Tooth survival following various methods of sub-apical osteotomy.
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Adolescent↗
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Eearly pulp changes following reduction of open bite by segmental surgery.
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Animals↗
Posttraumatic impaction of both maxillary central incisors.
Dental impactions are one of the problems orthodontists see that will usually require surgery along with orthodontic treatment. In most cases, a single tooth is impacted, and a single surgical procedure is performed. We present a case of posttraumatic bilateral impaction of both maxillary central incisors with complete inversion after combined 2-step surgery and orthodontic treatment.
Child↗
Teeth in the fracture line.
The department of maxillo-facial surgery in Cologne University has, for some 15 years, routinely treated patients with mandibular fractures, in which a tooth lies in the fracture line, by means of Champy miniplates. A review of such cases was conducted to determine the viability of such teeth not electively extracted at the time of fracture reduction. It was found that only rarely did the "salvaged" tooth subsequently require extraction and we believe our results should encourage the clinician to attempt to retain "fracture line" teeth unless there is an absolute contraindication.
Adolescent↗
[Dental traumatology: a matter of survival].
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Child↗
Orthodontic-endodontic treatment planning of traumatized teeth.
Occasionally, an orthodontic patient will accidentally traumatize a maxillary anterior tooth before or during orthodontic treatment. In some situations, the trauma will be substantial and avulse the tooth. In other accidents, the tooth may not avulse, but the pulp becomes nonvital. If the pulp is devitalized, and the root has not fully formed, the apex of the root canal may be wide. In this situation, the endodontist may recommend apexification procedures to help close the apex before conventional obturation of the root canal. If the patient is currently undergoing orthodontic movement of the traumatized incisor, what effect will the tooth movement have on the success of the apexification? If the tooth were avulsed, replanted, and then ankylosed, should it be extracted? If so, when should the ankylosed incisor be removed? What effect will further facial growth have on the ankylosed tooth and the potential to achieve a successful esthetic restoration? The answers to these questions are important during the interdisciplinary treatment planning of the patient with traumatized teeth. This article will elucidate the endodontic-orthodontic considerations for patients with traumatized anterior teeth.
Adolescent↗
Use of mineral trioxide aggregate for repair of furcal perforations.
The histologic response to intentional perforation in the furcations of 28 mandibular premolars in seven dogs was investigated. In half the teeth, the perforations were repaired immediately with either amalgam or mineral trioxide aggregate; in the rest the perforations were left open to salivary contamination before repair. All repaired perforations were left for 4 months before histologic examination of vertical sections through the site. In the immediately repaired group, all the amalgam specimens were associated with inflammation, whereas only one of six with mineral trioxide aggregate was; further, the five noninflamed mineral trioxide aggregate specimens had some cementum over the repair material. In the delayed group, all the amalgam specimens were associated with inflammation; in contrast only four of seven filled with the aggregate were inflamed. On the basis of these results, it appears that mineral trioxide aggregate is a far more suitable material than amalgam for perforation repair, particularly when used immediately after perforation.
Aluminum Compounds↗
Determination of location of root perforations by electronic apex locators.
OBJECTIVES: This study was conducted to evaluate the accuracy of two electronic apex locators, the Sono Explorer Mark 2 Junior (Hakusui, Osaka, Japan) and Apit 2 (Osada, Tokyo, Japan) in detecting root perforations. The adequacy of radiographs for identifying root perforations was also assessed. STUDY DESIGN: Thirty-two extracted human teeth were perforated in the middle third of the root and embedded in alginate. Determination of all perforations were carried out with K-files no. 25 attached to the apex locators tested. Two radiographs were taken at two angulations after each electronic measurement. The actual location of the file tip in relation to the perforation was determined with a stereomicroscope. A total of 512 radiographs were evaluated to attempt to identify root perforations. RESULTS: The mean distance of the file tip from the external outline of the root surface was short for both instruments. A statistical difference (p < 0.05) was found between the two apex locators in dry canals or if saline solution was present. There was no significant difference between the two instruments in the presence of sodium hypochlorite. Evaluators radiographically identified 45% of the root perforations when located in buccal-lingual directions. CONCLUSION: Under the in vitro conditions of this study, both devices determined the location of the perforations in an acceptable clinical range short of the root surface. Radiographs were found to be less reliable in identification of perforation locations.
Chi-Square Distribution↗
Repair of furcal perforations with mineral trioxide aggregate: two case reports.
Furcal perforation is an unfortunate incident that can occur during root canal therapy or post preparation of multirooted teeth. Studies have shown that the materials currently used to repair these iatrogenic accidents are inadequate. The poor prognosis of furcation perforations is probably due to bacterial leakage or lack of biocompatibility of repair materials. On the basis of the recent physical and biologic property studies of the newly introduced mineral trioxide aggregate, this material may be suitable for closing the communication between the pulp chamber and the underlying periodontal tissues. These case reports support this hypothesis.
Adolescent↗
Use of a hydroxylapatite-based material and calcium sulfate as artificial floors to repair furcal perforations.
OBJECTIVE: The purpose of this study was to evaluate a hydroxylapatite-based material and calcium sulfate when each was used under a resin-modified glass ionomer cement to repair furcation perforations. STUDY DESIGN: Perforations of pulp chamber floors were made in 72 teeth of 9 dogs. Perforations were divided into 3 equal-sized groups and repaired with resin-modified glass ionomer either alone or over an artificial floor. The artificial floor was either a hydroxylapatite-based material or calcium sulfate. Three dogs were killed at each of 3 intervals (1, 3, and 6 months). The tissue response to the tested materials was evaluated clinically, radiographically, and histologically. RESULTS: The hydroxylapatite-based material showed the highest radiographic success; this was followed by calcium sulfate and glass ionomer. From histologic evaluation, the average success rate was found to be 67% for calcium sulfate, 62% for the hydroxylapatite-based material, and 59% for glass ionomer. However, there was no statistical significant difference with the resin-modified glass ionomer when it was used alone and when it was used over a barrier. There was also no significant difference between the hydroxylapatite-based material and the calcium sulfate when they were used as artificial floors. CONCLUSION: The use of an artificial floor may not be necessary when flowable resin-modified glass ionomer cements are used.
Animals↗
Root defects following air polishing.
AIM: Air-polishing devices (APDs) are highly effective in removing plaque and extrinsic staining. Their application on root surfaces, however, may result in clinically relevant substance removal, limiting the use in patients with periodontitis, where denuded root surfaces are frequently found. Therefore, the purpose of the study was to assess the influence of different working parameters on root damage and to identify those minimizing root damage. MATERIAL AND METHODS: Defect depth and defect volume after instrumentation of roots with an APD (Dentsply Prophy-Jet) using conventional NaHCO3 powder at instrumentation times of 5, 10 and 20 s, combinations of low, medium and high powder and water settings, distances of 2, 4 and 6 mm, and angulations of 45 degrees and 90 degrees were quantified laseroptically. A total of 297 roots were instrumented and parameter combinations were performed in triplicate. The influence of each working parameter on substance loss was determined by multiple regression analysis. RESULTS: Time had the greatest influence on defect volume and depth (beta-weights 0.6 and 0.57, respectively), when compared with powder setting (beta-weights 0.49 and 0.3) and water setting (beta-weights 0.28 and 0.3). Variations in distance affected defect depth (beta-weight 0.44), but not volume (beta-weight 0.04). No major differences were found at 45 degrees and 90 degrees. Various parameter combinations led to maximal defect depths of 473.5 +/- 26.2 micro m within 20 s. CONCLUSION: Root damage varies among combinations of working parameters. Using the APD with the assessed NaHCO3 powder, all parameter combinations led to substantial root damage. Thus, APDs using NaHCO3 may not be safely utilized on exposed root surfaces.
Air Abrasion, Dental↗
An analysis of 58 traumatically intruded and surgically extruded permanent teeth.
Fifty-eight traumatically intruded and mainly surgically extruded permanent teeth were followed up for 3 years and 4 months (mid-term results: 29 teeth) and 9 months (short-term results: 29 teeth) on average. Statistically, the mid-term results showed more cases of severe crown discoloration (54%) than the short-term results (9%), but no difference in pulpal and periodontal healing. Three teeth (5%) were lost. Factors which positively influenced pulpal healing were shallow intrusion depth, intact crown and immaturity of the root. Factors which positively influenced periodontal healing were shallow intrusion depth and minimal surgical manipulation. Alveolar bone healing was positively influenced only by shallow intrusion depth.
Adolescent↗
Crown dilaceration of a first premolar caused by extraction of its deciduous predecessor: a case report.
This report describes a rare case of crown dilaceration of the mandibular first premolar caused by trauma during extraction of the precedent primary first molar. The mandibular first primary molar had been extracted at the age of 4 years 7 months. Compared to the pre-operative radiograph, the post-operative film showed that the direction of the first premolar tooth germ had changed, suggesting that crown dilaceration had been induced by the surgical procedures during tooth extraction. From radiographic examinations, the premolar was considered to have erupted spontaneously.
Bicuspid↗
Dental trauma management awareness of Singapore pre-school teachers.
The purpose of this study was to assess the awareness of pre-school teachers concerning the management of traumatized teeth. A questionnaire survey of teachers' backgrounds, attitudes/practices and knowledge was distributed to all teachers who attended a dental education program organized by the Singapore Dental Health Foundation. Of a total of 291 teachers surveyed, 29% had received tertiary education, while the rest (71%) had received secondary education. The mean teaching experience was 6.8 +/- 6.9 years. About a quarter had previous experience in handling dental trauma. Sixty-three percent admitted having no knowledge of dental trauma; 79% were unsatisfied with their level of knowledge in this area; 95% were keen to have further education in dental trauma; 65% thought dental trauma emergency should be dealt with as soon as possible. Concerning knowledge, during-office hour emergency services were more familiar (84%) than after-office hour emergency services (15%), as was the concept of management of avulsed teeth (71%) compared to that of fractured teeth (51%). Knowledge about optimal storage media for avulsed permanent teeth was especially poor--being as low as 15%. Using multiple logistic regression analysis, it was found that teaching experience significantly influenced the respondents' self-assessed knowledge and their level of satisfaction with their knowledge (P = 0.012). Teachers with more teaching experience had better knowledge about the replantation of permanent teeth (P = 0.003). It is recommended that public education targeted at teachers should be carried out to increase dental trauma management awareness.
Attitude to Health↗
Treatment of replacement resorption with Emdogain--preliminary results after 10 months.
Ankylosis of traumatized teeth in children and adolescents may inhibit further development and growth of the corresponding jawbone. Therefore, ankylosed teeth should be removed. As an alternative treatment option to autotransplantation of a premolar, intentional replantation using Emdogain may be considered, provided the ankylosis is detected at an early stage or has only affected a small area of the root. Eleven ankylosed teeth presenting with replacement resorption were treated as follows: after tooth extraction, the root canal was treated extraorally and obturated by retrograde insertion of a titanium post. Emdogain was applied to the root surface and into the extraction socket with subsequent replantation of the tooth. During a mean follow-up period of 6.3 months, no signs of recurrence of ankylosis were noted. The horizontally and vertically measured Periotest scores were identical to those obtained on the adjacent teeth. These results suggest that intentional replantation using Emdogain may prevent or delay ankylosis of these replanted teeth.
Adolescent↗
Prevalence of dental trauma in 5-6- and 12-14-year-old boys in Riyadh, Saudi Arabia.
This study involved 354 boys aged 5-6 years and 862 boys aged 12-14 years, attending 40 schools in Riyadh. All children were examined at school by a single dental examiner, using criteria similar to those employed in the survey of children's dental health in the United Kingdom. The prevalence of dental trauma in 354 Saudi boys aged 5-6 years was 33%. The most common type of dental trauma was fracture of enamel (71%) followed by loss of tooth due to trauma (13%), fracture into enamel and dentine (7%), discolouration (5%), pulp involvement (4%). No relationship between the degree of overjet and the occurrence of dental trauma in the primary dentition was observed. The prevalence of dental trauma in 862 12-14-year-old boys was 34%. The commonest dental trauma was fracture of enamel (74%) followed by fracture into enamel and dentine (15%), fracture into enamel-dentine and pulp (5%), loss of tooth due to trauma (3%), and discolouration (0.4%). A significant relationship (P=0.02) between the increased overjet (> or = 6 mm) and the occurrence of dental trauma in the permanent dentition was reported. The present study found no evidence of dental care provided for traumatised primary incisors in 5-6-year-old boys. The treatment of dental trauma in 12-14-year-old boys was negligible (2.4%). The present Saudi Arabian study showed higher prevalence of dental trauma in 5-6- and 12-14-year-old boys than the reported results of the United Kingdom Children's Dental Health Survey of the same age groups.
Adolescent↗
Traumatized permanent teeth in Brazilian children assisted at the Federal University of Santa Catarina, Brazil.
The goal of this study was to determine factors related to the occurrence of dental trauma in permanent teeth of children assisted at the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. During a period of 18 months, 36 children between 7 and 12 years of age had 72 traumatized teeth treated. The children were all assisted by one professional, a dentist working as a trainee of the Pediatric Dentistry Clinic. The occurrence of trauma was higher in male patients (61.3%) and in children between 8 and 9 years old with an average age of mean=9.4 years. In the group assisted, 63.9% of the children had more than one traumatized tooth and trauma reoccurred 19.4% of the time. The maxillary anterior teeth represented 96.1% of the cases and the central incisor teeth were the most affected. Both sides of the mouth had approximately the same number of traumas. Fractures were more frequent (51.4%) than luxations (48.6%). Enamel/dentin crown fractures represented 51.4% of the total traumatized teeth. Falls were the main cause of trauma (83.3%). A dental professional assisted 36.1% of the children in some way during the first 24 h after the incident. The study concluded that the permanent dentition is mostly affected by crown fractures that occur especially on maxillary central incisor teeth in patients between 8 and 9 years of age. The major etiological factor is falls that affected more than one tooth. Re-occurrence of trauma is fairly common.
Accidental Falls↗
Comparison of a new dental trauma splint device (TTS) with three commonly used splinting techniques.
Splinting is the standard of care for stabilization of replanted or repositioned permanent teeth following trauma. The present experimental study compared four dental trauma splints in 10 volunteers. The evaluated splints included a wire-composite splint (WCS), a button-bracket splint (BS), a resin splint (RS), and a new device (TTS=Titanium Trauma Splint) specifically developed for splinting traumatized teeth. All splints were bonded to the labial surfaces of the maxillary lateral and central incisors. Splints were left in place for 1 week. After splint removal, the next splint was placed after a 1-week rest period. The sequence of splint application was randomized for each individual. The following parameters were assessed: tooth mobility with horizontal and vertical Periotest values (PTV) before and after splint application and splint removal, respectively; probing depths, plaque and bleeding on probing indices before splint application and removal, and chair time needed for splint application and removal. After splint application, horizontal PTV were significantly lower in central incisors for BS compared to TTS (P=0.04), and for RS compared to TTS (P=0.005) and to WCS (P=0.006). Reduction of lateral tooth mobility (=splint effect) expressed by the difference between horizontal pre- and postoperative PTV was significantly greater in RS compared to TTS and WCS (P<0.05) for central as well as for lateral incisors. However, changes of vertical tooth mobility were not significant across the splinting techniques. Periodontal parameters remained unchanged, reflecting the excellent oral hygiene by the study subjects. The chair time needed for splint application was significantly shorter for TTS (P<0.01). In conclusion, all tested splints appeared to maintain physiologic vertical and horizontal tooth mobility. However, the latter was critically reduced in RS splints.
Acrylic Resins↗