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Diagnostic value of tuned-aperture computed tomography versus conventional dentoalveolar imaging in assessment of impacted teeth.

OBJECTIVE: This clinical study compares the diagnostic value of interactive 3-dimensional tuned-aperture computed tomography (TACT) with conventional dentoalveolar radiographic examinations of impacted maxillary incisors. STUDY DESIGN: TACT was compared variously with conventional intraoral, occlusal, rotational panoramic, and lateral cephalographic examinations. Sixteen dentists independently evaluated the clarity of anatomic structures of impacted anterior maxillary teeth and surrounding tissues. Estimation of confidence in clinical assessment of the patient was made together with a determination of the diagnostic potential of the studied modalities for altering treatment plans. RESULTS: TACT was found to significantly improve depiction of the buccal/palatal position of the impacted tooth and its relationship with adjacent teeth (P < .0001) irrespective of the availability of lateral cephalograms. Subjective assessments for clinical decision making approximated a 10% increase in confidence ratings with TACT. The added diagnostic value with TACT varied from case to case. CONCLUSIONS: The interactive 3-dimensional TACT display was perceived to be more informative for assessing impacted teeth and their relation to surrounding tissues than conventional methods in some cases but not in others. TACT altered treatment-option selection in some instances.

Adolescent↗

Factors predisposing to postoperative complications related to wisdom tooth surgery among university students.

In a retrospective study among 550 Helsinki University students 20 to 30 years old, factors predisposing to postoperative complications from removal of lower jaw wisdom teeth were evaluated. Patient records and panoramic tomograms covering the period from 1990 to 1993 were examined; 50 patients (9.1%) had postoperative complications after removal of a wisdom tooth. The most common complications were alveolar osteitis (2.9%), postoperative infection (2.6%), postoperative bleeding (1.5%), and dysesthesia of the lower lip or tongue (1.1%). Factors associated with increased postoperative complications were mesiohorizontal position of the tooth, deep impaction of the tooth, and use of oral contraceptives. Before patients undergo surgery for removal of wisdom teeth, those who use oral contraceptives or have difficult tooth impactions should be informed about the increased possibility of postoperative complications.

Adult↗

Delayed removal of a fully intruded primary incisor through the nasal cavity: a case report.

Complete intrusion of a primary anterior tooth may initially be diagnosed as an avulsion injury. The importance of a correct first clinical and radiological examination of a young patient who has sustained trauma to the anterior primary teeth is stressed in this article. This issue is illustrated by a case presentation where a 3-year-old girl had a delayed treatment of 5 days after a primary incisor was fully impacted by a fall trauma into the nasal cavity. This was due to an incomprehensible clinical and radiological examination by the first examining dentist. The impacted tooth was later removed through the right nostril under general anesthesia. Two-year follow-up showed no adverse clinical or radiological problems even though eruption of the permanent successor had not taken place at that time.

Child, Preschool↗

Immediate and late mandibular fractures after third molar removal.

PURPOSE: In this retrospective study, we analyzed immediate and late mandibular fractures after impacted lower third molar surgery. PATIENTS AND METHODS: One hundred fifty oral and maxillofacial surgeons in the north of- France were questioned about their experience with intraoperative and late mandibular fracture after third molar surgery. Cases were examined clinically and radiographically. RESULTS: Thirty-seven fractures were reported in about 750,000 extractions (incidence of 0.0049%). Only 27 cases could be precisely described: 17 intraoperative and 10 late fractures. The patients were 19 to 75 years of age, with an average age of 37 years for intraoperative fractures and 47 years for late fractures. All grades of tooth impaction were included. Only 2 patients did not have full dentition. CONCLUSIONS: The major incidence of immediate and late mandible fractures occurs in patients older than over 25 years. Men may be more likely to have late fractures (8 of 10 cases).

Adult↗

Outcomes of the surgical exposure, bonding and eruption of 82 impacted maxillary canines.

BACKGROUND: Advances in bonding techniques and materials allow for reliable bracket placement on ectopically positioned teeth. This prospective study evaluates the outcome of forced orthodontic eruption of impacted canine teeth in both palatal and labial positions. METHODS: Eighty-two impacted maxillary canines in 54 patients were included in the study and were observed for 18 to 30 months after exposure. Following exposure by means of a palatal flap or an apically repositioned buccal flap, an orthodontic traction hook, with a ligation chain attached, was bonded to each impacted tooth using a light cured orthodontic resin cement. A periodontal dressing was placed over the surgical site for a period of time. RESULTS: All teeth were successfully erupted. Complications consisted of: failure of initial bond, at the time of surgery, which required rebonding; premature debonding at the time of pack removal and; debonding of brackets during orthodontic eruption. There was no infection, eruption failure, ankylosis, resorption or periodontal defect (pocket greater than 3 mm) associated with any of the exposed teeth. Attached gingiva of less than 3 mm was seen in only two of the buccally positioned canines (9%). CONCLUSION: Forced orthodontic eruption of impacted maxillary canines with a well bonded orthodontic traction hook and ligation chain, used in conjunction with a palatal flap or an apically repositioned labial flap, results in predictable orthodontic eruption with few complications.

Adolescent↗

Prevalence of malocclusion in 13-15 year-old North Jordanian school children.

OBJECTIVES: This study was carried out to determine the prevalence of malocclusion in 13-15-year-old North Jordanian schoolchildren. METHODS: One thousand and three children aged 13-15 years (619 females, 384 males) were examined using Björk et al. (1964) registration method. A full clinical examination was carried out in the school premises using a mouth mirror under natural lighting. Alginate impressions were then taken for each student together with a wax bite. The impressions were poured the same day by an orthodontic technician. Peri-apical radiographs were taken for the students when hypodontia was suspected. RESULTS: Overall, the prevalence of malocclusion was 92%. Class II and III molars were found in 18.8% and 1.4% of the sample respectively. The malocclusion traits detected were crowding (50.4%), midline shift (31.7%), spaced dentition (26.7%), increased overjet (24.7%), deepbite (16.9%), crossbite (6.8), abnormal tooth form (7.7%), median diastema (6.9%), missing teeth (6%), ectopic canines (5.9%), inverted incisors (5.2%), high frenal attachment (3.9%), openbite (2.9%), tooth impaction (1.8%), reversed overjet (1.9%), scissorbite 0.3%. There was no statistically significant difference between males and females in the overall prevalence of malocclusion and the occlusal traits investigated. However, some dental anomalies showed significant differences. CONCLUSIONS: Prevalence of malocclusion among north Jordanians is comparable with other populations.

Adolescent↗

[A case of a calcifying odontogenic cyst associated with odontoma inducing impaction of a deciduous tooth].

A 4-year-old boy was examined with a chief complaint of "Delayed eruption of maxillary right deciduous central incisor". Oral examination revealed a firm swelling on the labial gingiva at the right deciduous incisor of maxilla. Radiographic examination revealed that odontoma-like substances disturbed the eruption of the central deciduous maxillary incisor. The odontoma-like substances were removed surgically and examined histopathologically. The thin sections showed findings typical of a Calcifying Odontogenic Cyst with Odontoma.

Child, Preschool↗

[Blood pressure changes in children during minor oral surgery].

The purpose of this study was to evaluate the influence of minor surgery conducted in the oral cavities of children. Changes in blood pressure and pulse during minor surgery were measured using a Pulse-Wave Korotokoff Sound Record Meter GP-303S (PARAMA). The subjects consisted of 28 children (15 boys and 13 girls) who underwent minor surgery at the pediatric dental clinic of Iwate Medical University. An examination of 16 of the 28 children to determine the relationship between their physique, personality, and blood pressure was made. The following results were obtained: 1) The maximum blood pressure formed a peak at the time of the impacted supernumerary teeth extraction. This was more conspicuous in boys than in girls. The pulse rose to the highest values with the infiltration of the anesthesia, the incision, and stripping. However, no significant values based on sex difference were demonstrated. 2) The maximum blood pressure changed more intensely during surgery in boys than in girls. This was distinctly observed during extraction of the impacted supernumerary tooth. 3) Both the maximum blood pressure and pulse increased with the progress of the surgery. After the surgery, it returned nearly to the presurgical level. With extraction of a supernumerary tooth and marsupialization, the return of the blood pressure to the preoperative level was more delayed in boys than in girls. 4. The changes in blood pressure and pulse seemed to be mostly induced by mental disquietude and stress such as anxiety and fear of surgery. 5. The physique and personality were related to the changes in blood pressure and pulse during minor surgery in the oral cavity.

Anesthesia, Dental↗

Benign cementoblastoma: a case report.

In the past the benign cementoblastoma was recognized in the World Health Organization's classification of odontogenic tumours as one of the cementoma neoplasias. Recently the benign cementoblastoma is included into Mesenchyme and/or odontogenic ectomesenchyme, with or without odontogenic epithelium odontogenic tumours. Benign cementoblastoma has characteristic radiologic and microscopic features and it appears to be fused to the tooth roots. Symptoms may be totally absent, and when they do occur, pain and swelling are frequent findings. The final diagnosis is usually made histopathologically, but the clinical diagnosis is comparatively easy if it is examined radiographically. The tumour has unlimited growth potential. Most frequently tends to be associated with an erupted permanent tooth, most often the first molar: rarely has an association with an impacted or partial impacted tooth been reported. This case represents a case of benign cementoblastoma associated with a partially impacted mandibular third molar.

Humans↗

An investigation into some of the factors concerned in the surgical removal of the impacted lower wisdom tooth, including a double blind trial of chymoral.

During the surgical extraction of 102 impacted lower wisdom teeth the following factors were studied: the amount of trauma applied during tooth removal; the duration of the operation; post-operative swelling; post-operative trismus; sex differences; the relationship between swelling and trismus; the pattern of development and subsidence of swelling and trismus. This study was combined with a clinical 'double-blind' trial of the drug Chymoral.

Chymotrypsin↗

Nonsurgical management of ectopic teeth.

Four cases have been presented involving malpositioned premolars and molars that were brought into the arch. From the cases presented, it appears that aggressive surgical intervention to redirect ectopic premolars creates significant secondary problems. Interference with the bone surrounding the ectopic tooth may compromise the adjacent teeth and bone level. Pressure against the root of the impacted tooth may cause resorption. If the buccal or labial plate is removed, orthodontic movement will be impeded. Specific biochemical changes in bone are induced by the application of orthodontic forces. In these cases, creating space with coiled spring appliances resulted in remarkable reorientation and proper eruption of ectopic, impacted teeth. When surgical intervention is required in cases involving ectopic teeth, close collaboration between orthodontist and oral and maxillofacial surgeon is imperative to achieve successful results without negative sequelae.

Bicuspid↗

Indications for digital volume tomography in orthodontics.

Disturbances in tooth eruption and tooth impactions make great demands on radiographic diagnostics. There is often need for radiographic images in various projections to assess the exact position of unerupted and impacted teeth. Digital volume tomography (DVT) is a method for localizing hard tissue structures such as bone and teeth on various planes. Moreover, it makes a three-dimensional image of the teeth, jaws and the viscerocranium possible. From an orthodontic point of view, digital volume tomography is indicated to detect impacted and ectopic teeth and to demonstrate the amount of bone available for orthodontic tooth movement. In patients with cleft lip and palate, DVT can be used to visualize the size of the alveolar cleft and to evaluate the position and development of multiple teeth, as these patients often suffer from disturbances in tooth eruption.

Germany↗

Single tooth replacement by Morse taper connection implants: a retrospective study of 80 implants.

The goal of this study was to provide data relative to the use of a new implant system (Mac System, Cabon, Milan, Italy) with a Morse taper implant-abutment connection for single implant restorations. The implant system is composed of an endosseous screw made of commercially pure titanium grade 2, while the abutment is titanium alloy (Ti-6Al-4V). A total of 80 single implants were placed in 69 patients (36 women and 33 men, mean age 42 years, range 16 to 61). All patients gave their informed consent and received a thorough clinical and radiographic examination. Smokers and diabetics were excluded from the study. Three implants were placed in areas of previous tooth impaction, 5 were placed in posttraumatic edentulous areas, 2 were used in situations involving tooth agenesis, and 60 replaced teeth lost because of caries or periodontal disease. All patients were edentulous for at least 1 year prior to treatment. The implants received a definitive prosthesis and had been in function for a mean period of 3.5 years. At second-stage surgery, 2 implants were removed because of lack of osseointegration. After 2 years of loading, 1 implant showed evidence of peri-implantitis and was removed. In addition, 2 fractured abutments and 1 loosened abutment were observed. Few mechanical or infectious complications were seen, and this may have been the result of high stability of the conical connection.

Adolescent↗

[Impacted bilateral first permanent molars induced by the migrated second permanent molars].

It is a relatively common clinical experience to see an impacted permanent tooth. In most cases, the cause is considered to be the existence of a supernumerary tooth or developmental crowding, but occasionally, the impacted tooth may occur with no apparent cause. The tooth most frequently impacted in the dental arch is a maxillary permanent canine or the third permanent molar, but the occurrence of the first permanent molar is an extremely rare situation. The patient, an eight-year, seven-month-old male was referred to the Pediatric Dentistry Clinic at the Higashi-Nippon-Gakuen University, School of Dentistry, for a detailed dental examination of his impacted lower permanent first molars. The oral findings through dental examination revealed that the bilateral upper first permanent molars were erupted, while the lower ones showed no clinical signs of eruption. Radiographic examination revealed that the lower second permanent premolars placed under the distal root of the second deciduous molars, and the first molars, inclined to the mesial position, placed at the under the second premolars bilaterally. There was nothing particular in his medical and dental history during the "teething" period. The authors determined that the cause of this impacted condition for the first molars seemed to be induced by a migration of an unerupted second permanent premolars. After extraction of the second deciduous molars and second permanent premolars, orthodontic therapy was undertaken in an attempt to move the impacted first molars into the arch.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗