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1.
Fa Yi Xue Za Zhi ; 40(2): 143-148, 2024 Apr 25.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-38847028

RESUMO

OBJECTIVES: To estimate adolescents and children age using stepwise regression and machine learning methods based on the pulp and tooth volumes of the left maxillary central incisor and cuspid on cone beam computed tomography (CBCT) images, and to compare and analyze the estimation results. METHODS: A total of 498 Shanghai Han adolescents and children CBCT images of the oral and maxillofacial regions were collected. The pulp and tooth volumes of the left maxillary central incisor and cuspid were measured and calculated. Three machine learning algorithms (K-nearest neighbor, ridge regression, and decision tree) and stepwise regression were used to establish four age estimation models. The coefficient of determination, mean error, root mean square error, mean square error and mean absolute error were computed and compared. A correlation heatmap was drawn to visualize and the monotonic relationship between parameters was visually analyzed. RESULTS: The K-nearest neighbor model (R2=0.779) and the ridge regression model (R2=0.729) outperformed stepwise regression (R2=0.617), while the decision tree model (R2=0.494) showed poor fitting. The correlation heatmap demonstrated a monotonically negative correlation between age and the parameters including pulp volume, the ratio of pulp volume to hard tissue volume, and the ratio of pulp volume to tooth volume. CONCLUSIONS: Pulp volume and pulp volume proportion are closely related to age. The application of CBCT-based machine learning methods can provide more accurate age estimation results, which lays a foundation for further CBCT-based deep learning dental age estimation research.


Assuntos
Determinação da Idade pelos Dentes , Tomografia Computadorizada de Feixe Cônico , Polpa Dentária , Aprendizado de Máquina , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Adolescente , Criança , Determinação da Idade pelos Dentes/métodos , Polpa Dentária/diagnóstico por imagem , Dente/diagnóstico por imagem , China , Incisivo/diagnóstico por imagem , Incisivo/anatomia & histologia , Feminino , Masculino , Algoritmos
2.
BMC Oral Health ; 24(1): 670, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851731

RESUMO

OBJECTIVE: To investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies. MATERIALS AND METHODS: Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA "ZirMDP": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons. RESULTS: The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, "E-max Non-MDP," where fractures within the endocrown/tooth complex occurred above the CEJ. CONCLUSIONS: Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength. CLINICAL RELEVANCE: Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.


Assuntos
Cimentação , Análise do Estresse Dentário , Incisivo , Humanos , Cimentação/métodos , Técnicas In Vitro , Cimentos de Resina/química , Zircônio/química , Teste de Materiais , Coroas , Falha de Restauração Dentária , Cerâmica/química , Materiais Dentários/química , Desenho Assistido por Computador , Porcelana Dentária/química
3.
Sci Rep ; 14(1): 13205, 2024 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851745

RESUMO

The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (-MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25-150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups (p ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C (p = 0.020) but did not significantly differ between the other groups (p ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.


Assuntos
Fraturas dos Dentes , Raiz Dentária , Humanos , Raiz Dentária/lesões , Tratamento do Canal Radicular/métodos , Incisivo/lesões , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Preparo de Canal Radicular/métodos , Preparo de Canal Radicular/efeitos adversos
4.
Clin Oral Investig ; 28(6): 351, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38822921

RESUMO

OBJECTIVES: This study aimed to assess membrane use with a bone substitute graft for guided bone regeneration (GBR) in experimental dehiscence defects. MATERIALS AND METHODS: Maxillary second incisors (I2) in 9 dogs were extracted. Six weeks later, implants were inserted and experimental dehiscence defects (5 × 3 mm) created on the buccal aspect. The defects and surrounding bone were grafted with deproteinized bovine bone mineral. One side (test) was covered with a resorbable collagen membrane whereas the contralateral side (control) was not. After 6 weeks, histomorphometrical analysis was performed to evaluate: (a) first bone-to-implant contact (fBIC), (b) buccal bone thickness at 1 mm increments from implant shoulder, (c) regenerated area (RA), (d) area and percentages of new bone (B), bone substitute (BS) and mineralized tissue (MT). RESULTS: The histological appearance was similar between test and control sites. At central and lateral sections, there were no differences between groups for fBIC, buccal bone thickness, RA, BS, B, %B, MT and %MT. At central sections, membrane use favoured more %BS and %MT (p = 0.052). There was significantly more B, %B and MT at lateral compared to central sections. CONCLUSIONS: Membrane use tended to retain more bone substitute, but had no effect on new bone ingrowth. Lateral sections showed significantly more bone ingrowth and mineralized tissue compared to central sections, confirming that new bone ingrowth takes place mainly from the lateral walls of the defect. CLINICAL RELEVANCE: Preclinical research to clarify the dynamics of bone regeneration in GBR procedures is relevant in clinical practice.


Assuntos
Substitutos Ósseos , Membranas Artificiais , Animais , Bovinos , Cães , Substitutos Ósseos/farmacologia , Regeneração Óssea , Incisivo , Regeneração Tecidual Guiada Periodontal/métodos , Maxila/cirurgia , Implantes Dentários , Colágeno , Deiscência da Ferida Operatória , Minerais
5.
Med Sci Monit ; 30: e944424, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38870101

RESUMO

BACKGROUND The nasopalatine canal (NPC), or incisive canal, is located in the midline of the palate, posterior to the maxillary central incisors. Its anatomy is important in prosthetic dentistry procedures. This study aimed to assess the anatomical morphology of the NPC according to age, sex, and dental status using cone-beam computed tomography (CBCT) in 335 patients. MATERIAL AND METHODS In this retrospective cross-sectional study, a total of 335 patients were recruited and categorized according to sex, age, and dental status. Individual CBCT images were analyzed in the sagittal, coronal, and axial planes. Also, we recorded the dimensions and morphological shape of the NPC and adjacent buccal bone plate (BBP) under standardized conditions. The associations between sex, age group, NPC shapes and types, and presence of central incisors were assessed. A significance level was set at P<0.05. RESULTS Mean labio-palatal and mediolateral measurements of the incisive foramen were 5.13±1.45 mm and 3.21±0.96 mm, whereas the mean diameter of Stenson foramen was 2.57±1.25 mm, and the total length of the NPC was 11.79±2.50 mm. Funnel, Y, and round-shaped canals were the most prevalent shapes of the NPC in sagittal, coronal, and axial planes. BBP was greater in men, with P=0.011, P=0.000, and P=0.001 at BBP1, BBP2, and BBP3, respectively. CONCLUSIONS NPC and BBP parameter values were slightly higher among male patients. NPC parameters increased with older age. The crest width of BBP decreased with older age and after missing maxillary central incisor teeth.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Incisivo , Palato , Humanos , Tomografia Computadorizada de Feixe Cônico/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estudos Retrospectivos , Palato/diagnóstico por imagem , Palato/anatomia & histologia , Estudos Transversais , Incisivo/diagnóstico por imagem , Incisivo/anatomia & histologia , Adolescente , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Idoso
6.
J Appl Oral Sci ; 32: e20240018, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38896641

RESUMO

OBJECTIVE: This study aimed to validate the integrated correlation between the buccal bone and gingival thickness of the anterior maxilla, and to gain insight into the reference plane selection when measuring these two tissues before treatment with implants. METHODOLOGY: Cone beam computed tomography (CBCT) and model scans of 350 human subjects were registered in the coDiagnostiX software to obtain sagittal maxillary incisor sections. The buccal bone thickness was measured at the coronal (2, 4, and 6 mm apical to the cementoenamel junction [CEJ]) and apical (0, 2, and 4 mm coronal to the apex plane) regions. The buccal gingival thickness was measured at the supra-CEJ (0, 1mm coronal to the CEJ) and sub-CEJ regions (1, 2, 4, and 6 mm apical to the CEJ). Canonical correlation analysis was performed for intergroup correlation analysis and investigation of key parameters. RESULTS: The mean thicknesses of the buccal bone and gingiva at different levels were 0.64~1.88 mm and 0.66~1.37 mm, respectively. There was a strong intergroup canonical correlation between the thickness of the buccal bone and that of the gingiva (r=0.837). The thickness of the buccal bone and gingiva at 2 mm apical to the CEJ are the most important indices with the highest canonical correlation coefficient and loadings. The most and least prevalent subgroups were the thin bone and thick gingiva group (accounting for 47.6%) and the thick bone and thick gingiva group (accounting for 8.6%). CONCLUSION: Within the limitations of this retrospective study, the thickness of the buccal bone is significantly correlated with that of the buccal gingiva, and the 2 mm region apical to the CEJ is a vital plane for quantifying the thickness of these two tissues.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Gengiva , Incisivo , Maxila , Humanos , Gengiva/anatomia & histologia , Gengiva/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Incisivo/diagnóstico por imagem , Incisivo/anatomia & histologia , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Feminino , Masculino , Adulto , Adulto Jovem , Valores de Referência , Reprodutibilidade dos Testes , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/anatomia & histologia , Pessoa de Meia-Idade , Adolescente , Estudos Retrospectivos
7.
J Appl Oral Sci ; 32: e20230439, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38896638

RESUMO

OBJECTIVE: To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and biomechanical safety under occlusal loading. METHODOLOGY: Three-dimensional finite element models were generated for maxillary central incisors with all-ceramic crown restorations. The labiolingual diameters of the tooth, defined as the horizontal distance between the protrusion of the labial and lingual surfaces, were changed as follows: (D1) 6.85 mm, (D2) 6.35 mm, and (D3) 5.85 mm. The model was constructed as follows: (S0) vital pulp tooth; (S1) ET tooth; (S2) ET tooth with a 2 mm ferrule, restored with a fiber post and composite resin core; (S3) ET tooth without a ferrule, restored with a fiber post and composite resin core. A total of 12 models were developed. In total, two force loads (100 N) were applied to the crown's incisal edge and palatal surface at a 45° oblique angle to the longitudinal axis of the teeth. The Von Mises stress distribution and maximum stress of the models were analyzed. RESULTS: Regardless of the loading location, stress concentration and maximum stress (34.07~66.78MPa) in all models occurred in the labial cervical 1/3 of each root. Both labiolingual diameter and construction influenced the maximum stress of the residual tooth tissue, with the impact of the labiolingual diameter being greater. A reduction in labiolingual diameter led to increased maximum stress throughout the tooth. The ferrule reduced the maximum stress of the core of S2 models (7.15~10.69 MPa), which is lower compared with that of S3 models (19.45~43.67 MPa). CONCLUSION: The labiolingual diameter exerts a greater impact on the biomechanical characteristics of ET anterior teeth with crown restoration, surpassing the influence of the construction. The ferrule can reduce the maximum stress of the core and maintain the uniformity of stress distribution.


Assuntos
Resinas Compostas , Coroas , Análise do Estresse Dentário , Análise de Elementos Finitos , Incisivo , Dente não Vital , Dente não Vital/fisiopatologia , Humanos , Fenômenos Biomecânicos , Incisivo/anatomia & histologia , Incisivo/fisiologia , Resinas Compostas/química , Análise do Estresse Dentário/métodos , Técnica para Retentor Intrarradicular , Reprodutibilidade dos Testes , Estresse Mecânico , Valores de Referência , Força de Mordida , Imageamento Tridimensional/métodos , Planejamento de Prótese Dentária , Teste de Materiais , Coroa do Dente/anatomia & histologia , Coroa do Dente/fisiologia
8.
Dental Press J Orthod ; 29(2): e2423253, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865515

RESUMO

OBJECTIVE: To assess the effectiveness of a customized distalizer with Variety SP® screws anchored on palatal miniscrews for upper molar distalization. METHODS: Seventeen patients aged between 12.5 and 24 years underwent distalization with a customized distalizer. Lateral cephalogram and cast analysis were performed before and after distalization. Linear and angular parameters of the upper first molar, first premolar, and central incisor were assessed. RESULTS: Distalization with the force passing near the center of resistance (CRes) of the upper first molars resulted in distal movement, with minimal distal tipping (2.8 ±â€Š0.45°, p< 0.05). However, distalization passing occlusal to the CRes led to greater distal tipping (13.6 ±â€Š1.63°, p< 0.05). Statistically significant spontaneous distal tipping and distal movement of the upper first premolars occurred, with a mean of 6.2 ±â€Š1.24° (p< 0.05) and 0.68 ±â€Š0.34 mm (p< 0.05), respectively. The positional change of the upper central incisors presented a mean of -0.23 ±â€Š0.1 mm (p> 0.05) and 2.65 ±â€Š1.1° (p< 0.05). Upper first molar intrusion was statistically significant, with a mean of 0.88 ±â€Š0.2 mm (p< 0.05). Upper right and left first molars rotation towards palatal midline presented mean of 4.1 ±â€Š0.19° (p< 0.05) and 3.4  ±â€Š0.1° (p< 0.05), respectively. Additionally, the distance between upper right and left first molars increased significantly, with a mean of 2.54 ±â€Š0.01 mm (p< 0.05). CONCLUSION: The study successfully demonstrated the efficiency of molar distalization without anchorage loss using a customized distalizer anchored on palatal miniscrews.


Assuntos
Parafusos Ósseos , Cefalometria , Dente Molar , Procedimentos de Ancoragem Ortodôntica , Desenho de Aparelho Ortodôntico , Técnicas de Movimentação Dentária , Humanos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Adolescente , Criança , Adulto Jovem , Feminino , Masculino , Maxila/cirurgia , Dente Pré-Molar , Incisivo , Modelos Dentários
9.
Clin Oral Investig ; 28(7): 386, 2024 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-38890207

RESUMO

OBJECTIVE: This study aimed to evaluate the effect of ultrasonic activation of etch-and-rinse and self-etch adhesive systems on the bond strength of resin cement to irradiated root dentin. MATERIALS AND METHODS: Eighty human maxillary anterior teeth were distributed into 8 groups (n = 10), according to the type of adhesive system used (etch-and-rinse and self-etch), the ultrasonic activation of the adhesive systems, and the dentin condition (irradiated or non-irradiated - 70 Gy). Endodontic treatment was performed followed by fiberglass post-space preparation. After fiberglass posts' luting, the roots were transversely sectioned on dentin discs and submitted to the push-out bond strength test (0.5 mm/min). The fractured specimens were analyzed under a stereomicroscope and Scanning Electron Microscope (SEM) for failure mode classification. One of the dentin discs was analyzed under SEM to evaluate the characteristics of the adhesive interface. RESULTS: Irradiated specimens had lower bond strength than non-irradiated specimens (P < 0.0001). Ultrasonic activation of both adhesive systems increased the bond strength of the resin cement to irradiated dentin (P < 0.0001). Radiotherapy significantly affected the failure mode in the middle (P = 0.024) and apical thirds (P = 0.032) (adhesive failure). CONCLUSION: Non-irradiated specimens had a more homogeneous adhesive interface. When ultrasonically activated, both adhesive systems showed a greater number of resinous tags, regardless of the dentin condition. CLINICAL RELEVANCE: Ultrasonic activation of adhesive systems is a feasible strategy to enhance fiberglass posts retention in oncological patients.


Assuntos
Colagem Dentária , Dentina , Teste de Materiais , Microscopia Eletrônica de Varredura , Técnica para Retentor Intrarradicular , Cimentos de Resina , Humanos , Cimentos de Resina/química , Colagem Dentária/métodos , Dentina/efeitos da radiação , Técnicas In Vitro , Adesivos Dentinários/química , Análise do Estresse Dentário , Propriedades de Superfície , Raiz Dentária/efeitos da radiação , Ultrassom , Condicionamento Ácido do Dente , Incisivo , Vidro/química
10.
BMC Oral Health ; 24(1): 690, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38872190

RESUMO

INTRODUCTION: Horizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling. CASE PRESENTATION: A healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement. CONCLUSION: DLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.


Assuntos
Aumento do Rebordo Alveolar , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Humanos , Masculino , Aumento do Rebordo Alveolar/métodos , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Implantação Dentária Endóssea/métodos , Transplante Ósseo/métodos , Incisivo/diagnóstico por imagem
12.
J Clin Pediatr Dent ; 48(3): 120-130, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755990

RESUMO

The root of late-dental-age labial inversely impacted maxillary central incisors (LIIMCIs) typically develops to severe dilacerated morphology. Therefore, reliable posttreatment periodontal estimates of orthodontic treatment prognosis would be critical to the treatment value of impacted incisors. This study aims to analyze further changes in dimensions of the alveolar bone following the closed-eruption treatment of late-dental-age dilacerated LIIMCIs. Cone beam computed tomography (CBCT) scanning data of 16 patients with unilateral dilacerated late-dental-age LIIMCIs were collected, including the pretreatment (T1) and at the 2.23 ± 0.78 years follow-up stage (T2) respectively. Patients underwent closed-eruption treatments to bring the impacted incisor into the dental arch. Dolphin imaging software was used to measure alveolar bone height labially, palatally, and proximally to the site at T1 and T2, as well as alveolar bone thicknesses at 0, 2, 4, 6 and 8 mm below the initial measurement plane (IMP). The alveolar bone heights on the impacted and contralateral sides increased from T1 to T2 (p < 0.05). Alveolar bone growth on both sides had no significant difference. In T2, the mean values of labial and distal alveolar heights on the contralateral sides were greater than on the impacted sides (p < 0.05). The mean values of total alveolar bone thicknesses on the impacted sides in T1 were significantly smaller than those on the contralateral sides in IMP-0, 2, 4, 6, 8 (p < 0.05). The total thicknesses on the impacted sides in T2 increased and were significantly greater than on the contralateral sides (p < 0.05), except for the thickness in IMP-0. The closed-eruption treatment of dilacerated late-dental-age LIIMCIs results in no significant changes to alveolar bone height, except on the labial and distal sides, with increased alveolar bone thickness, suggesting that this approach may be viable first choice therapy for non-extraction orthodontic cases.


Assuntos
Processo Alveolar , Tomografia Computadorizada de Feixe Cônico , Incisivo , Maxila , Dente Impactado , Humanos , Incisivo/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/crescimento & desenvolvimento , Estudos Retrospectivos , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Impactado/terapia , Dente Impactado/diagnóstico por imagem , Feminino , Masculino , Criança , Pré-Escolar
13.
J Clin Pediatr Dent ; 48(3): 171-176, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755996

RESUMO

To explore a new method to implant deciduous tooth pulp into the canal of young permanent teeth with necrotic pulps and apical periodontitis for the regenerative endodontic treatment of tooth no: 41 in a 7-year-old male. Briefly, 1.5% Sodium Hypochlorite (NaOCl) irrigation and calcium hydroxide-iodoform paste were used as root canal disinfectant at the first visit. After 2 weeks, the intracanal medication was removed, and the root canal was slowly rinsed with 17% Ethylene Diamine Tetraacetic Acid (EDTA), followed by flushing with 20 mL saline and then drying with paper points. Tooth no: 72 was extracted, and its pulp was extracted and subsequently implanted into the disinfected root canal along with induced apical bleeding. Calcium hydroxide iodoform paste was gently placed over the bleeding clot, and after forming a mineral trioxide aggregate (MTA) coronal barrier, the accessed cavities were restored using Z350 resin composite. The root developments were evaluated via radiographic imaging at 6 months, 1 year and 5 years after treatment. Imaging and clinical analysis showed closure of the apical foramen, thickening of the root canal wall, and satisfactory root length growth. Autologous transplantation might be useful to regenerate dental pulp in necrotic young permanent teeth.


Assuntos
Compostos de Alumínio , Compostos de Cálcio , Polpa Dentária , Incisivo , Dente Decíduo , Humanos , Masculino , Criança , Polpa Dentária/irrigação sanguínea , Compostos de Cálcio/uso terapêutico , Compostos de Alumínio/uso terapêutico , Óxidos/uso terapêutico , Combinação de Medicamentos , Necrose da Polpa Dentária/terapia , Silicatos/uso terapêutico , Seguimentos , Endodontia Regenerativa/métodos , Mandíbula/cirurgia , Hidróxido de Cálcio/uso terapêutico , Neovascularização Fisiológica , Tratamento do Canal Radicular/métodos , Irrigantes do Canal Radicular/uso terapêutico , Materiais Restauradores do Canal Radicular/uso terapêutico , Periodontite Periapical/terapia , Periodontite Periapical/cirurgia , Hipoclorito de Sódio/uso terapêutico , Cavidade Pulpar , Hidrocarbonetos Iodados
14.
Oper Dent ; 49(3): 336-344, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38807319

RESUMO

OBJECTIVE: Tooth color matching is challenging, and digital photocolorimetry using eLABor_aid (eLAB) provides objective evaluation through polarized photographs. However, its comparability with spectrophotometry remains unclear. METHODS AND MATERIALS: Bovine incisor root canals (n=30) were prepared to simulate an incomplete root apex. The teeth were randomly assigned to three groups based on intracanal medication: control (without medication); calcium hydroxide/propylene glycol; and triple-antibiotic paste (n=10 each). Tooth color was assessed using both eLAB and spectrophotometry. Measurements were taken at the crown medio-cervical region on five-time intervals (baseline, 1, 3, 7, and 14 days). Statistical analysis included two-way repeated-measures ANOVA, Sidak post hoc and Pearson's correlation test (α=0.05). RESULTS: No significant differences were observed between the two methods for either medication or follow-ups (p>0.05). Triple-antibiotic paste exhibited higher color variation (p<0.05). After 7 days, all groups presented significant color changes (p<0.05). Moderate to high correlations (R2 from 0.51 to 0.84, p<0.0001) were found between both methods for all groups at all intervals. CONCLUSION: The eLAB is a reliable method for detecting tooth color changes, and its results are comparable to spectrophotometry analysis.


Assuntos
Colorimetria , Espectrofotometria , Bovinos , Animais , Espectrofotometria/métodos , Colorimetria/métodos , Antibacterianos , Cor , Técnicas In Vitro , Hidróxido de Cálcio , Incisivo/anatomia & histologia , Propilenoglicol , Descoloração de Dente , Irrigantes do Canal Radicular/uso terapêutico , Metronidazol/uso terapêutico , Ciprofloxacina/uso terapêutico , Cavidade Pulpar/anatomia & histologia
15.
Clin Oral Investig ; 28(6): 340, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38801642

RESUMO

BACKGROUND: Pediatric rotary file systems were developed to solve manual file limitations. With many systems available, it may be tricky to select the most appropriate one. AIM: to assess & compare Kedo-S Square, Fanta-AF™-Baby rotary files with manual K-file concerning removed dentin amount, canal transportation, centric ability & root canal taper using CBCT in primary anterior teeth. DESIGN: Extracted Seventy-five upper primary anterior teeth with intact 2/3 root length were collected and divided into three groups based on root canal instrumentation, group-I: prepared using K-file, group-II: prepared using Kedo-S Square, and group-III: prepared using Fanta AF™ Baby file. The teeth were imaged with CBCT before & following canal instrumentation. Then, the removed dentin amount was calculated at each root-canal level. The Kruskal-Wallis test was utilized to statistically analyze study data. RESULT: The difference among the three groups was highly statistically significant at cervical & apical thirds concerning dentin thickness changes on both mesial & distal sides following canal preparation with the least removed dentin in the Kedo-S Square group(P < 0.0001). Regarding transportation & centering ability, a non-significant difference between the three groups was found. 80% of the Fanta AF™ Baby group had good-tapered preparation compared to the Kedo-S Square (72%) and K-file (40%) groups(P < 0.05). CONCLUSION: Kedo-S Square was preferable to Fanta-AFTM-Baby & manual K-files in primary root canal preparation.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Desenho de Equipamento , Preparo de Canal Radicular , Dente Decíduo , Humanos , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Técnicas In Vitro , Dente Decíduo/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Instrumentos Odontológicos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/cirurgia
16.
BMC Oral Health ; 24(1): 613, 2024 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-38802767

RESUMO

BACKGROUND: One of the most important steps in deciding on the treatment of a tooth is to determine the vitality and health status of the pulp. Since immature teeth innervation is not completed, the response to sensitivity tests may not yield definite results. Pulse oximetry (PO) which is considered as a vitality test, measures the arterial oxygen saturation (SpO2). This study aims to compare PO, electric pulp test (EPT) and cold test in mature and immature permanent teeth. METHODS: 20 immature and 20 mature permanent incisors of 6-12-year-old ASA1 children who did not use any analgesics, were included in the study. Pulp vitality of the teeth was determined by EPT, cold test and PO. An infant probe of PO device (CMS60D, Contec Medical Systems Co. Ltd, China) was used to determine the SpO2 of the teeth. The SpO2 level is controlled on the patient's finger by a children's probe and an infant probe of PO. Shapiro-Wilk, Spearman rank correlation test and Kruskal-Wallis test/Dunn post-hoc analysis were used for statistical comparisons. RESULTS: There was no significant correlation between finger SpO2 and the mature/immature teeth SpO2 (r=-0.026, r = 0.253). Arterial oxygen saturation values in the immature teeth were significantly higher than in the mature teeth (p = 0.002). There was a high correlation between the vitality response of the EPT, cold test and PO. CONCLUSIONS: Pulse oximetry can be used as an effective vitality test compared to sensitivity tests in both immature and mature permanent incisors.


Assuntos
Teste da Polpa Dentária , Oximetria , Humanos , Oximetria/métodos , Criança , Teste da Polpa Dentária/métodos , Masculino , Feminino , Incisivo , Polpa Dentária/irrigação sanguínea , Temperatura Baixa , Saturação de Oxigênio
17.
Eur J Paediatr Dent ; 25: 1, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38804663

RESUMO

BACKGROUND: Dilaceration can lead to impaction of maxillary incisors, resulting in both aesthetic and functional problems. This case report presents the multidisciplinary approach to managing an inverse impacted dilacerated left lateral incisor in a 9-year-old male patient. CASE REPORT: The orthodontic alignment of the remaining three incisors was achieved within six months. After using the diode laser to remove the gingiva covering the right lateral incisor during alignment process, a lingual button was bonded. The primary left canine and the impacted permanent left lateral incisor were extracted by raising the full-thickness mucoperiosteal flap, followed by the transplantation of the dilacerated lateral incisor into its correct position, splinted to the adjacent central incisors using composite resin. Root canal treatment was performed after the apical plug was created with mineral trioxide aggregate. The composite splint was removed after three weeks, and a new bracket was bonded to the left lateral incisor. It was left passively for 18 months until the permanent canines started to erupt. Light orthodontic forces were then applied for six months, and a passive eruption was expected over three months to properly position the canines within the dental arch. After an 11-year follow-up, the incisor displayed no clinical symptoms, although radiographic examination revealed external resorption in the long-term. CONCLUSION: This case demonstrates the successful and fast autotransplantation of an immature inverse impacted dilacerated incisor, highlighting the long-term clinical success and favorable aesthetic outcomes.


Assuntos
Incisivo , Dente Impactado , Humanos , Masculino , Criança , Incisivo/anormalidades , Dente Impactado/cirurgia , Dente Impactado/terapia , Seguimentos , Transplante Autólogo , Tratamento do Canal Radicular/métodos , Maxila/cirurgia , Resinas Compostas , Lasers Semicondutores/uso terapêutico , Dente Canino/anormalidades , Compostos de Cálcio/uso terapêutico , Óxidos/uso terapêutico , Combinação de Medicamentos , Compostos de Alumínio , Silicatos
18.
J Morphol ; 285(6): e21738, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38783683

RESUMO

The incisor teeth in pigs, Sus scrofa, function in association with a disc-shaped snout to explore the environment for potential food. Understanding how mechanical loading applied to the tooth deforms the periodontal ligament (PDL) is important to determining the role of periodontal mechanoreceptors during food exploration and feeding. The objective of this study was to use fiber Bragg (FBG) sensors to measure strain in vivo within the PDL space of pig incisors. The central mandibular incisors of pigs underwent spring loaded lingual tipping during FBG strain recording within the labial periodontal space. FBG sensors were placed within the periodontal space of the central mandibular incisors of ~2-3-month-old farm pigs. The magnitude and orientation of spring loads are expected to mimic incisor contact with food. During incisor tipping with load calibrated springs, FBG strains in vitro (N = 6) and in vivo (N = 6) recorded at comparable load levels overlapped in range (-10-20 µÎµ). Linear regressions between peak FBG strains, that is, the highest recorded strain value, and baseline strains, that is, strain without applied spring load, were significant across all in vivo experiments (peak strain at 200 g vs. baseline, p = .04; peak strain at 2000 g vs. baseline p = .03; peak strain at 2000 g vs. 200 g, p = .004). These linear relationships indicate that on a per experiment basis, the maximum measured strain at different spring loads showed predictable differences. A Friedman test of the absolute value of peak strain confirmed the significant increase in strain between baseline, 200 g, and 2000 g spring activation (p = .02). Mainly compressive strains were recorded in the labial PDL space and increases in spring load applied in vivo generated increases in FBG strain measurements. These results demonstrate the capacity for FBG sensors to be used in vivo to assess transmission of occlusal loads through the periodontium. PDL strain is associated with mechanoreceptor stimulation and is expected to affect the functional morphology of the incisors. The overall low levels of strain observed may correspond with the robust functional morphology of pig incisors and the tendency for pigs to encounter diverse foods and substrates during food exploration.


Assuntos
Incisivo , Ligamento Periodontal , Animais , Ligamento Periodontal/fisiologia , Estresse Mecânico , Suínos , Sus scrofa , Fenômenos Biomecânicos
19.
BMC Oral Health ; 24(1): 584, 2024 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-38773504

RESUMO

BACKGROUND: Apical surgery with standard retrograde maneuvers may be challenging in certain cases. Simplifying apical surgery to reduce operating time and streamline retrograde manipulation is an emerging need in clinical endodontics. AIM OF THE STUDY: The aim of the study was to compare the bacterial sealing ability of a calcium silicate-based sealer with the single cone technique combined with root end resection only, and calcium silicate-based sealer as a retrograde filling versus MTA retrofilling, and to analyze bacterial viability using confocal laser scanning microscope (CLSM). MATERIALS AND METHODS: In this in vitro experimental study, 50 extracted human maxillary incisor teeth were instrumented and randomly divided into five groups: three experimental groups, a positive control group, and a negative control group (n = 10/group). In the experimental groups, the roots were obturated using the single cone technique (SCT) and a calcium silicate-based sealer. In group 1, the roots were resected 3 mm from the apex with no further retrograde preparation or filling. In groups 2 and 3, the roots were resected, retroprepared, and retrofilled with either a calcium silicate-based sealer or MTA, respectively. Group 4 (positive control) was filled with a single gutta-percha cone without any sealer. In group 5 (negative control), the canals were left empty, and the roots were sealed with wax and nail varnish. A bacterial leakage model using Enterococcus faecalis was employed to assess the sealing ability over a 30-day period, checking for turbidity and analyzing colony forming units (CFUs) per milliliter. Five specimens from each group were examined using CLSM for bacterial viability. Data for the bacterial sealing ability were statistically analyzed using chi-squared and Kruskal-Wallis tests. RESULTS: The three experimental groups did not show significant differences in terms of bacterial leakage, or bacterial counts (CFUs) (P > 0.05). However, significant differences were observed when comparing the experimental groups to the positive control group. Notably, the calcium silicate-based sealer, when used as a retrofilling, yielded the best sealing ability. CLSM imaging revealed viable bacterial penetration in all the positive control group specimens while for the experimental groups, dead bacteria was the prominent feature seen. CONCLUSION: Within the limitations of this study, it could be concluded that the bacterial sealing ability of calcium silicate-based sealer with the single cone technique combined with root end resection only and calcium silicate-based sealer as a retrograde filling were comparable with MTA retrofilling during endodontic surgical procedures.


Assuntos
Compostos de Cálcio , Materiais Restauradores do Canal Radicular , Silicatos , Silicatos/uso terapêutico , Compostos de Cálcio/uso terapêutico , Humanos , Materiais Restauradores do Canal Radicular/farmacologia , Materiais Restauradores do Canal Radicular/uso terapêutico , Óxidos/farmacologia , Óxidos/uso terapêutico , Combinação de Medicamentos , Compostos de Alumínio/uso terapêutico , Técnicas In Vitro , Microscopia Confocal , Infiltração Dentária/microbiologia , Obturação Retrógrada/métodos , Enterococcus faecalis/efeitos dos fármacos , Viabilidade Microbiana , Incisivo , Apicectomia/métodos
20.
Dental Press J Orthod ; 29(2): e2423237, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38775600

RESUMO

OBJECTIVE: This retrospective study aimed to assess the predictability of Invisalign® aligners regarding rotational, mesio-distal and buccal-lingual tip movements. METHODS: Two materials were included in the analysis - EX30, used until 2013; and SmartTrack, in current use. The study comprised 56 adult patients treated with Invisalign Comprehensive. Data sample were assessed on three sets of digital models; model 1 - initial, model 2 - predicted, and model 3 - achieved. Sixty reference points were marked in each dental arch, and two reference planes assisted the superimposition. The degree of rotation, mesio-distal and buccal-lingual tip was obtained via trigonometric calculations, through a previously published validated method. The accuracy of outcomes was compared according to the types of tooth movement and teeth groups,and the influence of predetermined variables on movement accuracy was also investigated. RESULTS: Rotation and mesio-distal tip did not present any significant difference when comparing EX30 and SmartTrack groups. Only buccal-lingual tip presented a significant difference, incisor and canine groups treated with EX30 aligners presented an increase in accuracy (p= 0.007 and p = 0.007, respectively). For each additional degree planned for rotation movements, there was an increase of 0.35° in the discrepancy, and an increase of 0.40° and 0.41° for mesio-distal and buccal-lingual tip, respectively. EX30 and SmartTrack discrepancies were compared by multilevel linear regression. CONCLUSION: EX30 aligners reached higher accuracy for buccal-lingual tip in anterior teeth. However, for rotation and mesio-distal tip, SmartTrack and EX30 are similarly accurate. The total amount of planned movement has a significant impact on accuracy rates, with a decrease in accuracy for every additional degree.


Assuntos
Técnicas de Movimentação Dentária , Humanos , Técnicas de Movimentação Dentária/instrumentação , Estudos Retrospectivos , Adulto , Rotação , Feminino , Masculino , Desenho de Aparelho Ortodôntico , Incisivo , Modelos Dentários , Aparelhos Ortodônticos Removíveis , Arco Dental
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