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Medicina Oral, Patologia Oral Y Cirugia... Sep 2023The aim of the present study was to evaluate postoperative effects of platelet-rich fibrin (PRF) in wound and bone healing, pain, swelling and periodontal complications... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The aim of the present study was to evaluate postoperative effects of platelet-rich fibrin (PRF) in wound and bone healing, pain, swelling and periodontal complications outcomes after impacted third molars extraction.
MATERIAL AND METHODS
A prospective, randomized, split-mouth, double-blind clinical trial was conducted. PRF was placed within sockets following tooth removal and before suturing mucoperiosteal flap while no treatment was performed on control group's sockets. Patients were evaluated considering bone volume which was obtained in the 90-day postoperative period. Other variables included trabecular thickness, trabecular distance and grey values, pain, swelling, and wound healing. A Wilcoxon test and a t-Student test were used at a 5% significance level and a Friedman test was used to multiple comparisons.
RESULTS
Forty-four surgeries were performed in the present study. The patients' mean age was 22.41 (± 2.75 years) and 72.73% were women. PRF was associated to increased trabecular thickness and bone volume means (p < 0.001). The experimental group had significantly lower pain scores at 4h, 6h, 8h, 16h, 24h, and 72h (p ˂ 0.05). Mean swelling was lower on the experimental group (p < 0.001). The PRF group showed significant higher wound healing (p ˂ 0.001).
CONCLUSIONS
Alveolar filling with PRF improves wound and bone healing after extractions while also decreasing pain and swelling in the postoperative period.
Topics: Humans; Female; Young Adult; Adult; Male; Platelet-Rich Fibrin; Molar, Third; Prospective Studies; Tooth Extraction; Tooth, Impacted; Pain
PubMed: 37330965
DOI: 10.4317/medoral.25856 -
European Review For Medical and... Aug 2023The aim of this study was to summarize the results of the endocrown (EC) studies that compared tooth preparation designs, tooth types, and ceramic material types in...
OBJECTIVE
The aim of this study was to summarize the results of the endocrown (EC) studies that compared tooth preparation designs, tooth types, and ceramic material types in relation to fracture force values.
MATERIALS AND METHODS
A full literature search was conducted in Web of Science, PubMed/Medline, EMBASE, Scopus, Cochrane Library, Google Scholar, and ProQuest electronic databases. The following keywords: Endocrown [(molar(s)) or (premolar(s) or (posterior teeth)] and Ceramic materials as (Lithium disilicate glass-ceramic; Zirconia; Lava Ultimate) and (fracture strength) or (fatigue) were used. Articles were manually searched utilizing their reference lists. Study selection was not restricted or limited to the time of publication, type of tested tooth, ceramic material, and EC design.
RESULTS
A total of 34 laboratory studies published between 2008 and 2023 were included in this systemic review. Twelve studies were published in the last 3 years, the mandibular molar was examined by 14 studies, and premolars in both arches were investigated, followed by premolars in both arches. Lithium disilicate glass-ceramic (LDGC) was the most used material for EC testing, followed by LAVA Ultimate and zirconia materials. The EC design with a 2 mm extension inside the pulp (14 studies) was the most used. Fracture forces of maxillary molars or premolars were nearly equal and lower than those of mandibular molars. Differences among the fracture forces of the tested ceramic materials were marginal. EC with 2 mm deep inside the pulp showed the highest fracture force.
CONCLUSIONS
Mandibular EC molars showed the highest fracture forces, followed by maxillary premolars and molars. No differences among the EC materials in the 2- and 4-mm pulpal extension designs were found, which had higher fracture forces than other designs.
Topics: Humans; Flexural Strength; Databases, Factual; Fatigue; Fractures, Bone
PubMed: 37667944
DOI: 10.26355/eurrev_202308_33420 -
Journal of Dentistry Dec 2023To compare a three-dimensional (3D) artificial intelligence (AI)- driven model with panoramic radiography (PANO) and cone-beam computed tomography (CBCT) in assessing...
OBJECTIVE
To compare a three-dimensional (3D) artificial intelligence (AI)- driven model with panoramic radiography (PANO) and cone-beam computed tomography (CBCT) in assessing the risk of inferior alveolar nerve (IAN) injury after mandibular wisdom tooth (M3M) removal through a within-patient controlled trial.
METHODS
From a database of 6,010 patients undergoing M3M surgery, 25 patients met the inclusion criteria of bilateral M3M removal with postoperative unilateral IAN injury. In this within-patient controlled trial, preoperative PANO and CBCT images were available, while 3D-AI models of the mandibular canal and teeth were generated from the CBCT images using the Virtual Patient Creator AI platform (Relu BV, Leuven, Belgium). Five examiners, who were blinded to surgical outcomes, assessed the imaging modalities and assigned scores indicating the risk level of IAN injury (high, medium, or low risk). Sensitivity, specificity, and area under receiver operating curve (AUC) for IAN risk assessment were calculated for each imaging modality.
RESULTS
For IAN injury risk assessment after M3M removal, sensitivity was 0.87 for 3D-AI, 0.89 for CBCT versus 0.73 for PANO. Furthermore, the AUC and specificity values were 0.63 and 0.39 for 3D-AI, 0.58 and 0.28 for CBCT, and 0.57 and 0.41 for PANO, respectively. There was no statistically significant difference (p>0.05) among the imaging modalities for any diagnostic parameters.
CONCLUSION
This within-patient controlled trial study revealed that risk assessment for IAN injury after M3M removal was rather similar for 3D-AI, PANO, and CBCT, with a sensitivity for injury prediction reaching up to 0.87 for 3D-AI and 0.89 for CBCT.
CLINICAL SIGNIFICANCE
This within-patient trial is pioneering in exploring the application of 3D AI-driven models for assessing IAN injury risk after M3M removal. The present results indicate that AI-powered 3D models based on CBCT might facilitate IAN risk assessment of M3M removal.
Topics: Humans; Artificial Intelligence; Cone-Beam Computed Tomography; Mandible; Mandibular Nerve; Molar, Third; Radiography, Panoramic; Risk Assessment; Tooth Extraction; Trigeminal Nerve Injuries
PubMed: 38353315
DOI: 10.1016/j.jdent.2023.104765 -
BMC Oral Health Sep 2023Having a reliable and feasible method to estimate whether an individual has reached 16 years of age would greatly benefit forensic analysis. The study of age using...
BACKGROUND
Having a reliable and feasible method to estimate whether an individual has reached 16 years of age would greatly benefit forensic analysis. The study of age using dental information has matured recently. In addition, machine learning (ML) is gradually being applied for dental age estimation.
AIM
The purpose of this study was to evaluate the development of the third molar using the Demirjian method (Demirjian), measure the development index of the third molar (I) using the method by Cameriere, and assess the periodontal ligament development of the second molar (PL). This study aimed to predict whether Chinese adolescents have reached the age of criminal responsibility (16 years) by combining the above measurements with ML techniques.
SUBJECTS & METHODS
A total of 665 Chinese adolescents aged between 12 and 20 years were recruited for this study. The development of the second and third molars was evaluated by taking orthopantomographs. ML algorithms, including random forests (RF), decision trees (DT), support vector machines (SVM), K-nearest neighbours (KNN), Bernoulli Naive Bayes (BNB), and logistic regression (LR), were used for training and testing to determine the dental age. This is the first study to combine ML with an evaluation of periodontal ligament and tooth development to predict whether individuals are over 16 years of age.
RESULTS AND CONCLUSIONS
The study showed that SVM had the highest Bayesian posterior probability at 0.917 and a Youden index of 0.752. This finding provides an important reference for forensic identification, and the combination of traditional methods and ML is expected to improve the accuracy of age determination for this population, which is of substantial significance for criminal litigation.
Topics: Adolescent; Humans; Child; Young Adult; Adult; Molar, Third; Bayes Theorem; Periodontal Ligament; Molar; Machine Learning
PubMed: 37730591
DOI: 10.1186/s12903-023-03284-5 -
Brazilian Oral Research 2023This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and... (Meta-Analysis)
Meta-Analysis
This systematic review evaluated the available evidence on whether children with molar incisor hypomineralization (MIH) have more dental fear and anxiety (DFA) and dental behavior management problems (DBMPs) than those without MIH (Prospero CDR42020203851). Unrestricted searches were performed in PubMed, Scopus, Web of Science, Lilacs, BBO, Embase, Cochrane Library, APA PsycINFO, Open Grey, and Google Scholar. Observational studies evaluating DFA and/or DBMPs in patients with and without MIH were eligible. Reviews, case reports, interventional studies, and those based on questionnaires to dentists were excluded. The methodological quality assessment was based on the Newcastle-Ottawa Scale. Random-effects meta-analyses were conducted to synthesize data on DFA. The certainty of evidence was performed according to GRADE. Seven studies that evaluated a total of 3,805 patients were included. All of them presented methodological issues, mainly in the comparability domain. Most studies observed no significant difference in DFA between children with and without MIH. The meta-analysis did not show a significant effect of MIH on the standardized units for the DFA scores (SMD = 0.03; 95%CI: -0.06-0.12; p = 0.53; I2 = 0%). Synthesis including only the results for severe cases of MIH also did not show a significant effect of the condition on DFA scores (MD = 8.68; 95%CI: -8.64-26.00; p = 0.33; I2 = 93%). Two articles found DBMPs were significantly more frequent in patients with MIH. The overall certainty of evidence was very low for both outcomes assessed. The current evidence suggests no difference in DFA between children with and without MIH; DBMPs are more common in patients with MIH. This information should be viewed with caution because of the very low quality evidence obtained.
Topics: Child; Humans; Dental Enamel Hypoplasia; Dental Anxiety; Molar; Molar Hypomineralization; Surveys and Questionnaires; Prevalence
PubMed: 37436292
DOI: 10.1590/1807-3107bor-2023.vol37.0069 -
International Journal of Clinical... 2023Hypergenetic molars are uncommon in children and adolescents. Furthermore, the presence of multiple eumorphic supernumerary molars (SNMs) in children is sporadic. The...
BACKGROUND
Hypergenetic molars are uncommon in children and adolescents. Furthermore, the presence of multiple eumorphic supernumerary molars (SNMs) in children is sporadic. The author, therefore, reports a nonsyndromic case of multiple supplemental SNMs in a child.
CASE DESCRIPTION
A ten year old boy primarily complaining of cheek biting was found to have six molars on the maxillary left quadrant. Following investigations and case discussion, four molars and fibroma were surgically removed under general anesthesia.
DISCUSSION
This paper discusses the prevalence and management of SNMs in the pediatric population while documenting the first case of multiple eumorphic SNMs in the mixed dentition.
HOW TO CITE THIS ARTICLE
Venkatesh SP. Pediatric Molar Hyperdontia: A Descriptive Case Report. Int J Clin Pediatr Dent 2023;16(5):763-768.
PubMed: 38162231
DOI: 10.5005/jp-journals-10005-2658 -
Dental Press Journal of Orthodontics 2023This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of...
OBJECTIVE
This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of extraction space closure, and to evaluate if these teeth follow a curvilinear (acceleration and/or deceleration) movement rate.
MATERIAL AND METHODS
Twenty-five patients (23.3 ± 5.1 years of age) were enrolled. The retraction of the maxillary canines was accomplished using nickel-titanium closed coil springs (100gf) on 0.020-in stainless steel archwire. Oblique cephalograms were traced and superimposed on the anatomic best fit of the maxilla (before the retraction [T0], and after one month [T1], three [T3], five [T5] and seven [T7] months). Statistics was based in a normally distributed data. Multilevel procedures were used to derive polynomials for each of the measurements. Student's t-test and one-way repeated measures ANOVA were conducted. The level of significance of 5% was adopted.
RESULTS
Canine cusps and apexes did not follow a quadratic curve regarding horizontal movement (neither accelerate nor decelerate). Canine and molar cusps showed more horizontal movement than apexes (4.80 mm vs. 2.78 mm, and 2.64 mm vs. 2.17 mm, respectively).
CONCLUSIONS
Canine did not accelerate or decelerate overtime horizontally; the cusps and apexes of the canines and molars showed more horizontal movement and larger rate at the beginning of canine retraction, followed by significantly smaller and constant movement rate after the first month.
Topics: Humans; Multilevel Analysis; Cuspid; Molar; Capsaicin; Menthol
PubMed: 37729287
DOI: 10.1590/2177-6709.28.4.e232338.oar -
The Journal of Forensic... Dec 2023To investigate whether a specific tooth or teeth provide the most accurate estimation of chronological age (CA), and determine which of the three staging systems studied...
AIM
To investigate whether a specific tooth or teeth provide the most accurate estimation of chronological age (CA), and determine which of the three staging systems studied represents dental development for an individual tooth.
METHOD
Data were collected from 400 digital panoramic radiographs of healthy Saudi children aged 6.00-15.99 years. Each permanent tooth on the left side was evaluated to determine its developmental stage and dental age using the methods by Moorrees, Fanning, and Hunt (MFH) (1963), as adapted by Smith (1991), Gleiser and Hunt (1955), and Nicodemo et al. (1974). The accuracy (bias) of each tooth type and stage was assessed in relation to the CA, the teeth and the methods were compared, and the accuracy of age estimation using all teeth and the most accurate tooth in each method were compared.
RESULTS
Regarding staging systems, comparatively, Gleiser and Hunt's method had the lowest bias for the lower first molar (-0.50 ± 1.05 years). Nicodemo et al.'s method had a lower bias for all other mandibular teeth compared to the MFH method. For individual teeth using the MFH method, the most and least accurate teeth for the combined sexes were the lower central incisor (-0.59 ± 0.77 years) and the lower first molar (-1.54 ± 0.93 years), respectively. No significant difference was found between the biases when using the lower central incisor alone and when using all teeth for the combined sexes. For individual teeth using Nicodemo et al.'s method, the most and least accurate teeth for combined sexes were the upper central incisor (-0.03 ± 1.01 years) and the lower first molar (-1.08 ± 1.59 years), respectively. A significant difference was found between the biases using the upper central incisor alone and all teeth for the combined sexes, with the upper central incisor exhibiting the lowest bias (P=0.028).
CONCLUSIONS
Comparatively, Nicodemo et al.'s method had the lowest bias for all teeth except for the lower first molar, where Gleiser and Hunt's method had the lowest bias. This, however, should not be confused with precision. MFH's staging system was more representative of dental development for an individual tooth. For combined sexes, the lower central and lateral incisors were the most accurate teeth using the MFH method. The upper central incisor and lower first premolar were the most accurate teeth using Nicodemo et al.'s method. The lower first molar was the least accurate tooth using both methods.
Topics: Child; Humans; Incisor; Molar; Confusion; Household Articles; Metal Workers
PubMed: 38183969
DOI: No ID Found -
Journal of Clinical Medicine Nov 2023As specific flap designs performed for lower third molar extractions usually influence periodontal healing of the adjacent first and second molars, this study aimed to...
BACKGROUND
As specific flap designs performed for lower third molar extractions usually influence periodontal healing of the adjacent first and second molars, this study aimed to evaluate the periodontal conditions of these sites after 6 months post-surgery.
METHODS
Forty patients, aged 14-30 years, were included. Surgical extraction of the lower third molar was performed through a flap with papilla detachment (a modified envelope technique with detachment of gingival papilla between the first and second molars) or a trapezoidal flap (characterized by mesial- and distal-releasing incisions). Periodontal parameters at the first and second molar sites were assessed for visible plaque index, bleeding on probing, recession, probing pocket depth, and clinical attachment loss before surgery (T0), one month (T1), and six months after extraction (T2).
RESULTS
No statistical differences were found for the plaque and bleeding indexes between the two flaps at each observation time and considering both time intervals. For recession, no statistical differences were found between the two flaps considering the final time interval. For probing pocket depth at the second molar site, both techniques registered a significant increase between T0 and T1, followed by a decrease up to T2. For clinical attachment loss, mean values assessed for the first and second molar sites demonstrated evidently increased values between T0 and T1, followed by moderate decreases up to T2.
CONCLUSIONS
Considering short (T1) and mid-term (T2) follow-ups, a specific flap design does not seem to particularly influence periodontal healing six months after surgery.
PubMed: 38002631
DOI: 10.3390/jcm12227017 -
The Journal of Prosthetic Dentistry Jun 2024Computer-aided design and computer-aided manufacturing (CAD-CAM) technology has greatly improved the efficiency of the fabrication of dental prostheses. However, the...
STATEMENT OF PROBLEM
Computer-aided design and computer-aided manufacturing (CAD-CAM) technology has greatly improved the efficiency of the fabrication of dental prostheses. However, the design process (CAD stage) is still time-consuming and labor intensive.
PURPOSE
The purpose of this feasibility study was to investigate the accuracy of a novel artificial intelligence (AI) system in designing biomimetic single-molar dental prostheses by comparing and matching them to the natural molar teeth.
MATERIAL AND METHODS
A total of 169 maxillary casts were obtained from healthy dentate participants. The casts were digitized, duplicated, and processed with the removal of the maxillary right first molar. A total of 159 pairs of original and processed casts were input into the Generative Adversarial Networks (GANs) for training. In validation, 10 sets of processed casts were input into the AI system, and 10 AI-designed teeth were generated through backpropagation. Individual AI-designed teeth were then superimposed onto each of the 10 original teeth, and the morphological differences in mean Hausdorff distance were measured. True reconstruction was defined as correct matching between the AI-designed and original teeth with the smallest mean Hausdorff distance. The ratio of true reconstruction was calculated as the Intersection-over-Union. The reconstruction performance of the AI system was determined by the Hausdorff distance and Intersection-over-Union.
RESULTS
Data of validation showed that the mean Hausdorff distance ranged from 0.441 to 0.752 mm and the Intersection-over-Union of the system was 0.600 (60%).
CONCLUSIONS
This study demonstrated the feasibility of AI in designing single-molar dental prostheses. With further training and optimization of algorithms, the accuracy of biomimetic AI-designed dental prostheses could be further enhanced.
Topics: Humans; Feasibility Studies; Computer-Aided Design; Artificial Intelligence; Dental Prosthesis Design; Molar; Dental Prosthesis; Models, Dental; Adult
PubMed: 36631366
DOI: 10.1016/j.prosdent.2022.12.004