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1.
Artigo em Inglês | MEDLINE | ID: mdl-34076633

RESUMO

During bone augmentation procedures, primary wound healing determines the bone augmentation result. After a crestal incision in the maxilla, the palatal flap might not be an adequate length to correctly couple to the vestibular flap and to seal the wound with horizontal mattress and single sutures. Due to the histologic structure made of dense connective tissue, the palatal flap eversion is impossible, negatively impacting the wound seal and primary healing. This case report describes the effectiveness and efficacy of an incision design to improve palatal flap management during bone augmentation procedures in the maxilla. Indeed, palatal flap verticalization is achieved. The incision line is proportionally shifted on the vestibular side, based on the defect anatomy, to obtain a palatal flap length extending at least 4 mm coronal to the bone graft level prior to wound closure. The described approach simplifies the optimal adaptation of the inner faces of the palatal and vestibular flaps, reducing the risk of nonprimary wound healing.


Assuntos
Maxila , Retalhos Cirúrgicos , Transplante Ósseo , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Palato , Suturas
2.
Int J Periodontics Restorative Dent ; 41(3): e103-e112, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076644

RESUMO

Clinical evidence suggests using lateral and vertical ridge preservation procedures to make dental implant placement possible. This study evaluates and compares the radiographic and volumetric changes following ridge preservation procedures using either mineralized plasmatic matrix grafts (MPM) or bone grafts alone (non-MPM) in the existing crestal ridges of sockets in maxillary and mandibular regions using CBCT scans. Healthy volunteers (n = 26) were recruited and randomized into MPM and non-MPM groups (n = 13 patients per group). Ridge preservation (RP) was performed in sockets after extraction. Preoperative baseline vertical measurements (V1) were made from the existing highest level of the socket crestal ridges to a reference point in an apicocoronal direction. Similarly, baseline horizontal measurements (H1) were made in a buccolingual direction on CBCT scans. The measurements were repeated after 3 months (V2 and H2) and 6 months (V3 and H3) using the same reference points. Difference between V3 and V1 as well as H3 and H1 was used to assess the gains in height and width of the sockets after RP. No significant difference was found in the initial baseline V1 and H1 values in MPM and non-MPM groups. Median (Mdn) V2 and H2 scores were significantly different between MPM (Mdn = 18.91) and non-MPM groups (Mdn = 27.81) after 3 months of RP (U = 37, z = -6.302, P < .001.) However, after 6 months of treatment, V3 and H3 scores were significantly different between the MPM (Mdn = 27.19) and the non-MPM group (Mdn = 37.81). MPM can be used as a valuable and predictable technique in obtaining bone fill in the maxillary and mandibular sockets with residual crestal ridges deemed necessary for RP in implant therapy.


Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Transplante Ósseo , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Extração Dentária , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia
4.
Am J Orthod Dentofacial Orthop ; 159(6): 733-742, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33931257

RESUMO

INTRODUCTION: This study compared the skeletal and dental changes of microimplant assisted rapid palatal expansion (MARPE) with those produced by surgically assisted rapid maxillary expansion (SARPE) in postpeak adolescents and adults. METHODS: The sample comprised 17 patients (mean age, 26 ± 11 years) selected for the MARPE group and 15 (mean age, 28.5 ± 10.5 years) selected for the SARPE group. Cone-beam computed tomography scans taken just before and after the expansion were used to assess dental and skeletal changes and compare the changes between the groups. RESULTS: MARPE showed greater transversal skeletal changes in the midface and posterior and anterior maxillary base measurements. The transverse displacement of the alveolar process was greater but not significant for the SARPE group than the MARPE group. Regarding dental effects, the root distance measurements did not differ between the groups, but SARPE produced a significantly greater increase in intermolar and interpremolar distance and a greater buccal inclination of the alveolar process and supporting teeth than MARPE. CONCLUSIONS: The MARPE technique showed an increase in skeletal transverse maxillary expansion at the midface and basal bone compared with SARPE, especially at the posterior palatal region; however, no difference was found in the expansion of the alveolar process between the 2 methods. MARPE presented a more parallel expansion in both a coronal and axial view, whereas SARPE led to a V-shaped opening. The greater buccal inclination of the alveolar process and supporting teeth was observed in the SARPE group.


Assuntos
Técnica de Expansão Palatina , Dente , Adolescente , Adulto , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Palato/diagnóstico por imagem , Palato/cirurgia , Adulto Jovem
5.
BMJ Case Rep ; 14(5)2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33962919

RESUMO

Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of neonate nasal obstruction. Because newborns are natural nasal breathers, urgent treatment may be needed. CNPAS is diagnosed by clinical symptoms and signs, and CT. In severe cases, surgical approach is needed. The most often used approach is widening of pyriform aperture via sublabial incision with nasal tubing. We report a novel surgical approach as a curative treatment for CNPAS by immediate transverse enlargement of the maxilla. We also review current literature of the condition focusing on surgical management of the disease.


Assuntos
Obstrução Nasal , Constrição Patológica/diagnóstico por imagem , Constrição Patológica/cirurgia , Humanos , Hipertrofia/diagnóstico por imagem , Hipertrofia/cirurgia , Recém-Nascido , Maxila/diagnóstico por imagem , Maxila/cirurgia , Cavidade Nasal/diagnóstico por imagem , Cavidade Nasal/cirurgia , Obstrução Nasal/diagnóstico por imagem , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Nariz
6.
J Clin Pediatr Dent ; 45(2): 140-145, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33951166

RESUMO

AIM: To compare maxillary development of individuals with unilateral cleft lip and palate (CLP) to individuals with skeletal Class I and Class III malocclusions. STUDY DESIGN: Cephalometric X-ray films from 90 patients (mean age: 13 ± 2.3 years) were used. The number of samples was determined by Power analysis and three groups consisting of 30 patients (Group 1: Skeletal Class I, Group 2: Skeletal Class III, Group 3: CLP) were formed. A total of 13 cephalometric measurements were performed using Dolphin imaging software 11.7. The Kruskal-Wallis and ANOVA tests were used to calculate the differences. The Dunn test and Bonferroni correction were used in paired group comparisons. RESULTS: SNA, Co-A, A-PTV Horizontal, Na-APog, A-Na-Pog, FH-NA, Sn'-Mx1, MxOP-TVL (p<0.001***), U6-PTV Vertical (p<0.01**), and NaBa PTV-Gn (p<0.05*) values were significantly different between the three groups. There was no significant difference in Na-ANS, FH-NPog, or Mx1 labial-ULA. SNA, Co-A, A-PTV Horizontal, Na-APog, and A-Na-Pog values between the 1st and 2nd groups and between the 1st and 3rd groups (p<0.001***) were significantly different. FH-Na-A, Sn'-Mx1, MxOP-TVL (p<0.001***), and U6-PTV vertical were different between groups 1 and 3 (p<0.01**), while FH-Na-A (p<0.001***), Sn'-Mx1, MxOP-TVL (p<0.01**), A-PTV Horizontal, and A-Na-Pog (p<0.05*) were significantly different between groups 2 and 3. CONCLUSION: Maxillary development in CLP differs from skeletal Class I but is similar to skeletal Class III. Considering the delay in maxillary development in the CLP patient, maxillary protraction and maxillary expansion are important treatment protocols in the early period.


Assuntos
Fenda Labial , Fissura Palatina , Má Oclusão de Angle Classe III , Cefalometria , Fenda Labial/diagnóstico por imagem , Fissura Palatina/diagnóstico por imagem , Humanos , Má Oclusão de Angle Classe III/diagnóstico por imagem , Maxila/diagnóstico por imagem
7.
J Pak Med Assoc ; 71(3): 877-882, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34057939

RESUMO

OBJECTIVE: To compare two different skeletal anchorage methods with finite element analysis in the treatment of Class III patients with maxillary retrognathia. MATERIAL AND METHODS: Two different treatment scenarios were performed on skull model obtained from computerized tomography images of skeletal Class III patients with maxillary retrognathia and finite element analysis was performed. In the first group; mini plates were simulated on infra zygomatic crest. A unilateral 500 g protraction force was applied to the face-mask. In the second group; mini plates were simulated in infrazygomatic crest and mandibular symphysis. Then, 500g protraction force was applied with Class III elastic between the miniplates. Von Misses stresses and displacement values were evaluated comparatively. RESULTS: In Class III elastic group, maximum Von Misses stress occurred around infra zygomatic crest and symphysis anchored with 0.078 MPa. The maxillary posterior region and paranasal regions were the areas showing the highest Von Misses tension after infra zygomatic crest and symphysis. In the face-mask group, the most common site of Von Misses stress in nasomaxillary complex and alveolar structures were infra zygomatic area where plaques were applied, followed by pterygomaxillary suture. Tensile forces are reduced especially in these two areas by spreading to surrounding structures. CONCLUSIONS: In both methods, it was determined that the amount of force transmitted to circumaxillary sutures was sufficient to induce the formation of osteogenesis in these regions.


Assuntos
Maxila , Técnica de Expansão Palatina , Análise de Elementos Finitos , Humanos , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Crânio
8.
Int J Oral Implantol (Berl) ; 14(1): 101-112, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-34006075

RESUMO

PURPOSE: To compare 100% deproteinised bovine bone matrix grafts (DBBM, test group) and 100% autogenous bone grafts (AB, control group) for lateral maxillary sinus floor elevation in a blinded, parallel-group, randomised clinical trial. MATERIALS AND METHODS: Patients with 1 to 3 mm of residual bone height were randomised for sinus floor elevation with DBBM or AB grafts and simultaneous implant placement. The outcome variables were implant failure, complications, subjective satisfaction and radiographic peri-implant bone level 7 years after loading. RESULTS: A total of 20 patients (27 implants) were randomised to the test group and 20 (32 implants) to the control group. Ten patients from the test group and seven from the control group dropped out. Two implant failures occurred in the test group, whereas none were observed in the control group (P = 0.178). One complication occurred in the test group and two were recorded in the control group (P = 1.000). The radiographic peri-implant crestal bone level was 2.5 ± 1.3 mm in the test group and 0.9 ± 0.9 mm in the control group. The difference was 1.6 mm, favouring the control group (95% confidence interval 0.7-2.6; P = 0.002). The difference in vertical bone height was -0.4 mm, favouring the control group (95% confidence interval -1.9-1.1; P = 0.590). The difference in satisfaction measured using a visual analogue scale 7 years after loading was 0.0 mm (95% confidence interval -1.0-0.0; P = 0.639). CONCLUSIONS: Differences between treatments were found for crestal bone level, favouring the control group. No differences were observed for the other variables evaluated.


Assuntos
Levantamento do Assoalho do Seio Maxilar , Seios Transversos , Animais , Matriz Óssea , Bovinos , Implantação Dentária Endo-Óssea , Falha de Restauração Dentária , Humanos , Maxila/diagnóstico por imagem
9.
Biomed Res Int ; 2021: 6674400, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33969123

RESUMO

The objective of this paper was to evaluate the existence of golden percentage in natural maxillary anterior teeth with the aid of 3D digital dental models and 2D photographs. And to propose regional values of golden percentage for restoration of maxillary anterior teeth. For this purpose, one hundred and ninety dentate subjects with sound maxillary anterior teeth were selected. Standardized frontal images were captured with DSLR, and the apparent width of maxillary anterior teeth was measured utilizing a software on a personal laptop computer. Once the dimensions were recorded, the calculations were made according to the golden percentage theory (GPT). The data were analyzed by independent and paired T-test. The level of significance was set at p < 0.05. The golden percentage values were not found in this study. The values obtained were 16%, 15%, 20%, 20%, 15%, and 16% moving from the right canine to the left canine teeth. There was no significant gender difference in the golden percentage values. Thus, golden percentage should not be used solely for the correction of anterior teeth or for determining dental attractiveness. Emphasis should be given to a range of dental proportion on regional basis.


Assuntos
Modelos Dentários , Imageamento Tridimensional , Maxila/diagnóstico por imagem , Fotografação , Dente/diagnóstico por imagem , Feminino , Humanos , Masculino , Adulto Jovem
10.
Dental Press J Orthod ; 26(2): e2119187, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34008738

RESUMO

INTRODUCTION: A side effect observed in cases treated with extractions is the instability of orthodontic space closure. OBJECTIVE: The aim of this study was to investigate the influence of gingival invagination, presence of third molars and facial pattern, on the stability of orthodontic space-closure in the maxillary arch. METHODS: Ninety-nine subjects (41 male and 58 female) with Class I malocclusion treated with four premolars extraction were evaluated. Extraction sites reopening and gingival invaginations were evaluated in scanned dental models in the posttreatment and 1-year posttreatment stages (mean age 16.1 years). Third molars presence was evaluated at 1-year posttreatment panoramic radiographs, and the facial pattern (SN.GoGn) was evaluated in the initial lateral headfilms. Multiple logistic regression analysis was used to estimate the influence of the aforementioned independent variables on the frequency of extraction space reopening. RESULTS: Space reopening was observed in 20.20% of the subjects 1-year post-debonding. Gingival invaginations were present in 25.73% of quadrants after debonding and in 22.80% 1-year posttreatment. The mean pre-treatment SN.GoGn was 35.64 degrees (SD=5.26). No significant influence was observed of the three independent variables on the instability of extraction site closure. CONCLUSIONS: The presence of gingival invaginations, third molars and facial growth pattern do not seem to influence maxillary extraction sites reopening.


Assuntos
Má Oclusão de Angle Classe I , Extração Dentária , Adolescente , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Feminino , Humanos , Masculino , Má Oclusão de Angle Classe I/diagnóstico por imagem , Má Oclusão de Angle Classe I/terapia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Fechamento de Espaço Ortodôntico , Extração Dentária/efeitos adversos
11.
Medicina (Kaunas) ; 57(3)2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33808680

RESUMO

Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.


Assuntos
Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico , Humanos , Maxila/diagnóstico por imagem , Dente Molar
12.
Head Face Med ; 17(1): 14, 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888144

RESUMO

BACKGROUND: Estrogen is a well-known and important hormone involved in skeletal homeostasis, which regulates genes involved in bone biology. Some studies support that estrogen is important for craniofacial growth and development. Therefore this in vivo animal study aimed to investigate, whether and in which way low estrogen levels in the prepubertal period affect craniofacial development in the postpubertal stage and to quantify the gene expression of RANK, RANKL and OPG in cranial growth sites in ovariectomized estrogen-deficient rats during puberty. METHODS: Control (sham-operated, n = 18) and ovariectomy (OVX, n = 18) surgeries were performed on 21-days-old female Wistar rats. Animals euthanized at an age of 45 days (pubertal stage) were used for gene expression analyses (n = 6 per group) and immunohistochemistry of RANK, RANKL and OPG. Animals euthanized at 63 days of age (post-pubertal stage) were used for craniofacial two-dimensional and three-dimensional craniofacial measurements using µCT imaging (n = 12 per group). RESULTS: In the µCT analysis of the mandible and maxilla many statistically significant differences between sham-operated and OVX groups were observed, such as increased maxillary and mandibular bone length in OVX animals (p < 0.05). Condylar volume was also significantly different between groups (p < 0.05). The sham-operated group showed a higher level of RANK expression in the midpalatal suture (p = 0.036) and the RANKL:OPG ratio levels were higher in the OVX group (p = 0.015). CONCLUSIONS: Our results suggest that estrogen deficiency during the prepubertal period is associated with alterations in the maxillary and mandibular bone length and condylar growth.


Assuntos
Mandíbula , Maxila , Animais , Densidade Óssea , Estrogênios , Feminino , Expressão Gênica , Humanos , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Puberdade , Ratos , Ratos Wistar
13.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(2): 396-401, 2021 Mar 04.
Artigo em Chinês | MEDLINE | ID: mdl-33879917

RESUMO

OBJECTIVE: To analyze the three-dimensional radiographic characteristics of maxillary radi-cular cysts using cone-beam computed tomography (CBCT) and spiral CT. METHODS: Clinical records, histopathological reports, and CBCT or non-enhanced spiral CT images of 67 consecutive patients with maxillary radicular cysts were retrospectively acquired, and radiographic features, including size, shape, expansion, internal structure and relationship with the surrounding tissues, were analyzed. The lesions were divided into three types according to the involved tooth number, as follows: type Ⅰ (single tooth), the epicenter of the cyst was located at the apex of a nonvital tooth, without involvement of the neighbo-ring tooth; type Ⅱ (adjacent tooth involvement), the cyst was located at the apex of a nonvital tooth with involvement of the mesial and/or distal tooth root; and type Ⅲ (multi-teeth), the cyst involved the apexes of ≥4 teeth. Besides, these cysts were classified as another three types on sagittal views, as follows: centripetal, the root apex was oriented centripetally to the center of the cyst; palatal, the cyst was located mainly at the palatal side of the apex; and labial/buccal, the cyst was located mainly at the labial/buccal side of the apex. RESULTS: Totally, 67 patients with maxillary radicular cysts were acquired, including 38 males and 29 females, and their ages ranged from 13 to 77 years. Among them, 46 lesions (68.7%) were located in the anterior maxilla and 65 (97.0%) were round or oval. Labial/buccal cortex expansion was present in 43 cases (64.2%) and palatal cortex expansion in 37 cases (55.2%). The nasal floor was invaded in 27 cases (40.3%), the maxillary sinus was invaginated in 26 cases (38.8%), and root resorption was present in 9 cases (13.4%). The average diameter of lesions was (20.89±8.11) mm mesio-distally and (16.70±5.88) mm bucco-palatally. In spite of the 4 residual cysts, the remaining 63 lesions included 14 type Ⅰ, 26 type Ⅱ and 23 type Ⅲ cysts according to the involved tooth number. Besides, the 63 lesions included 46 centripetal, 15 palatal and 2 buccal cysts on sagittal views. CONCLUSION: The maxillary radicular cysts were frequently well-circumscribed round or oval radiolucency, with significantly different sizes. According to the involved tooth number, it can be divided into single tooth, adjacent tooth involvement and multi-teeth types. On sagittal views, the root-cyst relationship was centripetal in most cases, while a minority of cysts expanded palatally or buccally.


Assuntos
Maxila , Cisto Radicular , Adolescente , Adulto , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Cisto Radicular/diagnóstico por imagem , Estudos Retrospectivos , Raiz Dentária , Adulto Jovem
14.
Artigo em Inglês | MEDLINE | ID: mdl-33819331

RESUMO

This study aimed to assess how frequently the maxilla anatomy allows for lingualized immediate implants in the central incisor region with a screw channel that has an ideal distance of 1.5 mm from the incisal margin. The effect of abutments with angle correction on case selection will also be verified. A retrospective cross-sectional study of 181 CBCT scans was carried out. Using an implant-planning software, implant placement was simulated in the lingual aspect of the socket. The location of the prospective screw channel was registered as incisal, lingual, or facial. The angle between the actual screw channel and the position of the ideal one was calculated. The effect of angle correction on allowing an ideal screw channel configuration was computed. Out of 161 eligible cases, 144 presented favorable anatomy for an immediate implant. The screw channel had an incisal position in 40 cases (28%), a lingual position in 60 cases (42%), and a facial position in 44 cases (30%). The screw channel could be placed at the planned distance from the incisal edge in 35 cases (24%). The position was unfavorable in the remaining 109 cases. In 103 of these cases, an abutment with an angled screw channel could make the conditions feasible. Within the simulated conditions, a majority of maxillary central incisors present favorable ridge anatomy for lingualized immediate implant placement. Achieving a proper location of the screw channel requires abutments with angle correction in a majority of cases.


Assuntos
Implantes Dentários , Tomografia Computadorizada de Feixe Cônico Espiral , Parafusos Ósseos , Estudos Transversais , Estudos de Viabilidade , Humanos , Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Maxila/cirurgia , Estudos Prospectivos , Estudos Retrospectivos
15.
Artigo em Inglês | MEDLINE | ID: mdl-33819333

RESUMO

This study aimed to rehabilitate shortened maxillary dental arch with splinted crowns by connecting ultra-short implants with longer ones. In the posterior maxilla of 11 patients, one 10-mm (n = 11) and one or two ultra-short 4-mm (n = 17) dental implants were inserted. The insertion torque was lower than 20 Ncm in 55% of the 10-mm implants and in 94% of the 4-mm implants (P > .05). Median (range) implant stability quotients at the time of insertion and after 6 months were 61 (14 to 72) and 68 (51 to 79), respectively, for 4-mm implants, and 66 (52 to 78) and 78 (60 to 83), respectively, for 10-mm implants (P < .05). One 4-mm implant failed to integrate. All patients were restored with splinted metal-ceramic crowns connecting 4- and 10-mm implants. Median (range) clinical crown/implant ratios of 4-mm and 10-mm implants were 2.79 (1 to 3.66) and 1.06 (0.85 to 1.46), respectively (P < .05). Six months after prosthetic rehabilitation, the median (range) crestal bone loss was 0.3 mm (-0.7 to 1.7 mm) for 4-mm implants and was 0.5 mm (-0.8 to 3.5 mm) for 10-mm implants (P > .05). Splinted crowns combining 4- and 10-mm implants may contribute to a better force distribution in the treatment with ultra-short implant-supported prosthesis in the posterior maxilla.


Assuntos
Implantes Dentários , Maxila , Coroas , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/cirurgia
16.
Quintessence Int ; 52(6): 488-495, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33880909

RESUMO

OBJECTIVE: This study aimed to compare the accuracy performance of five different intraoral scanning systems for a full-arch scan on an edentulous cadaver maxilla. METHOD AND MATERIALS: Five digital intraoral impression systems were used to scan a fully edentulous cadaver maxilla. A master scan obtained with an ATOS Capsule industrial grade scanner provided the point of comparison. Experimental scans were compared to the master scan using a metrology software that allows images to be overlayed on one another and deviations interpreted. Once aligned, three comparisons were made between the experimental scans and the reference: the entire maxilla, the ridge area only, and the palate area only. RESULTS: Trueness deviations between the experimental scans and the master digital model were up to 0.1 mm in the 75th percentile. For the whole maxilla, only the Medit scanner had statistically significantly inferior trueness compared to other scanners. When only the palate was considered, Medit was significantly different from Element (P = .0025) and Trios 4 (P = .0040), with no differences found between other scanners. For the ridge region the results replicate the trend observed for the whole maxilla. In regard to precision, differences were found only in the whole maxilla and the ridge area. In both areas, only Medit's precision was significantly different compared to other scanners, with the exception of Element. However, Element performance was similar to all other scanners. CONCLUSION: Most intraoral scanners exhibited similar performance. Although several statistically significant differences were identified, the clinical impact of these variances is probably not meaningful. (Quintessence Int 2021;52:488-495; doi: 10.3290/j.qi.b1244373).


Assuntos
Técnica de Moldagem Odontológica , Maxila , Desenho Assistido por Computador , Arco Dental , Modelos Dentários , Humanos , Imageamento Tridimensional , Maxila/diagnóstico por imagem
17.
BMJ Case Rep ; 14(4)2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888482

RESUMO

We report the case of a 25-year-old man with a maxillary ghost cell odontogenic carcinoma (GCOC). The patient presented to the maxillofacial and head and neck surgery clinic with a growing lump in the left maxilla. Initial workup with CT revealed a cystic lesion in the left upper jaw with associated bone erosion and an enhancing soft-tissue component. Enucleation showed a GCOC associated with a calcifying odontogenic cyst. After the diagnosis was obtained, the patient underwent widening of the first surgical resection. GCOCs are rare odontogenic neoplasms with unspecific clinical and imaging presentation, whose definitive characterisation is based on pathology. Current treatment approaches mainly involve surgical excision, but the prognosis is highly unpredictable due to intertumoral heterogeneity. As tumour recurrences occur in 73% of cases, radical surgery with negative margins is highly recommended. Therefore, it is essential to recognise this entity to offer patients adequate management.


Assuntos
Carcinoma , Neoplasias Maxilares , Cisto Odontogênico Calcificante , Tumores Odontogênicos , Adulto , Humanos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Neoplasias Maxilares/diagnóstico por imagem , Neoplasias Maxilares/cirurgia , Recidiva Local de Neoplasia , Tumores Odontogênicos/diagnóstico por imagem , Tumores Odontogênicos/cirurgia
18.
Int J Oral Maxillofac Implants ; 36(2): 371-378, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909730

RESUMO

PURPOSE: The aim of this study was to evaluate the survival and success rates of oral rehabilitations in a shortened maxillary dental arch and expanded maxillary sinus with 4-mm extrashort implants splinted to longer ones. MATERIALS AND METHODS: One 10-mm and one/two extrashort 4-mm titanium-zirconium SLActive tissue-level dental implants were inserted into 11 patients with limited vertical bone availability due to an expanded maxillary sinus antrum. Immediately and 6 months after insertion, implant stability resonance frequency analysis (RFA) values were assessed with an Osstell device. Splinted crowns combining 4- and 10-mm implants were supplied to all 11 cases. RESULTS: In 10 cases, the bone quality was type III, and in one case, type IV. Among 17 4-mm and 11 10-mm implants, the median RFA values were 61 (interquartile ranges [IQR]: 59 to 64) and 66 (IQR: 64 to 72). One 4-mm implant failed to osseointegrate and was removed. After 6 months of healing, secondary-stability measurements of 16 of the remaining 4-mm implants increased to 68 (IQR: 62 to 72) and of 10-mm implants to 78 (IQR: 77 to 80). After 1 year, all (11/11) oral rehabilitations supported by 10-mm (11/11) and 4-mm (16/16) implants were functional. The medians and IQRs of the probing depths (median: 2.8 mm, IQR: 2.3 to 3.1 mm vs median: 2.9 mm, IQR: 2.4 to 3.1 mm) and the crestal bone loss (median: 0.75 mm, IQR: 0 to 0.9 mm vs median: 0.22 mm, IQR: 0 to 0.4 mm) for the 10-mm and 4-mm implants, respectively, were similar. CONCLUSION: Rehabilitations with splinted crowns combining 4- and 10-mm implants demonstrated a favorable 1-year performance in a shortened maxillary dental arch.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/cirurgia , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Estudos Prospectivos
19.
Braz Oral Res ; 35: e060, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909867

RESUMO

This study aimed to describe the morphometric relationship of root canal orifices on the pulp floor in the presence/absence of mesiobuccal second canal (MB2) in the maxillary first molars and other aspects of its internal anatomy. Sixty-two maxillary first molars were scanned by micro-CT. The presence of the MB2 canal was verified. The distance between the center points of the MB1, MB2, distobuccal (DB), and palatal (P) canal orifices on the pulp floor were measured (MB1-MB2, MB1-DB, MB2-DB, MB1-P, and DB-P). The MB1-P to DB-P ratio was calculated. The distances between the anatomic apex and the MB1 and MB2 apical foramina were measured. The length of the band-shaped isthmus was also measured. Student's t-test was applied to verify the association between the presence of an MB2 canal, the interorifice distances, and the ratio of the MB1-P to DB-P distance (α = 5%). The MB2 canal was present in 43 roots (69.35%). Statistics showed significant differences when MB2 was present for the largest MB1-P distance (p < 0.05) and higher values for the MB1-P to DB-P ratio (p < 0.05). A band-shaped isthmus was detected in 25.8% of MB roots. The mean distance from the apical foramen to the isthmus floor ranged from 1.74 for MB1 canals to 1.42 for MB2 canals. Canal orifice distances on the pulp floor may predict the presence of MB2 canals. There was a high incidence of isthmus, accessory canals, and apical delta in the critical apical zone in MB roots of maxillary first molars.


Assuntos
Maxila , Raiz Dentária , Cavidade Pulpar/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Microtomografia por Raio-X
20.
Artigo em Inglês | MEDLINE | ID: mdl-33919492

RESUMO

Dental implants are among the most common treatments for missing teeth. The thickness of the crestal cortical bone at the potential dental implant site is a critical factor affecting the success rate of dental implant surgery. However, previous studies have predominantly focused on female patients, who are at a high risk of osteoporosis, for the discussion of bone quality and quantity at the dental implant site. This study aimed to investigate the effect of male patients' age on the crestal cortical bone of the jaw at the dental implant site by using dental cone-beam computed tomography (CBCT). This study performed dental CBCT on 84 male patients of various ages to obtain tomograms of 288 dental implant sites at the jawbone (41 sites in the anterior maxilla, 95 in the posterior maxilla, 59 in the anterior mandible, and 93 in the posterior mandible) for measuring the cortical bone thickness. A one-way analysis of variance and Scheffe's test were performed on the measurement results to compare the cortical bone thickness at implant sites in the four jaw areas. The correlation between male patient age and cortical bone thickness at the dental implant site was determined. The four jaw areas in order of the cortical bone thickness were as follows: posterior mandible (1.07 ± 0.44 mm), anterior mandible (0.99 ± 0.30 mm), anterior maxilla (0.82 ± 0.32 mm), and posterior maxilla (0.71 ± 0.27 mm). Apart from dental implant sites in the anterior and posterior mandibles, no significant correlation was observed between male patients' age and the cortical bone thickness at the dental implant site.


Assuntos
Implantes Dentários , Estudos de Coortes , Osso Cortical/diagnóstico por imagem , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Maxila/cirurgia
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