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Medicina Oral, Patologia Oral Y Cirugia... May 2020Intubation is necessary during critical situations to reduce the risk of death. In Brazil, a need exists to determine the prevalence of tooth avulsions in emergency and...
BACKGROUND
Intubation is necessary during critical situations to reduce the risk of death. In Brazil, a need exists to determine the prevalence of tooth avulsions in emergency and urgent care. The objective of this study was to identify the causes of orotracheal intubation (OTI), the number of tooth avulsions, and the avulsed teeth that result from urgent and emergency intubation.
MATERIAL AND METHODS
The sample consisted of 116 patients (total group) in intensive care units (ICUs) distributed across Group 1 (G1), which was composed of 71 patients from an urgent-care hospital, and Group 2 (G2), which was composed of 45 patients from an emergency hospital. Clinical examinations showed dental alveolus with signs of recent exodontia in the upper and lower anterior regions. Sociodemographic data and the reason for intubation were evaluated. The Shapiro-Wilk normality test, chi-square test, Fisher's exact test, Mann-Whitney U test, and univariate logistic regression were performed with a significance level of 5%.
RESULTS
The avulsion prevalence was 4.3%, with more cases receiving emergency intubation (n=4). All avulsions occurred in adults, and a significant difference (p=0.011) was observed with regard to the elderly. A 1-year reduction in age increased the chance of tooth avulsion during intubation by 1.09 times; being female increased the chance by 2.88 times.
CONCLUSION
Pulmonary problems were the major causes of intubation, with the highest tooth avulsion prevalence observed during emergency intubation. The avulsed teeth were 11, 12, 13, 22, 32, and 33 across all cases.
Topics: Accidents; Adult; Aged; Brazil; Female; Health Knowledge, Attitudes, Practice; Humans; Intubation, Intratracheal; Surveys and Questionnaires; Tooth Avulsion; Tooth Replantation
PubMed: 32040466
DOI: 10.4317/medoral.23375 -
Journal of Dental Research Apr 2011Hypophosphatasia (HPP) occurs from loss-of-function mutation in the tissue-non-specific alkaline phosphatase (TNALP) gene, resulting in extracellular pyrophosphate...
Hypophosphatasia (HPP) occurs from loss-of-function mutation in the tissue-non-specific alkaline phosphatase (TNALP) gene, resulting in extracellular pyrophosphate accumulation that inhibits skeletal and dental mineralization. TNALP-null mice (Akp2(-/-)) phenocopy human infantile hypophosphatasia; they develop rickets at 1 week of age, and die before being weaned, having severe skeletal and dental hypomineralization and episodes of apnea and vitamin B(6)-responsive seizures. Delay and defects in dentin mineralization, together with a deficiency in acellular cementum, are characteristic. We report the prevention of these dental abnormalities in Akp2(-/-) mice receiving treatment from birth with daily injections of a mineral-targeting, human TNALP (sALP-FcD(10)). sALP-FcD(10) prevented hypomineralization of alveolar bone, dentin, and cementum as assessed by micro-computed tomography and histology. Osteopontin--a marker of acellular cementum--was immuno-localized along root surfaces, confirming that acellular cementum, typically missing or reduced in Akp2(-/-) mice, formed normally. Our findings provide insight concerning how acellular cementum is formed on tooth surfaces to effect periodontal ligament attachment to retain teeth in their osseous alveolar sockets. Furthermore, they provide evidence that this enzyme-replacement therapy, applied early in post-natal life--where the majority of tooth root development occurs, including acellular cementum formation--could prevent the accelerated tooth loss seen in individuals with HPP.
Topics: Alkaline Phosphatase; Alveolar Process; Animals; Animals, Newborn; Calcification, Physiologic; Cementogenesis; Crystallography; Dental Cementum; Dentin; Disease Models, Animal; Durapatite; Enzyme Replacement Therapy; Humans; Hypophosphatasia; Immunohistochemistry; Mice; Mice, Knockout; Microscopy, Electron, Transmission; Odontogenesis; Osteopontin; Periodontal Ligament; Tooth Abnormalities; Tooth Calcification; Tooth Root; Tooth Socket; X-Ray Microtomography
PubMed: 21212313
DOI: 10.1177/0022034510393517 -
Journal of Periodontology Sep 2014This report is the second part of the previously published study on the impact of light/chemical hardening technology and a newly formulated composite graft material for... (Comparative Study)
Comparative Study
The use of light/chemically hardened polymethylmethacrylate, polyhydroxylethylmethacrylate, and calcium hydroxide graft material in combination with polyanhydride around implants and extraction sockets in minipigs: Part II: histologic and micro-CT evaluations.
BACKGROUND
This report is the second part of the previously published study on the impact of light/chemical hardening technology and a newly formulated composite graft material for crestal augmentation during immediate implant placement.
METHODS
A total of 48 implants were placed into the sockets of the mesial roots of freshly extracted mandibular premolar teeth in three minipigs. Crestal areas and intrabony spaces were randomly augmented with light-hardened graft materials including a composite graft consisting of polymethylmethacrylate, polyhydroxylethylmethacrylate, and calcium hydroxide (PPCH) plus polyanhydride (PA); PPCH graft; and PA graft, or left untreated. Distal sockets not receiving implants and the sockets of first molars (n = 60) were randomly treated with one of the graft materials or left empty. In addition, two molar sockets were treated with the original PPCH graft material. Quantitative microcomputed tomography (micro-CT) was used to assess alveolar bone structure and tissue compositions. Histologic evaluations included descriptive histology to assess the peri-implant wound healing, as well as histomorphometric measurements to determine bone-to-implant contact (BIC).
RESULTS
Both trabecular and cortical bone measurements by micro-CT did not reveal any significant differences among the groups. Sites augmented with PPCH+PA resulted in significantly greater BIC surface than PPCH alone and no-graft-treated implants (P <0.05) histologically. Stained ground sections showed complete bone formation between bone and implant surface in the PPCH+PA group, whereas sites without augmentation showed large gaps between bone and implant surfaces, indicating a slower bone apposition and less BIC surface compared to all other groups. Similar to implant sections, all materials showed positive outcome on trabecular and cortical bone formation in extraction sockets with an intact crestal cortical bone.
CONCLUSION
Histologic evaluations supported the previous findings on implant stability and function and confirmed that PPCH+PA provides a greater BIC with a well-organized implant-bone interface and is useful in crestal augmentation during immediate implant placement.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Animals; Biocompatible Materials; Bone Density; Bone Substitutes; Calcification, Physiologic; Calcium Hydroxide; Dental Implantation, Endosseous; Dental Implants; Immediate Dental Implant Loading; Light-Curing of Dental Adhesives; Male; Mandible; Osseointegration; Osteogenesis; Periodontal Index; Polyanhydrides; Polyhydroxyethyl Methacrylate; Polymethyl Methacrylate; Random Allocation; Surface Properties; Swine; Swine, Miniature; Tooth Socket; X-Ray Microtomography
PubMed: 24502615
DOI: 10.1902/jop.2014.120424 -
Odontology Jan 2023Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised...
Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs. The study was based on a series of patients treated between 2014 and 2019, with a 1-year minimum follow-up, and up to over 4 years. An analysis of the clinical history of the treated patients and pre- and post-operative radiographs was performed to evaluate the implant success and to measure the marginal bone level (MBL). Overall, 149 implants were studied. There was only one failure in the test group (1%) and no failures in the control group. The test group gained 0.1 mm of the MBL compared to the baseline, while the control group lost 0.1 mm of the MBL. The difference between the two groups of only 0.2 mm was not statistically significant (P = 0.058). Immediate dental implants in infected sockets debrided and decontaminated using Er,Cr:YSGG laser do not appear to enhance the likelihood of failure; however, peri-implantitis and associated problems must be avoided by following a certain set of protocols and procedures.
Topics: Humans; Dental Implants; Treatment Outcome; Follow-Up Studies; Retrospective Studies; Lasers, Solid-State; Tooth Socket; Dental Implants, Single-Tooth; Immediate Dental Implant Loading; Tooth Extraction; Dental Prosthesis, Implant-Supported; Dental Restoration Failure
PubMed: 36074306
DOI: 10.1007/s10266-022-00734-4 -
Zhongguo Xiu Fu Chong Jian Wai Ke Za... Nov 2019To study the preservation effect of true bone ceramics (TBC) prepared by high-temperature calcination of bovine bone on alveolar ridge of canine extraction socket.
OBJECTIVE
To study the preservation effect of true bone ceramics (TBC) prepared by high-temperature calcination of bovine bone on alveolar ridge of canine extraction socket.
METHODS
Six healthy Beagle dogs (aged 1.5-2 years) were selected to extract the second and fourth premolars of both mandibles and the second premolars of the maxilla. The left extraction socket was implanted with TBC as the experimental group, and the right side was implanted with the calcined bovine bone (CBB) as the control group, to observe the alveolar ridge preservation effect. Three dogs were euthanized after general observation at 1 and 6 months after operation respectively. After separating the maxilla and mandible, cone beam CT (CBCT) was performed to measure the average gray value of the graft site and the adjacent reference area (the area between the roots of the adjacent third premolar) and calculate the gray scale ratio between the bone graft site and the reference area. Histological observation was made on the bone graft site to evaluate the new bone formation.
RESULTS
General observation showed that the wounds of both groups were basically healed at 2 weeks after operation, and the bone graft materials were not exposed. The wounds healed well at 1 and 6 months after operation without swelling. The results of CBCT showed that the residual material was found in both groups at 1 month after operation, and no significant residual material was found in both groups at 6 months after operation, and the alveolar ridge height of the bone graft area was not significantly reduced. There was no significant difference in the bone mineral density between the experimental group and the control group. The gray scale ratios of the experimental group at 1 month and 6 months after operation were 0.97±0.14 and 0.93±0.06, respectively, and were 0.99±0.16 and 0.94±0.05 in control group, showing no significant difference between the two groups ( =-1.030, =0.333; =-0.770, =0.466). HE staining observation showed that a large number of bone graft materials did not degrade and new bone formed around the grafts in both groups at 1 month after operation; the bone graft materials were absorbed and a large number of new bones were formed in both groups at 6 months after operation.
CONCLUSION
TBC can maintain bone mineral density and have good osteoconductivity in the alveolar ridge site preservation experiment of dogs, and can be used for alveolar ridge site preservation.
Topics: Alveolar Bone Loss; Alveolar Process; Animals; Cattle; Ceramics; Dogs; Tooth Extraction; Tooth Socket
PubMed: 31650765
DOI: 10.7507/1002-1892.201908052 -
Journal of Dental Sciences Mar 2021Natural compounds have become alternatives for bone regeneration. Acemannan, the main polysaccharide extracted from vera, has been demonstrated as a promising...
BACKGROUND/PURPOSE
Natural compounds have become alternatives for bone regeneration. Acemannan, the main polysaccharide extracted from vera, has been demonstrated as a promising osteoinductive material and . This clinical study investigated the effect of acemannan on tooth socket healing.
MATERIALS AND METHODS
Thirty-five otherwise healthy patients, 18-25 years old and diagnosed with horizontal or vertical partial impaction of the lower third molars, were enrolled in this randomized controlled trial. After removing the teeth, the sockets randomly received one of the following treatments: spontaneous blood-clotting (control), 20 mg acemannan sponge, or 50 mg acemannan sponge. Cone-beam computed tomography of the mandible was performed immediately (baseline), and at 3-, 6-, and 12-months postoperatively; the data were analyzed using the OsiriX MD program. Bone healing in the socket was determined measuring the socket volume. One-way ANOVA was used to analyze the differences within each group and between groups.
RESULTS
Thirty-five patients with 43 partially impacted lower third molars participated in this study. No patients exhibited alveolar osteitis or secondary infection. Compared with baseline, all groups showed significant reduction in socket volume at all observation time-points ( < 0.05). The 50 mg acemannan group had a significantly greater reduction in socket volume compared with the control at all postoperative time-points ( < 0.05). The 20 mg group had a significantly greater reduction in socket volume compared with the control at 3-months postoperatively ( < 0.05).
CONCLUSION
We conclude that acemannan increases bone healing at 3-, 6-, and 12-months after removal of partially impacted mandibular third molars.
PubMed: 33854714
DOI: 10.1016/j.jds.2020.10.003 -
Journal of Applied Oral Science :... 2012Hypertension is one of the most important public health problems worldwide. If undiagnosed or untreated, this pathology represents a systemic risk factor and offers...
UNLABELLED
Hypertension is one of the most important public health problems worldwide. If undiagnosed or untreated, this pathology represents a systemic risk factor and offers unfavorable conditions for dental treatments, especially those requiring bone healing.
OBJECTIVES
The purpose of this study was to demonstrate, by analysis of bone mineral density (BMD), that the alveolar bone healing process is altered in spontaneously hypertensive rats (SHRs).
MATERIAL AND METHODS
Wistar rats and SHRs were submitted to extraction of the upper right incisor and were euthanized 7, 14, 21, 28 and 42 days after surgery. Right maxillae were collected, radiographed and analyzed using Digora software. BMD was expressed as minimum (min), middle (med) and maximum (max) in the medium (MT) and apical (AT) thirds of the dental alveolus.
RESULTS
The results were compared across days and groups. Wistar showed difference in med and max BMD in the MT between 7 and 28 and also between 14 and 28 days. The AT exhibited significant difference in med and min BMD between 7 and 28 days, as well as difference in min BMD between 28 and 42 days. SHRs showed lower med BMD in the MT at 28 days when compared to 21 and 42 days. Differences were observed across groups in med and min BMD at day 28 in the MT and AT; and in max BMD at 14, 21 and 42 days in the MT.
CONCLUSIONS
These results suggest that the alveolar bone healing process is delayed in SHRs comparing with Wistar rats.
Topics: Animals; Blood Pressure; Bone Regeneration; Densitometry; Disease Models, Animal; Hypertension; Male; Radiography; Rats; Rats, Inbred SHR; Rats, Wistar; Species Specificity; Time Factors; Tooth Socket; Wound Healing
PubMed: 22666841
DOI: 10.1590/s1678-77572012000200017 -
Journal of Maxillofacial and Oral... Jun 2016The aim of this cross-sectional study was to assess knowledge regarding autogenous tooth transplantation among oral and maxillofacial surgery (OMFS) residents in India.
AIM
The aim of this cross-sectional study was to assess knowledge regarding autogenous tooth transplantation among oral and maxillofacial surgery (OMFS) residents in India.
STUDY DESIGN
The sample of the survey consisted of Indian OMFS post-graduate residents attending the "1st Asian Oral and Maxillofacial Surgery PG Convention" held from 29th to 31st August, 2013 at Mangalore, India. Questions were asked regarding the participant's preferred tooth replacement modality, the transplantation procedure (socket preparation and stabilization of transplanted tooth); fate of the transplanted tooth (pulpal and periodontal fate) and the possibility of replacing second molars with such procedure, cross-arch transplantation and transplantation after new-socket preparation. The responses of 1st, 2nd and 3rd year residents were assessed for statistical significant difference using Fishers exact test.
RESULTS
Out of 434 residents surveyed using a pre-tested self-administered questionnaire, 287 residents responded (response rate 66 %). 74 % were aware of the possibility of autogenous third molar transplantation. Only 24 % believed a new periodontal ligament would form around the transplanted tooth. Misconceptions regarding pulp healing, socket preparation and tooth stabilization and new alveolus transplantation were also seen. 44 % had never seen the procedure and 74 % had never performed it themselves. No statistical significant difference was seen among the responses classified according to the year of training.
CONCLUSION
OMFS residents were found to have inadequate knowledge regarding autogenous tooth transplantation. Tooth transplantation needs to be included in the dental curriculum and standard OMFS textbooks with practical training in post-graduation period.
PubMed: 27298540
DOI: 10.1007/s12663-015-0821-2 -
Journal of Applied Oral Science :... 2015The aim of this study was to investigate the in vitro and in vivo biological responses to nanostructured carbonated hydroxyapatite/calcium alginate (CHA) microspheres... (Comparative Study)
Comparative Study
OBJECTIVE
The aim of this study was to investigate the in vitro and in vivo biological responses to nanostructured carbonated hydroxyapatite/calcium alginate (CHA) microspheres used for alveolar bone repair, compared to sintered hydroxyapatite (HA).
MATERIAL AND METHODS
The maxillary central incisors of 45 Wistar rats were extracted, and the dental sockets were filled with HA, CHA, and blood clot (control group) (n=5/period/group). After 7, 21 and 42 days, the samples of bone with the biomaterials were obtained for histological and histomorphometric analysis, and the plasma levels of RANKL and OPG were determined via immunoassay. Statistical analysis was performed by Two-Way ANOVA with post-hoc Tukey test at 95% level of significance.
RESULTS
The CHA and HA microspheres were cytocompatible with both human and murine cells on an in vitro assay. Histological analysis showed the time-dependent increase of newly formed bone in control group characterized by an intense osteoblast activity. In HA and CHA groups, the presence of a slight granulation reaction around the spheres was observed after seven days, which was reduced by the 42nd day. A considerable amount of newly formed bone was observed surrounding the CHA spheres and the biomaterials particles at 42-day time point compared with HA. Histomorphometric analysis showed a significant increase of newly formed bone in CHA group compared with HA after 21 and 42 days from surgery, moreover, CHA showed almost 2-fold greater biosorption than HA at 42 days (two-way ANOVA, p<0.05) indicating greater biosorption. An increase in the RANKL/OPG ratio was observed in the CHA group on the 7th day.
CONCLUSION
CHA spheres were osteoconductive and presented earlier biosorption, inducing early increases in the levels of proteins involved in resorption.
Topics: Alginates; Animals; Biocompatible Materials; Bone Regeneration; Cell Count; Durapatite; Glucuronic Acid; Hexuronic Acids; Humans; Male; Materials Testing; Nanostructures; Osteoblasts; Osteoprotegerin; Rats, Wistar; Receptor Activator of Nuclear Factor-kappa B; Reproducibility of Results; Time Factors; Tooth Socket; X-Ray Diffraction
PubMed: 26814461
DOI: 10.1590/1678-775720150122 -
Indian Journal of Dental Research :... 2020The history of dentistry is not short; it started from ancient Egypt to ancient Romans and ancient Greeks. When it comes to extraction, all of them have made their own...
PURPOSE
The history of dentistry is not short; it started from ancient Egypt to ancient Romans and ancient Greeks. When it comes to extraction, all of them have made their own discoveries and progress. The progress they made also helped dentistry to move ahead in evolution of new extraction technique - the Physics Forceps. We have assessed the viability in using the Physics Forceps for routine dental extraction in our study for a period of 1 year.
MATERIALS AND METHODS
The study was conducted on 241 patients indicated for extraction based on our inclusion criteria using Physics Forceps after obtaining informed consent and University Ethics Committee approval. Tooth fracture, buccal alveolar bone fracture, and soft tissue injury around the tooth to be extracted were studied.
RESULTS
In our present study of 241 patients, 57.67% were females and 42.32% were males, out of which 93.77% had no tooth fracture, 3.32% had crown fracture, 1.65% had root fracture, and 1.24% had apex fracture. Further, 85.47% had no buccal alveolar bone fracture and 14.53% had buccal alveolar bone fracture. Using proper technique, 96.26% of patients had no soft tissue damage, and minimal damage was seen in 3.73% of patients.
DISCUSSION
Extraction by Physics Forceps is a very good technique of extraction. No or very minimal tooth fracture and soft tissue injury were noted. Though the forceps is costly, it represents a valuable addition to regular armamentarium for a general dentist for routine extraction. Physics Forceps is a dental extractor rather than a forceps.
Topics: Animals; Beak; Female; Humans; Male; Physics; Surgical Instruments; Tooth Extraction; Tooth Fractures; Tooth Socket
PubMed: 32246674
DOI: 10.4103/ijdr.IJDR_433_18