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1.
J Endod ; 47(5): 806-811, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33556424

RESUMO

INTRODUCTION: Dehydration has been considered as a potential contributor to vertical root fractures (VRFs) after root canal treatment (RCT). A loss of water could cause embrittlement of dentin and detrimental shrinkage strains. Senior patients have the highest risk of VRF. In this study, we characterized the spatial distribution in shrinkage of tooth roots with respect to donor age and prior RCT. METHODS: Single-rooted human teeth with and without prior RCT were collected from young (age <25 years) and old (age >60 years) adults. Transverse slices were sectioned from the apical, middle, and coronal thirds of the roots, and digital image correlation was used to evaluate shrinkage during free convection. Crack initiation and growth analysis was performed via optical microscopy, and bound water in dentin was characterized by Raman spectroscopy. RESULTS: The rate of shrinkage was significantly higher (p ≤ .05) in the apical third than in the middle and coronal thirds of all teeth regardless of donor age. The highest shrinkage strain occurred in the apical third of old donor teeth with prior RCT. In addition, the RCT-treated old teeth suffered the highest percentage of water loss with dehydration. Cracks initiated from the root surface and extended toward the canal with loss of water and shrinkage. CONCLUSIONS: The apical third undergoes significantly larger shrinkage strains with dehydration than the remainder of the root. Prior RCT exacerbates the extent of shrinkage, particularly in the teeth of seniors and after clinical function, which could increase the propensity for VRF.


Assuntos
Fraturas dos Dentes , Dente não Vital , Adulto , Dentina , Humanos , Pessoa de Meia-Idade , Fraturas dos Dentes/etiologia , Raiz Dentária , Água
2.
BMC Oral Health ; 21(1): 74, 2021 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-33593339

RESUMO

BACKGROUND: Tooth fractures can occur after temporary inter-appointment endodontic filling, resulting in not preserving and thus extraction of the affected tooth. The purpose of this investigation was therefore to evaluate the tooth substance fracture potential given by the expansion of endodontic temporary filling materials. METHODS: Tooth and access cavities were prepared in 80 mandibular molars. Four groups of 20 teeth each (Cavit, Cavit W and Coltosol F and control) were included. To simulate a clinical situation, the teeth were endodontically pre-treated and a calcium hydroxide dressing was placed. The cavities were filled with the corresponding temporary filling material, with exception of the control group, and kept submerged in distilled water for 15 days. The teeth were examined every 24 h by two calibrated observers under a stereomicroscope (7.5×), fractures of the temporary filling material and tooth structure were photo-documented, and the results statistically analyzed. Kaplan-Meier survival analysis were calculated to illustrate (survival = no fracture) probabilities to evaluate the time when the temporary filling material, tooth structure or both together occurred. Log-rank test was performed in order to assess significant differences between the materials and the subgroups used. RESULTS: Fractures were observed only in the Coltosol F group (p < 0.01), at the end of the observation period, a total of 13 teeth (65%) showed temporary filling material and eight teeth (40%) showed tooth structure fractures. No fractures in the pulp chamber area were observed at the end of the observation period in any group. CONCLUSIONS: Within the limitations of the current in vitro study, the results obtained suggest that tooth structure fractures caused by a temporary filling material can occur during endodontic treatment, thus compromising the success of the treatment.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Sulfato de Cálcio , Cimentos Dentários , Restauração Dentária Temporária , Humanos , Polivinil , Materiais Restauradores do Canal Radicular/efeitos adversos , Fraturas dos Dentes/etiologia , Óxido de Zinco , Sulfato de Zinco
3.
BMJ Case Rep ; 14(1)2021 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-33509889

RESUMO

Electronic cigarettes (also known as e-cigarettes or electronic nicotine delivery systems) were invented in China in 2003 then introduced to the British market in 2007. They remain popular among the public and are deemed to be effective in reducing tobacco smoking (the UK being one of the first countries to embrace them in a harm reduction policy). However, reports in the media of e-cigarettes exploding are of concern, considering the potential functional and psychological impairment that lifelong disfigurement will cause, especially given their uptake among people of any age. We present a case of this rare, but dramatic, effect of e-cigarette use as a warning to the public.


Assuntos
Queimaduras/etiologia , Sistemas Eletrônicos de Liberação de Nicotina , Explosões , Fraturas Cominutivas/etiologia , Fraturas Maxilares/etiologia , Fraturas dos Dentes/etiologia , Fraturas Cominutivas/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , Fraturas Maxilares/diagnóstico por imagem , Traumatismos Maxilofaciais/diagnóstico por imagem , Traumatismos Maxilofaciais/etiologia , Mucosa Bucal/lesões , Tomografia Computadorizada por Raios X , Fraturas dos Dentes/diagnóstico por imagem , Traumatismos Dentários/diagnóstico por imagem , Traumatismos Dentários/etiologia , Raiz Dentária/lesões , Adulto Jovem
4.
J Am Dent Assoc ; 152(2): 146-156, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33358237

RESUMO

BACKGROUND: The authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes. METHODS: Two-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified. RESULTS: Of the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression. CONCLUSIONS: Development of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both. PRACTICAL IMPLICATIONS: This information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.


Assuntos
Síndrome de Dente Quebrado , Fraturas dos Dentes , Dente , Esmalte Dentário , Humanos , Masculino , Fraturas dos Dentes/epidemiologia , Fraturas dos Dentes/etiologia
5.
Cient. dent. (Ed. impr.) ; 17(2): 115-120, mayo-ago. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195099

RESUMO

INTRODUCCIÓN: el tratamiento de conductos produce cambios físico-químicos en la dentina y una pérdida estructural significativa para el diente, lo que lo hace más susceptible a la fractura. MATERIAL Y MÉTODOS: 64 premolares mandibulares fueron decoronados y divididos aleatoriamente en cuatro grupos (n = 16): grupo control (CG) no tratado, grupo instrumentado ProTaperGold® (PTG®) (25.08), grupo instrumentado ProTaperNext® (PTN®) (25.06) y grupo instrumentado WaveOne Gold PRIMARY® (WOG®) (25.07). Durante la instrumentación, se realizó la irrigación con NaOCl al 5,25% con una jeringa Monoject® y tras la instrumentación, las muestras se irrigaron con NaOCl, EDTA 17% y NaOCl activado sónicamente. Los conductos radiculares se obturaron utilizando el sistema B&L®, y posteriormente se colocaron en bloques de resina acrílica estandarizados para ser cargados con una fuerza vertical constan-te de 0,02 mm/s hasta que se produjo la fractura de la raíz, mediante una máquina de ensayo universal (ME-405/20, Servo-sis®). Las comparaciones entre grupos se analizaron con la prueba ANOVA.RESULTADOS: No hubo diferencias esta-dísticamente significativas (p > 0,05) entre el GC y los grupos instrumentados con PTN® y WOG®; tampoco entre los grupos PTN® y WOG®. Sin embargo, se obtuvieron diferencias estadísticamente significativas entre el grupo instrumentado con PTG® y el resto de los grupos, siendo el grupo PTG® el más susceptible a la frac-tura. CONCLUSIONES: El sistema PTG® fue el que más debilitó las raíces después de la instrumentación, en comparación con los sistemas WOG® y PTN®


INTRODUCTION: root canal treatment produces physicist-chemist changes in the dentine and a significant structural loss for the tooth what makes it more susceptible to fracture. MATERIAL AND METHODS: 64 mandibular premolar were decoronated and randomly divided into four groups (n = 16): control group (CG) non-treated, ProTaper Gold(TM) (PTG(TM)) instrumented group (25.08), ProTaper Next(TM) (PTN(TM)) instrumented group (25.06) and WaveOne Gold(TM) PRIMARY (WOG(TM)) instrumented group (25.07). While shaping, cleaning was done with NaOCl 5,25% using a Monoject(TM) syringe and after shaping, roots were irrigated with NaOCl, EDTA 17% and NaOCl sonically activated. Root canals were obturated using B&L(TM) system, embedded into standardized acrylic resin blocks and load with a constant vertical force of 0,02 mm/s until root fracture was produced using a universal testing machine (ME-405/20, Servosis(TM)). Comparisons among groups were analyzed with ANOVA test. RESULTS: There were no statistically significant differences (p > 0.05) between the CG and the groups instrumented with PTN(TM) and WOG(TM); neither among PTN(TM) and WOG(TM) groups. However, statistically significant differences were obtained between the group instrumented with PTG(TM) and the rest of the groups being PTG(TM) group the most susceptible to fracture. CONCLUSIONS: PTG(TM) system was the one that weakened more the roots after the instrumentation in comparison with the WOG(TM) and PTN(TM) systems


Assuntos
Humanos , Preparo da Cavidade Dentária/métodos , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/terapia , Dente Pré-Molar/lesões , Preparo de Canal Radicular/instrumentação , Materiais Restauradores do Canal Radicular/uso terapêutico , Restauração Dentária Permanente/métodos , Análise de Variância , Irrigantes do Canal Radicular/uso terapêutico
6.
Sci Rep ; 10(1): 8527, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444845

RESUMO

The objective of this study was to evaluate potential risk factors, including the placement of dental implants, for the development of tooth cracks. A series of 212-patients, who were referred for endodontic treatment, were retrospectively screened, of which 72 (34%) patients had been diagnosed with 80-cracked teeth confirmed with an operating microscope. These patients had an average age of 53-years and were equally distributed between genders. Forty-one percent of the cracked teeth were diagnosed after the placement of dental implants, with an average of 3-implants per patient. Seventy percent of the cracks were diagnosed more than 1-year after implant loading. Implant placement was associated with higher odds of having multiple cracks (OR = 9.78, CI:2.320, 41.216)(p < 0.05). The proportion of cracked premolars was relatively high (30%), and most cracked teeth (79%) were vital and with a normal periapical diagnosis (86%). Most cracked teeth (71%) had an amalgam restoration, and teeth restored with amalgam were at a higher risk of having multiple cracks (p < 0.05). Clinicians should be aware of a common profile of endodontic patients with multiple cracks in a non-endodontically treated premolar, restored with an amalgam restoration, which was diagnosed with the cracks more than 1-year after reconstruction utilizing multiple implants.


Assuntos
Implantes Dentários/efeitos adversos , Tratamento do Canal Radicular/efeitos adversos , Fraturas dos Dentes/etiologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fraturas dos Dentes/patologia
7.
J Craniofac Surg ; 31(4): e378-e380, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32176009

RESUMO

The authors report a case of a 35-year-old man who presented with left maxillary toothache associated with left sided facial pain and a rapidly progressive loss of vision in the left eye. Clinical and radiological assessments revealed it to be an odontogenic orbital apex syndrome secondary to a vertical root fracture of a tooth. The infection was treated and controlled, postoperative follow-up showed no recurrent inflammation and the patient recovered well. However, the vision was lost permanently. Odontogenic orbital apex syndrome is a rare, aggressive disease. Once the infection spreads, it progresses rapidly, becoming a dangerous condition. To achieve better prognosis and improve survival rates, dental practitioners and oral surgeons should be aware of this distinct presentation and should have a high index of suspicion for the complication of tooth-related problems however minor they may seem.


Assuntos
Cegueira/etiologia , Doenças Orbitárias/complicações , Fraturas dos Dentes/etiologia , Raiz Dentária , Adulto , Humanos , Masculino , Extração Dentária
8.
Support Care Cancer ; 28(1): 239-247, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31020438

RESUMO

OBJECTIVES: To evaluate the in vitro effects of radiotherapy (RT) on the morphological surface of the enamel and dentin and to determine the best adhesive system and most appropriate time to restore teeth in head and neck cancer patients. METHODS: Sixty third molars were cut into 120 enamel fragments and 120 dentin fragments and divided into four groups (n = 30): G1 (control): nonirradiated, only restorative procedure; G2: restorative procedure immediately before RT; G3: restorative procedure immediately after RT; and G4: restorative procedure 6 months after RT. Each group was divided into two subgroups: Adper™ Single Bond 2 (SB) and Clearfill SE Bond (CL) based on the material used. After RT and restorative procedures, the specimens were subjected to confocal microscopy and shear bond strength test. Data were analyzed using a two-way ANOVA followed by Tukey's test at a significance level of 5%. RESULTS: Morphological changes were observed in both substrates after a cumulative dose of 40 Gy, and after 60 Gy, the changes were more evident in both substrates. CL had the highest strength values in both substrates (p < 0.05), and G2 had the lowest strength values for the enamel and dentin (p < 0.05). CONCLUSIONS: Based on the in vitro study results, we can conclude that RT substantially changes the morphological surface of enamel and dentin and impairs the bond strength. The Clearfill system yielded better results than Adper Single Bond 2, and restoring teeth before RT resulted in the worst results in both substrates.


Assuntos
Adesivos/efeitos da radiação , Esmalte Dentário/efeitos da radiação , Adesivos Dentinários/efeitos da radiação , Dentina/efeitos da radiação , Neoplasias de Cabeça e Pescoço/radioterapia , Bis-Fenol A-Glicidil Metacrilato/efeitos da radiação , Resinas Compostas/efeitos da radiação , Colagem Dentária , Dentição Permanente , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Teste de Materiais , Dente Molar/efeitos da radiação , Doses de Radiação , Distribuição Aleatória , Cimentos de Resina/efeitos da radiação , Resistência ao Cisalhamento/efeitos da radiação , Fraturas dos Dentes/etiologia , Fraturas dos Dentes/patologia
9.
Stomatologija ; 22(3): 67-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33821811

RESUMO

INTRODUCTION: A significant loss of dental structures during endodontic treatment increases the probability of tooth cracks, fractures or even tooth loss. The objective of this systematic review was to assess the influence of temporary filling material on dental cracks and fractures during endodontic treatment. MATERIALS AND METHODS: The literature was digitally searched for in vivo and in vitro studies using Pubmed, ScienceDirect and Wiley Online Library databases. A total of 38 potentially relevant records were identified in the literature search after duplicates were removed. After screening, full-text analysis of selected studies was done. Two reviewers independently selected the studies, extracted the data which was structured and summarized. RESULTS: Five publications met the selection criteria. Ten temporary filling materials were evaluated in this review. The analysis demonstrated that non-eugenol chemically hardening temporary filling materials significantly increase filling and dental fractures and have the lowest fracture and tooth fracture resistance. Glass ionomer cements (GIC) presented the higher hermetic, tightness and fracture resistance features. CONCLUSIONS: A temporary filling material during endodontic treatment may influence dental cracks and fractures. Highest impact for dental cracks and fractures has ready-to-use, eugenol-free temporary filling materials, whereas the least impact has GIC.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Cimentos de Ionômeros de Vidro , Humanos , Materiais Restauradores do Canal Radicular/efeitos adversos , Fraturas dos Dentes/etiologia
10.
BMC Oral Health ; 19(1): 241, 2019 11 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711474

RESUMO

BACKGROUND: To investigate the complications associated with the use of nickel titanium rotary instruments (NiTi-RIs) for root canal treatments (RCTs), in Saudi Arabia dental practice, and to explore the influencing factors. METHODS: After obtaining an ethical approval, two pilot studies were conducted to formulate the final questionnaire. The sample size was measured taking into consideration 60% expected response rates and confidence level of 99.9%. The questionnaire was emailed to 600 general dentists (GDs) randomly selected from the dental register and all of the endodontists (175). The email's introduction clarified objectives of the study and guaranteed that all of the collected information would remain confidential. A reminder was sent after 10 weeks. The data were collected and analyzed using the chi-squared test at a 0.05 significance level. RESULTS: With a 51% overall response rate, 71.9% off the respondents used NiTi-RIs. The majority (83.1%) experienced complications while using NiTi-RIs; with the instruments' fracture being significantly the most common complication (52.7%) (p < 0.001). The majority (87.7%) experienced NiTi-RIs' fracture at least once; with more endodontists (94.3%) than GDs (83.3%) (p < 0.001). The greater the number of weekly performed RCTs and participants' experiences, the more NiTi-RIs fractures and the greater the number of fracture incidents (p < 0.001). While 60% of those who performed 1-3 RCTs per week experienced NiTi-RIs fractures, 100% of those who performed more than 12 RCTs per week did so. The highest percentage of those who experienced more than 10 fractured NiTi-RIs (60%) was within the group who performed more than 12 RCTs per week. Although fracture incidents decreased with a smaller number of reuses, there was no significant correlation between the number of fractured instruments and NiTi-RIs discard strategy (p ≥ 0.05). CONCLUSION: Fracture incidence was the most common complication while using NiTi-RIs, regardless of the clinicians' experiences and skills. While the single use may reduce NiTi-RIs fractures, to some extent, the greater number of RCTs performed per week was the most influential factor.


Assuntos
Instrumentos Odontológicos/efeitos adversos , Níquel , Preparo de Canal Radicular/efeitos adversos , Titânio , Ligas , Cavidade Pulpar , Desenho de Equipamento , Humanos , Arábia Saudita , Fraturas dos Dentes/etiologia
11.
Niger J Clin Pract ; 22(6): 782-789, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187762

RESUMO

Objective: The aim of this in vitro study was to investigate the fracture strength and cuspal deflection of endodontically treated premolars restored using different composite resins along with or without fiber post application. Materials and Method: Eighty intact premolars were randomly divided into eight groups (n = 10); CO group: intact teeth (control), OPR group: mesio-occlusal-distal-palatal (MODP) preparation (OPR) + endodontic treatment (ET), TC group: MODP preparation + ET + Tetric N-Ceram, TB group: MODP preparation + ET + Tetric EvoCeram Bulk Fill, SO group: MODP preparation + ET + SonicFill 2, TC-P group: MODP preparation + ET + Hahnenkratt glass fiber post + Tetric N-Ceram, TB-P group: MODP preparation + ET + Hahnenkratt glass fiber + Tetric EvoCeram Bulk Fill, and SO-P Group: MODP preparation + ET + Hahnenkratt glass fiber post + SonicFill 2. After thermocycling, specimens were subjected to a compressive load until fracture. Data were analyzed using analysis of variance and Tukey tests (P < 0.05). Results: The mean fracture strength of groups which received post treatment showed similar fracture strength values [TC-P (931.6 ± 97.9), TB-P (882.0 ± 59.7), SO-P (862.0 ± 143.0) (P > 0.05)] and was significantly higher than OPR (530.6 ± 41.7), TC (841.2 ± 93.1), TB (774.5 ± 101.8), and SO (735.0 ± 178.01) groups (P < 0.05). No significant difference was detected among groups considering cuspal deflection (P > 0.05). The fiber post insertion resulted in more unfavorable fractures. Conclusion: Endodontically treated teeth restored with fiber post and bulk-fill or conventional composite resins demonstrated fracture strength values similar to intact teeth.


Assuntos
Resinas Compostas/uso terapêutico , Restauração Dentária Permanente/instrumentação , Vidro , Dente não Vital/terapia , Dente Pré-Molar/lesões , Força Compressiva , Análise do Estresse Dentário , Resistência à Flexão , Humanos , Teste de Materiais , Distribuição Aleatória , Fraturas dos Dentes/etiologia , Preparo do Dente/métodos
12.
Dent Traumatol ; 35(4-5): 259-267, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31054189

RESUMO

BACKGROUND/AIM: Dental trauma causes significant aesthetic, functional and psychosocial problems that often require emergency attention in children. The aim of this retrospective study was to assess the factors related to dental injuries in children. A secondary aim was to better understand how to improve the education given to children, parents and teachers in schools regarding dental trauma. MATERIALS AND METHODS: Records of children who were referred to the Department of Pedodontics at Suleyman Demirel University were reviewed. A total of 1971 patients with a history of dental trauma who attended the clinic from 1999 to 2017 were evaluated. The following information was recorded: age, gender, year, aetiology, location, season and time elapsed after trauma. Results were evaluated using the Pearson chi-square test. RESULTS: The patients' average age was 8.56 ± 0.08. Dental injuries were frequent in the 7- to 12-year age group (55.9%). Children in the 0- to 6-year age group attended the clinic more frequently during the years 2013 and 2017 compared to previous years. Boys had a higher frequency of trauma than girls (P < 0.05). The most frequent cause of trauma was falls (46%). The accidents occurred predominantly in the street (41.8%). Trauma that took place at home increased in the later years of the study period, whereas the percentage of injuries occurring in schools decreased. The ratio of patients who attended the clinic within the first two days after trauma was 33.4% between 1999 and 2007, and this increased to 59.8% between 2013 and 2017. The majority of the injuries occurred during the summer. CONCLUSIONS: The aetiological factors related to trauma in children, and the number of patients who attended the clinic, have not changed over the 18-year period but the elapsed time to attend the clinic has changed. Education will increase the awareness regarding the importance of emergency intervention immediately following dental trauma.


Assuntos
Avulsão Dentária , Fraturas dos Dentes , Traumatismos Dentários , Acidentes por Quedas , Criança , Feminino , Humanos , Masculino , Estudos Retrospectivos , Avulsão Dentária/etiologia , Fraturas dos Dentes/etiologia , Traumatismos Dentários/etiologia
13.
Acta Anaesthesiol Scand ; 63(8): 993-1000, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31016717

RESUMO

BACKGROUND: Dental injuries may occur during general anaesthesia, especially during airway management. The aim of this study was to describe cases of dental injury related to general anaesthesia, focusing on the type and extent of the injuries as well as the timing of recognition. METHOD: We reviewed the nationwide electronic database available at the Danish Patient Compensation Association and scrutinized all claims classified as possible dental injuries in relation to general anaesthesia between 2007 and 2017. RESULTS: During the 10-year study period, there were 2523 claims for compensation related to anaesthesia. Of these, 552 (21.9%) were cases of possible dental injuries following general anaesthesia. The most commonly injured teeth were the central maxillary incisors with 174 (25.3%) cases related to the left and 118 (17.2%) cases related to the right incisor. The most common injuries were fractures (41.2%) and subluxations (25.9%). Airway management included the use of Macintosh laryngoscope in 296 (64.4%) cases and a supraglottic airway device in 69 (15%) cases. Claims were more frequently approved if more than two intubation attempts were used (100% vs 82.8%, RR = 0.83, 95% CI [0.78-0.88], P = 0.0037). Injuries recognized in-hospital were more frequently approved than injuries recognized after discharge (91.6% vs 70.7%, RR = 0.83, 95% CI [0.70-0.86], P < 0.0001). CONCLUSION: The most commonly reported dental injury related to general anaesthesia in the Danish Patient Compensation Association database was a fracture. Claims were more frequently approved if more than two intubation attempts were used and if the injury was recognized in-hospital.


Assuntos
Manuseio das Vias Aéreas/efeitos adversos , Anestesia Geral/efeitos adversos , Traumatismos Dentários/etiologia , Idoso , Feminino , Humanos , Intubação Intratraqueal/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fraturas dos Dentes/etiologia
14.
Niger J Clin Pract ; 22(3): 328-334, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30837419

RESUMO

Aims: The aim of this study was to compare the effect of different restoration techniques on fracture resistance of endodontically treated teeth with different wall thicknesses. Materials and Methods: Extracted and endodontically treated 210 premolars were randomly divided into three thickness groups [2 mm (A), 1.5 mm (B), and 1 mm (C)] and, each group was further divided into seven restoration subgroups (n = 10): direct composite (control) (K), composite with fiber on cavity floor (KT), composite with fiber on occlusal level (KO), fiber post and composite (FP), inlay (L), fiber on cavity floor and inlay (LT), and inlay and fiber on occlusal level (LO). Fracture test was performed, and data were compared with Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Results: There were no differences between the subgroups in A and C statistically (P > 0.05). However, in B, KO subgroup showed statistically higher values (P = 0.039). Conclusion: Wall support of 2 mm was adequate, and support of 1 mm was completely insufficient. When the wall thickness was 1.5 mm, direct restoration with fiber at the occlusal level significantly improved resistance.


Assuntos
Resinas Compostas/uso terapêutico , Cárie Dentária , Preparo da Cavidade Dentária , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Fraturas dos Dentes/prevenção & controle , Dente não Vital/terapia , Dente Pré-Molar , Resinas Compostas/química , Materiais Dentários/uso terapêutico , Análise do Estresse Dentário , Humanos , Fraturas dos Dentes/etiologia , Dente não Vital/complicações
15.
J Endod ; 45(4): 447-452, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30827767

RESUMO

INTRODUCTION: The aim of this study was to assess the frequency of root crack formation caused by the use of manual instrumentation, 2 rotary systems, and 1 reciprocating system using light-emitting diode transillumination. METHODS: One hundred fifty mandibular premolars were randomly divided into 5 groups (n = 30): control 1, no intervention; control 2, instrumented with hand files; group 3, instrumented with ProTaper Universal rotary files (Dentsply Maillefer, Ballaigues, Switzerland); group 4, instrumented with OneShape rotary files (Micro-Mega, Besancon, France); and group 5: instrumented with the WaveOne reciprocal system (Dentsply Maillefer, Ballaigues, Switzerland). After root canal preparations, the roots were sectioned at 3, 6, and 9 mm from the apex with water irrigation. The slices were inspected under a stereomicroscope with light-emitting diode transillumination from the buccal, lingual, mesial, and distal directions at ×40 magnification to determine the presence/absence of cracks (dentinal defects). The chi-square test was used to analyze the data. RESULTS: There was a significant difference among the groups in crack frequency (P < .05). The 2 single systems had significantly higher cracks than the other 3 groups. At 3 mm from the apex, there were significantly more cracks in groups 4 and 5 than in groups 1, 2, and 3 (P < .05). At 6 mm from the apex, no significant difference was noted (P > .05). At 9 mm from the apex, the frequency of cracks in group 3 was significantly higher (P < .05). CONCLUSIONS: According to the results, using rotary instrumentation can result in some dentinal defects, and single-file systems, regardless of motion type, can cause significantly higher crack formation in the apical third of root canals.


Assuntos
Síndrome de Dente Quebrado/etiologia , Instrumentos Odontológicos/efeitos adversos , Dentina/lesões , Preparo de Canal Radicular/efeitos adversos , Preparo de Canal Radicular/instrumentação , Fraturas dos Dentes/etiologia , Raiz Dentária/lesões , Dente Pré-Molar , Humanos , Mandíbula
16.
J Endod ; 45(2): 189-193, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30711176

RESUMO

INTRODUCTION: Although the strength and toughness of dentin decrease with age, no study has explored if restorative treatments are a contributing factor. METHODS: Multiple extracted teeth were obtained from randomly selected donors and categorized according to donor age and prior root canal treatment. The microstructure and chemical composition of radicular dentin were evaluated using scanning electron microscopy and Raman spectroscopy, respectively, and the strength was evaluated in 4-point flexure to failure. Data were compared using the Student t test. RESULTS: Dentin from the root canal-restored teeth exhibited significantly lower strength (P < .05) than tissue from age- and donor-matched unrestored tooth pairs. Although there was no significant difference in the mineral-to-collagen ratio between the 2 groups, dentin obtained from the root canal-treated teeth exhibited more extensive collagen cross-linking and lower tubule occlusion ratios than the unrestored tooth pairs. CONCLUSIONS: There is a decrease in the strength of radicular dentin with aging, but prior root canal treatment increases the extent of degradation.


Assuntos
Envelhecimento , Análise do Estresse Dentário , Dentina , Resistência à Flexão , Tratamento do Canal Radicular , Resistência ao Cisalhamento , Fraturas dos Dentes/etiologia , Idoso , Colágeno/análise , Dentina/química , Dentina/ultraestrutura , Humanos , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Minerais/análise , Tratamento do Canal Radicular/efeitos adversos , Análise Espectral Raman
17.
Cranio ; 37(1): 45-52, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28876194

RESUMO

OBJECTIVE: To evaluate the effect of resistance training (RT) regarding potential hazard for dental wear, tooth abfractions, temporomandibular joint disc displacement, limitation in mouth opening, and existence of cervical spine disorders. The initial study hypothesis was that extensive resistance trainees (ExRT) would suffer from the above-mentioned symptoms more often than recreational trainees (RcT). METHODS: A controlled comparative study among male gym members via questionnaires and a clinical examination. RESULTS: ExRT had a higher prevalence of teeth indentations on the tongue (26% vs. 2% p < 0.001) and a higher prevalence of tooth abfractions than RcT (28% vs. 4% p < 0.005). ExRT exhibited a higher prevalence of cervical movement limitations (p < 0.05) and inadequate posture (p < 0.001). CONCLUSION: RT by itself may not be a risk factor for disc displacement. Nevertheless, it may act as a potential risk factor for irreversible hard tooth tissue damage and contribute to neck postural and mobility impairments.


Assuntos
Luxações Articulares/etiologia , Treinamento de Resistência/efeitos adversos , Disco da Articulação Temporomandibular , Fraturas dos Dentes/etiologia , Desgaste dos Dentes/etiologia , Adolescente , Adulto , Humanos , Luxações Articulares/epidemiologia , Masculino , Pescoço/fisiopatologia , Postura/fisiologia , Prevalência , Amplitude de Movimento Articular , Fatores de Risco , Inquéritos e Questionários , Fraturas dos Dentes/epidemiologia , Desgaste dos Dentes/epidemiologia , Adulto Jovem
18.
J Formos Med Assoc ; 118(3): 713-720, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30193836

RESUMO

BACKGROUND/PURPOSE: Diagnosis of vertical root fractures (VRFs) can often be challenging due to the similarity of signs and symptoms with other common dental infectious diseases. This study was aimed at evaluating the potential relationship between VRFs and commonly used clinical diagnostic factors. METHODS: 330 root-filled teeth with endodontic failures were subjected to endodontic microsurgery over a six-year period. VRFs were identified in 61 teeth. A randomly age- and sex-matched retrospective case-control study was conducted on a subset of 59 root-filled teeth with VRFs (cases) and 177 root-filled teeth without VRFs (controls). The strength of association between preoperative signs and radiographic findings and VRFs was evaluated using logistic regression model. RESULTS: Sinus tract, periodontal pocket depth ≥5 mm, periodontal swelling or abscess, and radiological image of J-shaped or "halo" radiolucency were significantly more frequent in cases than in controls (p < 0.05). With regard to logistic regression analysis, J-shaped or "halo" radiolucency demonstrated the greatest association with VRF, followed by periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess. Approximately 70% of cases manifested themselves as combinations of at least two of these factors. Teeth having two and three or four of these factors had 3.14 times and 11.64 times higher risks for the presentations of VRFs, respectively (p < 0.001). CONCLUSION: The major risk for VRFs was represented by those presenting radiological image of J-shaped or "halo" radiolucency, periodontal pocket depth ≥5 mm, sinus tract, and periodontal swelling or abscess simultaneously.


Assuntos
Obturação do Canal Radicular/efeitos adversos , Fraturas dos Dentes/epidemiologia , Raiz Dentária/lesões , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Taiwan/epidemiologia , Fraturas dos Dentes/etiologia
19.
J Prosthodont ; 28(2): e524-e529, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29533499

RESUMO

PURPOSE: To examine the fracture resistance of premolars restored with CAD/CAM lithium disilicate mesio-occlusal-distal (MOD) inlays and onlays of different cavity designs. MATERIALS AND METHODS: Two widths of occlusal isthmus (75%, 100% of intercuspal distance) and three designs of cuspal coverage (none, palatal, complete) were used for the preparation of MOD inlays and onlays in the extracted maxillary premolars. Sixty lithium disilicate restorations were milled and bonded into the cavities. After 24 hours of water storage, the specimens were loaded until fracture, and the fracture loads (N) were measured. Any evidence of cracks and fractures on the tested specimens were examined to classify failure patterns. RESULTS: Mean fracture load values for the tested groups were as follows: 664.4 ± 214.7 N (group A), 659.3 ± 391.2 N (B), 681.9 ± 258.1 N (C), 938.1 ± 862.0 N (D), 841.7 ± 375.4 N (E), and 994.2 ± 486.3 N (F). The width of occlusal isthmus did not significantly affect the fracture loads among all the groups. Within groups with identical isthmus width, the fracture loads showed no significant difference depending on the designs of cuspal coverage. The majority of specimens showed either type III or IV fracture mode. CONCLUSIONS: Within limitations of this study, the bonded restorations of premolars with CAD/CAM-generated lithium disilicate were reliable, regardless of cavity preparation design.


Assuntos
Desenho Assistido por Computador , Preparo da Cavidade Dentária/métodos , Falha de Restauração Dentária , Restauração Dentária Permanente/métodos , Restaurações Intracoronárias , Fraturas dos Dentes/etiologia , Dente Pré-Molar , Cerâmica , Porcelana Dentária , Análise do Estresse Dentário , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Propriedades de Superfície
20.
J Prosthodont ; 28(1): e325-e331, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29508474

RESUMO

PURPOSE: Molar MOD (mesial-occlusal-distal) cavity preparation weakens relative cuspal stiffness by up to 63%, often resulting in cuspal fracture. This investigation inspects fracture resistance of MOD cavities restored using direct composite restoration. MATERIALS AND METHODS: 120 extracted, intact mandibular molars were selected. MOD cavities with different depth/wall thickness were prepared in 9 groups (n = 12): A: 3 mm/3.5 mm, B: 3 mm/2.5 mm, C: 3 mm/1.5 mm, D: 5 mm/3.5 mm, E: 5 mm/2.5 mm, F: 5 mm/1.5 mm, G: 7 mm/3.5 mm, H: 7 mm/2.5 mm, I: 7 mm/1.5 mm. Specimens with 7 mm deep cavities received root canal treatment. The teeth were restored with dental composite. Maximal fracture strength test was conducted. Intact natural teeth were used as control. For statistical analysis Kruskal-Wallis ANOVA with post-hoc pairwise comparisons was used (α = 0.05). RESULTS: Significant difference was indicated between the control and groups D, E, F, G, H, and I. No significant differences were found between the A, B, C groups and the control. Comparing the 5 and 7 mm cavity depth groups, there was no statistical difference between any of them. CONCLUSIONS: Within the limitations of this investigation, the following conclusions can be drawn regarding molar teeth with a MOD cavity: 3 mm or shallower cavities can be restored to the physiological fracture strength with direct composite restorations; 5 mm or deeper cavities cannot be restored to the physiological fracture strength with direct composite restorations. Cusp thickness does not significantly influence fracture strength in molar MOD cavities with a direct composite restoration.


Assuntos
Preparo da Cavidade Dentária , Restauração Dentária Permanente , Dente Molar/cirurgia , Fraturas dos Dentes/etiologia , Preparo da Cavidade Dentária/efeitos adversos , Preparo da Cavidade Dentária/métodos , Falha de Restauração Dentária , Restauração Dentária Permanente/efeitos adversos , Restauração Dentária Permanente/métodos , Análise do Estresse Dentário , Humanos , Técnicas In Vitro , Fraturas dos Dentes/prevenção & controle
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