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1.
Braz. j. oral sci ; 21: e223759, jan.-dez. 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1355009

RESUMO

Aim: To evaluate the fracture resistance of roots restored with CAD/CAM-fabricated posts, receiving or not intracanal laser treatment, compared with glass fiber posts under mechanical cycling. Methods: Twenty-seven endodontically treated, single-rooted teeth were divided into 3 groups: group 1 (control), prefabricated glass fiber posts relined with resin composite; group 2, CAD/CAM-fabricated intraradicular posts using Resin Nano Ceramic (RNC) blocks; and group 3, CAD/CAM-fabricated intraradicular posts using RNC blocks in canals irradiated with a 940-nm diode laser (100 mJ, 300-um optic fiber, coronal-apical and apical-coronal helical movements, speed of 2 mm/second, 4 times each canal). After cementation of the coping, cyclic loading was applied at an angle of 135° to the long axis of the root, with a pulse load of 130 N, frequency of 2.2 Hz, and 150,000 pulses on the crown at a point located 2 mm below the incisal edge on the lingual aspect of the specimen. Every 50,000 cycles, the specimens were evaluated for root fracture occurring below or above the simulated bone crest. Results were analyzed by one-way ANOVA followed by Tukey's test (p<0.05). Results: Group 1 was the least resistant, while groups 2 and 3 were the most resistant. Group 1 differed significantly from groups 2 and 3 (p<0.01), but there was no difference between groups 2 and 3 (p<0.01). Conclusion: Treatment of the intracanal surface with diode laser had no influence on fracture resistance of roots restored with CAD/CAM-fabricated posts, but a longer cycling time is required to evaluate the real benefits of diode laser irradiation


Assuntos
Humanos , Fraturas dos Dentes/reabilitação , Raiz Dentária/lesões , Pinos Dentários , Odontologia , Lasers Semicondutores/uso terapêutico
2.
Rev. Odontol. Araçatuba (Online) ; 43(2): 43-48, maio-ago. 2022. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1362032

RESUMO

Casos de fraturas dentárias oblíquas muitas vezes possuem um prognóstico desfavorável, geralmente com indicação da extração do elemento dental. O presente artigo visou relatar o tratamento do caso clínico de um paciente do sexo masculino, 12 anos, que compareceu à Unidade de Saúde Bucal do Hospital Universitário de Brasília com encaminhamento de extração do dente 12, apresentando fratura oblíqua que se estendia subgengivalmente na face vestibular. O trauma havia ocorrido há três anos e o paciente havia sido submetido a diversas intervenções endodônticas, apresentando no momento da consulta inicial por nossa equipe uma lesão periapical extensa. Após a realização da anamnese, exame clínico e radiográfico, foi adotada uma abordagem multidisciplinar conservadora com a manutenção do dente e a realização da enucleação da lesão periapical por meio de intervenção cirúrgica e posterior reabilitação. Em uma mesma sessão, foi realizada a obturação do conduto com cone de guta percha e cimento sealer 26 e a cirurgia parendodôntica juntamente com a apicoplastia. Uma semana após a intervenção cirúrgica foi realizada restauração classe IV com resina composta baseada no enceramento dos modelos de diagnóstico montados em articulador. Com base em uma avaliação criteriosa e multidisciplinar, foi possível adotar uma abordagem conservadora no caso em questão, com a manutenção e reabilitação de um dente permanente em um paciente jovem, evitando a indicação de exodontia(AU)


Cases of oblique dental fractures often have an unfavorable prognosis, usually with the indication of extraction of the dental element. The present article aimed to report the treatment of the clinical case of a 12-year-old male patient, who attended the Oral Health Unit of the Hospital Universitário de Brasília with a referral for extraction of tooth 7, presenting an oblique fracture that extended subgingivally on the labial surface. The trauma had occurred three years ago and the patient had undergone several endodontic interventions, presenting an extensive periapical lesion at the time of the initial consultation by our team. After anamnesis, clinical and radiographic examination, a conservative multidisciplinar approach was adopted with the maintenance of the tooth and the enucleation of the periapical lesion through surgical intervention and subsequente rehabilitation. In the same session, the conduit was filled with gutta-percha cone and sealer cement 26 and parendodontic surgery was performed together with apicoplasty. One week after the surgical intervention, class IV restoration was performed with composite resin based on the waxing of the diagnostic models mounted on an articulator. Based on a careful and multidisciplinary evaluation, it was possible to adopt a conservative approach in the case in question, with the maintenance and rehabilitation of a permanent tooth in a young patient, avoiding the indication of extraction(AU)


Assuntos
Humanos , Masculino , Criança , Fraturas dos Dentes/terapia , Cavidade Pulpar/cirurgia , Cavidade Pulpar/lesões , Abscesso Periapical , Tratamento do Canal Radicular , Fraturas dos Dentes , Fraturas dos Dentes/cirurgia , Fraturas dos Dentes/diagnóstico , Incisivo
3.
J Contemp Dent Pract ; 23(1): 100-104, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-35656666

RESUMO

Edentulousness affects the mental health of most patients. Missing teeth in the anterior esthetic zones is a matter of concern, especially for young adults. Various replacement options such as fixed partial dentures, removable partial dentures, and dental implants are available to treat edentulousness. Dental implants have been a booming treatment option in modern-day dentistry as they more closely mimic the natural tooth. The most important criterion for placement of the implant in the esthetic zone is the conservation of alveolar bone, especially in the anterior region which is usually compromised due to tooth extraction or resorption of the ridge. The root membrane concept or the socket shield technique is a recently introduced concept in implant dentistry where a portion of the root acts as a shield to protect against alveolar bone resorption and maintain bone integrity, especially in the esthetic area. This case report describes the clinical management of fractured upper anterior teeth using a dental implant and the root membrane technique. Keywords: Anterior zone, Esthetics, Immediate implants, Implant, Missing teeth, Root membrane technique, Socket shield.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Carga Imediata em Implante Dentário , Boca Edêntula , Fraturas dos Dentes , Estética Dentária , Humanos , Carga Imediata em Implante Dentário/métodos , Fraturas dos Dentes/terapia , Alvéolo Dental , Adulto Jovem
4.
Quintessence Int ; 53(7): 568-578, 2022 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-35674168

RESUMO

Preservation and restoration of teeth with little coronal tooth structure due to crown-root fractures or caries lesions, ensuring restoration margins do not encroach on the biologic width, constitute a challenge. Available treatment options include surgical crown lengthening and orthodontic or surgical extrusion. This report presents two patients in which teeth were restored by surgical extrusion with an atraumatic extraction system and prosthetic therapy.


Assuntos
Fraturas dos Dentes , Aumento da Coroa Clínica , Coroas , Humanos , Extrusão Ortodôntica , Coroa do Dente , Fraturas dos Dentes/cirurgia , Raiz Dentária
6.
Photodiagnosis Photodyn Ther ; 38: 102845, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35381369

RESUMO

BACKGROUND: This study was designed to determine whether autofluorescence emitted from longitudinal tooth fractures (LTFs) differs between fracture types, with the aim of determining which clinical factors are related to red fluorescence at the fracture line. METHODS: Thirty-three extracted teeth were classified into cracked teeth, split teeth, and root fractures using LTF types according to the American Association of Endodontists classification. The types of LTFs were identified using an operating microscope. LTF autofluorescence was captured using a fluorescence technique. Clinical examinations were performed using the preoperative factors from clinical and radiographic findings. RESULTS: Red fluorescence was identified in 82% and 83% of cracked and split teeth, respectively. None of the vertical root fractures exhibited red fluorescence (p<0.001). When red fluorescence was identified on the outer tooth surface, it penetrated into the crack line, but fluorescence that was not red at the tooth surface did not penetrate the fracture line. Among the examined preoperative clinical factors, differences between the presence and absence of red fluorescence were identified for sinus tract formation (p = 0.021), and radiographic features (p = 0.027). Regression analysis revealed a significant factor related to the red fluorescence, with sinus tract formation having a negative effect on red fluorescence (odds ratio [OR]=0.09). The presence of comprehensive periradicular lesions in radiography had a positive effect on red fluorescence (OR=5.04). CONCLUSIONS: Cracks originating from tooth crowns in certain types of LTFs were associated with red fluorescence, and cracks with red fluorescence were associated with extensive periodontal bone resorption around the teeth roots.


Assuntos
Perda do Osso Alveolar , Síndrome de Dente Quebrado , Fotoquimioterapia , Fraturas dos Dentes , Fluorescência , Humanos , Fotoquimioterapia/métodos , Extração Dentária , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária
7.
Dent Traumatol ; 38(3): 170-174, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35481941

RESUMO

An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment. However, more than 50 classifications have been used in the past. The ideal solution would be that TDIs are adequately classified within the International Classification of Diseases (ICD), endorsed by the World Health Organization (WHO). TDI classification provided by the 11th Revision of the ICD (ICD-11), released in 2018, and previous Revisions, failed to classify TDIs satisfactorily. Therefore, in December 2018, a proposal was submitted by Dr's Stefano Petti, Jens Ove Andreasen, Ulf Glendor, and Lars Andersson, to the ICD-11, asking for a change of the existing TDI classification. Proposal #2130 highlighted the TDI paradox, the fifth most frequent disease/condition neglected by most public health agencies in the world, and the limits of ICD-11 classification. Namely, injuries of teeth and periodontal tissues were located in two separate blocks that did not mention dental/periodontal tissues; infraction, concussion, and subluxation were not coded; most TDIs lacked description; and tooth fractures were described through bone fracture descriptions (e.g., comminuted, compression, and fissured fractures). These limitations led to TDI mis-reporting, under-reporting, and non-specific reporting by untrained non-dental healthcare providers. In addition, no scientific articles on TDIs, present in PubMed, Scopus, and Web-of-Science, used the ICD classification. Proposal #2130 suggested to adopt the Andreasen classification, the most widely acknowledged classification used in dental traumatology. The Proposal was reviewed by two WHO teams, two scientific Committees, one WHO Collaborating Center, and the Department of Non-Communicable Disease Prevention at WHO headquarters, and it underwent two voting sessions. In March 2022, the Andreasen classification was accepted integrally. A new entity was generated, called NA0D, "Injury of teeth or supporting structures" (https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1413338122). Hopefully, this will contribute to increasing the public awareness, and the dental profession's management, of TDIs.


Assuntos
Fraturas dos Dentes , Traumatismos Dentários , Humanos , Prevalência , Organização Mundial da Saúde
9.
Br Dent J ; 232(7): 459, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35396429
10.
Braz Dent J ; 33(1): 22-30, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35262551

RESUMO

The aim of this study was to compare the influence of endodontic sealers artifacts on the detection of vertical root fracture in cone beam computed tomography (CBCT). Premolars and central incisors were assigned into five different groups: Control, Pulp Canal Sealer, AH Plus, Sealer 26, and BC Sealer (n= 10, per group). VRFs were mechanically induced and the teeth were inserted into an image phantom. Subsequently, CBCT (Cranex 3Dx, Soredex, Tuusula, Finland) images were obtained and two observers were asked separately to identify root fracture, by visual analysis. For both premolar and central incisors, kappa coefficients of intraobserver agreement varied from good to excellent (K: 80% - 87%), and the values for interobserver agreement varied from fair to moderate (K: 30% - 35%). As follows, the area under the curve (AUC) of receiver operating characteristic (ROC) values for VRFs highlighted that the use of BC sealer reduced the observers' ability to discriminate VRFs relative to other sealers. Moreover, sensitivity values for premolars teeth ranged from 20% to 60%, and specificity ranged from 60% to 100%; while sensitivity values for central incisors ranged from 30% to 70%, and specificity ranged from 70% to 100%. In conclusion, the low sensitivity values, mainly for premolars, demonstrated the difficulty in VRF diagnosis. Furthermore, BC Sealer induced significantly more imaging artifacts than other sealers. These results highlighting that endodontic sealers may interfere with the diagnosis of VRFs.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Artefatos , Dente Pré-Molar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
11.
BMC Oral Health ; 22(1): 48, 2022 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-35236348

RESUMO

BACKGROUND: Cracked teeth may cause various clinical symptoms depending on the extension depth of the crack and the subsequent bacterial infections. However, techniques to reliably determine the extension depths of cracks in teeth before treatment are lacking. The aim of this study was to develop a new technique based on contrast-enhanced cone beam computed tomography (CBCT) to improve the accuracy of crack depth evaluation in vitro. METHODS: We developed an in vitro artificial simulation model of cracked teeth. Pre-experimental CBCT (pre-CBCT), and micro-computed tomography (micro-CT) were first performed for all cracked teeth (n = 31). Contrast-enhanced CBCT was then performed by infiltrating the crack with ioversol under vacuum conditions. The sensitivities of pre-CBCT and contrast-enhanced CBCT for the diagnosis of cracked teeth were calculated. According to the K-means clusters, crack depths measured by micro-CT were changed into categorical variables. Bland-Altman plot and the intraclass correlation coefficient (ICC) were used to analyze the consistency of the crack depths between the pre-CBCT and contrast-enhanced CBCT, as well as the ICC between the contrast-enhanced CBCT and micro-CT. Receiver operating characteristic (ROC) curves were generated to assess the ability for predicting crack depth in the differential diagnosis using pre-CBCT and contrast-enhanced CBCT. Restricted cubic splines were also used to model the non-linear relationship between the crack depths of contrast-enhanced CBCT and micro-CT. RESULTS: The sensitivities of pre-CBCT and contrast-enhanced CBCT were 48.4%, and 67.7%, respectively. The ICC value of crack depth as measured by pre-CBCT and contrast-enhanced CBCT was 0.847 (95% confidence interval [CI] 0.380-0.960; P < 0.001). The areas under ROC curves (AUC) of pre-CBCT and contrast-enhanced CBCT were different: the AUC of pre-CBCT was 0.958 (P = 0.000, 95% CI 0.843-1.074), and the AUC of contrast-enhanced CBCT was 0.979 (P = 0.000, 95% CI 0.921-1.037), and the difference was not statistically significant (Z = - 0.707, P = 0.480). The ICC value of crack depth as measured by contrast-enhanced CBCT and micro-CT was 0.753 (95% CI 0.248-0.911; P < 0.001). CONCLUSION: Contrast-enhanced CBCT under vacuum conditions with a contrast medium can significantly improve the crack detection rate of cracked teeth; however, it cannot measure the crack depths accurately.


Assuntos
Síndrome de Dente Quebrado , Fraturas dos Dentes , Dente , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Microtomografia por Raio-X
12.
Eur Endod J ; 7(1): 27-32, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35353058

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effect of coronal restorations on the survival rates against fracture of endodontically treated premolars with exposed cervical lesions and to identify the prognostic factors for fracture. METHODS: Data of the endodontically treated premolars with exposed cervical lesions restored with resin composites or crowns between 2011 and 2020 were collected. The presence of a fracture was recorded, and the possible prognostic factors were recorded. Statistical analyses were performed, with a significance level of P<0.05, using a Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazard models were used to identify the prognostic factors. RESULTS: The survival rates against fracture were not significantly different between the teeth restored with crowns (93.3%) or resin composites (86%) (P≥0.05). A high frequency of non-restorable fractures was observed in both groups. Crestal bone reduction to the middle-third of the root was identified as the significant prognostic factor (P<0.05). CONCLUSION: For endodontically treated premolars with exposed cervical lesions, resin composite restorations provided a high comparable survival rate that was comparable to that of crowns. A higher risk of fracture was found in endodontically treated premolars with crestal bone loss to the middle-third of the root.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente Pré-Molar , Coroas , Falha de Restauração Dentária , Humanos , Estudos Retrospectivos , Taxa de Sobrevida
13.
Int Endod J ; 55 Suppl 3: 804-826, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35338655

RESUMO

Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co-axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre-existing fractures and biochemical effects of loss of vitality is highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits are imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post-endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed 'passively' and excessive 'post-space' preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi-rooted teeth. Innovative techniques to 'repair' VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post-endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.


Assuntos
Fraturas dos Dentes , Dente não Vital , Tomografia Computadorizada de Feixe Cônico , Humanos , Obturação do Canal Radicular/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Fraturas dos Dentes/diagnóstico por imagem , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapia , Raiz Dentária/diagnóstico por imagem
14.
Dent Mater ; 38(4): e83-e93, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35227528

RESUMO

OBJECTIVES: The aim was to investigate the fatigue performance of endodontically treated (ET) molars restored by various dentin-replacing materials and material configurations. Moreover, the impact of additional adhesive treatment with glass-ionomer cement (GIC) was evaluated. METHODS: 250 intact molars were collected and randomly distributed into ten groups (n = 25). After endodontic procedure standard Class I cavities were prepared and restored with different direct restorative techniques and dentin-replacing materials. Two-group were restored with either packable or flowable short fiber-reinforced composites (SFRCs). Two-group were restored by experimental fiber-reinforced GIC with and without adhesive treatment. Four-group were restored by conventional and resin-modified GICs with or without adhesive treatment. One-group was restored with a dual-cure composite resin and last group was restored with only conventional composite resin (control). Fatigue-survival was measured for all specimens using a cyclic-loading machine until fracture occurred or a number of 40.000 cycles were achieved. Kaplan-Meyer survival analysis was conducted, followed by pairwise log-rank post hoc comparisons. Fracture mode was then examined by means of optical microscopy and SEM. RESULTS: Group restored with flowable SFRC showed significantly higher survival (p < 0.05) compared to all of the groups, except for group restored with packable SFRC (p > 0.05). Group restored with fiber-reinforced GIC had significantly (p < 0.05) higher survival rates compared to other commercial GICs. SEM demonstrated change of the fracture line when fracture reached the SFRC layer. SIGNIFICANCE: Direct restoration of Class I in ET molars with the use of SFRCs as dentin-replacing materials demonstrated its ability to reinforce the dental structures and to increase the fatigue resistance in this specific clinical situation.


Assuntos
Fraturas dos Dentes , Dente não Vital , Resinas Compostas/química , Análise do Estresse Dentário , Dentina , Humanos , Teste de Materiais , Dente Molar
15.
J Mech Behav Biomed Mater ; 129: 105143, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35272149

RESUMO

OBJECTIVES: The aim of this study was to evaluate the effect of the amount of periodontal support and the presence or absence of root amputation on the fracture resistance of intracoronally splinted maxillary molar teeth. MATERIALS AND METHODS: 48 extracted human upper first molars and 48 s premolars were included in the study. All teeth underwent standard mesio-occluso-distal (MOD) (molars) and standard occluso-distal (OD) (premolars) cavity preparation. After the preparation, all molars were root canal treated, and 48 molar-premolar units were created by intracoronal splinting. The units were randomly divided into 4 groups (Groups A-D, 12 units per group): in Groups C and D, the disto-buccal (DB) roots of the molars were amputated, while in Groups A and B, no root amputation was performed. All units were embedded in methacrylate resin at different levels: in Groups A and C, at 4 mm apically from the cemento-enamel junction (CEJ), while in Groups B and D, at 6 mm apically from the CEJ, mimicking the different stages of furcation involvement. All units were submitted first to dynamic and then to static, load-to-fracture mechanical testing. Fracture resistance values were recorded fracture mode was analysed. RESULTS: During the load-to-facture test, Groups A and B (without root amputation) were characterized by significantly higher fracture resistance values compared to Groups C and D (with root amputation) (p < 0.05). Regarding fracture mode, irreparable fracture was more frequent in Group D (with root amputation and advanced furcation involvement) than in any other group (n = 8). CONCLUSIONS: Root amputation has a negative effect on the fracture resistance of intracoronally splinted upper first molar-second premolar units with modeled furcation involvement.


Assuntos
Dente Molar , Fraturas dos Dentes , Amputação , Dente Pré-Molar , Humanos , Dente Molar/cirurgia , Tratamento do Canal Radicular , Raiz Dentária/cirurgia
16.
J Mech Behav Biomed Mater ; 129: 105147, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35290852

RESUMO

Understanding aging of tooth tissues is the first step to developing robust treatments that support lifelong oral health. In this study selected nanomechanical, compositional and structural parameters of human enamel were characterized to assess the effects of aging on its durability in terms of the apparent fracture toughness (KApp) and brittleness (B). The interdependencies between aging and the enamel properties were assessed using a combination of traditional Pearson's correlation coefficient matrices and self-organizing maps (SOMs) via unsupervised machine learning. To consider age effects, the enamel of three age groups of donor teeth was studied, including primary (donor age ≤10), young (20 age ≤ age ≤50), and old (55 ≤ age) and differences in properties and correlations were identified. Results showed that KApp was negatively correlated to the E, H, degree of crystallinity, and fluoridation, but positively correlated with carbonate content; the opposite trends were observed in B. Interestingly, the SOMs showed that the outer enamel of the old group underwent a degradation in durability (decrease in KApp and increase in B) that was related to multiple contributions, whereas the inner enamel did not undergo this change. Application of K-means clustering on the trained SOMs offered novel insights into the contributions of enamel durability with aging, unique visualization of high-dimensional data onto 2D plots and identified new research directions that would not have otherwise been discovered. Overall, the findings demonstrate the opportunities for understanding aging of enamel using machine learning techniques to pursue age-targeted oral health care.


Assuntos
Fraturas dos Dentes , Dente , Envelhecimento , Ciência de Dados , Esmalte Dentário , Humanos
17.
Swiss Dent J ; 132(5): 334-341, 2022 05 16.
Artigo em Inglês | MEDLINE | ID: mdl-35297592

RESUMO

Automotive mechanics are exposed to an increased risk for occupational injuries (OI) to the hands, arms, head and teeth. The aim of this study was to assess the self-reported prevalence of OIs to the head, including traumatic dental injuries (TDIs), among automotive repair and maintenance workers dealing with motorcycles, cars and vehicles over 3.5 tons. We surveyed healthy mechanics in Swiss automotive repair workshops from 2019 to 2021. Overall, 121 automotive repair and maintenance workers responded to our 12-item questionnaire concerning their professional experience, protective measures and occupational injuries to the head and teeth (response rate: 12%). 119 were considered eligible for inclusion and two were excluded. Most persons surveyed (94%) were males with more than 10 years of professional experience. Eighty-five (72%) reported occupational injuries in general, 37 (43.5%) specified OIs to the head or tooth area, and 16 stipulated that these cases teeth were affected. The most common self-reported diagnosis was tooth fracture (p=0.191). Traumatic dental injury in childhood increased the odds ratio (OR) for occupational injury to the head or teeth by a factor of 2.4 (95% CI: 1.1, 5.5, p=0.036). Age, gender and dental trauma in childhood may also influence the prevalence of occupational injuries in general in this cohort. We conclude that occupational dental accidents in automotive repair workshops can be reduced by raising awareness of this issue and by taking effective preventive measures.


Assuntos
Traumatismos Ocupacionais , Fraturas dos Dentes , Traumatismos Dentários , Feminino , Humanos , Masculino , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/etiologia , Prevalência , Inquéritos e Questionários , Suíça , Traumatismos Dentários/epidemiologia , Traumatismos Dentários/etiologia
18.
BMC Oral Health ; 22(1): 99, 2022 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-35354462

RESUMO

BACKGROUND: Whether to preserve a structurally compromised tooth or remove it is a dilemma often encountered by clinicians. The aim of this study was to assess the long-term success rate of fractured teeth preserved by modified crown lengthening surgery and restorations. METHODS: Thirty-nine patients with a total of 45 fractured teeth who had received modified crown lengthening surgery were recruited and examined. Numbers of teeth lost were recorded, and the criteria for successful teeth were defined. Kaplan-Meier estimator was used to determine the success rate. Possible risk factors were compared between successful and unsuccessful groups by a Cox regression analysis to explore the potential predictors of failure with a significant level at α = 0.05. RESULTS: The mean ± SD of success time without considering variants was 6.2 ± 0.6 years (95% CI 5.1-7.7). The mean survival rates ± SD at 1.0-, 2.0-, 3.0-, 5.0-, 7.0-, and 9.0-year intervals was 97.8 ± 2.2%, 92.2 ± 4.4%, 72.8 ± 7.9%, 68.2 ± 8.6%, 60.7 ± 10.5%, and 40.4 ± 13.6%, respectively. Failure cases in teeth with poor plaque control and step-shaped fracture margin were significantly more than those with good plaque control and knife-shaped fracture margin (HR = 7.237, p = 0.011; HR = 15.399, p = 0.006; respectively). CONCLUSIONS: Fractured teeth treated with modified crown lengthening surgery are anticipated to have a high clinical success rate for 6.2 ± 0.6 years. Plaque control and fracture morphology appeared to be significantly associated with the success of the multidisciplinary treatment approach.


Assuntos
Aumento da Coroa Clínica , Fraturas dos Dentes , Aumento da Coroa Clínica/efeitos adversos , Coroas , Humanos , Coroa do Dente/cirurgia , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/cirurgia
19.
J Mech Behav Biomed Mater ; 130: 105175, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35320764

RESUMO

OBJECTIVES: To explore the feasibility of using sodium iodide (NaI)+dimethyl sulfoxide (DMSO)+ethyl alcohol+ethyl acetate as a cone-beam CT (CBCT) contrast agent in the diagnosis of vertical root fracture (VRF). METHODS: 21 endodontically treated VRF teeth of 21 patients were collected in this study. All these 21 teeth were confirmed subtle fracture lines under transillumination, the number and position of fracture lines were recorded. All these patients had CBCT routine scanning (RS1) before extraction. After extraction, the teeth was performed micro-CT scanning and 3 in vitro CBCT scanning: CBCT routine scanning in vitro(RS2), CBCT enhanced scanning using meglumine diatrizoate (MD) as contrast agent(ES1); and CBCT enhanced scanning using NaI+DMSO+ethyl alcohol+ethyl acetate as contrast agent(ES2). The number of fracture lines was evaluated on all the 5 scanning modes and the accuracy of diagnosis was calculated. RESULTS: In all, there were 43 fracture lines on the 21 teeth. The accuracy of detection of fracture lines of CBCT RS1, RS2, ES1, ES2 and micro-CT was 0%, 20.9% (9/43), 11.6% (5/43), 93% (40/43) and 95.3% (41/43) respectively. Significant differences were found between ES2 vs. RS2, ES2 vs. ES1 (p < 0.01); however, no significant difference was found between ES2 vs. micro-CT (p > 0.05). CONCLUSION: CBCT enhanced scanning using NaI+DMSO+ethyl alcohol+ethyl acetate as contrast agent could be a prospective technique in the diagnosis of VRF.


Assuntos
Fraturas Ósseas , Fraturas dos Dentes , Tomografia Computadorizada de Feixe Cônico/métodos , Meios de Contraste , Dimetil Sulfóxido , Etanol , Humanos , Estudos Prospectivos , Fraturas dos Dentes/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem
20.
Quintessence Int ; 53(6): 522-531, 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35119237

RESUMO

Maintaining and restoring teeth exhibiting subgingival or even subcrestal defect extensions represent a common problem in daily practice. Such teeth are often deemed "unrestorable" due to a significant hard tissue loss and defect locations violating the biologic width. In order to achieve a sufficient 2-mm-ferrule design and reestablish the biologic width, both surgical crown lengthening and orthodontic extrusion have been suggested. However, surgical crown lengthening has a negative effect on the attachment level of adjacent teeth as well as esthetic disadvantages particularly in the esthetic zone. Therefore, orthodontic extrusion might be considered as a valid therapeutic alternative since gingival architecture is maintained. While most orthodontic appliances are too complex for daily application, forced orthodontic extrusion by means of the Tissue Master Concept might be a cost- and time-effective approach due to advances in adhesive and computer-assisted dentistry. This clinical case series illustrates the methodology of the rather straightforward Tissue Master Concept in specific clinical situations that may occur in clinical routine.


Assuntos
Produtos Biológicos , Fraturas dos Dentes , Coroas , Humanos , Extrusão Ortodôntica , Coroa do Dente
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