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Genesis (New York, N.Y. : 2000) Sep 2022The periodontal complex involves the hard and soft tissues which support dentition, comprised of cementum, bone, and the periodontal ligament (PDL). Periodontitis, a... (Review)
Review
The periodontal complex involves the hard and soft tissues which support dentition, comprised of cementum, bone, and the periodontal ligament (PDL). Periodontitis, a prevalent infectious disease of the periodontium, threatens the integrity of these tissues and causes irreversible damage. Periodontal therapy aims to repair and ultimately regenerate these tissues toward preserving native dentition and improving the physiologic integration of dental implants. The PDL contains multipotent stem cells, which have a robust capacity to differentiate into various types of cells to form the PDL, cementum, and alveolar bone. Selection of appropriate growth factors and biomaterial matrices to facilitate periodontal regeneration are critical to recapitulate the physiologic organization and function of the periodontal complex. Herein, we discuss the current state of clinical periodontal regeneration including a review of FDA-approved growth factors. We will highlight advances in preclinical research toward identifying additional growth factors capable of robust repair and biomaterial matrices to augment regeneration similarly and synergistically, ultimately improving periodontal regeneration's predictability and long-term efficacy. This review should improve the readers' understanding of the molecular and cellular processes involving periodontal regeneration essential for designing comprehensive therapeutic approaches.
Topics: Biocompatible Materials; Dental Implants; Periodontal Ligament; Periodontium; Tissue Engineering
PubMed: 36086991
DOI: 10.1002/dvg.23499 -
The Journal of Clinical Pediatric... 2019This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis assessed clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification after a minimum of three months to determine which one provides the best results. The literature was screened via PubMed/MEDLINE and Embase databases up to June 2017 to select observational studies that compared pulp revascularization and apexification treatments assessing clinical, radiographic and functional retention outcomes. Two reviewers independently performed screening and evaluation of articles. A total of 231 articles were retrieved from databases, wherein only four articles were selected for full-text analyses. After exclusion criteria, three studies remained in quantitative and qualitative analyses. Pooled-effect estimates were obtained comparing clinical and radiographic outcomes ('overall outcome') and functional retention rates between apexification and pulp revascularization treatment. The meta-analysis comparing apexification vs. revascularization for 'overall outcome' (Z=0.113, p=0.910, RR=1.009, 95%CI:0.869-1.171) and functional retention rates (Z=1.438, p=0.150, RR=1.069, 95%CI:0.976-1.172) showed no statistically significant differences between the treatments. All studies were classified as high quality. The current literature regarding the clinical, radiographic and functional retention outcomes in immature necrotic permanent teeth treated either with pulp revascularization or apexification is limited. Based on our meta-analysis, the results do not favor one treatment modality over the other.
Topics: Apexification; Dental Pulp; Dental Pulp Necrosis; Dentition, Permanent; Humans; Observational Studies as Topic; Tooth Apex
PubMed: 31560588
DOI: 10.17796/1053-4625-43.5.1 -
European Journal of Orthodontics May 2023Temporary anchorage devices (TADs) offer the clinician an immediate temporary source of skeletal anchorage for a range of orthodontic interventions. It is important to... (Review)
Review
BACKGROUND
Temporary anchorage devices (TADs) offer the clinician an immediate temporary source of skeletal anchorage for a range of orthodontic interventions. It is important to understand forces involved in using TADs and the effects on the dentition and surrounding structures, to improve clinical outcomes.
OBJECTIVE
To examine and qualitatively synthesize literature on the forces involved with the use of TADs and the effects on the dentition and surrounding structures in orthodontic tooth movement, to provide better understanding of the complex interactions and the clinical implications.
SEARCH METHODS
Electronic databases searched included: Cochrane Library [including Central Register of Controlled Trials (CENTRAL)], Embase via OVID, Pubmed, and Scopus. Study screening and selection were conducted in duplicate.
SELECTION CRITERIA
Studies selected were clinical studies, simulation studies (computer or laboratory-based), or animal studies with no restriction over gender, age, study type (excluding case reports), or setting. Studies focusing on the forces involved with the use of TADs in orthodontic treatment and their effects on the dentition and surrounding structures were included.
DATA COLLECTION AND ANALYSIS
A data charting form was piloted and refined. Data charting was performed independently and in duplicate. This consisted of key fields with predetermined options and free text. The extracted data were collated, and a narrative synthesis conducted.
RESULTS
The results from 203 included studies were grouped into seven TAD based interventions combining the clinical, simulation, and animal studies. They were: En masse retraction of anterior teeth, intrusion, movement of a single tooth, orthopaedic interventions, distalisation, maxillary expansion and other types. The forces involved with the use of TADs, and their effects on the dentition and surrounding structures, were presented in descriptive and tabular formats.
LIMITATIONS
This review restricted study language to English. Formal appraisal of the quality of evidence is not a required feature of scoping reviews, as per the PRISMA-ScR guidelines, however it was evident that a proportion of clinical studies were of high risk of bias and low quality and therefore any proposed changes the reader may consider to their clinical practice should be contextualized in light of this.
CONCLUSIONS
Across the seven types of TAD based interventions the effects on the dentition and surrounding structures are described providing a better understanding of the complex interactions. A guide to the level and direction of forces in each type of intervention is provided to aid clinicians in achieving high quality outcomes.
IMPLICATIONS
There is a need to validate future FEA simulation studies by comparing to clinical data. It is also recommended that future scoping reviews incorporate a formal critical appraisal of studies to facilitate the translation of the results into clinical practice. Development of a standard set of terms for TADs is recommended to facilitate future research.
REGISTRATION
Registration of a scoping review is not possible with PROSPERO.
FUNDING
None to declare.
Topics: Dentition; Palatal Expansion Technique; Tooth Movement Techniques
PubMed: 36763546
DOI: 10.1093/ejo/cjac072 -
European Archives of Paediatric... Jun 2021To evaluate and assess the current knowledge about apexification and regenerative techniques as a meaningful treatment modality and to map the scientific evidence for...
PURPOSE
To evaluate and assess the current knowledge about apexification and regenerative techniques as a meaningful treatment modality and to map the scientific evidence for the efficacy of both methods for the management of traumatised immature teeth with pulp necrosis and apical periodontitis.
METHODS
This systematic review searched five databases: PubMed, Web of Science, Cochrane Library, Ovid (Medline), and Embase. Published articles written in English were considered for inclusion. The following keywords were used: Regenerative endodontic treatment OR regenerat* OR revital* OR endodontic regeneration OR regenerative endodontics OR pulp revascularization OR revasculari* OR 'traumatized immature teeth'. Only peer-reviewed studies with a study size of at least 20 cases followed up for 24 months were included. Eligibility assessment was performed independently in a blinded manner by three reviewers and disagreements were resolved by consensus. Subgroup analyses were performed on three clinical outcomes: survival, success, and continued root development.
RESULTS
Seven full texts out of 1359 citations were included and conventional content analysis was performed. Most of the identified citations were case reports and case series.
CONCLUSIONS
In the present systematic review, the qualitative analysis revealed that both regenerative and apexification techniques had equal rates of success and survival and proved to be effective in the treatment of immature necrotic permanent teeth. Endodontic regenerative techniques appear to be superior to apexification techniques in terms of stimulation of root maturation, i.e. root wall thickening and root lengthening. Knowledge gaps were identified regarding the treatment and follow-up protocols for both techniques.
Topics: Apexification; Dental Pulp; Dental Pulp Necrosis; Dentition, Permanent; Humans; Periapical Periodontitis; Root Canal Therapy
PubMed: 33420674
DOI: 10.1007/s40368-020-00575-1 -
Journal of Anatomy Aug 2018In this review, classical data on the early steps in human odontogenesis are summarized and updated with specific insights into the development of the upper and lower... (Review)
Review
In this review, classical data on the early steps in human odontogenesis are summarized and updated with specific insights into the development of the upper and lower embryonic jaws to help in understanding some oral pathologies. The initial step of human odontogenesis is classically characterized by two parallel horseshoe-shaped epithelial laminae. These originate from the oral epithelium and an ingrowth into the jaw mesenchyme: the internal dental lamina gives rise to deciduous tooth primordia, while the external vestibular lamina represents the developmental base of the oral vestibule. However, a more complex situation was revealed by recent studies combining analyses of the dental and adjacent oral epithelia on histological sections and computer-aided three-dimensional (3D) reconstructions during the 2nd month of human embryonic development. The dental epithelium forms a mound, where swellings appear later, corresponding to the individual primordia of deciduous teeth. External to the developing deciduous dentition, the 3D reconstructions do not show any continuous vestibular lamina but instead a complex of discontinuous epithelial bulges and ridges. The patterns of these epithelial structures and their relationship to the dental epithelium differ not only between the upper and lower jaws but also between the lip and cheek segments in each jaw. Knowledge of early odontogenesis may help in understanding some oral pathologies. For example, the human lateral incisor has a dual origin: it arises in the area of fusion between the medial nasal and maxillary facial processes and involves material from these two regions. Such a dual origin at the site of fusion of facial processes represents a predisposition to developmental vulnerability for the upper lateral incisor, resulting in its frequent anomalies (absence, hypoplasia, duplication), especially in patients with a cleft lip and/or jaw. Other pathologies, such as a minute supernumerary tooth, desmoplastic ameloblastoma or extraosseous odontogenic cysts are located external to the upper or lower dentition, and might be derived from structures that transiently appear during early development of the oral vestibule in humans.
Topics: Dentition; Humans; Jaw; Tooth
PubMed: 29745448
DOI: 10.1111/joa.12825 -
PloS One 2023Among mammals, hippopotamids ('hippos') have been described as the species with the lowest chewing efficacy despite elaborate enamel folds on the occlusal surface or...
Among mammals, hippopotamids ('hippos') have been described as the species with the lowest chewing efficacy despite elaborate enamel folds on the occlusal surface or their cheek teeth, which was hypothesized to result from the lack of a grinding chewing motion. We investigated the chewing and dentition of the two extant hippo species, the common hippo (Hippopotamus amphibius) and the pygmy hippo (Choeropsis liberiensis), making (video) observations of live animals and gathering data on museum specimens (n = 86 H. amphibius and 26 C. liberiensis skulls). Hippos have a low degree of anisodonty (differences in width between maxillary and mandibular cheek teeth) and anisognathy (difference in width between the upper and the lower jaw), corresponding to a mainly orthal (up-and-down) chewing motion. The two hippo species differ slightly, but distinctively, in their anterior dental morphology and chewing mode. In both species, the canines do not completely prevent a lateral jaw movement but would, in theory, permit this movement until the mandibular canines get into contact with the maxillary protruding snout. This movement is only realized, to a small extent, in pygmy hippos, leaving distinct wear traces on their incisors and creating relatively wider wear facets on the maxillary canines. In common hippos, the interlocking upper and lower incisors prevent lateral jaw movement. Corresponding contact wear facets are evident on the medial aspect of the upper, and on the lateral aspect of the lower incisors-unless museal reconstructions mispositioned these teeth. If these facets are interpreted as an indication for a relic of a lateral jaw movement that was probably more prominent in hippo ancestors, i.e. if we assume that hippos evolved orthal chewing secondarily, several other characteristics of hippos can be explained, such as a low degree of hypsodonty (in the absence of distinct attrition due to a grinding chewing movement), a secondary loss of complexity in their enamel schmelzmuster, a secondary evolution of a wide mouth gape, a reduction in anisodonty compared to their ancestors, and the evolution of a bilaterally symmetrical ('trifoliate') enamel folding pattern on the molar occlusal surface from an ancestral bunoselenodont condition. As an underlying driving force, selection for intraspecific combat with canines and incisors, necessitating a wide gape and a rigid jaw, has been suggested.
Topics: Animals; Mastication; Dentition; Tooth; Tooth Wear; Artiodactyla; Mammals; Incisor; Maxilla
PubMed: 37792716
DOI: 10.1371/journal.pone.0291825 -
BMC Oral Health Aug 2022Accurate integration of the dentitions with the face is essential in dental clinical practice. Here we introduce a noninvasive and efficient protocol to integrate the...
BACKGROUND
Accurate integration of the dentitions with the face is essential in dental clinical practice. Here we introduce a noninvasive and efficient protocol to integrate the digitized maxillary dentition with the three-dimensional (3D) facial photo using a prefabricated modified computer-aided design/computer-aided manufacture (CAD/CAM) facebow.
METHODS
To integrate the maxillary dentition with the 3D facial photo, the CAD/CAM facebow protocol was applied to 20 patients by taking a series of 3D facial photos in the clinic and integrating them in the laboratory. The integration accuracy of this protocol was compared with that of a valid 3D computed tomography (CT)-aided protocol concerning translational deviations of the landmarks representing maxillary incisors and maxillary first molars as well as the rotational deviation of the maxillary dentition. The intra- and inter-observer reproducibility was assessed, and the time of clinical operation and laboratory integration was recorded.
RESULTS
This facebow-aided protocol generated 3D fused images with colored faces and high-resolution dentitions, and showed high reproducibility. Compared with the well-established CT-aided protocol, the translational deviations ranged from 0 to 1.196 mm, with mean values ranging from 0.134 to 0.444 mm, and a relatively high integration error was found in the vertical dimension (Z) with a mean ± standard deviation (SD) of 0.379 ± 0.282 mm. Meanwhile, the rotational deviations ranged from 0.020 to 0.930°, with mean values less than 1°, and the most evident deviation was seen in pitch rotation with a mean ± SD of 0.445 ± 0.262°. The workflow took 4.34 ± 0.19 min (mins) for clinical operation and 11.23 ± 0.29 min for laboratory integration.
CONCLUSION
The present radiation-free protocol with the modified CAD/CAM facebow provided accurate and reproducible transfer of the digitized maxillary dentition to the 3D facial photo with high efficiency.
Topics: Computer-Aided Design; Dentition; Humans; Imaging, Three-Dimensional; Reproducibility of Results; Tomography, X-Ray Computed
PubMed: 36028874
DOI: 10.1186/s12903-022-02394-w -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Dec 2022This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the...
OBJECTIVES
This study aimed to investigate the accuracy of model superimposition and automatic analysis for upper and lower dentition widths in iTero Progress Assessment during the clear aligner process.
METHODS
Nineteen cases were included in this retrospective case control study. Pretreatment dental cast (T0) and post treatment dental cast after staged treatment (T1) were available for three-dimensional (3D) model superimposition. The movements of maxillary teeth in the horizontal plane (cross section) after staged treatment and the widths of upper and lower dentitions were measured by 3D model superimposition in real world and iTero Progress Assessment. The data collected from the two methods were compared.
RESULTS
The movements [Median (upper and lower quartiles)] of maxillary teeth in the horizontal plane after staged treatment were 2.31 (1.59, 3.22) and 1.79 (1.21, 3.03) mm in iTero Progress Assessment and 3D model analysis, respectively. Significant difference was observed between the two groups (<0.05). In the measurement of upper and lower dentition width, four indicators were measured, including intercanine width upper, intermolar width upper, intercanine width lower, and intermolar width lower. Before treatment, the measurement of iTero Progress Assessment were (35.78±2.49), (56.21±2.51), (27.43±1.38), (52.26±2.91) mm, respectively, and actual measurement were (35.77±2.53), (56.17±2.47), (27.40±1.41), (52.30±2.86) mm, respectively, without significant difference (>0.05). After stage treatment, the measurement of iTero Progress Assessment were (37.37±2.86), (57.76±2.56), (28.89±2.00), (54.16±2.19) mm, respectively, and actual measurement were (37.29±2.94), (57.71±2.63), (28.88±2.05), (54.01±2.15) mm, respectively, and there was no significant difference (>0.05).
CONCLUSIONS
The data from iTero Progress Assessment did not coincide with the model superimposition results with palate as reference. The accuracy of model superimposition in iTero Progress Assessment needs further investigation, whereas the arch width analysis is accurate. Therefore, iTero Progress Assessment results should be interpreted with caution by orthodontists in clinical applications.
Topics: Case-Control Studies; Cuspid; Dental Arch; Orthodontic Appliances, Removable; Retrospective Studies; Humans
PubMed: 36416323
DOI: 10.7518/hxkq.2022.06.011 -
International Journal of Environmental... Dec 2022Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis...
Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.
Topics: Humans; Tooth Ankylosis; Tooth Crown; Alveolar Process; Tooth; Tooth Avulsion
PubMed: 36612921
DOI: 10.3390/ijerph20010603 -
TheScientificWorldJournal 2022To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females.
AIM
To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females.
MATERIALS AND METHODS
A retrospective descriptive study on dental treatments in primary and mixed dentitions was conducted in the Department of Pediatric Dentistry at the Faculty of Dental Medicine, Lebanese University, from 2015 to 2020. The total number of children was 1291. Data were classified and reviewed according to the dentition type, gender, and type of dental treatment.
RESULTS
The number of children decreased from 741 for the period 2015-2017 to 550 during the period 2018-2020 (279 males and 271 females). No significant association was found between the admission periods and the genders. A significant relationship was found between the number of treatments performed in both genders and the dentition types ( value = 0,015). Males were slightly more likely than females to present for the treatment in mixed dentition (54.58% versus 45.2%, respectively). Results portrayed a significant relationship between surgical treatment and gender ( value = 0.049). However, no significant relationship between gender and other treatment types was noted. The comparison between the 2 time frames and the types of treatments showed a significant association in composite fillings ( value = 0.043), extractions ( value < 0.0001), sealants ( value = 0.039), preventive resin restoration (=0.011), pulp therapies ( value < 0.0001), pediatric crowns ( value < 0.0001), and surgical interventions ( value = 0.013). A nonsignificant relationship was recorded for the appliances and composite crowns ( value = 0.45 and 0.14, respectively).
CONCLUSION
The present study points out the implications of the COVID-19 outbreak and Lebanon's economic collapse on children's dental status, with the number of children receiving dental care dropping remarkably. A decrease in all types of dental procedures was noted in mixed dentition, whereas an increase in dental treatments related to aggravated carious lesions was reported in primary dentition. More medical and financial aids are required to encourage and support parents' attitude towards children dental care during unprecedented crises.
Topics: COVID-19; Child; Crowns; Dental Care; Dental Caries; Female; Humans; Male; Retrospective Studies; Tooth, Deciduous
PubMed: 35615224
DOI: 10.1155/2022/9285893