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1.
J Contemp Dent Pract ; 21(6): 626-631, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025930

RESUMO

AIM: To evaluate the microtensile bond strength (µTBS) and the fracture modes of four bulk-fill resin composites (Tetric EvoCeram Bulk Fill/Ivoclar Vivadent, Filtek Bulk Fill/3M ESPE, Venus Bulk Fill/Heraus Kulzer, and Filtek Bulk Fill Flow/3M ESPE) and one conventional incrementally filled resin composite (Filtek Z250/3M ESPE) inserted in class I cavities, after 24 hours and 6 months of water storage. MATERIALS AND METHODS: In all, 30 sound human extracted molars were divided into five restorative groups. Standardized class I cavities were prepared and restored following the manufacturer's instructions. The restored teeth were then assigned into one of the storage times (24 hours or 6 months). The molars were then cut into 1 mm2 sticks and submitted to µTBS. All fractured specimens were analyzed under a stereomicroscope (40×). Data were submitted to analysis of variance (ANOVA) and the Tukey post hoc test was applied for comparison between groups; and paired t test for comparison within storage times (p = 0.05). RESULTS: After 24 hours of storage, statistically significant differences were observed between Filtek Z250 and Filtek Bulk Fill Flow groups. However, after 6 months, no statistical differences were observed between groups. Additionally, no differences were observed for the µTBS between the storage times. Adhesive failures were the most frequent fracture mode after 24 hours (54%) and 6 months (43%), the resin cohesive fracture mode showed 16% for 24 hours and 14% for 6 months, the dentin cohesive fracture mode showed 14% for 24 hours and 26% for 6 months, and the mixed fracture mode showed 16% for 24 hours and 17% for 6 months. CONCLUSION: Bulk-fill resin composites obtained similar µTBS in high C-factor cavities as conventional incrementally filled resin composites. No bond strength reduction was observed after 6 months of storage. CLINICAL SIGNIFICANCE: Single increment restorations in high C-factor cavities with bulk-fill resin composites did not reduce µTBS after 24 hours or 6 months of storage. The comparable results to the conventional incrementally filled resin composites and the reduction in the operative time, make the bulk-fill resin composites a restorative option for posterior teeth restorations.


Assuntos
Cárie Dentária , Humanos , Dente Molar
2.
J Contemp Dent Pract ; 21(6): 673-677, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025937

RESUMO

AIM: Simulated pulpal pressure (PP) has been shown to affect the bond strength and nanoleakage of different adhesives at dentin interfaces but the effect of simulated PP on polymerization of adhesives has not been studied yet. Furthermore, it has been proposed that strong and mild self-etch adhesives have different polymerization behaviors. This study aimed to evaluate the effect of simulated PP on polymerization of two self-etch adhesives, Adper Prompt L-Pop (APLP) and Adper Easy Bond (AEB), by means of the Knoop hardness test. MATERIALS AND METHODS: Sixty caries-free human molars were used to prepare deep dentin specimens with a mean remaining dentin thickness of 0.9 mm. The specimens were bonded in the absence or presence of PP. The specimens were assigned to four equal groups (n = 15) as follows: AEB/-PP, APLP/-PP, AEB/+PP, and APLP/+PP. Bonding procedures were completed; then the specimens' hardness was measured with the Knoop test. Data were analyzed with two-way ANOVA and the t test. RESULTS: In the absence of PP, the hardness of AEB was significantly higher than that of APLP (p < 0.001). In contrast, when PP was simulated, the hardness of APLP was higher than that of AEB (p = 0.002). The hardness of AEB was not influenced by the presence of PP (p = 0.153). Simulation of PP resulted in a significant improvement in the hardness of APLP (p < 0.001). CONCLUSION: The polymerization degree of strong self-etch adhesive was lower compared to mild self-etch adhesive. In the presence of hydrostatic PP, the polymerization degree of strong self-etch adhesive was higher than mild self-etch adhesive. CLINICAL SIGNIFICANCE: Dentin moisture caused by positive PP might improve polymerization of strong self-etch adhesives.


Assuntos
Cimentos Dentários , Polpa Dentária , Dureza , Humanos , Dente Molar , Polimerização
3.
Stomatologiia (Mosk) ; 99(5): 32-37, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034174

RESUMO

THE AIM OF THE STUDY: Was to identify the features of the anatomical structure of the root canals of teeth according to CBCT data in patients in different age groups. MATERIAL AND METHODS: Patients of europeoid race, both sexes, who have indications for endodontic treatment (60 people), were divided into three groups: group 1 (young) 20 people aged 18 to 44 years, group 2 (middle age) 20 people - from 45 to 60 years, group 3 (elderly) 20 people - from 61 to 75 years old. To assess the root canal anatomy, all patients underwent x-ray examination (CT) on a Vatech computed tomography and analyzed with the Ez3D plus program before beginning endodontic treatment. The object of study was the first molars of the lower jaw (distal root canal). RESULTS: The analysis of axial, sagittal, coronal sections of the first molar of the lower jaw revealed that patients belonging to the 1st group, the distal root canal often had an oval shape all over (95%) and over a wide apical opening, in only one case out of 20 (5%) were identified at slit-like form of the distal root canal, probably due to malocclusion or as a consequence of increased abrasion of teeth. In group 2, two independent root canals were identified in the distal root of the first lower molar (in 65%), extending from the tooth cavity to the apex.in 35% of cases, the distal root canal began with a single entrance in the oral part and bifurcated into two separate channels at about the level of 2 /3 canals, then re - joined into a single apical opening, in group 3, in 75% of cases, a slit-like form of the distal root canal was observed. The obtained CLCT data (taking into account the image error) were confirmed in the clinic at the stage of endodontic treatment using optical magnification (microscope). CONCLUSION: CBCT and operation microscopy with x40 magnification data showed clear age-dependent variations of first lower molar distal root canal anatomy.


Assuntos
Cavidade Pulpar , Mandíbula , Adolescente , Adulto , Idoso , Cavidade Pulpar/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar/diagnóstico por imagem , Tratamento do Canal Radicular , Raiz Dentária/diagnóstico por imagem , Adulto Jovem
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 737-742, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045784

RESUMO

Objective: To explore the accuracy of occlusal contacts on digital model made by intraoral scanner. Methods: Twenty healthy subjects [6 males, 14 females, (24.4±1.4) years old] with intact dentition were randomly recruited from postgraduate students in Capital Medical University School of Stomatology who volunteered to participate in this study. For each participant, the 2nd and 3rd quadrant of natural dentition was scanned. A diagnostic test design was performed. The occlusal contacts of the maximal intercuspal position (MIP) were extracted with the transillumination of silicone interocclusal records, and the extraction threshold was set as ≤50 µm. Intraoral scanning system was used to scan in MIP and generate occlusal contacts on digital model. Five groups were designed as test groups according to included tooth position: group 1 (buccal scanning ranged from tooth 21 to 23), group 2 (buccal scanning ranged from tooth 23 to 26), group 3 (buccal scanning ranged from tooth 24 to 26), group 4 (buccal scanning ranged from tooth 25 to 26), group 5 (buccal scanning ranged from tooth 21 to 26). Five groups occlusal contacts on digital model were generated respectively. According to the relevant literature, the upper occlusal surface was divided into 28 partitions, and the accuracy of occlusal contacts on digital model was calculated with the transillumination of silicone interocclusal records as the reference standard. Subgroup analysis was performed according to anterior teeth area, premolars area and molars area. Results: The accuracy of occlusal contacts on digital models of the half dentition in five buccal scanning positions were: group 1 (86.8%), group 2 (92.0%), group 3 (90.7%), group 4 (91.1%), group 5 (90.4%), and the accuracy of occlusal contacts in group 1 was significantly lower than those in the other four groups (P<0.05). The accuracy of anterior teeth area were 85.6%-93.9%; the accuracy of premolar area were 92.5%-94.4%; the accuracy of molar area were 77.3%-93.6%, group 1 was significantly lower than those in the group 4 in molars area (P<0.05), the accuracy of anterior area was statistically less than premolars area and molars area in group 1 (P<0.05). There was no statistical difference in pairwise comparison between the three sections (P>0.05). Conclusions: The digital models scanned intraoral methods provide accurate, quantitative measures of occlusal contacts when transillumination contacts are the reference standard.


Assuntos
Oclusão Dentária , Testes Diagnósticos de Rotina , Adulto , Dente Pré-Molar , Arco Dental , Feminino , Humanos , Masculino , Dente Molar , Adulto Jovem
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(10): 743-749, 2020 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-33045785

RESUMO

Objective: To quantitatively evaluate the change of the long axis angle and the relative displacement of the crown feature points of the posterior teeth under normal bite force utilizing an intraoral scanner, and to provide clinical reference. Methods: From May to December 2019, fifteen graduate volunteers (5 males and 10 females, aged from 22 to 30, with an average age of 25.7 years) from Peking University School and Hospital of Stomatology were recruited to participate in the study. The surface data (U1, L1) of the maxillary and mandibular posterior teeth were scanned by an intraoral scanner i500, and saved as original data. The volunteers were guided to bite in the intercuspal position with normal bite force. The buccal bite data of the posterior teeth were scanned as the basis for registration. The digital casts were imported into Geomagic studio 2013 software and the boundary lines along the gingival margin and mesial and distal contact area of posterior teeth of data (U1, L1) were determined. Long axis of the crown, crown centroid and mesial functional cusp vertex were establishd. The data (U1, L1) were segmented into single tooth. Single tooth was aligned to buccal bite data separately using best-fit alignment command based on the buccal common area of the crown and new casts data (U2, L2) were obtained as the data under bite force. The long axis angle and centroid distance between adjacent teeth (second premolar and first molar, second molar and first molar) were measured and the deviation between data obtained at mouth-open state and that at biting state was calculated. Negative value meant centroid distance became shorter under bite force. The first molar was set as the common area and registrate the U1, L1 to U2, L2. The angle of long axes, and displacement of centroid and of functional cusp vertex between second premolar of two casts were calculated, as well as between second molar of two casts. Wilcoxon signed rank test was used to analyze the differences of teeth displacement between second premolar and second molar, and between maxillary and mandibular jaws with SPSS 26.0 statistical software. Results: The result of second premolar and second molar in the same jaw had no statistical difference (P>0.05). The centroid distance deviation of mandibular second premolar-first molar [-0.022(0.046) mm] was larger than that of maxilla [-0.006 (0.040) mm] (P<0.05). The long axis angle of second premolar itself [0.913°(0.647°)] and centroid distance of second molar itself [0.102 (0.106) mm] on the mandibular jaw were different from that on the maxillary jaw, which were 0.590°(0.550°) and 0.074(0.060) mm respectively (P<0.05). Conclusions: Under bite force, displacement of the second premolar and second molar was present, including the displacement of centroids and deflection of long axes. The mandibular posterior teeth have larger displacement than the maxillary teeth.


Assuntos
Força de Mordida , Dente Molar , Adulto , Dente Pré-Molar , Oclusão Dentária , Feminino , Humanos , Masculino , Maxila , Dente Molar/diagnóstico por imagem
6.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 913-918, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047729

RESUMO

OBJECTIVE: To understand the oral health status of children aged 3-12 in Shaoshan area of Hunan province and to evaluate the role of oral health educations based on community such as fluoride varnish, oral hygiene introduction in improving the oral health of children in the area so as to gain expe-rience. METHODS: The study used cluster sampling to select 3 kindergartens and 2 primary schools in different economic development areas of Shaoshan. Oral health status survey and interventions were conducted in December 2014 and September 2016, respectively. The average debris index, decayed missing filled teeth (deciduous teeth: dmft; permanent teeth: DMFT), and caries prevalence rate of children aged 3-6 years and 6-12 years were compared. At the same time, children aged 5 and 12 were used as representative populations to compare the indices as listed before and the caries prevalence rate of the first permanent molar in 12-year-old children was compared as well. Finally, health economic analysis was carried out based on the 2 years' result. RESULTS: In this study, 992 children and 896 children in 2014 and 2016 were included respectively. As for children aged 3-6 years, the average debris index and dmft in 2016 were significantly less than that in 2014 (P < 0.001, P < 0.001), and the difference of DMFT was not significant (P=0.419). Children aged 6-12 years showed the same result, the average debris index and dmft in 2016 were significantly less than those in 2014 (P < 0.001, P=0.013), and the difference in DMFT was not significant (P=0.674). 173 and 179 5-year-old children were included in 2014 and 2016 respectively, and the dmft showed significant difference (P=0.038); the caries prevalence rate was 75.7% and 71.5%, respectively, which was also not significant (P=0.370). With respect to the 12-year-old children, 65 and 104 children were included and the differences in dmft and DMFT were not significant (P=0.133, P=0.171). The caries prevalence of the first permanent molar in the 12-year-old children was 36.9% and 26.9%, whose difference was not significant (P=0.171). CONCLUSION: The application of fluoride varnish and oral health education can significantly reduce the dmft of children aged 3-12 years in Shaoshan area and significantly improve the oral hygiene status. DMFT, the caries prevalence rate of 5-year-old children's deciduous teeth and 12-year-old children's first permanent molar showed a decline.


Assuntos
Fluoretos , Saúde Bucal , Criança , Pré-Escolar , Índice CPO , Humanos , Dente Molar , Prevalência
7.
Prog Orthod ; 21(1): 37, 2020 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-33015719

RESUMO

OBJECTIVES: Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. MATERIALS AND METHODS: Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. RESULTS: A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = - 0.8 month; 95% CI = - 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. CONCLUSIONS: While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. TRIAL REGISTRATION: PROSPERO: ( CRD42019148169 ).


Assuntos
Dente Molar , Aparelhos Ortodônticos Fixos , Adolescente , Adulto , Duração da Terapia , Humanos , Estudos Prospectivos , Estudos Retrospectivos
10.
Dental Press J Orthod ; 25(4): 68-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965389

RESUMO

OBJECTIVE: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. METHODS: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). RESULTS: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). CONCLUSIONS: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


Assuntos
Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Dente Impactado/diagnóstico por imagem , Humanos , Mandíbula/diagnóstico por imagem , Dente Molar , Cirurgiões Bucomaxilofaciais , Ortodontistas , Radiografia Panorâmica , Erupção Dentária , Extração Dentária
11.
Eur J Paediatr Dent ; 21(3): 243-247, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893660

RESUMO

AIM: Research aimed to gather aepidemiological parameters of MIH from a sample of Sarajevo children born between the years 1999 and 2003. Prevalence of MIH, distribution according to severity (mild vs. moderate/severe cases) and distribution according to phenotypes (MIH vs MH) were investigated. MATERIALS AND METHODS: Study design: This was a cross-sectional, observational, aepidemiological study that was conducted on a sample of 446 children aged 6 to 9 years. It was conducted as a part of regular dental screening of children attending a randomly selected primary school in the Bosnian capital city of Sarajevo. RESULTS: The overall prevalence of MIH was 11.5%. MIH prevalence varied between 19.9% of examinees born in year 2002 to 8.4% among those born in 2003. Number of teeth affected varied from 1 to 7. The average number of affected teeth was 3.82 ± 1.46. Demarcated opacities were recorded on 13.89%, post-eruptive enamel breakdown on 11.28% and atypical filling on 6.2% index teeth. Mild cases of MIH were rare in our sample, 18% of subject had only demarcated opacities present. A smaller percentage of examinees (35.3%) had hypomineralisation present only on first permanent molars (MH group). Out of 64.7% of subjects in MIH group, 37.25% had one incisor affected and 21.57% had two incisors affected. CONCLUSION: Over 80% of study subjects with MIH were categorised as moderate/severe case of MIH and they represent a major problem with regards to dental treatment. It is necessary to plan a multi-disciplinary approach for dental care of this population. It is necessary to educate primary care dentists to recognise this condition and provide recommended treatment to patients with mild clinical picture, while directing those with more severe problems to specialised doctors.


Assuntos
Hipoplasia do Esmalte Dentário , Dente Molar , Criança , Estudos Transversais , Humanos , Incisivo , Prevalência
12.
Am J Orthod Dentofacial Orthop ; 158(3): 349-356, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862936

RESUMO

INTRODUCTION: The purpose of this study was to use cone-beam computed tomography (CBCT) to determine bone thickness in the mandibular buccal shelf (MBS) and the infrazygomatic crest (IC) in individuals with different vertical facial heights for ultimate placement of miniscrews. METHODS: The sample consisted of 100 individuals aged at least 16 years, of whom 58 were women, and 42 were men. The mean age was 19.18 years (± 5.5 standard deviation). The patients' facial height was determined by the gonial angle. Cross-sectional slices of the MBS and IC were obtained with CBCT to evaluate bone thickness for the insertion of miniscrews in these extra-alveolar sites. Spearman's nonparametric test was used to correlate the gonial angle with MBS and IC thickness. The level of significance was 5%. RESULTS: The gonial angle ranged from 102.4° to 143.2°. Bone thickness in the MBS increased posteriorly, whereas bone thickness in the IC decreased posteriorly. There was an inversely proportional correlation between the gonial angle and the MBS. There was no correlation between the IC and the gonial angle. CONCLUSIONS: Short-faced individuals had higher bone thickness values in the MBS than long-faced ones. There was no correlation between the patients' vertical face height and the bone width in the IC. The best site to install miniscrews in the MBS is buccal to the second molar distal root, whereas in the IC, it is buccal to the first molar mesiobuccal root. CBCT may be necessary to install extra-alveolar miniscrews correctly, especially in the IC.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Estudos Transversais , Feminino , Humanos , Masculino , Mandíbula , Maxila , Dente Molar , Adulto Jovem
13.
Eur J Paediatr Dent ; 21(3): 238-242, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32893659

RESUMO

BACKGROUND: Molar Incisor Malformation (MIM) or Molar Root Incisor malformation (MRIM) is a recently discovered root malformation with constricted pulp and abnormally located furcation presented in permanent first molars and sometimes incisors. CASE REPORT: Two cases that feature MIM are presented with the description of the characteristic tooth form, clinical/radiographic examination, medical history, the supposed aetiology, treatment procedure and results at the 2-year follow-up. Conservative endodontic treatment was performed in both cases, furcation perforation and canal perforation were filled with MTA (Mineral Trioxide Aggregate), and a good prognosis was observed after 2 years of follow-up. Furthermore, recommended treatment options are discussed to provide a more appropriate treatment for the patients. CONCLUSION: Patients with MIM need to be treated at the right time to avoid severe infection and other problems. Early diagnosis with appropriate treatment is more likely to lead to a more favourable prognosis.


Assuntos
Incisivo , Materiais Restauradores do Canal Radicular , Compostos de Alumínio , Compostos de Cálcio , Polpa Dentária , Cavidade Pulpar , Combinação de Medicamentos , Humanos , Dente Molar , Óxidos , Silicatos , Raiz Dentária
14.
Acta Odontol Latinoam ; 33(2): 90-97, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920610

RESUMO

The aim of this study was to determine the caries situation of three-year-old preschool children residing in low socioeconomic status districts in Lima, Peru. The study is a crosssectional analysis of the caries situation of suburban areas of Lima. A stratified sampling procedure by geographical distribution, considering healthcare centers with a motherand- child health clinic and surrounding preschools as factors, identified 45 randomly selected preschools, of which 17 accepted to participate. Children from 3-year-old classrooms were examined by two independent calibrated dentists using the Caries Assessment Spectrum and Treatment (CAST) instrument at their premises using artificial light, sterile examination mirrors and gauze for drying each tooth before evaluation. ANOVA and the Tamhane method were used to analyze the data. 308 children, mean age 3.4 years (min: 3 years; max: 3 years, 7 months), were examined. The sample prevalence of enamel and dentine carious lesions (CAST code 3-7) was 91.2% while the prevalence of dentine carious lesions (CAST code 4-7) was 58.8%. The mean number of teeth with cavities that had reached the pulp and those that had an abscess or fistula were 2.0% and 0.5% respectively. The majority of enamel and dentine carious lesions were observed in molars. The CAST severity score was 7.0. Mean examination time was 57 seconds. The burden of dental caries of the children at this young age was high.


Assuntos
Cárie Dentária/epidemiologia , Dente Molar/patologia , Pré-Escolar , Estudos Transversais , Cárie Dentária/classificação , Esmalte Dentário/patologia , Feminino , Humanos , Masculino , Peru/epidemiologia , Prevalência , Reprodutibilidade dos Testes , Fatores Socioeconômicos , População Suburbana
15.
Evid Based Dent ; 21(3): 100-101, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32978541

RESUMO

This paper reports the findings from a research project named FiCTION (Filling Children's Teeth: Indicated or Not?).Design FiCTION was a multi-centre, parallel-group, patient-randomised controlled trial comparing the effectiveness of three treatment strategies. There were three strategies within the trial: conventional caries removal and restoration plus prevention (C+P); biological sealing-in caries plus prevention (B+P); and prevention alone (PA).Case selection Children aged 3-7 years with at least one asymptomatic primary molar carious into dentine were included in the study. Participants were randomly allocated to one of the three treatment strategies. Dental professional's (DPs) attended one day training for treatment delivery. Seventy two practices randomised at least one participant. Ten practices withdrew but data collected to the withdrawal date were included in the analysis. The project ran for 3 years between 2012 and 2015. One thousand and fifty eight participants (C+P:352; B+P:352; PA:354) from 68 practices were included in the analysis set. Baseline demographic and clinical characteristics for each arm of the study were balanced.During routine practice visits data were collected on a case report form (CRF). The data included:A. Co-primary outcomes: pain due to caries and evidence of dental infection (without radiographic evidence)B. Secondary outcomes: cost effectiveness, oral health related quality of life (COHRQOL), parental and caregivers perception questionnaire (P-CPQ-16), modified child dental anxiety scale, child and parent-reported anticipatory and treatment-related anxiety, caries incidence at baseline and final visit, qualitative views of parents/carers and DPs.Sound methodology was described in the narrative of the paper. The median follow-up period was 33.8 months (IQR 23.8, 36.7).Results For the co-primary outcomes the proportions of participants with at least one episode of dental pain and/or infection were: C+P 42%, B+P 40%, PA 45%. When comparing C+P with B+P and PA, there were no significant observed differences, adjusted risk difference (97.5%CI): B+P vs C+P -2%(-10%, 6%), PA vs C+P 4% (-4%, 12%). The number of episodes of dental pain and/or infection were C+P 0.62 (sd 0.95), B+P 0.58 (sd 0.87), PA 0.72 (sd 0.98). When comparing C+P with B+P and PA no significant differences were observed, adjusted incident rate ratio (97.5% CI): B+P vs C+P 0.95 (0.75, 1.21), PA vs C+P 1.18 (0.94, 1.48).Secondary outcomes:• Cost effectiveness, PA was the least costly but least effective for both co-primary outcomes with little evidence in this paper as to how and why B+P and C+P would provide greater benefits• COHRQOL, P-CPQ-16, anxiety showed no statistical differences• Parent reported anticipatory anxiety showed differences between PA vs C+P; 6% lower in the PA arm, adjusted risk difference -0.06 ((97.5% CI): -0.11 to -0.003)• Caries incidence showed no differences in the caries in primary or first permanent molars• Qualitative views showed that all three approaches were generally acceptable but trust in the dental professional played a significant role. Local anaesthesia and dental extractions were generally viewed more negatively.Conclusions There were no statistical differences between the three strategies for the co-primary outcomes, namely the incidence or number of episodes of dental pain and/or infection experienced by the study participants. The secondary outcomes suggest less anticipatory anxiety in the PA arm of the trial and that local anaesthesia and dental extractions were viewed negatively.


Assuntos
Cárie Dentária , Medicina Geral , Criança , Pré-Escolar , Humanos , Dente Molar , Qualidade de Vida , Dente Decíduo
16.
Oral Maxillofac Surg Clin North Am ; 32(4): 561-570, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32912779

RESUMO

Impacted incisors, canines, premolars, and second molar are problems encountered frequently by general dentists, orthodontists, and oral and maxillofacial surgeons. The etiology of impacted teeth is multifactorial. Traditional radiographs can be used for location of the impacted tooth but 3-D CBCT is superior in evaluating the tooth's position. Successful management requires an interdisciplinary approach with an orthodontist responsible for the overall success of the treatment plan. Surgical exposure of these impacted teeth is accomplished using an open or closed surgical procedure. Choosing the appropriate surgical procedure and orthodontic treatment plan will result in a stable, predictable, and aesthetic result.


Assuntos
Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Dente Pré-Molar , Dente Canino , Estética Dentária , Humanos , Maxila , Dente Molar
17.
Prog Orthod ; 21(1): 35, 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32888097

RESUMO

OBJECTIVES: The aim of this systematic review and meta-analysis is to assess the degree of stability of anterior open bite (AOB) treatment performed through the molar intrusion supported with skeletal anchorage at least 1 year posttreatment. METHODS: This study was registered in PROSPERO (CRD42016037513). A literature search was conducted to identify randomized (RCT) or non-randomized clinical trials based including those considering before and after design. Data sources were electronic databases including PubMed, Cochrane Library, Science Direct, Google Scholar, Scopus, Lilacs, OpenGrey, Web of Science, and ClinicalTrials.gov . The quality of evidence was assessed through the JBI tool and certainty of evidence was evaluated through the GRADE tool. Random effects meta-analysis was conducted when appropriate. RESULTS: Six hundred twenty-four articles met the initial inclusion criteria. From these, only 6 remained. The mean posttreatment follow-up time was 2.5 years (SD = 1.04). The overbite showed a standardized mean relapse of - 1.23 mm (95% CI - 1.64, - 0.81, p < 0.0001). Maxillary and mandibular incisors presented a non-significant mean relapse, U1-PP - 0.04 mm (95% CI - 0.55, 0.48) and L1-MP - 0.10 mm (95% CI - 0.57, 0.37). Molar intrusion showed a relapse rate around 12% for the maxillary molars and a 27.2% for mandibular molars. CONCLUSION: The stability of AOB through molar intrusion using TADs can be considered relatively similar to that reported to surgical approaches, since 10 to 30% of relapse occurs both in maxillary and mandibular molars. The level of certainty ranged between very low and low. RCTs reporting dropout during the follow-up are in dire need.


Assuntos
Mordida Aberta , Procedimentos de Ancoragem Ortodôntica , Cefalometria , Humanos , Maxila , Dente Molar , Técnicas de Movimentação Dentária
18.
Artigo em Inglês | MEDLINE | ID: mdl-32925991

RESUMO

The purpose of this retrospective study was to evaluate bone level stability around 441 mandibular and 350 maxillary molar implants, placed using an immediate implant protocol, that had been in function from 2 to 17 years postrestoration (mean: 9.9 years). Independent radiographic measurements using the known distance between threads on the specific implant that was used indicated a mean bone loss of 0.27 ± 0.68 mm around maxillary implants and 0.27 ± 0.67 mm around mandibular implants. Maxillary implants showed a statistically significant (SS) difference in bone loss on the mesial (0.20 mm) compared to the distal side (0.34 mm). In the mandibular group, there was an SS difference in bone loss around implants with wide (≥ 5 mm) and regular (< 5 mm) diameters. There was also an SS difference in bone loss in patients 50 years and older (0.28 mm) compared to patients younger than 50 (0.18 mm). In both groups, there were no SS differences in bone loss between machined- and rough-surface implants, men and women, single and splinted implants, nonsmokers and light/heavy smokers, or in patients with a penicillin allergy who were prescribed azithromycin as an alternate prophylactic antibiotic. All SS differences found in variables evaluated in the study were < 1.0 mm and therefore were considered clinically insignificant.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Feminino , Humanos , Masculino , Mandíbula/cirurgia , Dente Molar , Estudos Retrospectivos
19.
Artigo em Inglês | MEDLINE | ID: mdl-32925999

RESUMO

The aim of this study was to investigate which factors play a major role in the healing of Class II mandibular furcation defects treated with different surgical techniques. Twenty-five systemically healthy subjects with periodontitis stage III grade B and Class II buccal mandibular furcation involvement received one of the following open flap debridement approaches: Group 1 (n = 10), no further treatment; Group 2 (n = 10), piezoelectric contouring of the furcation roof; Group 3 (n = 9), piezoelectric contouring of the furcation roof and bone grafting; Group 4 (n = 10), piezoelectric contouring of the furcation roof and bone grafting with coronally positioned flap. Clinical and radiologic variables-bleeding on probing, probing depth (PPD), vertical and horizontal bone level (CAL and PH), gingival recession, root trunk length, radicular separation, and furcation perimeter (FP)-were evaluated at baseline and 180 days and 1 year after surgery. All clinical parameters were statistically analyzed. Surgical techniques caused clinical (CAL, PPD, PH) and radiographic (FP) improvements. Regenerative techniques and the coronally positioned flap yielded a major radiographic reduction of furcation areas. All therapies resulted in significant horizontal and vertical PPD reduction and CAL gain.


Assuntos
Defeitos da Furca/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Mandíbula/cirurgia , Dente Molar/cirurgia , Índice Periodontal , Resultado do Tratamento
20.
Braz Oral Res ; 34: e116, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32901731

RESUMO

The exposure to amoxicillin has been associated with molar incisor hypomineralization. This study aimed to determine if amoxicillin disturbs the enamel mineralization in in vivo experiments. Fifteen pregnant rats were randomly assigned into three groups to received daily phosphatase-buffered saline or amoxicillin as either 100 or 500 mg/kg. Mice received treatment from day 13 of pregnancy to day 40 postnatal. After birth, the offsprings from each litter continued to receive the same treatment according to their respective group. Calcium (Ca) and phosphorus (P) content in the dental hard tissues were analyzed from 60 upper first molars and 60 upper incisors by the complexometric titration method and colorimetric analysis using a spectrophotometer at 680 nm, respectively. Lower incisors were analyzed by X-ray microtomography, it was measured the electron density of lingual and buccal enamel, and the enamel and dentin thickness. Differences in Ca and P content and electron density among the groups were analyzed by one-way ANOVA. There was no significant difference on enamel electron density and thickness among the groups (p > 0.05). However, in incisors, the higher dose of amoxicillin decreased markedly the electron density in some rats. There were no statistically significant differences in Ca (p = 0.180) or P content (p = 0.054), although the higher dose of amoxicillin could affect the enamel in some animals. The amoxicillin did not significantly alter the enamel mineralization and thickness in rats.


Assuntos
Esmalte Dentário , Amoxicilina , Animais , Hipoplasia do Esmalte Dentário , Feminino , Incisivo , Camundongos , Dente Molar , Gravidez , Ratos
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