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Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Tooth, Impacted; Cuspid; Bicuspid; Molar; Female; Tooth Movement Techniques; Male; Child; Patient Care Planning; Anodontia
PubMed: 38917044
DOI: No ID Found -
Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Patient Care Planning; Tooth Movement Techniques; Female; Gingiva; Computer-Aided Design; Orthodontic Appliances, Removable; Orthodontic Appliance Design
PubMed: 38917042
DOI: No ID Found -
Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Orthodontic Anchorage Procedures; Molar, Third; Malocclusion, Angle Class III; Female; Tooth Movement Techniques; Orthodontic Appliance Design; Male; Adolescent
PubMed: 38917041
DOI: No ID Found -
Journal of Clinical Orthodontics : JCO May 2024
Topics: Humans; Palatal Expansion Technique; Computer-Aided Design; Molar; Orthodontic Appliance Design; Female; Child
PubMed: 38917039
DOI: No ID Found -
Clinical Oral Investigations Jun 2024The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes...
INTRODUCTION
The study aims to compare the detection of the middle mesial canal (MMC) in mandibular molar teeth using cone beam computed tomography (CBCT) with different voxel sizes when the mesiobuccal (MB) and mesiolingual (ML) canals have three distinct phases (unpreparation, preparation and obturation and the removal of the obturation and repreparation).
METHODS
Two hundred forty-two extracted human mandibular molars were collected and kept in a physiological saline solution prior to use. 0.2-, 0.28- and 0.35-mm voxel sizes CBCT (n = 242) were performed in three phases (Ph): Ph1, no MB and ML canal preparation or obturation; Ph2, after MB and ML canals preparation and obturation; and Ph3, after the removal of the obturation of MB and ML canals and canals repreparation. Images were analyzed using OnDemand3D® software. After the CBCT acquisition in Ph3, all the samples were clarified to visualize the presence of the MMC directly. A blinded, previously calibrated examiner analyzed all the images.
RESULTS
The MMC was detected in 15 of the 242 teeth after the clearing technique. The lowest MMC detection rate was observed at 0.35-mm voxel size regardless of the ML and MB canal condition, while the highest was observed at 0.2-mm voxel size (P < 0.05). There is no statistically significant difference between 0.2-mm and 0.28-mm voxel sizes (P > 0.05). In all voxel sizes, the highest rate of detectability of the MMC was seen in Phase 1, while the lowest was in Phase 2.
CONCLUSIONS
It may be appropriate to take a 0.20-mm voxel size CBCT image, especially after the removal of root canal filling.
CLINICAL RELEVANCE
An appropriate CBCT voxel size and the absence of root canal filling in the root canal system help to detect the missing MMC.
Topics: Cone-Beam Computed Tomography; Humans; Molar; Mandible; Dental Pulp Cavity; In Vitro Techniques; Root Canal Obturation; Root Canal Preparation; Root Canal Filling Materials
PubMed: 38916762
DOI: 10.1007/s00784-024-05773-5 -
Regenerative Endodontic Procedure on an Immature Necrotic Molar: A Case Report with a 5-Year Review.The American Journal of Case Reports Jun 2024BACKGROUND The regenerative endodontic procedure (REP) for managing necrotic immature permanent teeth has the advantage of promoting root growth over the traditionally...
BACKGROUND The regenerative endodontic procedure (REP) for managing necrotic immature permanent teeth has the advantage of promoting root growth over the traditionally used apexification techniques. However, there is limited evidence on the long-term outcome of standardized REPs performed on immature molars. This case report presents the 5-year clinical and radiographic outcomes of REP performed on an immature mandibular first molar. CASE REPORT A healthy 7-year-old girl with a carious right mandibular first molar was referred to the endodontic clinic for evaluation and treatment. Clinical examination showed large occlusal caries, no tenderness to palpation and percussion tests, and no response to cold and electric pulp tests. Radiographic examination showed deep caries, apical radiolucency related to the open apices, and wide root canal space. Accordingly, the tooth was diagnosed with necrotic pulp and asymptomatic apical periodontitis. The REP was performed following the American Association of Endodontics guidelines, which comprise minimal instrumentation, disinfection with sodium hypochlorite irrigant, use of triple antibiotic paste, induced intracanal bleeding, and application of a coronal mineral trioxide aggregate plug. The patient missed the scheduled follow-up appointments but presented at the clinic 5 years later with an asymptomatic tooth. Clinical and radiographic examination revealed no tenderness to percussion and palpation test, no response to cold test, positive response to electric pulp test, apical healing, apical closure, root lengthening, and canal wall thickening and calcification. CONCLUSIONS While true pulp regeneration is unachievable, the REP, following the current protocol, is clinically successful in achieving root maturation and tooth retention.
Topics: Humans; Female; Child; Regenerative Endodontics; Molar; Dental Pulp Necrosis; Drug Combinations; Periapical Periodontitis
PubMed: 38915185
DOI: 10.12659/AJCR.944179 -
BMJ Case Reports Jun 2024Conventional operative dental procedures are being revisited with an approach that seeks to preserve the original tissue as much as possible. Implant dentistry has also...
Conventional operative dental procedures are being revisited with an approach that seeks to preserve the original tissue as much as possible. Implant dentistry has also seen the advent of various techniques which make minimal alteration to natural tissue. The flapless technique involves implant placement either through a freshly extracted socket or through a tansmucosal punch hole, without elevating mucoperiosteal flap. This paper presents a report on three cases of patient centric, conventional dental implant-based full-mouth rehabilitation, which was successfully carried out using the flapless technique, under varied clinical situations. Each case showed a favourable outcome in terms of restoration of the form and function of the patient's dentition.
Topics: Humans; Female; Male; Minimally Invasive Surgical Procedures; Mouth Rehabilitation; Dental Implantation, Endosseous; Middle Aged; Dental Implants; Adult
PubMed: 38914524
DOI: 10.1136/bcr-2024-259781 -
Quintessence International (Berlin,... Jun 2024The study aims to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommending a preferred treatment...
OBJECTIVE
The study aims to provide a comprehensive case analysis from a single center, with the objective of clarifying the optimal timing and recommending a preferred treatment strategy customized to the specific presentation of each type of supernumerary tooth (SNT) identified in our research.
METHODS AND MATERIAL
A retrospective study was conducted on patients who presented with SNT and were treated through an interdisciplinary at the clinic.
RESULTS
55 patients with 81 SNT of the permanent dentition were analyzed. They included 30 males and 25 females. The dentition status of the patients was as follows: 31 patients with mixed dentition, 0 patients with deciduous dentition, and 24 patients with permanent dentition. The diagnosis of SNT diagnosis was primarily made by general or pediatric dentists and/or orthodontists. Patients were then referred to maxillofacial surgeons for treatment decision. The timing of treatment was mainly determined by the oral surgeon, based on the recommendations of the other specialists involved. Cases involving mal-eruption or malalignment of permanent teeth required both surgical and orthodontic treatment. Patients over 9 years old were treated either under local anesthesia or sedation, while those under 9 years old were treated under deep sedation or general anesthesia A comprehensive investigation of cases involved the utilization of cone beam computerized tomography (CBCT) at the SNT site to facilitate treatment planning. There was a significant correlation between younger age and the preference for treatment under sedation or general anesthesia (p=0.01, t-test). Similarly, a strong association was found between younger age and the need for additional orthodontic treatment (p=0.016, t-test). Cases of surgical removal of SNT at a young age typically did not require orthodontic traction of the permanent tooth, in contrast to cases of late surgical intervention (patients over 11 years old), which often did necessitate such traction. There was a strong tendency for treating supernumerary teeth (SNT) in the maxilla. The proximity of SNTs to vital anatomical landmarks significantly influenced treatment decisions. Patients with SNTs near the mental foramen or the inferior dental canal in the premolar area were exclusively placed under follow-up care (p=0.002, Pearson's chi-square test). However, in the maxilla, the proximity of SNTs to vital structures such as the floor of the nose and the incisive nerve did not affect the treatment approach, and those supernumerary teeth were mostly removed.
CONCLUSIONS
A team approach for managing supernumerary teeth (SNT) is recommended. The timing of treatment should carefully consider the advantages and disadvantages of early versus late intervention. Early surgical treatment in cases where eruption is disturbed might result in spontaneous eruption, eliminating the need for orthodontic traction of the permanent teeth.
PubMed: 38912671
DOI: 10.3290/j.qi.b5503749 -
Journal of Maxillofacial and Oral... Jun 2024Complete failure of eruption leads to impaction. Impacted teeth are more common in maxilla as compare to mandible. The impaction of permanent dentition is not uncommon...
Complete failure of eruption leads to impaction. Impacted teeth are more common in maxilla as compare to mandible. The impaction of permanent dentition is not uncommon but out of them, few permanent teeth are rarely impacted such as maxillary first molars. Etiology behind this can be multifactorial. Here, we report two rare cases of impacted maxillary first molars which require very technique sensitive surgical removal so as to minimize risks of injury to adjacent teeth and other adjacent structures. Follow-up was made first day, third day, seventh day, and 1 month with no complication.
PubMed: 38911397
DOI: 10.1007/s12663-023-02087-z -
Bone Research Jun 2024Stem/progenitor cells differentiate into different cell lineages during organ development and morphogenesis. Signaling pathway networks and mechanotransduction are...
Stem/progenitor cells differentiate into different cell lineages during organ development and morphogenesis. Signaling pathway networks and mechanotransduction are important factors to guide the lineage commitment of stem/progenitor cells during craniofacial tissue morphogenesis. Here, we used tooth root development as a model to explore the roles of FGF signaling and mechanotransduction as well as their interaction in regulating the progenitor cell fate decision. We show that Fgfr1 is expressed in the mesenchymal progenitor cells and their progeny during tooth root development. Loss of Fgfr1 in Gli1 progenitors leads to hyperproliferation and differentiation, which causes narrowed periodontal ligament (PDL) space with abnormal cementum/bone formation leading to ankylosis. We further show that aberrant activation of WNT signaling and mechanosensitive channel Piezo2 occurs after loss of FGF signaling in Gli1-Cre;Fgfr1 mice. Overexpression of Piezo2 leads to increased osteoblastic differentiation and decreased Piezo2 leads to downregulation of WNT signaling. Mechanistically, an FGF/PIEZO2/WNT signaling cascade plays a crucial role in modulating the fate of progenitors during root morphogenesis. Downregulation of WNT signaling rescues tooth ankylosis in Fgfr1 mutant mice. Collectively, our findings uncover the mechanism by which FGF signaling regulates the fate decisions of stem/progenitor cells, and the interactions among signaling pathways and mechanotransduction during tooth root development, providing insights for future tooth root regeneration.
Topics: Animals; Wnt Signaling Pathway; Tooth Root; Mechanotransduction, Cellular; Fibroblast Growth Factors; Mice; Cell Differentiation; Stem Cells; Receptor, Fibroblast Growth Factor, Type 1; Ion Channels
PubMed: 38910207
DOI: 10.1038/s41413-024-00345-5