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1.
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
2.
Quintessence Int ; 51(3): 204-211, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32020130

RESUMO

OBJECTIVES: Presence of clinical attachment loss on the distal aspect to the second molar may be associated with malposition of the third molar. The aim of this study was to evaluate the reduction of clinical attachment loss at the distal aspect of the second molar after third molar extraction and application of leukocyte- and platelet-rich fibrin (L-PRF). METHOD AND MATERIALS: Eighteen subjects with a clinical attachment loss on the distal site to the second molar associated with impacted third molar in both sides of the jaw were recruited for the study. For each subject the teeth were randomly allocated in test and control groups. After surgical removal of the impacted third molar, the L-PRF was inserted in the fresh alveolar socket of test sites; in the control sites no graft was inserted after extraction. Full-mouth plaque score, full-mouth bleeding score, clinical attachment level (CAL), probing depth, and gingival recession were assessed at baseline and 6 months later. RESULTS: After 6 months, mean CAL change was 1.99 ± 1.18 mm in the test group and 1.15 ± 1.01 mm in the control group; probing depth change was 1.33 ± 0.87 mm in the test group and 0.50 ± 0.63 mm in the control group. Statistically significant differences (P < .05) were observed between groups in terms of CAL and probing depth changes. No differences were found in gingival recession changes. CONCLUSION: Within the limits of the present study, the sites treated by means of application of L-PRF after impacted third molar extraction showed better results in terms of CAL gain and probing depth reduction when compared with control sites.


Assuntos
Fibrina Rica em Plaquetas , Dente Impactado , Humanos , Dente Molar , Dente Serotino , Bolsa Periodontal , Extração Dentária
3.
Medicine (Baltimore) ; 99(5): e19061, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32000455

RESUMO

To analyze whether a correlation exists between the caries status (Decayed, Missing and Filled Teeth, DMFT Index) of the first permanent molars (FPMs) and that of the full permanent dentition of Mexican adolescents, and to propose its use in large epidemiological studies of dental caries.We conducted a cross-sectional study of 1538 adolescents from 12 to 15 years old. Based on a clinical oral examination, we determined the DMFT Indices of their FPMs (FPM-DMFT) and of their full permanent dentition (comprehensive DMFT Index). We explored each FPM to determine whether it was with or without caries, filled, missing or sealed. For our statistical analysis, we used Fisher exact test and Spearman correlation in Stata software.After examining a total of 6157 FPMs, we found that 56.8% of our sample of adolescents had no caries in their 4 FPMs whereas 4.9% experienced caries in all 4. No significant differences emerged by sex (P > .05); however, by age, the older adolescents experienced greater FPM-DMFT (P < .05). Analysis yielded a correlation of r = 0.8693 between the FPM-DMFT and comprehensive DMFT scores (P < .0001) of participants. The underestimation of caries prevalence (DMFT > 0) was 5.4% (48.6% vs 43.2%), while the DMFT Index was underestimated at 0.34 (1.15 vs 0.81).The strong correlation between the FPM-DMFT and comprehensive DMFT Indices suggests that overall caries status can be inferred on the basis of FPM caries status. This evidence is useful when conducting large epidemiological studies such as national surveys.


Assuntos
Cárie Dentária/epidemiologia , Dentição Permanente , Dente Molar , Adolescente , Criança , Estudos Transversais , Índice CPO , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência
4.
J Clin Pediatr Dent ; 44(1): 55-59, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995414

RESUMO

Molar root-incisor malformation (MRIM) or molar-incisor malformation (MIM) is a new type of dental anomaly characterized by dysplastic roots of permanent first molars, occasionally second primary molars, and the crowns of maxillary central incisors. MRIM involving permanent first molars and second primary molars is characterized by normal crowns with short, thin, and narrow roots, whereas MRIM involving permanent maxillary central incisors exhibits constrictions of the crown in the cervical area. In the first case, we extracted the affected first permanent molars at the optimal timing to minimize space deficiencies and induce space closure. In addition, composite resin restorations were performed on the anterior central incisors. In the second case, a mandibular lingual arch was used to stabilize the affected teeth in order to mitigate discomfort by reducing rotational biting forces.


Assuntos
Incisivo , Raiz Dentária , Criança , Coroas , Humanos , Dente Molar , Dente Decíduo
5.
J Clin Pediatr Dent ; 44(1): 41-46, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995416

RESUMO

OBJECTIVE: To evaluate penetration of a flowable resin composite into fissures using three different application methods: (1) conventional, (2) heat, and (3) sonic vibration. STUDY DESIGN: Forty-five sound maxillary third molars were divided randomly into three groups (n=15 per group). The occlusal surfaces of the teeth were etched and flowable resin composites were applied into the fissure using the assigned application method. The crowns were sectioned and examined with an optical microscope to assess penetration. In addition, three-point flexural strength was analyzed. RESULTS: The sonic vibration group exhibited significantly greater penetration into the fissure compared with the other test groups (p<0.001). The heat group exhibited greater penetration into the fissure compared with the conventional group (p=0.003). However, three-point flexural strength was similar among all groups (p>0.05). CONCLUSIONS: Sonic vibration and heat increased penetration into fissures. Notably, sonic vibration exhibited the greatest penetration. We found that the application method did not influence the three-point flexural strength.


Assuntos
Temperatura Alta , Selantes de Fossas e Fissuras , Resinas Compostas , Dente Molar , Vibração
6.
J Clin Pediatr Dent ; 44(1): 20-27, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31995422

RESUMO

Purpose: Molar Incisor Hypomineralization (MIH) is a developmental enamel anomaly of systemic origin affecting the first permanent molars and often the permanent incisors. Despite MIH being a prevalent anomaly, its diagnosis and management are challenging for practitioners; including poor anesthesia, failure of restorations, rapid enamel breakdown, poor resin adhesion, and related child anxiety. This study aimed to evaluate knowledge regarding and management of MIH amongst orthodontists and dentists. Study design: The study was performed from March to September 2017 and included 336 dentists and 32 orthodontists. Questionnaires comprised questions on MIH diagnosis, socio-demographic characteristics of the subjects, and photographs of a case of MIH with related questions regarding management. Results: Our results showed that 48% of dentists and 25% of orthodontists misdiagnosed MIH; with misdiagnosis associated with graduation prior to 1986 (p < 0.001). Amongst dentists, 59% applied a fluoridated product and 34% applied fissure sealants in the case of moderate MIH. The application of fluoride was associated with graduation after 1986 (p < 0.0001).Conclusion: Large disparities about knowledge and management of MIH exist between dental practitioners in France. Education regarding diagnosis and management of MIH is necessary.


Assuntos
Hipoplasia do Esmalte Dentário , Ortodontistas , Criança , Esmalte Dentário , Odontólogos , Humanos , Dente Molar , Prevalência
7.
Compend Contin Educ Dent ; 41(1): e1-e5, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31904245

RESUMO

Implants used to replace molar teeth present issues of space distribution and crown contours that are unique to these sites. Because the diameter of the implant typically is smaller than that of the tooth being replaced, and the circular shape of the implant does not replicate the anatomy of the tooth, a large gingival embrasure area between the implant platform and adjacent tooth often results. Upon the review of radiographs of molar implants placed over an 11-year period in one private practice, the authors identified an unusually high incidence of approximal, cervical, and root caries on teeth adjacent to these implants. This retrospective radiographic study investigated the incidence of decay as related to: (1) the horizontal distance from the implant to the adjacent tooth (ie, the implant-tooth distance, or ITD) as measured at the alveolar crest, (2) the vertical distance from the apical portion of the prosthetic contact area to the implant platform, and (3) the presence of an existing restoration on the adjacent tooth. Of the three variables examined, both the horizontal distance of the implant to a natural tooth (ITD) and the presence of an existing restoration on an adjacent tooth proved to be significantly correlated with the incidence of decay. Results showed that incidence of decay ranges from 7.4% when the ITD is <2 mm to 40% when the ITD is ≥6 mm. The mean ITD in cases in which decay was found was 4.1 mm, and it was 3.5 mm in cases that showed no decay (P = .005). It is therefore suggested that the horizontal threshold of 4 mm be considered as the "critical ITD." The results also indicated that the presence of a previous restoration on an adjacent tooth increases the incidence of decay to a statistically significant degree with an odds ratio of 2.25 at a 95% confidence level. This information may prove useful in diagnosis and treatment planning for molar implant replacement.


Assuntos
Implantes Dentários para Um Único Dente , Dente , Incidência , Dente Molar , Estudos Retrospectivos
8.
J Endod ; 46(1): 81-88, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31767340

RESUMO

INTRODUCTION: Pulp capping materials allow healing of injured pulp with a layer of reparative dentin. Glucose is needed to cure the injured area. Glucose is transported by glucose transporter (Glut) 2 and Glut4, which are transmembrane proteins that act as gatekeepers. We hypothesized that the transport of glucose via Glut2/Glut4 might contribute to the production of a dentin bridge during wound healing. Therefore, we explored Glut2 and Glut4 expression during reparative dentinogenesis after mineral trioxide aggregate capping. METHODS: The upper left first molar of 8-week-old Wistar rats underwent pulpotomy with mineral trioxide aggregate. At 1, 3, 5, 7, and 14 days after treatment, localization and colocalization of Glut2, Glut4, nestin (odontoblast marker), and antiendothelial cell antigen 1 (RECA-1; endothelial cell marker) were analyzed with immunohistochemical staining. Messenger RNA expression levels of Slc2a2 (encoding Glut2), Slc2a4 (encoding Glut4), Igf-1r (encoding insulinlike growth factor 1 receptor), and nestin were analyzed in the extracted teeth using real-time polymerase chain reaction. RESULTS: Glut2 and Glut4 were localized within odontoblasts and endothelial cells in normal control teeth. Three days after pulpotomy, Glut2- and Glut4-positive cells were detected; 7 days after pulpotomy, immunoreactivity for Glut2 and Glut4 was confined to newly differentiated odontoblastlike cells arranged beneath reparative dentin. Messenger RNA expression levels of Slc2a2 and Slc2a4 were significantly up-regulated after pulpotomy. CONCLUSIONS: Glut2 and Glut4 regulate glucose transport during wound healing beneath the injured area. This may contribute to the development of new vital pulp therapy for patients with deep caries.


Assuntos
Transportador de Glucose Tipo 2 , Transportador de Glucose Tipo 4 , Glucose , Pulpotomia , Cicatrização , Compostos de Alumínio , Animais , Compostos de Cálcio , Polpa Dentária , Capeamento da Polpa Dentária , Combinação de Medicamentos , Células Endoteliais , Glucose/metabolismo , Transportador de Glucose Tipo 2/fisiologia , Transportador de Glucose Tipo 4/fisiologia , Humanos , Dente Molar , Óxidos , Ratos , Ratos Wistar , Silicatos
9.
J Endod ; 46(1): 103-109, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31761330

RESUMO

INTRODUCTION: This in vitro study compared the performance of the XP-endo Shaper (XP; FKG, La Chaux-de-Fonds, Switzerland) in curved canals when used with a higher speed (3000 rpm) without a glide path with the manufacturer's protocol. METHODS: Twenty extracted mandibular molars with separate mesial curved canals were matched to obtain 2 standardized groups (n = 20). For the XP 1000 group, a glide path up to a size 15 hand file was performed followed by rotary instrumentation with the XP shaper at 1000 rpm, following the manufacturer's recommendations. For the canals in the XP 3000 group, the file was rotated at 3000 rpm after only negotiation the canal with a size 8 hand file (patency file). The operating time and the number of strokes taken to reach the working length (WL) and fit a 30/.04 gutta-percha cone to the WL were recorded. The shaping abilities were evaluated by micro-computed tomographic imaging and file deformation by scanning electron microscopy. Data were analyzed using analysis of variance and chi-square tests at a 5% significance level. RESULTS: The XP 3000 group required less time and strokes to reach the WL (P < .05) and resulted in a higher percentage of adequate cone fit (P < .05). No difference was found between groups regarding the micro-CT parameters, except for the taper, which was larger in the XP 3000 group in the apical and middle thirds (P < .05). No difference was found regarding file deformation between the 2 groups. CONCLUSIONS: The suggested protocol for the use of the XP (3000 rpm without a glide path) appears to be more efficient than the manufacturer's recommended protocol to prepare curved canals in vitro.


Assuntos
Cavidade Pulpar , Preparo de Canal Radicular , Desenho de Equipamento , Guta-Percha , Técnicas In Vitro , Dente Molar
10.
Int Endod J ; 53(2): 176-185, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31702056

RESUMO

AIM: To establish the effects of submucosal single doses of two medicines on postoperative pain after root canal treatment in mandibular molar teeth with symptomatic irreversible pulpitis. METHODOLOGY: In this randomized controlled, double-blind clinical trial, 90 patients with the diagnosis of symptomatic irreversible pulpitis in their mandibular first or second molars were included and randomly divided into three groups (n = 30): a control group that received normal saline and two experimental groups that received a single dose of either tramadol (100 mg 2 mL-1 ) or dexamethasone (8 mg 2 mL-1 ). After local anaesthesia and before treatment, submucosal injections were administered into the mucobuccal fold adjacent to the mandibular molars, and a routine single-visit root canal treatment procedure was performed in all groups. After the root canal treatments, the patients were asked to score their pain level using the Heft-Parker visual analogue scale (0-170 mm) at 6, 12, 24, 48 and 72 h. The experimental groups were compared using one-way anova or Kruskal-Wallis H-test. The groups that were significantly different were compared pairwise using Student's t-test or the Mann-Whitney U-test. The findings were expressed as the mean ± standard deviation or median (min-max). The categorical variables were tested using the chi-square test or Fisher's exact chi-square test, and the results were expressed as counts and percentages. RESULTS: At the 6-h and 48-h time intervals, the intensity of pain was significantly less in both the dexamethasone and tramadol groups than in the control group (P < 0.0167). At the end of 12 h, the pain level in the dexamethasone group was significantly less compared to the other groups (P < 0.0167). CONCLUSIONS: Pretreatment submucosal dexamethasone and tramadol injections significantly diminished post-treatment endodontic pain of patients with symptomatic irreversible pulpitis following single-visit root canal treatment. However, dexamethasone was more effective than tramadol in pain reduction in the first 12 h.


Assuntos
Pulpite , Tramadol , Anestésicos Locais , Dexametasona , Método Duplo-Cego , Humanos , Nervo Mandibular , Dente Molar
11.
J Endod ; 46(1): 29-33, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735361

RESUMO

INTRODUCTION: Altered sensation is a rare but disturbing adverse event after mandibular premolar and molar periapical surgery procedures, and its incidence is not known. The aim of this study was to determine the incidence of altered sensation after periapical surgery procedures in mandibular premolars and molars. METHODS: This retrospective study includes patients who received periapical surgery in endodontic clinics of a university hospital in the United States. Data were obtained by review of the records for patients who met the inclusion criteria, and statistical analysis of possible predictive factors was performed using the 2-tailed Fisher exact test (α = 0.05). RESULTS: Sixty-two patients (63 teeth, 13 premolars and 50 molars) met the inclusion and exclusion criteria and were analyzed in the study. The first follow-up visit occurred 3 to 37 days after surgery. Altered sensation was observed in 9 patients. Observation of altered sensation was significantly higher (odds ratio = 7.19) after premolar surgeries (5/13) compared with molar surgeries (4/50). CONCLUSIONS: Despite the limited size and retrospective nature of this study, it was concluded that the incidence of altered sensation after periapical surgery appears to be relatively high (14%), with a higher incidence found in premolars compared with molars.


Assuntos
Dente Pré-Molar , Mandíbula , Dente Molar , Transtornos das Sensações , Dente Pré-Molar/cirurgia , Humanos , Incidência , Mandíbula/cirurgia , Dente Molar/cirurgia , Estudos Retrospectivos , Sensação , Transtornos das Sensações/etiologia
12.
Int J Paediatr Dent ; 30(1): 4-10, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31593607

RESUMO

AIM: To assess the efficacy of treatment using a minimally invasive approach (selective removal of carious tissue, restoration and preventive strategies) in immature permanent molars with MIH. DESIGN: A total of 281 patients, aged 6-8 years, with carious lesions (ICDAS 5-6), severe MIH, and incomplete root formation (one tooth/patient) were included. After clinical and radiographic examinations, selective carious tissue removal was performed, and the teeth received interim restoration for 6 months and were then restored with composite resin. Clinical and radiographic follow-up was undertaken, 6, 12, 18, and 24 months. A protocol of preventive oral care measures was established and repeated at each follow-up, including diet counselling, oral hygiene instruction, dental plaque control, and topical application of fluoride varnish containing CPP-ACP. All clinical procedures and evaluations were done by a single operator. RESULTS: Clinical and radiographic success was observed 24 months after treatment in 96.8% of the cases. Failures were due to enamel fracture at restoration margins, resulting in pulpitis and absence of apex closure. CONCLUSION: Selective removal of carious tissue, interim, and subsequently definitive restoration, combined with home and professional preventive measures, maintained marginal integrity of restorations in immature permanent molars with severe MIH, confirmed by pulp vitality and occurrence of apexogenesis.


Assuntos
Hipoplasia do Esmalte Dentário , Restauração Dentária Permanente , Criança , Resinas Compostas , Humanos , Estudos Longitudinais , Dente Molar
13.
Int J Paediatr Dent ; 30(1): 27-34, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31583786

RESUMO

BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental enamel defect characterized by well-demarcated discolorations frequently detected in molars, causing pain and esthetic alterations. AIM: To assess the interests of Google users on MIH-related information. DESIGN: Digital data were collected in Google Trends through two search strategies, 'molar incisor hypomineralization' (topic) and 'MIH' (search term), between January 2004 and November 2018. ARIMA models were applied to analyze trends of curves and to predict the activity of Google users during 12 months. Autocorrelation and partial autocorrelation (ACF/PACF) plots were used to detect trends in the variation of relative search volume (RSV) related to search strategies over time. The most popular queries were analyzed qualitatively, whereas geographical heat maps were retrieved to determine search volumes according to countries (P < .05). RESULTS: Gradual increasing trends were detected, with forecasts indicating similar levels of RSVs to the period between December 2017 and November 2018. Most popular queries and topics were associated with MIH diagnosis, being retrieved predominantly in European countries. CONCLUSIONS: The activity of Google users related to this condition is maintained low, with a reduced intensification over time, suggesting that the awareness on MIH is probably confined to dentists and affected people worldwide.


Assuntos
Hipoplasia do Esmalte Dentário , Incisivo , Esmalte Dentário , Humanos , Internet , Dente Molar , Prevalência
14.
Int J Paediatr Dent ; 30(1): 18-26, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31393632

RESUMO

BACKGROUND: Untreated caries on primary molars often leads to pulp inflammation and extraction. AIM: To retrospectively investigate the effect of pulp inflammation and extraction of primary molars on their successors regarding alignment in the dental arch and developmental enamel defects (DED). DESIGN: The participants in this study were children at public schools in Petropolis (Brazil), who participated in a 3-year longitudinal clinical trial. Children (N = 44) were selected for the present study if they had at least one erupted premolar of which the predecessor primary molar presented pulp inflammation at baseline or during any of the 6-month follow-up assessments. All premolars were examined for DED and misalignment. Distinction was made between extraction performed before (E <8) or after the age of 8 years (E ≥8). Distinction was also made between pulp inflammation occurred before (P < 7) or after the age of 7 years (P ≥ 7). A logistic regression analysis was performed, and the odds ratio was calculated. RESULTS AND CONCLUSIONS: Misalignment occurred more frequently in E <8 as compared to E ≥8 (OR = 2.85; P = .03). There was no significant difference in DED between P < 7 and P ≥ 7. CONCLUSION: Misalignment of premolars occurs more frequently when the predecessor primary molars are extracted before the age of 8 years.


Assuntos
Cárie Dentária , Dente Decíduo , Brasil , Criança , Humanos , Inflamação , Dente Molar , Estudos Retrospectivos
15.
Int Endod J ; 53(2): 154-166, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31563148

RESUMO

AIM: This randomized, prospective, double-blind, clinical trial assessed the effect of 1.3% and 5.25% sodium hypochlorite (NaOCl) as irrigants on post-endodontic pain and medication intake following root canal treatment of mandibular molars with nonvital pulps. METHODOLOGY: Three hundred and eight patients, each with one symptomatic or asymptomatic molar, were randomly assigned, using the permuted-block method, into two equal groups according to NaOCl concentration: 1.3% or 5.25% (n = 154). For both groups, syringe irrigation was performed using a 27-gauge needle advanced into the canal to a depth of 3 mm from the working length; 3 mL were used between every two consecutive instruments. All root canal treatments were carried out in two visits, with no intracanal medication, by trained postgraduate students. The canals were prepared using the ProTaper Universal rotary system during the first visit. In the second visit 7 days later, the same irrigant per group was used and the canal walls were reprepared with the final instrument before filling the canal using the modified single-cone technique with an epoxy resin-based sealer. Patients assessed their postoperative pain using a 0-10 numerical rating scale immediately after instrumentation, 3, 24, 48 h and 7 days after the first visit and immediately following root canal filling. The incidence of rescue medication intake (Sham or analgesic) was also recorded; patients received a sham capsule to be used first, but, if pain persisted, an analgesic was prescribed. Outcome data were analysed using Mann-Whitney U-test, Friedman's test, Wilcoxon's rank test and chi-square (χ2 ) test. Relative risk reduction (RRR) and its 95% confidence interval (CI) were calculated for binary data. RESULTS: The incidence and intensity of postoperative pain were significantly lower with 1.3% NaOCl than 5.25% NaOCl at all time-points (P < 0.05). Postoperative pain intensity exceeded preoperative pain at 3 and 24 h with 5.25% NaOCl only (P < 0.05). The RRR in pain incidence was 38% (95% CI: 17%, 54%) immediately after instrumentation, 41% (95% CI: 31%, 49%) at 3 h, 42% (95% CI: 32%, 51%) at 24 h, 59% (95% CI: 45%, 69%) at 48 h, 62% (95% CI: 27%, 80%) at 7 days and 81% (95% CI: 68%, 89%) after root filling. RRR was 38% (95% CI: 1%, 61%) for sham intake and 69% (95% CI: 37%, 85%) for analgesic intake. CONCLUSIONS: Using 1.3% NaOCl was associated with less intense and less frequent post-endodontic pain than 5.25% NaOCl in mandibular molars with nonvital pulps treated in two visits. The incidence of pain was reduced by up to 60% within the week post-instrumentation and 80% after root canal filling and the rescue analgesic intake by about 70% on using 1.3% NaOCl compared to 5.25% NaOCl.


Assuntos
Dente Molar , Hipoclorito de Sódio , Cavidade Pulpar , Método Duplo-Cego , Humanos , Dor Pós-Operatória , Estudos Prospectivos , Irrigantes do Canal Radicular , Preparo de Canal Radicular
16.
Int Endod J ; 53(2): 167-175, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31519062

RESUMO

AIM: To measure the coronal root canal morphology of permanent mandibular first molars using 3D coordinates for more precise conservative endodontic cavity preparation. METHODOLOGY: In total, 57 cone beam computed tomography (CBCT) images of sound mandibular molars with fully formed apices without previous endodontic treatment were taken from 33 patients aged 16 to 75 years. The CBCT machine (MCT-1[EX-2F], J. Morita Manufacturing Corp, Kyoto, Japan) provided 14-bit greyscale images with the voxel size of 0.125 mm. All images were taken at 80 kV and 5.0 mA, with a 17-s exposure time, which were then reconstructed in 3D models and viewed by an endodontist. The gender of the patients and the tooth position, and number of root canals, were recorded. The landmarks of coronal root canals were determined, then the distribution of landmarks, maximum curvature in the axial direction and curvature directions in the horizontal direction of coronal root canals were measured. Distributions of landmarks were analysed using a spatial statistics method. Data about curvature were compared using a t test. RESULTS: Overall, the distribution of root canal orifices and the centre of the canal primary curve were more centralized than other landmarks. The landmarks were located more mesiobuccally to the centre of the occlusal plane of mandibular first molars. Specifically, the measurements of the maximum curvature of coronal root canals in the axial direction were as follows: in 3-canal teeth, the average angles of curvatures were 22°,23°,15° for mesiobuccal (MB), mesiolingual (ML) and distobuccal (DB) canals, respectively; in 4-canal teeth, the average angles of curvatures were 24°,26°,15°,22°for MB, ML, DB and distolingual (DL) canals, respectively. The degrees of coronal root canal curvatures in the horizontal direction were as follows: in 3-canal teeth, the average angles of curvatures were -8°,47°,-2° for MB, ML and DB canals, respectively; in 4-canals teeth, the average angles were -11°,50°,-28°,45° for MB, ML, DB and DL canals, respectively. Statistically, there was no reliable side or sex difference in any of the measurements (P > 0.05). CONCLUSIONS: In permanent two-rooted mandibular first molars, the coronal canals clustered in the direction of the mesiobuccal side of the occlusal surface of the teeth.


Assuntos
Cavidade Pulpar , Raiz Dentária , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula , Pessoa de Meia-Idade , Dente Molar , Adulto Jovem
17.
Oper Dent ; 45(1): 52-61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31084532

RESUMO

PURPOSE: The purpose of this study was to investigate the effect of four direct restorative materials that can be used in the proximal box elevation (PBE) technique. METHODS AND MATERIALS: Seventy-five molar teeth were randomly assigned to one of five groups (n=15): type II glass ionomer (GI), type II resin-modified glass ionomer (RMGI), resin-based composite (RBC), bulk-fill (BF) resin-based composite, and a control with no box elevation procedure. Specimens were prepared for a standard mesio-occlusal-distal, computer-aided design/computer-aided manufactured (CAD-CAM) resin, nanoceramic onlay with mesial cervical margins located 1 mm above the cementoenamel junction (CEJ) and distal cervical margins located 2 mm below the CEJ. PBE was used to elevate the distal margins to 1 mm above the CEJ in all groups except the control group. For the control group the onlay margin was placed directly on the prepared distal tooth structure without PBE. A Lava Ultimate CAD/CAM resin, nanoceramic onlay restorative was manufactured and bonded on all specimens with RelyX Ultimate adhesive resin cement. The quality of the tooth-PBE material and PBE material-onlay interface was evaluated with scanning electron microscopy using epoxy resin replicas before and after cyclic loading (100,000 cycles, 1.2 Hz at 65N and 37°C). In addition to margin quality, the fracture resistance of each group was measured using a universal testing machine. Fracture pattern was recorded by visual examination. The Levene test for homogeneity and the Welch analysis of variance were completed for fracture resistance and margin quality. A χ2 test was completed for break mode. RESULTS: For dentin margins, a statistically significant difference was detected between the RMGI and control groups at baseline (p=0.0442). All other groups-GI, RBC, and BF-showed no difference from the control at baseline (p>0.05). No statistical significance was observed among groups for post-cyclic fatigue (p=0.8735). For onlay margins, no statistical significance was observed among groups for pre-cyclic fatigue, post-cyclic fatigue, or change (p=0.9713, p=0.528, p=0.4385, respectively). No significant difference was observed for the fracture resistance among groups or for the type of break by material used (p=0.1593, p=0.77, respectively). CONCLUSION: Within the parameters of this study, after mechanical fatigue, the materials used for PBE: RMGI, RBC, and BF, did not influence results in terms of margin quality and fracture resistance. Therefore, collective findings suggest that these materials might be suitable for PBE procedures. Nevertheless, clinical caution is recommended with any PBE procedure and further testing of GI materials is needed.


Assuntos
Resinas Compostas , Restaurações Intracoronárias , Projeto Auxiliado por Computador , Materiais Dentários , Análise do Estresse Dentário , Teste de Materiais , Dente Molar , Cimentos de Resina
18.
Acta Odontol Scand ; 78(1): 1-5, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31282797

RESUMO

Objective: (1) To test Hägg-Taranger's method of dental age assessment (DAA) in Bogotanian children comparing findings by sex with Swedishes' standards and (2) to investigate its chronological age predictive value for identification purposes.Material and methods: Dental age was assessed in 5-14-year-old Bogotanians, 2075 girls and 2032 boys and compared with the method's standards. For statistical analysis, matched-pair signed-rank tests were used, and a regression model was used for investigating value as chronological age predictor from dental age.Results: No significant difference was found between means of dental ages of Bogotanians and Swedishes, except for the lower central incisors' and second molars' emergences. Differences by sex between dental age means were seen at all stages especially, in mixed dentition (p<.01), being Bogotanian girls earlier maturers than boys. The established regression model as chronological age predictor, was tested by the coefficient of determination, which was found r2=0.979 for girls, and 0.957 for boys.Conclusions: Sexual dimorphism in dental age suggests Hägg-Taranger's method for identification by sex at mixed dentition. Additionally, high coefficients of determination show its reliability as chronological age predictor for ages from 5 to 12 years in girls, and to 13 years in boys.


Assuntos
Determinação da Idade pelos Dentes/métodos , Erupção Dentária , Dente/fisiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Colômbia , Dentição Mista , Feminino , Humanos , Masculino , Dente Molar , Valor Preditivo dos Testes , Radiografia Panorâmica , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Suécia , Dente/crescimento & desenvolvimento
19.
J Prosthet Dent ; 123(1): 50-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31113665

RESUMO

Mesial tilting of adjacent teeth may appear after the removal of a tooth, leading to a lack of restorative space. This dental technique presents a method of uprighting a mesially tilted adjacent tooth by using a dental implant as anchorage.


Assuntos
Implantes Dentários , Arco Dental , Dente Molar , Técnicas de Movimentação Dentária
20.
Int J Oral Maxillofac Surg ; 49(2): 218-223, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31239083

RESUMO

This study examined the influence of bone thickness on the split pattern of sagittal ramus osteotomy at 62 sites using Dolphin 3D software. Four measurements of thickness were obtained from the preoperative computed tomography scans: measurement A was made 1.5mm above the lingula, using the coronal and sagittal planes; measurement B was made at the same height as measurement A and 1mm from the anterior border of the ramus; measurement C was obtained 5mm distal to the last molar and 5mm below the upper border of the mandible; measurement D was made in the area between the first and second molars, 6mm above the mandibular border. Three-dimensional postoperative images were used to classify the split pattern into types, based on the classification of Plooij et al. The data were analyzed using the Kruskal-Wallis test, followed by Dunn post-hoc test. Thirty-five sagittal splits were type I, one was type II, 19 were type III, and seven were type IV. Type I presented the greatest thickness, whereas type IV presented the lowest. There was a statistically significant difference in thickness only for measurement A, when types I and IV were compared. The results indicate that thinner mandibular rami are more prone to bad splits.


Assuntos
Mandíbula , Osteotomia Sagital do Ramo Mandibular , Humanos , Imagem Tridimensional , Dente Molar , Tomografia Computadorizada por Raios X
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