generalization of the results. Multicenter studies with a larger variety of patients are needed to confirm the promising results of this study.


Assuntos
Dente Serotino , Piezocirurgia , Dente Impactado , Feminino , Humanos , Masculino , Mandíbula , Osteotomia , Dor Pós-Operatória , Extração Dentária , Resultado do Tratamento
10.
Rev. Asoc. Odontol. Argent ; 108(1): 6-13, ene.-abr. 2020. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1096296

RESUMO

Objetivo: Evaluar la prevalencia y el patrón de reten- ción ósea de los terceros molares en pacientes que concurrie- ron a un servicio de urgencias y orientación de pacientes en el Área Metropolitana de Buenos Aires. Materiales y métodos: Se realizó un estudio obser- vacional retrospectivo en el que se evaluaron radiografías pa- norámicas de pacientes mayores de 18 años que concurrieron a un servicio de urgencias en el Área Metropolitana de Bue- nos Aires. Resultados: Fueron evaluadas 949 radiografías pano- rámicas. En 347 casos, se presentó al menos un tercer molar retenido. Entre los 1878 terceros molares registrados, hubo 768 retenidos (41%). Según la clasificación de Gregory y Pell, la ubicación más frecuente de los terceros molares retenidos inferiores fue la IIA (28%), y de los superiores, la C (54%). La angulación más frecuente fue la vertical (62%). En el 9% de los casos estudiados, se encontró una radiolucidez asociada al tercer molar mayor a 3 mm. No se encontró diferencia signifi- cativa en la prevalencia de retención según el sexo. Conclusiones: La prevalencia de retención fue mayor en el maxilar inferior que en el superior. La posición más fre- cuente fue la vertical. No se encontraron diferencias significa- tivas en cuanto a la distribución según el sexo (AU)


Aim: To evaluate the prevalence and pattern of bone re- tention of third molars in patients attending a patient orienta- tion and urgency service in the metropolitan area of Buenos Aires City. Materials and methods: This retrospective observa- tional study was conducted in a department of dental urgency in the city of Buenos Aires where we evaluate radiografic or- topantomograms. Results: 949 panoramic radiographs were evaluated. In 347 there was at least one third molar retained. Within the 1878 third molars registered, there were 768 retained (41%). In the lower retained third molars the most frequent location corresponded to the IIA location (28%) and in the upper ones it corresponded to the C location (54%) according to Gregory & Pell. The vertical position was the most frecquent (62%). A radiolucency associated with the third molar greater than 3 mm was found in 9% of the cases studied. No significant difference was found in the prevalence of retention according to sex. Conclusions: The prevalence of retention was higher in the lower than in the upper jaw, the vertical position being the most frequent. No significant difference was found in the distribution by sex (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Dente Impactado/epidemiologia , Dente Serotino/diagnóstico por imagem , Argentina , Radiografia Panorâmica , Estudos Transversais , Análise Estatística , Estudos Retrospectivos , Serviços Médicos de Emergência , Distribuição por Idade e Sexo , Mandíbula , Maxila
11.
Pediatr Dent ; 42(2): 123-125, 2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32276679

RESUMO

Purpose: The purpose of this study was to determine the prevalence of permanent mandibular second molar impaction in pediatric patients treated with a lower lingual holding arch (LLHA) to maintain lower arch perimeter. Methods: In this retrospective study, 259 radiographs of nine- to 17-year-old pediatric patients were examined for permanent mandibular second molar impaction. A total of 127 patients with LLHA were compared to a control group of 132 patients who had not received LLHA. Other independent variables (sex and treatment age) were also tested for their value as predictors of impaction difficulty. For statistical analysis, the chi-square test was used. Logistic regression analysis was used to determine the statistical significance of the possible predictors of second molar impaction. Results: The mean age of the subjects was 9.2±1.7 (standard deviation) years old. The prevalence of permanent mandibular second molar impaction was 7.1 percent in patients with LLHA compared to 1.5 percent in the control group. The LLHA group had a likelihood of second molar impaction 6.53 times higher than controls after controlling for age. The relationship was significant with P-value of 0.021. Conclusions: The lower lingual holding arch is associated with an increased risk of second molar impaction in patients nine to 17 years old.


Assuntos
Mandíbula , Dente Impactado , Adolescente , Criança , Humanos , Dente Molar , Dente Serotino , Radiografia Panorâmica , Estudos Retrospectivos
12.
Cient. dent. (Ed. impr.) ; 17(1): 7-14, ene.-abr. 2020. tab, graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-189744

RESUMO

INTRODUCCIÓN: La inclusión de caninos tiene una alta incidencia y plantea varias complicaciones clínicas, siendo de vital importancia el diagnóstico precoz y exacto para minimizar los riesgos y complicaciones derivadas. El objetivo de este trabajo es analizar, utilizando como referencia las líneas planteadas por Alqerban, la efectividad de las dos dimensiones en el diagnóstico volumétrico de la inclusión de los caninos maxilares. MÉTODOS: Seleccionamos 27 pacientes con 36 caninos maxilares incluidos que se realizaron estudio de ortodoncia con ortopantomografía y tomografía computarizada de haz cónico (Cone Beam Computed Tomography, CBCT) del maxilar en la Clínica Universitaria de la Universidad Europea. Se trazaron tres líneas de referencia basándose en la distancia de la cúspide del canino al plano oclusal (L1), a la línea media (L2) y a su lugar ideal de erupción (L3), tanto en la ortopantomografía como en el CBCT. Como valores de referencia ideales seleccionamos un grupo control de 36 caninos maxilares erupcionados. RESULTADOS: Se compararon los resulta-dos en dos y tres dimensiones mediante la prueba T de Student, tras comprobar su distribución normal mediante la prueba de contraste de Anderson-Darling. No se obtuvo significación estadística (p > 0.05) para ninguna de las variables estudiadas. CONCLUSIONES: El uso del CBCT es vi-tal para asegurar un buen diagnóstico en cuanto a la posición del canino y su relación con estructuras adyacentes y así establecer un plan de tratamiento adecuado. Aun así, la ortopantomografía aporta información suficiente para la planificación inicial


INTRODUCTION: Impacted canines have a high incidence and pose several clinical complications, with early and exact diagnosis being of vital importance to minimise the risks and derived complications. The objective of this study is to analyse the effectiveness of the two dimensions in the volumetric diagnosis of impacted maxillary canines, using the lines proposed by Alqerban as a reference. METHODS: We selected 27 patients with 36 maxillary canines who underwent an orthodontic study with orthopantomography and cone beam computed tomography (CBCT) of the maxilla at the Madrid European University Dental Clinic. Three reference lines were drawn based on the distance from the cusp of the canine to the occlusal plane (L1), to the midline (L2) and to its ideal eruption site (L3), both in the orthopantomography and in the CBCT. As ideal reference values, we selected a control group of 36 erupted maxillary canines. RESULTS: The results were compared in 2 and 3 dimensions using the Student's t-test, after verifying their normal distribution using the Anderson-Darling test. Statistical significance (p > 0.05) was not obtained for any of the variables studied. CONCLUSIONS: The use of CBCT is vital to ensure a good diagnosis for the position of the canine and its relationship with adjacent structures, thus establishing an adequate treatment plan. However, orthopantomography provides enough information for initial planning


Assuntos
Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Dente Canino/diagnóstico por imagem , Diagnóstico Precoce , Maxila/diagnóstico por imagem , Ortodontia/métodos , Tomografia Computadorizada de Feixe Cônico , Dente Impactado/diagnóstico por imagem , Intervalos de Confiança , Radiografia Panorâmica/métodos
13.
Am J Orthod Dentofacial Orthop ; 157(3): 377-384, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32115116

RESUMO

INTRODUCTION: Treatment of a palatally impacted canine (PIC) is associated with demanding anchorage control, increased treatment duration, and undesirable side effects. Accurate PIC localization and force application impact treatment success. The objective of this research was to determine the stresses on the PIC when subjected to initial force activation in various directions (buccal, vertical, and distal) and relative to impaction severity. METHODS: Thirty PICs from 21 scans underwent finite element modeling. A prototype 3D model was reconstructed and segmented into its anatomic components. Each PIC was precisely positioned in the prototype model according to impaction position. Stresses in response to a (1.0 N) force in the distal, vertical, and buccal directions were evaluated at different levels of the root (apical, middle, and cervical). RESULTS: Distal and buccal forces yielded higher stress (6.64 and 6.41 kPa, respectively) than the vertical force (5.97 kPa) on the total PIC root and the apical and cervical root levels, but not at midroot. Statistically significant differences between severity groups were found mostly at the apical level among all force directions, except between distal and buccal forces in the higher severity group. In this group, stress was greatest at the cervical level with the buccal force significantly different from the stresses generated by either the distal or the vertical force. CONCLUSIONS: Vertical forces generated the lowest stresses. Differentially distributed stresses over the root reflected an initial tipping movement. Greater cervical stresses from the buccal force indicate resistance to movement, suggesting treatment initiation with vertical and distal forces over buccal forces, particularly with severely inclined canines.


Assuntos
Dente Canino , Dente Impactado , Análise de Elementos Finitos , Humanos , Fenômenos Mecânicos , Técnicas de Movimentação Dentária , Tração
14.
Am J Orthod Dentofacial Orthop ; 157(3): 287, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32115105
15.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(1): 97-102, 2020 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-32071470

RESUMO

OBJECTIVE: To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using ß-tertiary calcium phosphate (ß-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone. METHODS: A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant. RESULTS: Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups. CONCLUSION: The randomized controlled clinical trial showed that the application of ß-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.


Assuntos
Dente Serotino , Dente Impactado , Fosfatos de Cálcio , Humanos , Mandíbula , Dente Molar , Extração Dentária
16.
Pediatr Dent ; 42(1): 55-57, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-32075712

RESUMO

The purpose of this article was to present the case of a 13-year-old patient with impacted, ectopic, permanent maxillary canines that were repositioned into their natural positions via autotransplantation without endodontic treatment and aligned into ideal occlusion via orthodontic treatment. The autotransplanted canines demonstrated normal masticatory function, physiologic mobility, and long-term tooth vitality. Clinical considerations, clinical procedures, and the rationale behind this alternative approach in managing this common growth and developmental dental anomaly are also discussed.


Assuntos
Dente Canino , Dente Impactado , Adolescente , Assistência Odontológica , Oclusão Dentária , Humanos , Maxila , Transplante Autólogo
17.
Rev. ADM ; 77(1): 6-10, ene.-feb. 2020. ilus, tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1087675

RESUMO

Objetivo: Evaluar la eficacia de la radiografía panorámica para establecer la relación de los terceros molares superiores y la cortical inferior del seno maxilar, en comparación con la tomografía computarizada de haz cónico (CBCT). Material y métodos: El trabajo incluyó 72 pacientes, se estudiaron 34 terceros molares superiores retenidos izquierdos y 38 derechos. Se realizaron mediciones con el programa para establecer la distancia entre la cortical inferior del seno maxilar y el ápice del tercer molar superior a partir de la imagen de la radiografía panorámica en lo que se estableció como parámetros: «a distancia, en contacto y dentro del piso de seno maxilar¼. Luego, con los cortes oblicuos o paraaxiales de la tomografía computarizada (CBCT) se observó la verdadera ubicación en el plano bucopalatino. Resultados: Del total de los terceros molares superiores 34 fueron izquierdas (47.22%) y 38 derechas (52.78%). En la Rx. Panorámica, 18 casos (25%) se encontraron a distancia al seno maxilar, 12 en contacto (16.7%) y 42 por dentro (58.3%) del seno maxilar. En la tomografía se observaron 20 casos (27.8%) a distancia del conducto, 16 (22.2%) en contacto y 36 (50%) por dentro del seno maxilar. Se observaron diferencias estadísticamente significativas (p < 0.05) entre la Rx. panorámica y la tomografía (CBCT) de los terceros molares que se hallan por dentro del seno maxilar. Conclusión: A partir de los resultados obtenidos, podemos establecer que la radiografía panorámica no permite conocer la verdadera relación entre la cortical inferior del seno maxilar y los terceros molares superiores (AU)


Objective: To evaluate the effectiveness of panoramic radiography to establish the relationship of the upper third molars and the inferior cortical of the maxillary sinus, in comparison with the Cone Beam Computed Tomography (CBCT). Material and methods: The work included 72 patients, 34 upper left maxillary molars and 38 rights were studied. Measurements were made with the program to establish the distance between the lower cortex of the maxillary sinus and the apex of the upper third molar from the image of the panoramic radiograph in what was established as parameters: «at a distance, in contact and inside the floor of maxillary sinus¼. Then with the oblique or paraaxial slices of the computed tomography (CBCT) the true location in the bucco-palatal plane was observed. Results: Of the total upper third molars, 34 were left (47.22%) and 38 right (52.78%). In the panoramic X-ray 18 cases (25%) were found at distance to the maxillary sinus, 12 in contact (16.7%) and 42 inside (58.3%) of the maxillary sinus. The tomography showed 20 cases (27.8%) at a distance from the canal, 16 (22.2%) in contact and 36 (50%) inside the maxillary sinus. Statistically significant differences were observed (p < 0.05) between the Rx. panoramic and tomography (CBCT) of the third molars that are inside the maxillary sinus. Conclusion: From the results obtained, we can establish that the panoramic radiograph does not allow knowing the true relationship between the inferior cortical of the maxillary sinus and the upper third molars (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Dente Impactado/diagnóstico por imagem , Radiografia Panorâmica , Tomografia Computadorizada de Feixe Cônico , Dente Serotino/diagnóstico por imagem , Argentina , Epidemiologia Descritiva , Estudos Retrospectivos , Interpretação Estatística de Dados , Maxila , Seio Maxilar/anatomia & histologia
18.
Med Oral Patol Oral Cir Bucal ; 25(2): e233-e239, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32062667

RESUMO

BACKGROUND: To review the literature on the effect of different surgical flaps upon patient morbidity (pain perception, trismus, swelling and osteitis) after impacted third molar extraction. MATERIAL AND METHODS: An electronic and complementary search of main databases and grey literature was performed up to January 2019 to retrieve randomized clinical trials. The Cochrane risk of bias assessment tool was used for methodological appraisal. A random-effects meta-analysis was conducted of pain perception and trismus. RESULTS: From the initially 1314 screened studies, only 11 were included in the qualitative synthesis, and 5 in the meta-analysis. There were no statistically significant differences in pain between the envelope and triangular flap designs over time, except on the sixth postoperative day, when the envelope flap proved more painful. Regarding trismus, statistically significant differences were observed on the seventh postoperative day, with greater mouth opening in the envelope flap group than in the triangular flap group. There were no clear differences in swelling and osteitis among the flap designs. CONCLUSIONS: Despite its limitations, the present meta-analysis found no clear differences in patient morbidity between the different flap designs.


Assuntos
Dente Serotino , Dente Impactado , Edema , Humanos , Mandíbula , Dor Pós-Operatória , Complicações Pós-Operatórias , Retalhos Cirúrgicos , Extração Dentária , Trismo
20.
Compend Contin Educ Dent ; 41(2): 76-82; quiz 83, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32017585

RESUMO

Bone loss at the distal aspect of mandibular second molars frequently is reported after extraction of impacted third molars. Typically, osseous grafting of the extraction site is not routinely performed. This study examined osseous healing following guided bone regeneration treatment of osseous defects distal to mandibular second molars after surgical removal of impacted mesioangularly or horizontally inclined third molars using the processed third molar as the graft material. For the study, 13 patients who required impacted third molar extractions were selected based on angulation of impaction. Patients requiring bilateral extractions were designated for a split-mouth study, while others were selected based on impaction angulation as a random study group. After surgical extraction of the third molars, the extracted teeth were stripped of any soft tissue, including the periodontal ligament, then ground and disinfected using a dentin grinding protocol to produce an autogenous dentin graft (ADG). This graft was then placed into the extraction socket and covered with a hemostatic sponge prior to site closure. Patients in the control group underwent the same procedure as those in the study group except that no ADG was placed in the socket and only a hemostatic sponge was placed prior to wound closure. Clinical and radiological examinations were performed, including panoramic radiographs and probing depths at 3 months and 12 months postoperatively. The alveolar bone level distal to the second molar was established by both probing depths and radiographic evaluation, which were compared between the two groups. At 12 months postoperative the study group showed probing distal to the second molar with a mean depth of 1.15 mm, whereas the control group showed probing with a mean depth of 4.45 mm. The authors conclude that autogenous dentin grafting is a viable option for use in the treatment of osseous defects distal to mandibular second molars following extraction of impacted third molars.


Assuntos
Dente Serotino , Dente Impactado , Dentina , Humanos , Mandíbula , Dente Molar , Extração Dentária
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