Three-dimensional space changes after premature loss of a maxillary primary first molar.

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Park, Kitae; Jung, Da-Woon; Kim, Ji-Yeon

2009-11-01

A space maintainer is generally preferred when a primary first molar is lost before or during active eruption of the first permanent molars in order to prevent space loss. However, controversy prevails regarding the space loss after eruption of the permanent first molars. The purpose of this study was to examine spatial changes subsequent to premature loss of a maxillary primary first molar after the eruption of the permanent first molars. Thirteen children, five girls and eight boys, expecting premature extraction of a maxillary primary first molar because of caries and/or failed pulp therapy, were selected. Spatial changes were investigated using a three-dimensional laser scanner by comparing the primary molar space, arch width, arch length, and arch perimeter before and after the extraction of a maxillary primary first molar. Also, the inclination and angulation changes in the maxillary primary canines, primary second molars, and permanent first molars adjacent to the extraction site were investigated before and after the extraction of the maxillary primary first molar in order to examine the source of space loss. There was no statistically significant space loss on the extraction side compared to the control side (P = 0.33). No consistent findings were seen on the inclination and angulation changes on the extraction side. The premature loss of a maxillary primary first molar, in cases with class I molar relationship, has limited influence on the space in permanent dentition.

Effect of Attachment Type on Implant Strain in Maxillary Implant Overdentures: Comparison of Ball, Locator, and Magnet Attachments. Part 1. Overdenture with Palate.

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Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu

Implant overdentures with attachments have been used in clinical practice and the effect of attachments on implant strain has been frequently reported. However, most studies have focused on mandibular overdentures; there are few reports on maxillary overdentures. The purpose of this study was to examine the influence of attachment type on implant strain in maxillary overdentures under various implant configurations. A maxillary edentulous model with implants and experimental overdentures were fabricated. Four strain gauges were attached to each implant, positioned in anterior, premolar, and molar areas. Three types of unsplinted attachments-ball, locator, and magnet-were set on the implants under various implant configurations. A vertical occlusal load of 98 N was applied through the mandibular complete denture, and implant strain was compared using the Kruskal-Wallis test. Ball attachments caused the greatest amount of strain, while magnet attachments caused the least amount under all conditions. For all attachments, two anterior implants caused significantly more strain than four implants (P magnet attachments are recommended to reduce implant stress. Using only two implants, especially two anterior implants, is not recommended regardless of attachment type.

The not-so-harmless maxillary primary first molar extraction.

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Northway, W M

2000-12-01

Premature loss of primary molars has been associated with space loss and eruptive difficulties, especially when the loss occurs to the primary second molars and when it occurs early. This has not been thought to be the case for primary first molars. The author revisited 13 cases from an earlier study on the effects of premature loss of maxillary primary molars. These longitudinal cases were scrutinized, using serial panoramic radiographs, to explain the irregular response in terms of dental migration. The author presents two case reports. In the earlier study, the author used digitized study casts and the concept of D + E space--the space occupied by the primary first and second molars--to describe the dental migration that occurred after premature tooth loss. Using analysis of variance on data generated using an instrument capable of measuring in tenths of millimeters, the author produced findings regarding the amount of space loss, rate of space loss, effect of age at loss, amount of space regained at the time of replacement by the permanent tooth and effect on Angle's classification. Finally, the author created a simulation describing directional change; this revealed that the maxillary primary first molar loss resulted in a mesial displacement of the permanent canine during eruption. When the maxillary primary first molar is lost prematurely, the first premolar erupts in a more mesial direction than normal, as a result of the mesial incline of the primary second molar, and consumes the space of the permanent canine, which becomes blocked out. Rather than use a space maintainer after the premature loss of the maxillary primary first molar, the author suggests, clinicians can choose from a number of other options for preventing the first premolar from erupting too far in a mesial direction.

Two-rooted maxillary first molars with two canals: a case series.

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Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal treatment of maxillary first molars with fusion of the two buccal roots.

Influence of Implant Number and Location on Strain Around an Implant Combined with Force Transferred to the Palate in Maxillary Overdentures.

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Yang, Tsung-Chieh; Chen, Yi-Chen; Wang, Tong-Mei; Lin, Li-Deh

This study evaluated the effect of implant number and location on strain around the implant and force transferred to the palate in maxillary implant overdentures (IODs), including two locators attached bilaterally in the canine region (IOD 2), four locators attached bilaterally in the canine and premolar regions (IOD 4CP), four locators attached bilaterally in the canine and molar regions (IOD 4CM), and six locators attached bilaterally in the canine, premolar, and molar regions (IOD 6). As the implant number increased, strain around the implant regions increased, whereas force transferred to the palate decreased under loading. However, the differences were small between IOD 4CM and IOD 6, suggesting identical biomechanical effectiveness.

Evaluation of single-tooth implants in the second molar region: a 5-year life-table analysis of a retrospective study.

Science.gov (United States)

Koo, Ki-Tae; Wikesjö, Ulf M E; Park, Jang-Yeol; Kim, Tae-Il; Seol, Yang-Jo; Ku, Young; Rhyu, In-Chul; Chung, Chong-Pyoung; Lee, Yong-Moo

2010-09-01

To our knowledge, no study has evaluated the success or survival rate of single-tooth implants that replaced missing maxillary and mandibular second molars. The purpose of the present study was to evaluate the 1- to 5-year cumulative survival rate (CSR) for single-tooth implants placed in the second molar region and the effects of associated factors. Four hundred eighty-nine patients (298 males and 191 females; age range: 23 to 91 years; mean age: 47 years) who were admitted to the Seoul National University Dental Hospital between March 2003 and July 2008 and treated with single-tooth implants in the second molar region (227 maxillary implants and 294 mandibular implants; total: 521 implants) were included in the study. Thirty-two subjects received two implants each. A 1- to 5-year CSR was calculated using a life-table analysis. A comparison of CSRs between maxillary versus mandibular implants, one-stage versus two-stage implants, short (10 mm) implants, and standard-diameter (or=5.0 mm) implants was performed using Wilcoxon (Gehan) statistics. P CSR was 95.1%. There were no statistically significant differences in CSRs between implants placed in maxillas and mandibles (96.3% versus 94.9%, respectively; P = 0.084), one- and two-stage implants (95.6% versus 94.7%, respectively; P = 0.267), short and long implants (100% versus 95.1%, respectively; P = 0.582), and standard- and wide-diameter implants (93.8% versus 96.8%, respectively; P = 0.065). Within the limitations of the study, the placement of single-tooth implants in the second molar region was an effective and reliable treatment modality. Also, associated factors such as implant diameter, length, and location (the maxilla versus the mandible) may not have an impact on the long-term success of implants.

Maxillary First Molars with 2 Distobuccal Canals: A Case Series.

Science.gov (United States)

Fogel, Howard M; Cunha, Rodrigo Sanches

2017-11-01

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A Radiologic Study of the Relationship of the Maxillary Sinus Floor and Apex of the Maxillary Molar

International Nuclear Information System (INIS)

Yoon, Hae Rym; Park, Chang Seo

1998-01-01

In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA in male and female adults in their 20 s on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop, and postop, root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows ; 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the accrual maxilla specimen were 2.83 mm, 4.51 mm, and 4.15 mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography.3. In cross-sectional view, when

[Comparing the anchorage effects of micro-implant and J hook on treating patients with maxillary protrusion].

Science.gov (United States)

Wu, Xin; Liu, Guo-yuan; Jiang, Yong-lian

2015-10-01

To investigate the differences in anchorage effects between micro-implants and J hook in treating patients with Class II division 1 maxillary protrusion. Thirty-one cases of adult patients with Class II division 1 maxillary protrusion were treated. They were divided into 2 groups depending on their selection. The first group included 17 patients for micro-implant anchorage, who adopted micro-implant and sliding mechanism to close maxillary extraction space and depress the mandibular molar. The second group encompassed 14 cases for J hook, who adopted sliding mechanism, J hooks in high traction and Class II intermaxillary traction to close extraction space. X-ray lateral cephalometric radiographs were measured before and after treatment, and SPSS16.0 software package was employed to compare the differences in soft and hard tissue changes before and after treatment between 2 groups. There were statistically significant differences in SNB, ANB, MP-FH, U1-Y, U6-Y, L6-MP, NLA, and UL-Y between the 2 groups before and after treatment, while there was no significant difference in SNA, U1-SN, U1-X, and U6-X between the 2 groups. In treating patients with Class II division 1 maxillary protrusion, micro-implant has stronger anchorage effects than J hook, while at the same time depressing the mandibular molars, and making it more favorable to improve Class II faces.

Influence of unilateral maxillary first molar extraction treatment on second and third molar inclination in Class II subdivision patients

NARCIS (Netherlands)

Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Halazonetis, Demetrios J.; Katsaros, Christos; Ren, Yijin

Objective: To assess the maxillary second molar (M2) and third molar (M3) inclination following orthodontic treatment of Class II subdivision malocclusion with unilateral maxillary first molar (M1) extraction. Materials and Methods: Panoramic radiographs of 21 Class II subdivision adolescents (eight

Keratocystic odontogenic tumor with impacted maxillary third molar involving the right maxillary antrum:An unusual case report

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Abhishek Gupta

2011-01-01

Full Text Available The odontogenic keratocyst (OKC, first described by Phillipsen in 1956, has metamorphosized as a keratocystic odontogenic tumor (KCOT as reported in WHO classification of head and neck tumors in 2005. KCOT is a benign intraosseous neoplasm of the jaw and its occurrence in maxilla is unusual and its appearance in maxillary antrum along with maxillary impacted third molar is very uncommon. This article reports a case of KCOT associated with impacted maxillary third molar in right maxillary antrum and describes its rare site of occurrence.

C-shaped root canal in a maxillary first molar: a case report.

Science.gov (United States)

Yilmaz, Z; Tuncel, B; Serper, A; Calt, S

2006-02-01

This case report presents an unusual C-shaped root canal system in a maxillary first molar tooth. Although C-shaped root canals are most frequently seen in the mandibular second molar, they may also appear in maxillary molars. A literature search revealed only a few case reports of C-shaped root canal systems in maxillary molars. The present case describes a C-shaped canal in the buccal root of a maxillary first molar. The endodontic access cavity displayed two canal orifices, one leading to the canal system in the buccal root, the other into the palatal root canal system. In the buccal root, what appeared to be the mesial and distal canals joined to form a single C-shaped canal. --Careful examination of radiographs and the internal anatomy of teeth is essential.-- The location and morphology of root canals should be identified at high magnification under the microscope.

Effects of Reinforcement on Denture Strain in Maxillary Implant Overdentures: An In Vitro Study Under Various Implant Configurations.

Science.gov (United States)

Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu

Maxillary implant overdentures are often designed without palatal coverage to maximize wearer comfort. Although palateless dentures have been reported to be less rigid than conventional dentures, and require reinforcement to prevent complications, there is little documentation about the effects of such reinforcement. The purpose of this study was to examine the effects of reinforcement on the strain on maxillary implant overdentures supported by implants in a variety of configurations. A maxillary edentulous model with implants inserted in the anterior, premolar, and molar area was fabricated. Five types of experimental overdentures, with and without reinforcement, were fabricated, and two strain gauges were attached at the anterior midline of the labial and palatal sides. A vertical occlusal load of 98 N was applied through a mandibular complete denture, and the shear strain on the denture was measured. The measurements were compared using the Kruskal-Wallis test (P = .05). On both the labial and palatal sides, the strain on the palateless dentures with reinforcement was significantly lower than the strain on palateless dentures without reinforcement in all implant configurations (P overdenture with residual ridge reinforcement and a palatal bar could reduce the strain in the anterior midline to almost the same level as a denture with palatal coverage. This type of reinforcement may prevent prosthetic and implant complications.

Bone density around the fixture after function of implant molar prosthesis using CBCT

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Jung, Jae Hyun; Hwang, In Taik; Jung, Byung Hyun; Kim, Jae Duk; Kang, Dong Wan [School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju (Korea, Republic of)

2010-03-15

The purpose of this study was to examine the significance of increased bone density according to whether bone grafts were applied using demographic data with Cone Beam Computed Tomography (CBCT) and to compare the bone densities between before and after implant prosthesis using the Hounsfield index. Thirty-six randomly selected computed tomography (CT) scans were used for the analysis. The same sites were evaluated digitally using the Hounsfield scale with V-Implant 2.0TM, and the results were compared with maxillary posterior bone graft. Statistical data analysis was carried out to determine the correlation between the recorded Hounsfield unit (HU) of the bone graft and implant prosthesis using a Mann-Whitney U test and Wilcoxon Matched-pairs test. The bone grafted maxillary posterior teeth showed an increase in the mean values from-157 HU to 387 HU, whereas non-grafted maxillary posterior teeth showed an increase from 62 HU to 342 HU. After implantation, the grafted and non-grafted groups showed significantly higher bone density than before implantation. However, the grafted group showed significantly more changes than the non-grafted group. Bone density measurements using CBCT might provide an objective assessment of the bone quality as well as the correlation between bone density (Hounsfield scale) and bone grafts in the maxillary molar area.

Root Canal Configuration of Maxillary First Permanent Molars in an Iranian Population

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Saeed Rahimi

2007-06-01

Full Text Available

Background and aims. It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The purpose of this study was to investigate variations in the root canal system of maxillary first permanent molars in an Iranian population.

Materials and methods. In this study, 137 maxillary first molars were decalcified, dye-injected, cleared and studied.

Results. The results demonstrated that 37.96% of the maxillary first molars under study had three canals, 58.4% had four canals and 3.64% had five canals.

Conclusion. According to the results of this study and considering variations in the root canal systems of maxillary first molars, it seems that great care should be taken in the root canal treatment of these teeth.

Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with Class II Division 1 malocclusion treated with maxillary first molar extractions

NARCIS (Netherlands)

Livas, Christos; Halazonetis, Demetrios J.; Booij, Johan Willem; Pandis, Nikolaos; Tu, Yu-Kang; Katsaros, Christos

Introduction: Our objective was to investigate potential associations between maxillary sinus floor extension and inclination of maxillary second premolars and second molars in patients with Class II Division 1 malocclusion whose orthodontic treatment included maxillary first molar extractions.

Maxillary sinus floor extension and posterior tooth inclination in adolescent patients with Class II Division 1 malocclusion treated with maxillary first molar extractions

NARCIS (Netherlands)

Livas, C.; Halazonetis, D.J.; Booij, J.W.; Pandis, N.; Tu, Y.K.; Katsaros, C.

2013-01-01

INTRODUCTION: Our objective was to investigate potential associations between maxillary sinus floor extension and inclination of maxillary second premolars and second molars in patients with Class II Division 1 malocclusion whose orthodontic treatment included maxillary first molar extractions.

Bilateral maxillary fused second and third molars: a rare occurrence

OpenAIRE

Liang, Rui-Zhen; Wu, Jin-Tao; Wu, You-Nong; Smales, Roger J; Hu, Ming; Yu, Jin-Hua; Zhang, Guang-Dong

2012-01-01

This case report describes the diagnosis and endodontic therapy of maxillary fused second and third molars, using cone-beam computed tomography (CBCT). A 31-year-old Chinese male, with no contributory medical or family/social history, presented with throbbing pain in the maxillary right molar area following an unsuccessful attempted tooth extraction. Clinical examination revealed what appeared initially to be a damaged large extra cusp on the buccal aspect of the distobuccal cusp of the secon...

CT analyses of the location of the maxillary third molar in relation to panoramic radiographic appearance

International Nuclear Information System (INIS)

Obayashi, Naofumi; Ariji, Yoshiko; Goto, Masakazu; Izumi, Masahiro; Naitoh, Munetaka; Kurita, Kenichi; Shimozato, Kazuo; Ariji, Eiichiro

2009-01-01

We compared the relationship between anatomical structures analyzed by panoramic radiographs and CT images of uninfected impacted maxillary third molars and investigated the pathway of infection originating from pericoronitis of maxillary third molars. Patients (n=62) with uninfected impacted maxillary third molars and patients (n=8) with odontogenic infection originating from pericoronitis of the maxillary third molars were selected from an image database. CT and panoramic images were evaluated separately by an oral surgeon and a radiologist for the vertical position of the tooth, the presence of bone around the crown, proximity to the maxillary sinus, visibility of masticatory muscles, and mesiodistal and buccopalatal inclinations. In uninfected patients, a significant correlation was observed between the vertical positions evaluated by the two methods. Of the third molars, 79 (63.7%) were identified as vertical type on both panoramic and CT images. Regarding the maxillary sinus, of the 19 molars classified as the separate type on panoramic images, 2 (10.5%) were identified as the close type on CT. CT examination revealed the involvement of buccal cortical plates and the buccal space in the majority of infected patients. CT images revealed that 94 molars (75.8%) showed vertical type on the buccopalatal inclination and that 45 impacted molars (36.3%) showed bone defects in the buccal area. Infections originating from pericoronitis of the maxillary third molar showed involvement of the buccal cortical plates, the buccal space, and other spaces, which were clearly depicted on CT images. (author)

A New Anatomically Based Nomenclature for the Roots and Root Canals—Part 1: Maxillary Molars

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Jojo Kottoor

2012-01-01

Full Text Available Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequently named based on definite sets of criteria. A new method for identification and naming of roots and root canal anatomy in maxillary molars, based on their root and canal relationship, was formulated and is presented in this paper. The nomenclature makes certain essential modifications to the traditional approach to accommodate naming of the various aberrations presented in the maxillary molars. A simple, yet extensive, nomenclature system has been proposed that appropriately names the internal and external morphology of maxillary molars.

A new anatomically based nomenclature for the roots and root canals-part 1: maxillary molars.

Science.gov (United States)

Kottoor, Jojo; Albuquerque, Denzil Valerian; Velmurugan, Natanasabapathy

2012-01-01

Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequently named based on definite sets of criteria. A new method for identification and naming of roots and root canal anatomy in maxillary molars, based on their root and canal relationship, was formulated and is presented in this paper. The nomenclature makes certain essential modifications to the traditional approach to accommodate naming of the various aberrations presented in the maxillary molars. A simple, yet extensive, nomenclature system has been proposed that appropriately names the internal and external morphology of maxillary molars.

Endodontic Treatment of a Maxillary Second Molar with Developmental Anomaly: A Case Report

OpenAIRE

Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decid...

Evaluation of stress patterns on maxillary posterior segment when intruded with mini implant anchorage: A three-dimensional finite element study

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Nikhita Pekhale

2016-01-01

Full Text Available Introduction: The aim of this study is to evaluate stress and displacement effects of maxillary posterior intrusion mechanics with mini-implant anchorage by using finite element method. Materials and Methods: A computer stimulation of three-dimensional model maxilla with all teeth, PDL, bone, mini-implants, brackets, arch wire, force element, and transpalatal arch was constructed on the basis of average anatomic morphology. Finite element analysis was done to evaluate the amount of stress and its distribution during orthodontic intrusive force. Results: Increased Von Mises stress values were observed in mesio-cervical region of first molar. The middle third of second premolar and second molar and regions adjacent to force application sites also showed relatively high stress values. Minimum stress values were observed in apical region of first premolar as it is away from force application. Conclusion: Using three mini-implant and transpalatal arches, this study demonstrates that significant amount of true intrusion of maxillary molars could be obtained with lesser concentration of stresses in the apical area recorded.

Two-Rooted Maxillary First Molars with Two Canals: A Case Series

OpenAIRE

Shakouie, Sahar; Mokhtari, Hadi; Ghasemi, Negin; Gholizadeh, Seddigheh

2013-01-01

Thorough understanding of the anatomic and internal morphology of a root canal system is absolutely essential for the success of endodontic treatment. Since permanent maxillary first molars have shown variation in internal anatomy, morphology, this tooth has been reviewed extensively. Presence of two canals in a two-rooted maxillary first molar has rarely been reported in studies describing tooth and root canal anatomies. In this report, three cases are presented, which involve the root canal...

Maxillary first molar with an O-shaped root morphology:report of a case

Institute of Scientific and Technical Information of China (English)

Yooseok Shin; Yemi Kim; Byoung-Duck Roh

2013-01-01

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

Maxillary first molar with an O-shaped root morphology: report of a case.

Science.gov (United States)

Shin, Yooseok; Kim, Yemi; Roh, Byoung-Duck

2013-12-01

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography (CBCT) were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

Does fixed retention prevent overeruption of unopposed mandibular second molars in maxillary first molar extraction cases?

NARCIS (Netherlands)

Livas, Christos; Halazonetis, Demetrios J; Booij, Johan W; Katsaros, Christos; Ren, Yijin

2016-01-01

BACKGROUND: The objective of this study was to investigate whether multistranded fixed retainers prevented overeruption of unopposed mandibular second molars in maxillary first molar extraction cases. METHODS: The panoramic radiographs of 65 Class II Division 1 Caucasian Whites (28 females, 37

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

OpenAIRE

Patel, Surbhi; Patel, Pawan

2012-01-01

Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal r...

Maxillary "All-On-Four" treatment using zygomatic implants. A mechanical analysis.

Science.gov (United States)

de Moraes, P H; Olate, S; Nóbilo, M de Arruda; Asprino, L; de Moraes, M; Barbosa, J de Albergaría

2016-04-01

Zygomatic implants may be used for dental rehabilitation in atrophic maxillae. The aim of this study was to establish experimentally the areas of stress distribution using 2 kinds of "All-On-Four" maxillary procedures. The best position to insert the implants was selected using polyurethane craniomaxillary models and surgical guides were made. Group 1 was designed with two posterior zygomatic implants and two conventional anterior implants, and group 2 with two posterior zygomatic implants and two anterior zygomatic implants. A titanium bar was built to link the 4 implants in both groups. Photoelastic replicas of these models were made and the implants were inserted using the surgical guides. An Instrom 4411 testing machine was used to perform a unilateral compressive loading at the level of the right first molar until 2mm of displacement was obtained. Group 1 showed a high strain concentration in the right lateral orbital region at the level of the apex of the zygomatic implant. Less strain was noticed at the apical levels of the conventional implants in the anterior sector and of the contralateral zygomatic implant. Group 2 showed high strains in the lateral inferior orbital area. The load was low in the alveolar bone sector. Zygomatic bone and paranasal structures are loaded at high levels when zygomatic implants are used to stabilize a full maxillary prosthodontic rehabilitation on 4 implants. The use of 4 zygomatic implants loads the alveolar bone to a lower extent and seems better suited from a mechanical point of view than the use of 2 zygomatic implants. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Sex assessment efficacy of permanent maxillary first molar cusp dimensions in Indians

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Achla Bharti Yadav

2015-01-01

Full Text Available Background: The human first maxillary molar provides clues about evolution and is functionally important. It has four main cusps, and each cusp has an independent growth pattern and different evolutionary background. Though less explored, the analysis based on measurement of each cusp appears to be more meaningful biologically than conventional measurements of the whole crown. Aim: This study aimed to demonstrate the extent of sexual dimorphism in permanent maxillary first molar cusp diameters and their potential utility in sex prediction among Indians using logistic regression analysis (LRA. Materials and Methods: The mesiodistal and buccolingual (BL crown diameters along with cusp dimensions and cusp indices of right maxillary first molar were measured in an Indian sample (149 males, 151 females; age range of 18–30 years. The possible sex dimorphism in these parameters was evaluated, and LRA was performed to ascertain their usefulness in sex prediction. Results: BL crown dimension and the hypocone (distolingual cusp showed the highest sexual dimorphism. The combination of metacone and hypocone, i.e., distal cusp diameters among cusp parameters showed the highest accuracy (61.3%. While, on combining all the crown and cusp diameters together the overall accuracy was raised (64.3%. Conclusion: This study supports the ontogeny hypothesis suggesting that early-forming mesial cusps demonstrate less sexual variation as compared to subsequently formed distal cusps in the maxillary molar. Though the sex identification accuracy for cusp diameters of the permanent maxillary first molar in Indians is relatively moderate (≈61%, it can be used as an adjunct for sexing of adult Indians in forensic contexts.

Ectopic eruption of the maxillary first permanent molar: characteristics and occurrence in growing children.

Science.gov (United States)

Barberia-Leache, Elena; Suarez-Clúa, María Cruz; Saavedra-Ontiveros, Dolores

2005-07-01

The purpose of this study was to determine the characteristics and occurrence of the ectopic eruption of the maxillary first permanent molar in a sample of growing Spanish children. A descriptive, observational, retrospective study was done using the radiographs of 509 consecutive patients, who were in the first phase of mixed dentition. A method was designed to evaluate the amount of pathologic resorption of the second maxillary primary molar and the impaction of the first permanent molar measured in millimeters. Statistical analysis of the studied variables was done using chi-square, analysis of variance, and Pearson correlation coefficient. The frequency of occurrence was 4.3% with no differences in both sexes. Of these, 36.4% were unilateral and 63.6% bilateral with a right:left relation of 3:1. Of the 36 ectopic molars, 69.4% self-corrected spontaneously. In such cases, the pathological resorption of the root of the second maxillary primary molar and its adverse clinical implications were persistent. The relation between self-correction and impaction was 2.27:1. The average impaction on the right side was 2.91 mm and 1.6 mm on the left side. Correlation between the magnitude of resorption and grade of impaction was not observed. Although resorption was found on grades I and II, spontaneous self-correction could occur without arch length loss. However, on grade III or more, therapeutic intervention has to be done. The benefit of early diagnosis and treatment of the maxillary first permanent molar is the prevention of the premature loss of second maxillary deciduous molar and the resulting malocclusion.

Immediate and six-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2007-03-01

Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

Endodontic treatment of a maxillary second molar with developmental anomaly: a case report.

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Asgary, Saeed

2007-01-01

Fusion is a rare occurrence in molar teeth. The purpose of this rare case presentation is to describe the nonsurgical endodontic treatment of maxillary molar. A 28-year-old patient was referred for endodontic treatment of her chronic apical abscess of right maxillary second molar. In the clinical examination, a sinus tract adjacent to involved tooth and a small crown of supernumerary tooth fused to the buccal surface of the molar at gingival margin was observed. Endodontic treatment was decided for the involved molar for functional reason. Recall examination, a year after completion of endodontic and restorative treatments, showed the tooth was clinically asymptomatic and there was no radiographic lucency around the apical region.

Endodontic Management of a Maxillary Molar with Three Mesiobuccal Canals

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Sirisha Gundam

2014-01-01

Full Text Available It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals.

Unusual Root Canal Morphology of the Maxillary Second Molar: A Case Report

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Neslihan Şımşek

2013-01-01

Full Text Available Introduction. This clinical case report presents the successful endodontic treatment of a maxillary second molar that has a mandibular molar-like anatomy with no palatal root and with each of its roots containing two separate root canals. Cone-beam computed tomography (CBCT was used to confirm this unusual anatomy. Methods. A 34-year-old male patient was referred to the Department of Endodontics at Inonu University’s Faculty of Dentistry because of severe pain in his right maxillary second molar. Clinical and radiographic examinations identified unusual roots and root canals anatomy, and CBCT was planned in order to understand the nature of these variations. Cleaning and shaping procedures were performed using the crown down technique with Sybron Endo (Glendora, CA, USA rotary instruments, and endodontic treatment was completed with gutta-percha cones and AH Plus resin sealers using the cold lateral compaction technique. Conclusions. The maxillary second molar exhibits aberrations and variations in terms of the numbers and configurations of its roots and root canals, and CBCT can be a useful imaging technique in endodontics.

Evaluation of sexual dimorphism using permanent maxillary first molar in Sri Ganganagar population

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Sakshi Mehta

2017-01-01

Full Text Available Aim of Study: The aim is to evaluate existence of sexual dimorphism by variation in right and left permanent maxillary molars using buccolingual width (BLW and mesio-distal width (MDW measured intraorally and on study casts among Sri Ganganagar population. Materials and Methods: Fifty patients (25 males and 25 females with 17–25 years of age were selected. Impressions of maxillary arch were taken and the BLW and MDW were measured using digital Vernier calipers on study casts and intraorally. Results: Highly significant correlation was found between MDW and BLW of both the maxillary permanent first molars for both genders (P < 0.05 intraorally. The MDW and BLW on study cast of both sides in both gender were more on left side in males while on right side in females. Conclusion: Left maxillary permanent first molar showed minimum mean difference of measurements on study cast and introrally than right, thus better predictor for gender dimorphism in forensics.

Twelve-month space changes after premature loss of a primary maxillary first molar.

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Lin, Yai-Tin; Lin, Wen-Hsien; Lin, Yng-Tzer J

2011-05-01

Many early investigations concerning space changes following premature extraction of primary molars had a cross-sectional design, a small sample size, and a somewhat crude methodology, which may have led to misunderstandings. The aim of this study was to use established longitudinal data to investigate ongoing (12-month) dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. Thirteen children (mean ± SD age at time of tooth extraction, 6.0 ± 0.74 years) with unilateral premature loss of a primary maxillary first molar were selected for this study. Maxillary dental study casts were obtained from participants 2 or 3 days after the tooth was removed, as well as at a follow-up appointment 12 months later. Six reference lines were measured on the study cast: D + E space, arch width, arch length, intercanine width, intercanine length, and arch perimeter. For each participant, the D + E space of the contralateral intact primary molar served as a control. A paired t-test was used to compare the cast measurements between initial examination and 12-month follow-up. A t-test was used to compare D + E space changes with those of the control group. The D + E space of the extraction side after 12 months was significantly smaller than that of the control side (P 0.05). The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar. © 2010 The Authors. International Journal of Paediatric Dentistry © 2010 BSPD, IAPD and Blackwell Publishing Ltd.

Maxillary molars with morphologic variations of the palatal root canals: a report of four cases.

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Holderrieth, Silke; Gernhardt, Christian Ralf

2009-07-01

The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.

Morphology of the Physiological Apical Foramen in Maxillary and Mandibular First Molars.

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Abarca, J; Zaror, C; Monardes, H; Hermosilla, V; Muñoz, C; Cantin, M

2014-06-01

Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3-5 mm from the apex were sectioned and prepared for analysis at 40× magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24-0.33 mm in maxillary first molars and between 0.25-0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully.

Morphology of the Physiological Apical Foramen in Maxillary and Mandibular First Molars

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Abarca, J.; Zaror, C.; Monardes, H.; Hermosilla, V.; Muñoz, C.; Cantin, M.

2015-01-01

SUMMARY Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3–5 mm from the apex were sectioned and prepared for analysis at 40× magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24–0.33 mm in maxillary first molars and between 0.25–0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully. PMID:25937698

Maxillary second molar with four roots and five canals

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Xinjia Sha

2018-06-01

Full Text Available In this case report, we present a maxillary second molar variant, which had two palatal roots with two canals and two buccal roots with three canals, including a second mesiobuccal canal. A 44-year-old female patient complained about a tooth crown fracture and severe pain in her right maxillary second molar. A clinical intraoral inspection and radiography were carried out on the tooth, and a diagnosis of chronic apical periodontitis was made. Four roots (two buccal and two palatal and five canals (three buccal and two palatal were found. The anatomical variation of the tooth was further confirmed by cone-beam computed tomography, a cone-fit procedure, and a radiograph with a shifted projection angle. Root-canal treatment was performed under an endodontic microscope.

Ectopic third molar in maxillary sinus: A rare case report

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Abhishek Sinha

2017-01-01

Full Text Available Ectopic tooth eruption in a non-dental area is a rare entity, and is most common in oral cavity. There have been a few case reports of teeth erupting in mandibular condyle, chin, palate, coronoid process, and maxillary sinus. Ectopic tooth in the maxillary sinus are found incidentally on routine radiological examination, same time they can be symptomatic and associated with pathologies usually dentigerous cyst or odontogenic keratocyst. Facial pain, purulent rhinorrhoea, epistaxis, headache, swelling, and epiphora-related naso-lacrimal duct obstruction can also be seen. By Caldwell-Luc procedure the ectopic teeth within the maxillary sinus are often removed. In this study, a case of ectopic maxillary third molar tooth on right maxillary sinus is presented.

DIRECT USAGE OF MINISCREW ANCHORAGE TO INTRUDE OVERERUPTED MAXILLARY POSTERIOR TEETH BEFORE PROSTHODONTIC PREPARATION:A CASE REPORT

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Yasemin Bahar Acar

2016-01-01

Full Text Available Overeruption of maxillary molars due loss of opposing teeth creates occlusal and functional interferences. Before reconstruction can be initiated, intrusion of overerupted molars becomes essential. This report illustrates treatment of overerupted maxillary premolar and molar via direct use of miniscrew anchorage. A 24-year old female had lost first and second left mandibular molars due to pulpal necrotizing agents, resulting with a large alveolar bone defect and overerupted maxillary premolar and molar. She had a history of unsuccessful alveolar distraction of mandibular left premolars to increase the alveolar bone height prior to implant placement. Patient was satisfied with her smile and refused comprehensive orthodontic treatment. Maxillary premolar and molar were intruded segmentally for 4mm in 8 months, using a combination of a mini-implant and partialfixed edgewise appliances. Biological responses of teeth and surrounding bony structures to intrusion appeared normal and acceptable in radiographic and clinical examination.

Asymmetric extractions in a patient with a hopeless maxillary central incisor, followed by treatment with mini-implant anchorage.

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Jung, Min-Ho

2018-05-01

Premolar extraction is 1 option for treatment of patients with malocclusion and severe crowding or protrusion. When the patient has missing or hopeless teeth other than premolars, it is possible to consider removal of those teeth to use the space to decrease crowding. A 15-year-old girl sought treatment for severe crowding. She had already lost her maxillary right first premolar as a result of caries 1 year previously and had a hopeless maxillary right central incisor. Her mandibular left first molar still caused discomfort even after endodontic treatment. Extractions of the maxillary right central incisor and mandibular right first premolar and left first molar were chosen to resolve the occlusion problems. Orthodontic mini-implants were placed to translocate the maxillary left central incisor across the midpalatal suture to use the space in the maxillary right quadrant to relieve the crowding. Although a different extraction option was used in each quadrant, the final occlusion was acceptable. After debonding, porcelain crowns were placed on the anterior teeth to improve esthetics. The treatment result remained stable after 2 years of retention. Copyright © 2018 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Patient satisfaction with maxillary 3-implant overdentures using different attachment systems opposing mandibular 2-implant overdentures.

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Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T

2012-05-01

Patient-based outcomes with maxillary overdentures on a minimum number of implants, opposing mandibular 2-implant overdentures are not evident in the literature. To evaluate patient's satisfaction with maxillary 3-implant overdentures, opposing mandibular 2-implant overdentures, using two different attachment systems over the first 2 years of service. Forty participants wearing mandibular 2-implant overdentures for 3 years were randomly allocated to one of two similar implant system groups to receive maxillary 3-implant overdentures. Twenty participants were allocated to splinted and unsplinted attachment system treatment groups for each system. Patient satisfaction with pre-treatment complete maxillary dentures, with maxillary 3-implant overdentures at baseline and annually for 2 years, was measured using visual analogue scale questionnaires and the oral health impact profiles. Palatal coverage of the maxillary overdentures was reduced at the first annual recall. Data showed significant improvement in pain reduction, comfort, stability, and function variables of the visual analogue scale after treatment. Analysis by prosthodontic design using visual analogue scale showed no significant difference. The total oral health impact profile-14 scores after treatment for all participants, regardless of prosthodontic design, were significantly lower (more satisfied). The overall oral health impact profile-20E score at baseline was significantly higher (more satisfied) compared with pre-treatment conventional maxillary dentures. No significant changes were observed in the first or second years compared with baseline results. Twenty-two participants (84.6%) preferred reduced palatal coverage, regardless of prosthodontic design, after 1 year. Twenty participants (76.9%) still preferred reduced palatal coverage at the end of the second year. The provision of maxillary 3-implant overdentures to oppose mandibular 2-implant overdentures significantly improve levels of patient

Spiral Computed Tomography Based Maxillary Sinus Imaging in Relation to Tooth Loss, Implant Placement and Potential Grafting Procedure

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Reinhilde Jacobs

2010-01-01

Full Text Available Objectives: The purpose of the present study was to explore the maxillary sinus anatomy, its variations and volume in patients with a need for maxillary implant placement.Materials and Methods: Maxillary sinus data of 101 consecutive patients who underwent spiral computed tomography (CT scans for preoperative implant planning in the maxilla at the Department of Periodontology, University Hospital, Catholic University of Leuven, Leuven, Belgium were retrospectively evaluated. The alveolar bone height was measured on serial cross-sectional images between alveolar crest and sinus floor, parallel to the tooth axis. In order to describe the size of the maxillary sinus anteroposterior (AP and mediolateral (ML diameters of the sinus were measured.Results: The results indicated that the alveolar bone height was significantly higher in the premolar regions in comparison to the molar region (n = 46, P 4 mm mucosal thickening mostly at the level of the sinus floor. The present sample did not allow revealing any significant difference (P > 0.05 in maxillary sinus dimensions for partially dentate and edentulous subjects.Conclusions: Cross-sectional imaging can be used in order to obtain more accurate information on the morphology, variation, and the amount of maxillary bone adjacent to the maxillary sinus.

Long-term space changes after premature loss of a primary maxillary first molar

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Lin, Yng-Tzer J.; Lin, Yai-Tin

2016-01-01

Background/purpose: The consequence of premature loss of primary teeth resulting in the need for space maintainers has been controversial for many years. There is no longitudinal long-term report in literature regarding the premature loss of a primary maxillary first molar. The aim of this study was to continue observing the long-term space changes of 19 cases following premature loss of a primary maxillary first molar during the transition from primary to permanent dentition. Materials an...

Assessment of Root Morphology and Apices of First and Second Maxillary Molars in Tehran Population

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Mandana Naseri

2015-12-01

Full Text Available Introduction: Objective: This study aimed to assess the possible variations in root canal anatomy and topography of the apices of first and second maxillary molars. Materials and methods: A total of 67 first and second maxillary permanent molars were collected. Access cavity was prepared and 2% methylene blue was injected. The teeth were demineralized by 5% nitric acid and cleared with methyl salicylate. Specimens were evaluated under stereomicroscopy and analyzed using the sample t-test. Results: Based on Vertucci’s classification, the mesiobuccal root of maxillary first molars was type I in 87.5% and type IV in 12.5% of the cases. The mesiobuccal root of second maxillary molars was type I in 60%, type II in 8.6%, type IV in 25.7% and type V in 5.7% of cases. In maxillary first and second molars, the distobuccal and palatal roots were type I in 100% of the cases. The distance of the apical constriction from the apical foramen was 0.21±0.09 mm, the distance from the apical constriction tothe anatomic apex was 0.44±0.19 mm and the distance of the apical foramen from the anatomic apex was 0.15±0.15 mm. The mean percentage of delta prevalence was 3.2% in both teeth. Conclusion: The mean distance of the apical foramen and apical constriction from the anatomic apex was less than 0.6 and 1.2 mm, respectively. In maxillary first and second molars, the mean distance of the apical constriction from the apical foramen and anatomic apex was 0.21 and 0.44, respectively and the mean distance of the apical foramen from the anatomic apex was 0.15 mm

In-depth morphological study of mesiobuccal root canal systems in maxillary first molars: review

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Seok-Woo Chang

2013-02-01

Full Text Available A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

Endodontic Management of Maxillary Second Molar with Two Palatal Roots: A Report of Two Cases

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Surbhi Patel

2012-01-01

Full Text Available Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.

Atypical Case of Three Dental Implants Displaced into the Maxillary Sinus

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João Felipe Bonatto Bruniera

2015-01-01

Full Text Available Oral rehabilitation with dental implants has become a routine treatment in contemporary dentistry. The displacement of dental implants into the sinus membrane, a complication related to the maxillary sinus, is one of the most common accidents reported in the literature. The treatment for this complication is the surgical removal of the implant. A 60-year-old woman with three dental implants displaced into the maxillary sinus (one implant displaced into the left maxillary sinus and two implants displaced into the right maxillary sinus underwent surgery for removal of the implants. The surgery to remove the implants was performed under local anesthesia through the Caldwell-Luc technique. The patient was subsequently administered antibiotic, anti-inflammatory, and analgesic drugs. The patient returned 7 days after the surgery for suture removal and is being regularly monitored to determine whether future rehabilitation of the edentulous area is necessary. In conclusion, surgical removal of the dental implant displaced into the maxillary sinus is the treatment of choice. This technique is appropriate because it allows the use of local anesthesia and provides direct visualization for the removal of the implants.

An innovative technique to distalize maxillary molar using microimplant supported rapid molar distalizer

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Meenu Goel

2013-01-01

Full Text Available Introduction: In recent years, enhancements in implants have made their use possible as a mode of absolute anchorage in orthodontic patients. In this paper, the authors have introduced an innovative technique to unilaterally distalize the upper left 1 st molar to obtain an ideal Class I molar relationship from a Class II existing molar relationship with an indigenous designed distalizer. Clinical Innovation: For effective unilateral diatalization of molar, a novel cantilever sliding jig assembly was utilized with coil spring supported by a buccally placed single micro implant. The results showed 3 mm of bodily distalization with 1 mm of intrusion and 2° of distal tipping of upper left 1 st molar in 1.5 months. Discussion: This appliance is relatively easy to insert, well-tolerated, and requires minimal patient cooperation compared to other present techniques of molar distalization. Moreover, it is particularly useful in cases that are Class II on one side and Class I on the other, with a minor midline discrepancy and nominal overjet. Patient acceptance level was reported to be within patients physiological and comfort limits.

Canal pattern in mesiobuccal root of maxillary molars of Nigerians ...

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planed maxillary first and second molars respectively were sectioned transversely at three different points corresponding to the cemento-enamel junction, the peak of the external outline of the furcation and the margin of the middle and apical thirds ...

A New Anatomically Based Nomenclature for the Roots and Root Canals—Part 1: Maxillary Molars

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Kottoor, Jojo; Albuquerque, Denzil Valerian; Velmurugan, Natanasabapathy

2012-01-01

Numerous terminologies have been employed in the dental literature to describe the roots and root canal systems of maxillary molars. This multiplicity in naming of roots and canals makes the reader susceptible to misinterpretation and confusion. No consensus thus far has been arrived at for defining the names of roots and root canals in maxillary molars, including their various morphological aberrations. The anatomical relation of roots and their root canals were identified and were subsequen...

Management of a maxillary first molar having atypical anatomy of two roots diagnosed using cone beam computed tomography.

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Sharma, Sarang; Mittal, Meenu; Passi, Deepak; Grover, Shibani

2015-01-01

Most often, a clinician working on maxillary first molar when anticipates an aberration thinks of an extra canal but rarely does he preempt fewer canals. Maxillary first molar is a tooth, which has been extensively reviewed with respect to its external and internal morphology. Abundant literature related to its anatomy is available, but reports on incidence of two roots and two root canals in maxillary first molar are very limited. Here, a case of maxillary first molar is presented that had two roots: one palatal root with Type I canal configuration and one bulbous fused buccal root with Type V canal configuration; a unique root and canal configuration not seen in any of the earlier reported cases. Diagnosis of root canal aberrancy and subsequently, accurate management of the tooth was greatly facilitated by cone beam computed tomography (CBCT) scan. The relevance of CBCT in improving treatment prognosis is greatly emphasized in this report.

Maxillary first molars with six canals confirmed with the aid of cone-beam computed tomography

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Tahra Mohammad Al-Habboubi

2016-01-01

Full Text Available The maxillary first molar exhibits unpredictable root canal morphology. Different number of root canals has been reported with the aids of new tools. It is very important to clinically detect all canals for better outcome results. The purpose of the present case is to present a case of the maxillary first molar in a Saudi male patient with an anatomical variation of having six root canals that were confirmed with cone-beam computed tomography.

Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography

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Hyoung-Hoon Jo

2016-02-01

Full Text Available Objectives The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT in a Korean population. Materials and Methods Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.. The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test. Results Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001. Conclusions In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.

Maxillary molar distalization with aligners in adult patients: a multicenter retrospective study

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Serena Ravera

2016-04-01

Full Text Available Abstract Background The aim of the present study was to test the hypothesis that bodily maxillary molar distalization was not achievable in aligner orthodontics. Methods Forty lateral cephalograms obtained from 20 non-growing subjects (9 male, 11 female; average age 29.73 years (group S, who underwent bilateral distalization of their maxillary dentition with Invisalign aligners (Align Technology, Inc., San José, CA, USA, were considered for the study. Skeletal class I or class II malocclusion and a bilateral end-to-end class II molar relationship were the main inclusion criteria. Cephalograms were taken at two time points: (T0 pretreatment and (T2 post-treatment. Treatment changes were evaluated between the time points using 39 variables by means of paired t test. The level of significance was set at P < 0.05. Reproducibility of measurements was assessed by the intraclass correlation coefficient (ICC. Results The mean treatment time was 24.3 ± 4.2 months. At the post-treatment point, the first molar moved distally 2.25 mm without significant tipping (P = 0.27 and vertical movements (P = 0.43. The second molar distalization was 2.52 mm without significant tipping (P = 0.056 and vertical movements (P = 0.25. No significant movements were detected on the lower arch. SN^GoGn and SPP^GoGn angles showed no significant differences between pre- and post-treatment cephalograms (P = 0.22 and P = 0.85, respectively. Conclusions Aligner therapy in association with composite attachments and class II elastics can distalize maxillary first molars by 2.25 mm without significant tipping and vertical movements of the crown. No changes to the facial height were revealed.

Pendulum and modified pendulum appliances for maxillary molar distalization in Class II malocclusion - a systematic review.

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Al-Thomali, Yousef; Basha, Sakeenabi; Mohamed, Roshan Noor

2017-08-01

The main purpose of the present systematic review was to evaluate the quantitative effects of the pendulum appliance and modified pendulum appliances for maxillary molar distalization in Class II malocclusion. Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus and key journals and review articles; the date of the last search was 30 January 2017. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP). In total, 203 studies were identified for screening, and 25 studies were eligible. The quality assessment rated four (16%) of the study as being of strong quality and 21 (84%) of these studies as being of moderate quality. The pendulum appliances showed mean molar distalization of 2-6.4 mm, distal tipping of molars from 6.67° to 14.50° and anchorage loss with mean premolar and incisor mesial movement of 1.63-3.6 mm and 0.9-6.5 mm, respectively. The bone anchored pendulum appliances (BAPAs) showed mean molar distalization of 4.8-6.4 mm, distal tipping of molars from 9° to 11.3° and mean premolar distalization of 2.7-5.4 mm. Pendulum and modified pendulum appliances are effective in molar distalization. Pendulum appliance with K-loop modification, implant supported pendulum appliance and BAPA significantly reduced anchorage loss of the anterior teeth and distal tipping of the molar teeth.

Detection of Mesiobuccal Canal in Maxillary Molars and Distolingual Canal in Mandibular Molars by Dental CT: A Retrospective Study of 100 Cases

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Sushma Rathi

2010-01-01

Full Text Available Objective. To detect presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars by Dental CT. Material and Methods. A retrospective study of 100 Dental CTs was done. Axial and paraxial images obtained were used to assess the presence of MB2 canal in maxillary molars and distolingual canal in mandibular molars. Results. The youngest patient was of 11 years while the eldest patient was of 77 years. Males were 58 in number and females were 42 in number. MB2 canals were present in 57 patients and distolingual canal was present in 18 patients. Maximum MB2 canals were present in age group between 51 and 60 years, while distolingual canals were present in age group of 21–30 years. Conclusion. Dental CT allows adequate visualization of variation in root canal morphology and can be important diagnostic tool for successful endodontic therapy.

[Mapping mini-implant anatomic sites in the area of the maxillary first molar with the aid of the NewTom 3G® system].

Science.gov (United States)

Dumitrache, Marius; Grenard, Annabelle

2010-12-01

The goal of our study was to construct a map of the implant sites in the region of the attached gingiva around the maxillary first molars that would be appropriate locations for placement of miniscrews to serve as orthodontic anchorage. We conducted 58 radiographic examinations with the NewTom 3G(®) cone beam technique. For each interdental space, between upper second bicuspids and first molars (5/6) and between upper first and second molars (6/7), we studied the mesio-distal width and depth of bucco-lingual bone at two different levels, L1 and L2, that corresponded to the lower and upper limits of the attached gingiva in the general population. The widths of the interdental spaces varied very little between L1 and L2 and their variances were comparable. At the level of the 5/6 space, the interdental widths displayed a Gaussian distribution, which made it possible for us to determine the confidence intervals at the two borders of attached gingiva as a function of age: IC(99%) of L1 = [2.045 ; 3.462] from 12 to 17 years or [1.594 ; 2.519] from 18 to 24 or [1.613 ; 2.5] from 25 to 48 years and IC(99%) of L2 = [2.37 ; 3.69] from 12 to 17 years or [1.5 ; 2.613] from 18 to 24 or [1.546 ; 2.619] from 25 to 48 ans. The interdental depths increased in an apical direction and their variance diminished. Even if the adequacy of the Gaussian law is less reliable in the sagittal plane, we find a greater consistency in depths in the spaces around 5/6 that allows us to establish very precise confidence levels: IC(99%) of L1 = [9.213; 10.575] and IC(99%) of L2 = [10.295; 11.593]. The mesial areas of the first molars constitute safe zones for implantation of miniscrews with a maximum of 2-2.3 mm for 12 to 17 years old or 1.5-1.6 mm for 18 to 48 year olds and of a maximum of 9-10 mm in length whether the attached gingival level is strong or feeble. The distal areas of the first molars, because of their great variability, require an individualized radiographic study before any mini

Evaluation the success of osseointegrated implants in maxillary sinus grafts

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Rubens Eduardo Gigli

2008-01-01

Full Text Available Objective: To analyze implants placed in maxillary sinus grafts with biomaterial of bovine origin and platelet-rich plasma, observing bone neoformation and the clinical and histologic success rate presented.Methods: Analysis of the clinical findings was based on 36 maxillary sinus grafts with 101 implants placed in 30 patients with a mean age of 47 years, and the histologic analysis, based on nine samples of the 36 grafts performed, with a mean interval of 7.5 months time of the graft, the majority of patients being men with a mean age of 42 years. Results: Clinically, 91 implants placed were osseointegrated.Conclusion: Based on the results presented, it was concluded that when implants are placed in the maxillary sinus region grafted with biomaterial, they present a high success rate. ISRCTN24003246

Maxillary overdentures retained by splinted and unsplinted implants : A retrospective study

NARCIS (Netherlands)

Narhi, TO; Hevinga, M; Voorsmit, RACA; Kalk, W

2001-01-01

The purpose of this retrospective study was to evaluate the clinical performance of and patients' satisfaction with maxillary overdentures retained by splinted and unsplinted implants. Patients who had been treated with maxillary implant-retained overdentures because of functional problems with

An original micro-CT study and meta-analysis of the internal and external anatomy of maxillary molars - implications for endodontic treatment.

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Tomaszewska, Iwona M; Jarzębska, Anna; Skinningsrud, Bendik; Pękala, Przemysław A; Wroński, Sebastian; Iwanaga, Joe

2018-05-07

The aim of this work was to conduct a radiological micro-CT study and meta-analysis to determine the morphological features of the root canal anatomy of the maxillary molars. The radiological study included micro-CT scans of 110 maxillary first molars and 98 maxillary second molars. To identify articles eligible for inclusion in our meta-analysis, PubMed, Embase, and Web of Science were search comprehensively. The following data were extracted: study type (cadaveric, intraoperative or imaging), Vertucci types of canal configuration, presence/number of canals, roots, apical foramina, apical deltas, and inter-canal communications. The mesiobuccal root was the most variable with respect to canal configuration, type I being the most common configuration followed by type II and type IV. Type I was the most common canal configuration in the distobuccal and palatal root. Regarding the number of canals in the maxillary first and second molars, one canal was most prevalent in all roots of the three molars, except for the mesiobuccal root of maxillary first molar, in which two canals were most prevalent. The most prevalent number of roots in all maxillary molars was three. Knowledge of endodontic anatomy determines the parameters of root canal treatment and significantly affects the probability of success. It is therefore especially important to know the morphology of the root canal system in order to perform endodontic treatment correctly. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Maxillary implant-retained partial overdenture with Dolder bar attachment: a clinical report.

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Kim, Hyeongil; Buhite, Robert J; Monaco, Edward A

2015-03-01

This article describes a technique for maintaining a maxillary Kennedy III partial removable dental prosthesis design in a patient who had non-restorable failing abutments by replacing the abutments with dental implants. Two implants were placed immediately after extraction of the abutment teeth in the anterior maxilla. After the implants were fully integrated, a Dolder bar attachment was fitted onto the implants. A new maxillary partial removable dental prosthesis was fabricated using the implants and the remaining natural teeth as abutments to restore function and esthetics. With the aid of dental implants, this Kennedy III maxillary removable dental prosthesis design could provide additional retention and support by promoting cross-arch stability and tissue, implant and tooth support. The patient's satisfaction was significantly increased.

上颌窦气化与上颌第一磨牙的相关性分析%The correlation between maxillary sinus aeration and maxillary molars: A CT image analysis

Institute of Scientific and Technical Information of China (English)

周泉生; 胡志; 孙大明; 刘成蛟; 李兴花

2017-01-01

AIM:To investigate the relationship between the aeration of maxillary sinus and maxillary molars.METHODS:The CT images of 50 patients with normal sinus(n =100) were analyzed retrospectively.The volume of maxillary sinus,the length of the first maxillary molar and its corresponding alveolar bone height and width were measured.The molars were divided into embedded and non-embedded types.The conelations between the molar length,the volume of maxillary sinus and the mass of alveolar bone were statistically analyzed.RESULTS:The average volume of maxillary sinus was (13.56 ± 5.63) mL,alveolar bone height and width were (11.35 ± 4.09) mm and (14.83 ± 1.56) mm respectively,the first molar length was (18.88 ± 2.69) mm.There was no correlation between the length of maxillary molars and the volume of maxillary sinus and alveolar bone mass (P ＞ 0.05).No difference of the molar length was found between the embedded and non-embedded molars (P ＞ 0.05).The volume of maxillary sinus in the embedded group was greater than that in the non-embedded group (P ＜0.05) and the alveolar bone mass in embedded group was less than that in the non-embedded group (P ＜ 0.05).CONCLUSION:The maxillary molar has no significant correlation with the volume of maxillary sinus and the alveolar bone mass.But for maxillary sinus with obvious aeration,the probability of molar protrusion into the maxillary sinus increases.%目的:探讨上颌窦气化与上颌第一磨牙的关系.方法:回顾性分析50例(100个上颌第一磨牙)副鼻窦CT检查正常的患者影像资料,测量上颌窦容积、上颌第一磨牙长度以及对应牙槽骨的高度和宽度;并将第一磨牙分为嵌入型和非嵌入型,分析两组间差异以及上颌第一磨牙长度与上颌窦容积、牙槽骨骨量的相关性.结果:50例(100个)正常上颌窦平均容积(13.56 5.63) mL,牙槽骨高度(11.35±4.09) mm,牙槽骨宽度(14.83±1.56)mm,第一磨牙长度(18.88 ±2.69) mm

Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report

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Ankit Arora

2013-08-01

Full Text Available The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multi-detector computed tomography (MDCT scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report.

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Arora, Ankit; Acharya, Shashi Rashmi; Saraswathi, Muliya Vidya; Sharma, Padmaja; Ather, Amber

2013-08-01

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multi-detector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

Double palatal roots in maxillary second molars: A case report and literature review

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Mohammed S Alenazy

2015-01-01

Full Text Available A thorough understanding of internal and external anatomy of various teeth is critical for a successful outcome of endodontic therapy. The aims of this paper were (1 to describe the clinical retreatment of a maxillary second molar with two palatal roots and (2 to review the available literature regarding this anatomical variation. A 45-year-old Saudi female presented for non-surgical retreatment of maxillary left second molar. Careful radiographic and clinical examinations revealed the presence of two buccal and two palatal roots each with a single root canal. Anatomical variations can occur in any tooth; therefore, the clinicians should always anticipate the occurrence of these variations and utilize all the available tools to diagnose and manage them

Long-term space changes after premature loss of a primary maxillary first molar

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Yng-Tzer J. Lin

2017-03-01

Conclusion: The anterior and posterior arch dimensions significantly increased 81 months after premature loss of a primary maxillary first molar, which suggested that space maintainers were not needed in these cases.

Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report

OpenAIRE

Arora, Ankit; Acharya, Shashi Rashmi; Saraswathi, Muliya Vidya; Sharma, Padmaja; Ather, Amber

2013-01-01

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for...

Analysis of the internal anatomy of maxillary first molars by using different methods.

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Baratto Filho, Flares; Zaitter, Suellen; Haragushiku, Gisele Aihara; de Campos, Edson Alves; Abuabara, Allan; Correr, Gisele Maria

2009-03-01

The success of endodontic treatment depends on the identification of all root canals so that they can be cleaned, shaped, and obturated. This study investigated internal morphology of maxillary first molars by 3 different methods: ex vivo, clinical, and cone beam computed tomography (CBCT) analysis. In all these different methods, the number of additional root canals and their locations, the number of foramina, and the frequency of canals that could or could not be negotiated were recorded. In the ex vivo study, 140 extracted maxillary first molars were evaluated. After canals were accessed and detected by using an operating microscope, the teeth with significant anatomic variances were cleared. In the clinical analysis, the records of 291 patients who had undergone endodontic treatment in a dental school during a 2-year period were used. In the CBCT analysis, 54 maxillary first molars were evaluated. The ex vivo assessment results showed a fourth canal frequency in 67.14% of the teeth, besides a tooth with 7 root canals (0.72%). Additional root canals were located in the mesiobuccal root in 92.85% of the teeth (17.35% could not be negotiated), and when they were present, 65.30% exhibited 1 foramen. Clinical assessment showed that 53.26%, 0.35%, and 0.35% of the teeth exhibited 4, 5, and 6 root canals, respectively. Additional root canals were located in this assessment in mesiobuccal root in 95.63% (27.50% could not be negotiated), and when they were present, 59.38% exhibited 1 foramen. CBCT results showed 2, 4, and 5 root canals in 1.85%, 37.05%, and 1.85% of the teeth, respectively. When present, additional canals showed 1 foramen in 90.90% of the teeth studied. This study demonstrated that operating microscope and CBCT have been important for locating and identifying root canals, and CBCT can be used as a good method for initial identification of maxillary first molar internal morphology.

Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population

International Nuclear Information System (INIS)

Kalender, Atakan; Aksoy, Umut; Basmaci, Fatma; Celikten, Berkan; Tufenkci, Pelin; Kelahmet, Umay; Orhan, Kaan

2016-01-01

The aim of this retrospective study was to review, analyse and characterize the root canal morphology of maxillary molars, using cone beam computed tomography (CBCT), in a group of the Turkish Cypriot population. The sample for this cross-sectional study consisted of retrospective evaluation of CBCT scans of 290 adult patients (age range 1680). The number of roots and their morphology, the number of canals per tooth and the root canal configurations were also classified according to the method of Vertucci. Pearson’s chi-square test was performed for canal configurations, sides and gender (p < 0.05). Among the 373 first molars, there was no single-rooted specimen, 2 (0.53%) teeth had 2 roots, 365 (97.8%) teeth had 3 roots and 6 ones (1.6%) had 4 roots. Among the 438 second molars, 14 (3.1%) were single-rooted, 26 (5.9%) teeth had 2 roots, 392 (89.4%) teeth had 3 roots and 6 teeth (1.3%) had 4 roots. No sex difference was found in the frequency of additional canals both in the maxillary first and second molars. Occurrence of additional canals did not differ with age. These results provide detailed knowledge of the root canal anatomy of the maxillary molar teeth in this particular population, which is of clinical importance for dental professionals when performing endodontic treatment

Diagnosis and Management of a Patient with Congenitally Missing Maxillary First Permanent Molars: A Rare Case Report

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Megha Gupta

2016-01-01

Full Text Available Congenitally missing teeth are the most commonly seen dental anomalies. Agenesis of the permanent first molar has the least frequency of all the tooth types, and it usually occurs in association with oligodontia or anodontia. Thus, agenesis of the bilateral maxillary first permanent molar is an extremely rare occurrence, and no such case has been reported in ethnic Saudi Arabian population. We hereby report a case of nonsyndromic bilateral congenitally missing maxillary first permanent molar in an eight-year-old Saudi female patient. Comprehensive oral rehabilitation was done for the patient. The implications of the tooth agenesis are also discussed. The prognosis of this case is presented.

Morphology of the Physiological Apical Foramen in Maxillary and Mandibular First Molars

OpenAIRE

Abarca, J.; Zaror, C.; Monardes, H.; Hermosilla, V.; Muñoz, C.; Cantin, M.

2014-01-01

Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3–5 mm from the apex were sect...

Early Eruption of Maxillary Pre Molar with Turner's Hypoplasia in a 5-Year-Old Boy.

Science.gov (United States)

Rai, Nitya; Mathur, Shivani; Sandhu, Meera; Sachdev, Vinod

2016-08-01

Early eruption of permanent maxillary premolar appears to be a unique finding, at such an early chronological age. Untimely eruption of permanent maxillary premolar is discussed in a 5-year-old male patient. On intra oral examination grossly carious primary maxillary first molar (tooth number 54,64) were reported. The erupting teeth presented with a hypomineralized cusp tip. Extraction following space maintainer in 64 region was given. Pediatric dentist should consider these kinds of rarities in eruption pattern while examining a pediatric patient.

Morphological evaluation of maxillary second molars with fused roots: a micro-CT study.

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Ordinola-Zapata, R; Martins, J N R; Bramante, C M; Villas-Boas, M H; Duarte, M H; Versiani, M A

2017-12-01

To evaluate the internal and external morphologies of fused-rooted maxillary second molars by means of micro-computed tomography (micro-CT) analysis. A total of 100 fused-rooted maxillary second molars from a Brazilian subpopulation were divided into six groups according to the root morphology. The samples were scanned at a resolution of 19.6 μm and evaluated with regard to the external morphology of the roots, the root canal configuration, the percentage frequency of C-shaped canals and isthmuses, as well as the morphology of the root canal system at 1, 2 and 3 mm from the anatomical apex of the fused roots. The most prevalent root canal fusions were type 1, mesiobuccal root fused with distobuccal root (32%), followed by type 3, DB root fused with P root (27%), and type 4, MB root fused with DB root, and P root fused with MB or DB roots (21%). The prevalence of C-shaped root canal systems were 22%. Depending on the type of root fusion, the percentage frequency of isthmuses in the apical level varied from 9.3% to 42.8%, whilst the presence of apical deltas ranged from 18.5% to 57.1% of teeth. The root canal system of maxillary second molars with fused roots may have a high incidence of merging canals, isthmuses, apical deltas and C-shaped configurations. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes.

Science.gov (United States)

Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel

2017-07-01

To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Zygomatic bone graft for oral-antral communication closure and implant placement.

Science.gov (United States)

Peñarrocha-Diago, Miguel; García, Berta; Gomez, Dolores; Balaguer, José

2007-01-01

The roots of molar and premolar maxillary teeth are often very close to the floor of the maxillary sinus. As a result, extraction of these teeth can leave an oral-antral communication or lead to a fistula that requires treatment. A woman with an oral-antral communication secondary to extraction of a maxillary molar is presented. The communication was closed by means of a bone graft harvested from the wall of the sinus (zygomatic bone). After 3 months, 2 dental implants were placed, one in the pterygoid area and the other with parasinusal angulation. Rehabilitation followed in the form of a screw-retained, fixed prosthesis 3 months after implant placement. There have been no complications after 1 year of follow-up. This surgical technique allowed closure of an oral-antral communication produced by molar extraction through placement of a zygomatic bone graft and subsequent placement of 2 dental implants.

Maxillary complete denture outcome with two-implant supported mandibular overdentures. A systematic review.

Science.gov (United States)

Rutkunas, Vygandas; Mizutani, Hiroshi; Peciuliene, Vytaute; Bendinskaite, Ruta; Linkevicius, Tomas

2008-01-01

Research data regarding maxillary complete denture outcome with two-implant supported mandibular overdentures are not consistent. Considering multiple publications on implant supported mandibular overdentures, it was decided to summarize currently present evidence on the maxillary complete dentures opposed by implant-supported mandibular overdentures, and analyze factors that could potentially influence the outcomes. The articles from 1985 to 2007 related to the topic were identified in the online MEDLINE/Pubmed and other databases and manually. Primary articles were scanned, and irrelevant studies were excluded from the further review process. Potentially relevant titles and abstracts were provisionally included for consideration on the basis of full text articles. Full text articles were obtained from on-line and printed sources. The data from the studies were extracted and reviewed. The study has failed to identify any prospective satisfying inclusion/exclusion criteria RCT reporting on maxillary bone resorption. The number of maxillary complete denture relining incidences per patient was constantly increasing during the 10-year period. Maxillary complete denture remake incidences comprised 16-33 % of the number of patients followed during the 10-year period. Comparing patient satisfaction with upper dentures at the baseline and after two years, no decrease in satisfaction was noticed. There is no evidence that maxillary ridge resorption is accelerated with certain types of two-implant supported mandibular overdenture attachments. Most common complication for the maxilla - prosthetic maintenance. There is a risk of decreased patient satisfaction with bar-supported mandibular overdenture. Further studies are needed to provide evidence for the maxillary complete denture outcome with two-implant supported mandibular overdentures.

Comparison of the Distances between the Maxillary Sinus Floor and Root-Tips of the First and Second Maxillary Molar Teeth Using Panoramic Radiography among Dolichocephalic and Brachycephalic and Mesocephalic Individuals

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Hamidreza Arabion

2015-06-01

Full Text Available Introduction: Comparison of the relationships and distance between maxillary root tips and   the maxillary sinus floor using oral panoramic in the dolichocephalic and brachycephalic compared to mesocephalic individuals. Methods: Oral panoramic images from 300 individuals were analyzed and the relationships and distance between the maxillary root tips and the sinus floor was assessed by qualitative and quantitative variables. Results: The distance was significantly higher in the brachycephalic groups than that of the mesocephalic, and the mesocephalic group showed longer distance in comparison to dolichocephalic individuals. Qualitative comparison showed that type 1 relationship was the dominant position in the brachycephalic individuals while most of dolichocephalic individuals demonstrated type 2 and 3 relationships of the molar root tips and the maxillary sinus floor. Conclusion: Higher distances between the molar root tips and the maxillary sinus floor could be expected in the brachycephalic than mesocephalic and dolichocephalic individuals

The edentulous mandible opposing maxillary natural teeth: treatment considerations utilizing implant overdentures.

Science.gov (United States)

Winkler, S; Monasky, G E

1993-01-01

The restoration of the edentulous mandible opposing all or part of the maxillary natural dentition with implant overdentures is described. There are many situations in which the maxillary teeth opposing an edentulous mandible can and should be retained. Mandibular implant overdentures can be utilized as long as health considerations, morphologic features of the resorbed mandible, and maxillomandibular jaw relationships are satisfactory.

Classification of alveolar bone destruction patterns on maxillary ...

African Journals Online (AJOL)

Objective: The defective diagnosis of alveolar structures is one of most serious handicaps when assessing available periodontal treatment options for the prevention of tooth loss. The aim of this research was to classify alveolar bone defects in the maxillary molar region which is a challenging area for dental implant ...

Mini-screw implant or transpalatal arch-mediated anchorage reinforcement during canine retraction: a randomized clinical trial.

Science.gov (United States)

Sharma, Mohit; Sharma, Vineet; Khanna, Bharat

2012-06-01

To compare mesial movement of upper first molars during maxillary canine retraction using a pre-adjusted edgewise appliance provided by anchorage reinforcement and a transpalatal arch or mini-screw implant. Randomized clinical trial. Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India. From a cohort of subjects requiring the extraction of both upper first premolars and pre-adjusted edgewise appliances to correct their malocclusion, a total of 30 were randomly allocated to receive two different forms of anchorage reinforcement: group A--receiving mini-screw implant and group B--receiving a transpalatal arch Group A subjects received titanium mini-screw implants placed at the start of treatment between the maxillary second premolar and maxillary first molar. Maxillary second premolars were secured to the mini-screw implants using of 0.010-inch stainless steel ligature wire. Group B subjects received a custom-made transpalatal arch which was soldered to maxillary first molar bands. Active canine retraction was initiated in both groups on placement of a 0.019×0.025-inch stainless steel archwire using nickel titanium closed coil springs. Mesial movement of the upper first molars as measured on pre- (T1) and post-treatment (T2) lateral skull radiographs. The results showed that in group A the mean mesial movement of the first molars between T1 and T2 was 0.0 mm (SD 0.02; P = 0.90), whereas in Group B there was a mean forward movement of the first maolars of 2.48 mm (SD 0.71; Pimplants placed prior to levelling and aligning were able to provide absolute anchorage during maxillary canine retraction, in contrast to a transpalatal arch.

Mini implant supported molar tubes: A novel method for attaching the molar tubes

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Nitin V Muralidhar

2017-01-01

Full Text Available Banding or bonding procedures have been the only means of attaching molar tubes onto the permanent molar teeth till date in the field of orthodontics. This clinical innovation aims to include the use of mini implant for the purpose of attaching the molar tubes thereby eliminating the iatrogenic effects of banding and bonding of the teeth.

The single-tooth implant treatment of congenitally missing maxillary lateral incisors using angled abutments: A clinical report

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Suleyman Hakan Tuna

2009-01-01

Full Text Available The maxillary lateral incisor is the second most common congenitally absent tooth. There are several treatment options for replacing the missing maxillary lateral incisor, including canine substitution, tooth-supported restoration, or single-tooth implant. Dental implants are an appropriate treatment option for replacing missing maxillary lateral incisor teeth in adolescents when their dental and skeletal development is complete. This case report presents the treatment of a patient with congenitally missing maxillary lateral incisors using dental implants with angled abutments.

Removal of a Dental Implant Displaced into the Maxillary Sinus by Means of the Bone Lid Technique

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Pietro Fusari

2013-01-01

Full Text Available Background. Rehabilitation of edentulous jaws with implant-supported prosthesis has become a common practice among oral surgeons in the last three decades. This therapy presents a very low incidence of complications. One of them is the displacement of dental implants into the maxillary sinus. Dental implants, such as any other foreign body into the maxillary sinus, should be removed in order to prevent sinusitis. Methods. In this paper, we report a case of dental implant migrated in the maxillary sinus and removed by means of the bone lid technique. Results and Conclusion. The migration of dental implants into the maxillary sinus is rarely reported. Migrated implants should be considered for removal in order to prevent possible sinusal diseases. The implant has been removed without any complications, confirming the bone lid technique to be safe and reliable.

Maxillary implant-supported overdentures opposed by (partial) natural dentitions : A 5-year prospective case series study

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Boven, G. C.; Slot, J. W. A.; Raghoebar, G. M.; Vissink, A.; Meijer, H. J. A.

2017-01-01

The aim of this study was to assess the 5-year treatment outcome of maxillary implant-retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone

Maxillary first molar extraction in Class II malocclusion : Follow-up studies on treatment effects

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Livas, Christos

2015-01-01

This PhD research investigated treatment effects of extraction of one and two maxillary first molars in Class II subdivision and Class II/1 malocclusion cases respectively from a longer time perspective. Private practice records were scrutinized to evaluate aspects of a treatment technique combining

An in vitro study of mesiobuccal root thickness of maxillary first molars.

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Mohammadzadeh Akhlaghi, Nahid; Ravandoust, Yasaman; Najafi, Mohammad; Dadresanfar, Bahareh

2012-01-01

Understanding the internal anatomy of root canal system can significantly influence outcomes of root canal treatment. The aim of this in vitro study was to measure the thickness of mesiobuccal root at different levels in maxillary first molars. In this cross-sectional study, forty extracted human maxillary first molars were radiographed; accordingly, the mesial and distal root thicknesses of mesiobuccal (MB) roots were measured at four parallel horizontal levels. The samples were sectioned at the measured levels and then sections were scanned and saved in the computer. Buccal (B), Palatal (P), Mesial (M) and Distal (D) aspects of root thicknesses in single-canalled roots were measured. In two-canalled mesiobuccal roots, Distobuccal (DB) and Distopalatal (DP) aspects were evaluated alongside other measurements. Average radicular thickness in each aspect and each level was compared using ANOVA and t-test. A total of 25 had two canals and 15 had one canal in MB root. In single-canalled roots M and D aspects were the thinnest whereas in two-canalled samples, the thicknesses of DP and DB aspects were significantly less than others (Pmolar roots in order to avoid technical mishaps.

Quantitative three-dimensional analysis of root canal curvature in maxillary first molars using micro-computed tomography.

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Lee, Jong-Ki; Ha, Byung-Hyun; Choi, Jeong-Ho; Heo, Seok-Mo; Perinpanayagam, Hiran

2006-10-01

In endodontic therapy, access and instrumentation are strongly affected by root canal curvature. However, the few studies that have actually measured curvature are mostly from two-dimensional radiographs. The purpose of this study was to measure the three-dimensional (3D) canal curvature in maxillary first molars using micro-computed tomography (microCT) and mathematical modeling. Extracted maxillary first molars (46) were scanned by microCT (502 image slices/tooth, 1024 X 1024 pixels, voxel size of 19.5 x 19.5 x 39.0 microm) and their canals reconstructed by 3D modeling software. The intersection of major and minor axes in the canal space of each image slice were connected to create an imaginary central axis for each canal. The radius of curvature of the tangential circle was measured and inverted as a measure of curvature using custom-made mathematical modeling software. Root canal curvature was greatest in the apical third and least in the middle third for all canals. The greatest curvatures were in the mesiobuccal (MB) canal (0.76 +/- 0.48 mm(-1)) with abrupt curves, and the least curvatures were in the palatal (P) canal (0.38 +/- 0.34 mm(-1)) with a gradual curve. This study has measured the 3D curvature of root canals in maxillary first molars and reinforced the value of microCT with mathematical modeling.

Single-rooted maxillary first molar with a single canal: endodontic retreatment.

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de la Torre, Francisco; Cisneros-Cabello, Rafael; Aranguren, José Luis; Estévez, Roberto; Velasco-Ortega, Eugenio; Segura-Egea, Juan José

2008-12-01

This case report presents an unusual root canal system in a maxillary first molar tooth: a single canal in a single root. The endodontic access cavity displayed only 1 canal orifice. This case demonstrated that: 1) clinicians must have adequate knowledge about root canal morphology and its variations; 2) the location and morphology of root canals should be identified radiologically before the root canal treatment; and 3) careful examination of radiographs and the internal anatomy of teeth is essential.

Long-term evaluation of Class II subdivision treatment with unilateral maxillary first molar extraction

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Livas, Christos; Pandis, Nikolaos; Booij, Johan Willem; Katsaros, Christos; Ren, Yijin

Objective: To evaluate the long-term effects of asymmetrical maxillary first molar (M1) extraction in Class II subdivision treatment. Materials and Methods: Records of 20 Class II subdivision whites (7 boys, 13 girls; mean age, 13.0 years; SD, 1.7 years) consecutively treated with the Begg technique

Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

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F. Ugurlu

2012-01-01

Full Text Available Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4×6×3cm cyst was discovered in the left maxillary molar region and enucleated. Three months postoperatively, the area had a severe bone defect extending to the zygomatic buttress superiorly and hamular notch posteriorly. Three months later, a bone segment including the right upper second premolar was osteotomised and distracted horizontally. The bone segment was distracted 15 mm distally. After consolidation, implants were placed when the distractor was removed. A fixed denture was loaded over the implants after 3 months. Complete alveolar bone loss extending to the cranial base can be reconstructed with transport distraction osteogenesis. Distalisation of the alveolar bone segment adjacent to the bony defect is an easy method for reconstructing such severe defects.

Maxillary Three-Implant Overdentures Opposing Mandibular Two-Implant Overdentures: 10-Year Surgical Outcomes of a Randomized Controlled Trial.

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Ma, Sunyoung; Tawse-Smith, Andrew; De Silva, Rohana K; Atieh, Momen A; Alsabeeha, Nabeel H M; Payne, Alan G T

2016-06-01

The surgical placement of four maxillary implants for overdentures may not be obligatory when opposing mandibular two-implant overdentures. To determine 10-year surgical outcomes and implant success of three narrow diameter implants in edentulous maxillae with conventional loading. Forty participants with mandibular two-implant overdentures were randomly allocated for surgery for maxillary overdentures. Using osteotomes, three implants of similar systems were placed with a one-stage procedure and 12-week loading with splinted and unsplinted prosthodontic designs. Marginal bone and stability measurements were done at surgery, 12 weeks, 1-, 2-, 5-, 7-, 10 years. One hundred seventeen implants were placed in 39 participants, with 35 being seen at 1 year; 29 at 2 years; 28 at 5 years; 26 at 7 years; and 23 (59%) at 10 years. Marginal bone loss was 1.35 mm between surgery and 12 weeks; 0.36 mm between 12 weeks and 1 year; 0.48 mm between 1 and 5 years; and 0.22 mm between 5 and 10 years. Implant stability quotients were 56.05, 57.54, 60.88, 58.80, 61.17 at surgery, 12 weeks, 1 year, 5 years, and 10 years. Four-field tables by implant showed success rates of 82% at 1 year; 69.2% at 2 years; 66.7% at 5 years; 61.5% at 7 years; 51.3% at 10 years. Data showed no differences between surgical technique, systems, or prosthodontic designs. Surgical placement with osteotomes of three narrow diameter implants for maxillary overdentures, opposing mandibular two-implant overdentures, is an acceptable approach, subject to strict patient selection. Implant success is independent of prosthodontic design. © 2015 Wiley Periodicals, Inc.

The maxillary second molar - anatomical variations (case report).

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Beshkenadze, E; Chipashvili, N

2015-01-01

To be acquainted with dental anatomical specificity is of great importance for dental endodontic treatment algorithm. The subject of present publication is 2 clinical cases of upper second molars, detailed characterization of, which is considered very important for enrichment of anatomical knowledge about dental anatomical variations. In one case, the reason for admission to the clinic of a 38-year-old woman was complains as of esthetic character as well as functional misbalance (disturbance of chewing function due to the damage of orthopedic construction). The patient indicated to the existence of coronary defects of large size aesthetic discomforts, damage and discolouration of old orthopedic construction (denture) in maxillary right molar area. According to the data obtained after clinical and visiographical examinations, chronic periodontitis of 17 teeth was identified as a result of incomplete endodontic treatment. According to the data obtained after clinical and visiographical examinations, the diagnosis of chronic periodontitis of 17 teeth was identified, tooth 17 with 2 roots and 2 canals. In the second clinical case, the reason for admission to the clinic of a 39-year-old woman was severe pain in the upper right molar area. The patient indicated to the caries on the tooth 17. After completion of proper survey clinical and visiographical examinations, acute pulpitis (K04.00) - with three roots and 4 canals was diagnosed. In both cases after the proper examinations and agreement with the patients a treatment plan envisaging: 17 teeth endodontic treatment, filling of caries defects and their preparation on one hand for orthopedic construction (denture) and on the other hand for restoration of anatomical integrity by light-cured composite, was scheduled. The present study is designed to prevent complications of endodontic treatment of the second molar, to optimize diagnosis and treatment algorithm, once again proving reliable information indicating to the

Morphologic variations of maxillary molars palatal root and the importance of its knowledge for endodontic practice: a case series.

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Scarparo, Roberta Kochenborger; Pereira, Leticia; Moro, Diana; Grundling, Grasiela; Gomes, Maximiliano; Grecca, Fabiana Soares

2011-03-01

The present report describes and discusses root canal variations in the internal morphology of maxillary molars. Dental internal anatomy is directly related to all the technical stages of the endodontic treatment. Even though, in some situations a typical anatomical characteristics can be faced, and the professional should be able to identify them. This clinical report describes five cases with different pulpar and periapical diagnostics where the endodontic treatment was performed, in which during the treatment the unusual occurrence of two or three canals in the palatal root 'or even two distinct palatal roots' of first and second maxillary molars, were described and important details for achieving treatment success were discussed. The knowledge of tooth internal anatomy must be considered during clinical and radiographic examinations. This should be valued not only to find atypical canals but also to enable calcified canals cleaning and shaping, once they are frequently omitted during endodontic therapy. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. The complexity of the root canal system and the importance of identifying its internal anatomy for planning endodontic treatment increase the chances of success.

Microcomputed tomography analysis of mesiobuccal orifices and major apical foramen in first maxillary molars.

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Spagnuolo, Gianrico; Ametrano, Gianluca; D'Antò, Vincenzo; Formisano, Anna; Simeone, Michele; Riccitiello, Francesco; Amato, Massimo; Rengo, Sandro

2012-01-01

Aim of the study was to determined by microcomputed tomography (µCT) the horizontal distance between the main (MB1) and the second mesiobuccal canal (MB2) orifices, the vertical distance between the MB1 and MB2 orifices planes, and the distance between the anatomic apex and major apical foramen (AF). Furthermore, we characterized the entire internal and external anatomy of the MB, distalbuccal (DB) and palatal (P) maxillary first molars roots. Twenty-two intact extracted first maxillary molars were scanned by X-ray computed transaxial µCT and then 2D and 3D images were processed and analyzed. The results showed that 77.27% of the mesiobuccal (MB) roots presented a second MB canal, and 29.41% of the MB2 were independent from the MB1 canals. In 15 teeth, there were three root canal orifices on the chamber floor, and 10 of these teeth presented MB2 canals. The mean vertical distance between the MB1 and MB2 planes was 1.68 ± 0.83 mm. Seven teeth had four orifices. The mean horizontal interorificial distance between the MB1 and MB2 orifices was 1.21 ± 0.5 mm. Accessory canals were observed in 33.33% of the roots, loops in 6.06%, while isthmuses were found in 15 of the 22 MB roots. Of the total roots, 74.24% presented one foramen, while all of the roots showed a major apical foramen that was not coincident with the anatomic apex. Our µCT analysis provided interesting features on the horizontal and vertical distance between the MB1 and MB2 orifices and on the distance of AF and anatomic apex. These results have an important clinical value because might support the endodontist in the recruitment, negotiation and obturation of maxillary first molar canal system.

Maxillary sinus function after sinus lifts for the insertion of dental implants

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Timmenga, NM; Raghoebar, GM; Boering, G; VanWeissenbruch, R

Purpose: The influence of bone augmentation of the floor of the maxillary sinus for the insertion of denial implants on sinus function has not been well investigated, In this study, the influence of the sinus lift on the development of maxillary sinus pathology was evaluated using generally accepted

Success of Unsplinted Implant-Retained Removable Mandibular and Maxillary Overdentures: A Retrospective Study of Consecutive Cases.

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Strong, Samuel M

2015-01-01

Implant-retained overdentures have been provided on both splinted and freestanding implants. For the mandible, a long history shows that both approaches can be successful over the long term. For the maxilla, many clinicians prefer to splint the implants because of concerns about softer bone quality and insufficient data supporting the use of freestanding overdenture abutments. However, a few investigations have found survival rates for unsplinted maxillary overdentures to be comparable to those for splinted ones. The present study analyzed records of consecutive patients who were treated with unsplinted maxillary and mandibular overdentures and followed for 4 to 107 months. A total of 31 overdentures were identified, 15 maxillary and 16 mandibular, supported by 129 implants. All the overdentures, along with all the implants, survived throughout the follow-up period.

Asymmetrical distalization of maxillary molars with zygomatic anchorage, improved superelastic nickel-titanium alloy wires, and open-coil springs.

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Ishida, Takayoshi; Yoon, Hyung Sik; Ono, Takashi

2013-10-01

In nongrowing patients with skeletal Class II malocclusion, premolar extraction or maxillary distalization can be used as camouflage treatment. Zygomatic anchorage enables distalization in uncooperative or noncompliant patients. We describe 1 such procedure in a 24-year-old woman. We used novel improved superelastic nickel-titanium archwires combined with nickel-titanium open-coil springs to provide a constant and continuous low force to the dentition. We were able to successfully eliminate the protrusive profile and correct the Class II molar relationship using this system of zygomatic anchorage. The posterior occlusal relationships were improved to achieve Class I canine and molar relationships on both sides, and ideal overbite and overjet relationships were established. Facial esthetics was improved with decreased protrusion of the upper and lower lips. The method used here is a promising alternative to traditional distalization techniques and might offer an effective and simple means of distalizing maxillary molars in uncooperative patients. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The effect of number and distribution of unsplinted maxillary implants on the load transfer in implant-retained maxillary overdentures: an in vitro study.

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Damghani, Sahar; Masri, Radi; Driscoll, Carl F; Romberg, Elaine

2012-06-01

There is little information as to how the number and distribution of implants affect the amount of load transmitted to the palate in implant-retained maxillary overdentures. The purpose of this study was to evaluate the effect of the number and distribution of dental implants on the load transmitted to the palate. Eight implant analogues were placed in a replica of an average sized edentulous maxilla corresponding to the position of canines, first and second premolars, and first molars. The anteroposterior distance between the centers of implants in each quadrant was 8 mm. Fifteen denture bases were fabricated to fit the edentulous maxilla analogue. The denture bases were attached to the oral analogue using 6 different configurations of attachments (6 groups): Either no Locator attachments were used (control group), or the 2 most anterior attachments were attached, or 4 implants were engaged with a distance of 8, 16, or 24 mm between the centers of implants on left and right side, and finally, when all 8 attachments were activated. A force-measuring sensor was used to measure the force transmitted to the palate when a static force of 245 N was applied on the occlusal rims of the denture bases. Data (Newtons) were analyzed using 1-way ANOVA and Tukey's HSD test α=.05). The mean (SD) amount of force measured on the palate when the overdentures were supported by 4 Locator attachments; [49.84 (26.52) at 8 mm spacing], [24.42 (15.05) at 16 mm spacing], [35.66 (22.94) at 24 mm spacing] was significantly lower than when no attachments [90.98 (20.20), control], or when 2 Locator attachments were used [76.07 (27.63)] (Poverdentures were supported by 8 Locator attachments, the force measured on the palate [20.67(16.06) N] was significantly lower than that for the control group (Poverdentures supported by 2 Locator attachments (Poverdentures supported by 4 Locator attachments when the distance between the anterior and posterior implants was 8 mm P=.006). The distribution of

Canal Configuration of Mesiobuccal Roots in Permanent Maxillary First Molars in Iranian Population: A Systematic Review.

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Naseri, Mandana; Kharazifard, Mohammad Javad; Hosseinpour, Sepanta

2016-11-01

It is essential for clinicians to have adequate knowledge about root canal configurations; although its morphology varies largely in different ethnicities and even in different individuals with the same ethnic background. The current study aims to review the root canal configurations of mesiobuccal roots of maxillary first molars in an Iranian population based on different epidemiological studies. A comprehensive search was conducted to retrieve articles related to root canal configuration and prevalence of each type of root canal based on Vertucci's classification for the mesiobuccal root of maxillary first molars. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. The articles were evaluated and methods, population, number of teeth and percentage of each root canal type evaluated in each study were summarized in the data table. Websites such as http://www.magiran.com/ , http://health.barakatkns.com/journal-internal-list and www.sid.ir were used to search all related studies published in Persian. Totally, out of nine studies conducted on the Iranian populations in nine provinces of Iran and 798 teeth, the Vertucci's type I was the most common type (35.70%), followed by type II (30.37%), type IV (16.66%), type III (7.93%) and type V (2.61%). From this review article, it is concluded that the root canal morphology of mesiobuccal roots of maxillary first molars in the Iranian population predominantly has more than one canal. Therefore, careful evaluation of radiographs and anatomy of the pulp chamber is essential in order to achieve a successful root canal therapy.

Endodontic Management of Maxillary First Molar With Two Palatal Canals Aided With Cone Beam Computed Tomography: A Case Report.

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Pamboo, Jaya; Hans, Manoj Kumar; Chander, Subhas; Sharma, Kapil

2017-04-01

The success of endodontic therapy is based on having sufficient endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on having a sound knowledge of the internal anatomy of human teeth, especially when anatomic variations are present. Reporting these alterations is important for improving the understanding and expertise of endodontists. The aim of this case report is to describe a unique case of maxillary first molar with 2 palatal canals within a single root, as confirmed by cone-beam computed tomography (CBCT) scans. This article also reviews recent case reports of extra palatal root canals in the maxillary first molars and the role of CBCT analysis in successfully diagnosing them.

A treatment method for Class II Division 1 patients with extraction of permanent maxillary first molars.

NARCIS (Netherlands)

Booij, J.W.; Kuijpers-Jagtman, A.M.; Katsaros, C.

2009-01-01

Throughout the years, various treatment modalities have been presented for the treatment of Class II Division 1 malocclusions. The goal of this paper is to present a treatment approach that involves the extraction of the maxillary first molars followed by use of fixed appliances with low-friction

Expansão rápida da maxila ancorada em implantes: uma nova proposta para expansão ortopédica na dentadura permanente Rapid maxillary expansion anchored by implants: a new proposal to orthopedic expansion in the permanent dentition

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Daniela Gamba Garib

2007-06-01

Full Text Available OBJETIVO: este trabalho apresenta um método para expansão ortopédica da maxila, na dentadura permanente, utilizando implantes como ancoragem. METODOLOGIA: detalharam-se os procedimentos cirúrgicos e laboratoriais da confecção de um expansor com ancoragem dento-óssea em crânio seco humano. Dois implantes de titânio foram colocados na região anterior do palato, e o parafuso Hyrax adaptado de modo que a expansão ancorou-se nos implantes e nos primeiros molares permanentes. RESULTADOS: o experimento laboratorial em crânio seco mostrou que o procedimento apresenta-se anatômica e operacionalmente viável. Os implantes suportaram a força gerada pela ativação do parafuso expansor, redundando na separação transversal das hemimaxilas. CONCLUSÕES: vislumbra-se que a expansão rápida da maxila ancorada em implantes (ERMAI poderá potencializar a eficiência da expansão ortopédica, assim como reduzir o custo periodontal dos procedimentos convencionais de expansão. Futuros estudos clínicos são necessários para testar essas hipóteses.AIM: This study presents a method for maxillary orthopedic expansion, in the permanent dentition, using implants as anchorage. METHODS: Surgical and laboratorial procedures for the construction of a tooth-bone-borne expansor was detailed in a human dry skull. Two titanium implants were placed in the anterior region of the palate and a Hyrax screw was adapted in a way that the expansion was anchored both on the palatal implants and on permanent first molars. RESULTS: The laboratorial experiment in dry skull showed that the procedure is operationally and anatomically possible. The implants supported the force generated by the expansion screw activation and the maxilla halves were transversally split. CONCLUSIONS: Rapid maxillary expansion anchored on implants can increase the efficiency of orthopedic expansion and decrease the periodontal sequela caused by conventional RME. Further clinical studies are

An Unusual Complication After the Extraction of a Maxillary Third Molar: Extensive Subcutaneous Emphysema. A Case Report

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Emrah Soylu

2016-09-01

Full Text Available Third molar surgery is one of the most frequently performed procedures in oral and maxillofacial surgery. Various complications including pain, bleeding, infection, edema, hematoma, perforation of the maxillary sinus, and subcutaneous emphysema (SE can occur after third molar surgery. Cervicofacial subcutaneous emphysema (CSE most often occurs after the extraction of third molars, especially when using high-speed air-turbine drills and air syringes, or during dental laser treatment or even after endodontic treatment. This report presents the diagnosis and treatment protocol of a CSE in a 42-year-old healthy male patient that occurred after extraction of a totally erupted upper third molar with just a straight elevator and extraction forceps.

Maxillary Implant-Supported Fixed Prosthesis: A Survey of Reviews and Key Variables for Treatment Planning.

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Gallucci, German O; Avrampou, Marianna; Taylor, James C; Elpers, Julie; Thalji, Ghadeer; Cooper, Lyndon F

2016-01-01

This review was conducted to provide information to support the establishment of clinical guidelines for the treatment of maxillary edentulism using implant-supported fixed dental prostheses. Initial efforts were directed toward a systematic review with a defined PICO question: "For maxillary edentulous patients with dental implants treated using a fixed prosthesis, what is the impact of prosthesis design on prosthesis survival and complications?" Following a title search of more than 3,000 titles identified by electronic search of PubMed, 180 articles were identified that addressed the clinical evaluation of maxillary dental implant prostheses. The broad methodologic heterogeneity and clinical variation among reports precluded this approach for a systematic review. The information was extracted using a standardized extraction table by two pairs of investigators, and the reported outcomes were then summarized according to reported outcomes for implant prostheses supported by four, six, or eight implants using unitary or segmented prostheses. This review indicated that high prosthetic survival is observed using all approaches. The advantages of using fewer implants and a unitary prosthesis are revealed in the surgical phases, and complications commonly involve the fracture or detachment of acrylic teeth and reduced access for proper oral hygiene and related biologic complications. Using six implants typically involved grafting of posterior regions with advantages of reduced cantilevers and redundancy of implant support. Reduced prosthesis survival in these cases was associated with poor implant distribution. Segmented prostheses supported by six or more implants offered greater prosthetic survival, perhaps due to posterior implant placement. Advantages of a segmented prosthesis included pragmatic issues of accommodating divergent implants, attaining passive fit, combining prosthetic materials, and relative simplicity of repair. The existing literature demonstrated

Nonsurgical management of soft tissue around the restorations of maxillary anterior implants: a clinical report

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Seyedan K

2010-01-01

Full Text Available "nBackground and Aims: Soft tissue management with providing the esthetic for restoration of a single implant in the anterior maxilla is of great importance. Tissue training helps to develop a proper emergence profile and natural tooth appearance. The aim of this article was to report a nonsurgical management of undesirable contours of soft tissue around maxillary anterior implants to achieve an optimum appearance. "nMaterials and Methods: A 23-year-old female with congenital missing of maxillary lateral incisors, after completion of a fixed orthodontic treatment and gain enough space, received 2 dental implants. After second phase surgery and healing period, construction of the restorations was not possible through conventional method because of severe soft tissue collapse. In this case, soft tissue contours were corrected using a provisional restoration and then final restoration was made and delivered. "nConclusion: Tissue training with a provisional restoration helps to re-establish normal gingival tissue contours and interdental papillae around the restoration of maxillary anterior implants.

Attachment of clips in a bar-retained maxillary implant overdenture : a clinical report

NARCIS (Netherlands)

Slot, J.W.A.; Raghoebar, G.M.; Dijk, G. van; Meijer, H.J.A.

Implant-supported overdentures are a good alternative for patients with conventional dentures that lack retention and stability. The most common prosthetic complications in mandibular and maxillary implant-supported overdentures are fracture and loosening of the attachment system. This clinical

Maxillary Four Implant-retained Overdentures via Locator® Attachment: Intermediate-term Results from a Retrospective Study.

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Wang, Feng; Monje, Alberto; Huang, Wei; Zhang, Zhiyong; Wang, Guomin; Wu, Yiqun

2016-06-01

Maxillary overdentures have been utilized to restore oral function in scenarios where limited bone structure represents a drawback for financial issues and for cases where oral hygiene is uncertain. The aim of this study was to evaluate the intermediate-term clinical outcome of four locator attachment retaining maxillary overdentures and to test their reliability. A retrospective study was conducted from January 2007 to October 2013. After the placement of four maxillary dental implants and a healing period of approximately 3 months, all the implants were restored with locator-retained overdentures with partial palatal coverage. Subjects and implant characteristics, implant position (anterior vs posterior maxilla), bone quality, and opposing dentition were recorded. Peri-implant clinical parameters and marginal bone loss (MBL) were evaluated after delivery of the final prosthesis and annually thereafter. The performance of locator components and the prosthetic restoration were also recorded at follow-up. A total of 104 implants were placed in 26 subjects (11 women, 15 men; mean age, 64 years; age range, 55-76 years). One implant failed before loading. One subject dropped out of the study during a mean follow-up period of 46 months (range: 7-73 months), achieving an overall survival rate of 95.2%. Clinical parameters revealed healthy tissues around most of the implants, with low scores of plaque and bleeding indices. At the last follow-up evaluation, the mean MBL was 1.7 ± 1.1 mm (0.4-2.6 mm). Regression model analysis indicated that MBL for implants in the posterior maxilla was significantly higher than that for implants in the anterior maxilla (p = .0487). Overall, 26 technical and prosthetic complications were reported. Within the limitations of this study, maxillary four implant-retained overdentures via Locator attachment seem to be a predictable alternative for oral rehabilitation. © 2015 Wiley Periodicals, Inc.

Transverse maxillary and mandibular growth during and after bionator therapy: study with metallic implants.

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Monini, André da Costa; Júnior, Luiz Gonzaga Gandini; Maia, Luiz Guilherme Martins; Pinto, Ary dos Santos

2013-01-01

This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 - before bionator therapy, T2 - after bionator therapy and T3 - 5.74 years after T2. There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. During the study period only the anterior maxillary area did not show transverse growth.

Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study

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Francesco Mangano

2014-01-01

Full Text Available Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females to support bar-retained maxillary overdentures (ODs. Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB. Results. The 3-year implant survival rate was 97.4% (implant-based and 92.9% (patient-based. Three implants failed. The incidence of biological complication was 3.5% (implant-based and 7.1% (patient-based. The incidence of prosthetic complication was 17.8% (patient-based. No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.

Maxillary overdentures supported by four splinted direct metal laser sintering implants: a 3-year prospective clinical study.

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Mangano, Francesco; Luongo, Fabrizia; Shibli, Jamil Awad; Anil, Sukumaran; Mangano, Carlo

2014-01-01

Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results.

Unilateral distalization of a maxillary molar with sliding mechanics: a case report.

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Keles, Ahmet

2002-06-01

A unilateral Class II relationship could arise due to early loss of an upper second deciduous molar on one side during the mixed dentition period. This would allow the mesial drift of the molars, which may block the eruption of the second premolar. A 15-year 8-month-old male patient presented with a Class II molar relationship on the right, and Class I canine and molar relationship on the left side. His E was extracted when he was 5 years old. The 54 were impacted and the 3 was ectopically positioned due to the space loss from the mesial migration of the 76. In addition 21 1 were in cross-bite. Skeletally he had Class III tendency with low MMPA. He presented with a straight profile and retruded upper lip. For maxillary molar distalization, a newly developed 'Keles Slider' was used. The appliance was composed of one premolar and two molar bands, and the anchorage unit was composed of a wide Nance button. 46 were connected to the Nance button and, therefore, included into the anchorage unit. The point of distal force application was close to the centre of resistance of the 6 and parallel to the occlusal plane. Ni-Ti coil springs were used and 200 g of distal force was applied. Seven months later the space required for eruption of the permanent premolars and canine was regained, and the anterior cross-bite corrected. The appliance was removed and final alignment of the teeth was achieved with fixed appliances. At the end of the second phase treatment Class I molar and canine relationship was achieved on the both sides, the anterior cross-bite was corrected, inter-incisal angle was improved, and ideal overbite and overjet relationship was achieved. The active treatment time was 27 months.

Transverse maxillary and mandibular growth during and after Bionator therapy: study with metallic implants

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André da Costa Monini

2013-06-01

Full Text Available INTRODUCTION: This study evaluated posteroanterior cephalograms before and after treatment and long term follow-up of Class II division 1 patients treated with bionator. OBJECTIVE: The objective was to demonstrate the transverse growth of maxilla and mandible during and after bionator therapy. METHODS: Measurement of transverse dimensions between posterior maxillary and mandibular implants, as well as the distances between the buccal, gonial and antegonial points were recorded. Measurements were analyzed at three periods: T1 = before bionator therapy, T2 = after bionator therapy and T3 = 5.74 years after T2. RESULTS: There was statistically significant transverse increase due to growth and/or treatment for all variables, except for the distance between the anterior maxillary implants. CONCLUSIONS: During the study period only the anterior maxillary area did not show transverse growth.

Longitudinal eruptive and posteruptive tooth movements, studied on oblique and lateral cephalograms with implants.

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Zhang, Xiaoyun; Baumrind, Sheldon; Chen, Gui; Chen, Huizhong; Liang, Yi; Xu, Tianmin

2018-05-01

The purpose of this study was to investigate the eruptive and posteruptive tooth displacements of untreated growing subjects longitudinally and the potential connections between posteruptive displacement of the maxillary and mandibular first molars and skeletal facial growth. The sample comprised 11 series of right 45° oblique cephalograms and lateral cephalograms of untreated children with metallic implants of the Björk type obtained from the archives of a growth study. Cephalograms generated at approximately 2-year intervals between the ages of 8.5 and 16 years were selected and traced. Superimpositions of serial tracings of oblique cephalograms on stable intraosseous implants were made to determine the displacements of buccal segment teeth in both arches, and superimpositions of serial tracings of lateral cephalograms were used to evaluate growth of the jaws. Continuous mesial tipping of the maxillary molars was observed from 8.5 to 16 years of age, averaging 8.2° ± 5.5° for the first molars and 18.3°± 8.5° for the second molars. Compared with the maxillary molars, the mandibular first molars showed less change in angulation except in the later mixed dentition when more than half of the subjects had accelerated forward tipping of the first molar in the late mixed dentition associated with migration into the leeway space. Average amounts of cumulative eruption from 8.5 to 16 years of age were 12.1 ± 2.1 mm downward and 3.8 ± 1.7 mm forward for the maxillary first molar. The mandibular first molar showed 8.6 ± 2.3 mm of eruption and 4.4 ± 1.9 mm of mesial migration. Peak velocity of vertical eruption of the maxillary and mandibular first molars corresponded to the skeletal vertical growth spurt. The maxillary canines and first premolars showed remarkable and continuous uprighting migration during eruption, averaging 9.5° ± 5.0° and 10.5° ± 6.7°, respectively. However, when they erupted into the occlusion, their changes in

The Efficacy of Buccal Infiltration of 4% Articaine and PSA Injection of 2% Lidocaine on Anesthesia of Maxillary Second Molars

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Maljaei, Ensiyeh; Pourkazemi, Maryam; Ghanizadeh, Milad; Ranjbar, Rana

2017-01-01

Introduction: During the early mixed dentition period, the location of the deciduous maxillary second molar results in ineffectiveness of the infiltration technique in this area. In such cases, administration of posterior superior alveolar (PSA) nerve block is recommended; however, such a technique has some complications. The present study was undertaken to compare the effects of buccal infiltration of 4% Articaine and PSA technique with 2% Lidocaine on the success of anesthesia of maxillary ...

Maxillary overdentures supported by four or six implants in the anterior region: 5-year results from a randomized controlled trial.

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Slot, Wim; Raghoebar, Gerry M; Cune, Marco S; Vissink, Arjan; Meijer, Henny J A

2016-12-01

To compare a four- and six-implant maxillary overdenture after an observation period of 5 years. Fifty subjects with functional problems concerning their maxillary denture, who had ample bone volume in the anterior region to place four or six implants, were included and randomly assigned to either group. Implant and overdenture survival, clinical performance, marginal bone loss and patient satisfaction were assessed. Forty-six patients completed the 5-year follow-up. One implant failed in the six implants group (99.2% survival) and none in the four implants group (100% survival). No overdentures had to be replaced during the observation period and the number of complications was limited. Clinical function was good, with no difference in clinical parameters between the groups. Mean marginal bone resorption was 0.50 ± 0.37 and 0.52 ± 0.43 mm in the four and six implant group respectively. In patients with functional complaints of their maxillary denture, bar-supported overdentures on four implants in the anterior maxillary region were not inferior to overdentures supported by six implants after 5 years of function. Implant survival and patient satisfaction were high, clinical parameters favourable, bone loss and complications to the denture were minor in both groups (Clinical trial registration number: NTR2969). © 2016 The Authors. Journal of Clinical Periodontology Published by John Wiley & Sons Ltd.

Titanium versus zirconia implants supporting maxillary overdentures: three-dimensional finite element analysis.

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Osman, Reham B; Elkhadem, Amr H; Ma, Sunyoung; Swain, Michael V

2013-01-01

The purpose of this study was to compare the stress and strain occurring in peri-implant bone and implants used to support maxillary overdentures. Three-dimensional finite element analysis (3D FEA) was used to compare one-piece zirconia and titanium implants. Two types of implants were simulated using a 3D FEA model: one-piece zirconia and titanium implants (diameter, 3.8 × 11.5 mm) with 2.25-mm diameter ball abutments. In each simulation four implants were placed bilaterally in the canine/premolar region of an edentulous maxillary model. Static loads were applied axially and 20 degrees buccolingually on the buccal slope of the lingual cusps of posterior teeth of the first quadrant. Von Mises stresses and equivalent strains generated in peri-implant bone and first principal stresses in the implants were calculated. Comparable stress and strain values were shown in the peri-implant bone for both types of implants. The maximum equivalent strain produced in the peri-implant region was mostly within the range for bone augmentation. Under oblique loading, maximum von Mises stresses and equivalent strain were more evident at the neck of the most distal implant on the loaded side. Under axial load, the stress and strain were transferred to the peri-implant bone around the apex of the implant. Maximum tensile stresses that developed for either material were well below their fracture strength. The highest stresses were mainly located at the distobuccal region of the neck for the two implant materials under both loading conditions. From a biomechanical point of view, ceramic implants made from yttrium-stabilized tetragonal polycrystalline zirconia may be a potential alternative to conventional titanium implants for the support of overdentures. This is particularly relevant for a select group of patients with a proven allergy to titanium. Prospective clinical studies are still required to confirm these in vitro results. Different simulations presenting various cortical bone

Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

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Lara-Mendes, Sônia T de O; Barbosa, Camila de Freitas M; Santa-Rosa, Caroline C; Machado, Vinícius C

2018-05-01

The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Orthopantomographic study of the maxillary sinus

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Kim, Hyun Joo; Yu, Dong Su [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1971-11-15

The author has observed the orthopantomograms of the maxillary sinus which were taken by special exposure method to study mesiodistal dimension, shape, symmetrical relationship, bony septum of the maxillary sinus and relationship between upper lst molar and the maxillary sinus, that were selected 56 cases of 23 to 27 years old male, who have good systemic conditions and no missing teeth on upper posterior molar in normal occlusion, and obtained following conclusions: 1. Mesiodistal dimensions of the maxillary sinus are shown as follows; The mean of left dimension is 50.94 {+-} 8.34 mm and of right dimension is 49.50 {+-} 9.87 mm. 2. To the shape of the maxillary sinus, V or U shape are 33 cases(29.5%) and W shape are 77 cases (70.5%). 3. In the ralationship between upper lst molar and floor of the maxllary sinus, superimposition are 62 cases (55.36%) a nd approach are 50 cases (44.64%). 4. In the right and left symmetrical relationship of the maxillary sinus, symmetry are 37 cases (66.07%) and asymmetry are 19 cases (33.93%). 5. The bony septums in the maxillary sinuses revealed that presence of bony septums are 29 cases (25.8%) and absence ar e 83 cases (74.11%).

Evaluation of Maxillary Interpremolar, Molar Width by DRNA Indices and Arch Dimension, Arch Form in Maratha Population

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Nitin Dungarwal

2013-01-01

Conclusion: Significant correlation was found between the sum of maxillary incisors and interpremolar width but not with the intermolar width while sum of mandibular incisors showed significant correlation with the interpremolar and intermolar arch width. There is no single arch form unique to any of the ethnic groups. A new formula is proposed to determine the premolar and molar index.

Two-dimensional real-time blood flow and temperature of soft tissue around maxillary anterior implants.

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Nakamoto, Tetsuji; Kanao, Masato; Kondo, Yusuke; Kajiwara, Norihiro; Masaki, Chihiro; Takahashi, Tetsu; Hosokawa, Ryuji

2012-12-01

The aims of this study were to (1) evaluate the basic nature of soft tissue surrounding maxillary anterior implants by simultaneous measurements of blood flow and surface temperature and (2) analyze differences with and without bone grafting associated with implant placement to try to detect the signs of surface morphology change. Twenty maxillary anterior implant patients, 10 bone grafting and 10 graftless, were involved in this clinical trial. Soft tissue around the implant was evaluated with 2-dimensional laser speckle imaging and a thermograph. Blood flow was significantly lower in attached gingiva surrounding implants in graftless patients (P = 0.0468). On the other hand, it was significantly lower in dental papillae (P = 0.0254), free gingiva (P = 0.0198), and attached gingiva (P = 0.00805) in bone graft patients. Temperature was significantly higher in free gingiva (P = 0.00819) and attached gingiva (P = 0.00593) in graftless patients, whereas it was significantly higher in dental papilla and free gingiva in implants with bone grafting. The results suggest that simultaneous measurements of soft-tissue blood flow and temperature is a useful technique to evaluate the microcirculation of soft tissue surrounding implants.

An economic evaluation of maxillary implant overdentures based on six vs. four implants.

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Listl, Stefan; Fischer, Leonhard; Giannakopoulos, Nikolaos Nikitas

2014-08-18

The purpose of the present study was to assess the value for money achieved by bar-retained implant overdentures based on six implants compared with four implants as treatment alternatives for the edentulous maxilla. A Markov decision tree model was constructed and populated with parameter estimates for implant and denture failure as well as patient-centred health outcomes as available from recent literature. The decision scenario was modelled within a ten year time horizon and relied on cost reimbursement regulations of the German health care system. The cost-effectiveness threshold was identified above which the six-implant solution is preferable over the four-implant solution. Uncertainties regarding input parameters were incorporated via one-way and probabilistic sensitivity analysis based on Monte-Carlo simulation. Within a base case scenario of average treatment complexity, the cost-effectiveness threshold was identified to be 17,564 € per year of denture satisfaction gained above of which the alternative with six implants is preferable over treatment including four implants. Sensitivity analysis yielded that, depending on the specification of model input parameters such as patients' denture satisfaction, the respective cost-effectiveness threshold varies substantially. The results of the present study suggest that bar-retained maxillary overdentures based on six implants provide better patient satisfaction than bar-retained overdentures based on four implants but are considerably more expensive. Final judgements about value for money require more comprehensive clinical evidence including patient-centred health outcomes.

Within-Subject Comparison of Maxillary Implant-Supported Overdentures with and without Palatal Coverage.

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Zembic, Anja; Tahmaseb, Ali; Wismeijer, Daniel

2015-06-01

The purpose of this study was to compare patient-reported outcomes for maxillary implant-supported overdentures with and without palatal coverage. Twenty-one maxillary edentulous patients (six women, 15 men) were included. In total, 42 implants were inserted in the anterior maxilla. All patients received implant-supported overdentures on two retentive anchors with palatal coverage for 2 months. Thereafter, patient satisfaction was assessed by means of questionnaires capturing the oral health impact profile (OHIP) on functional limitation, physical pain, psychological discomfort, physical, psychological and social disability, and handicap. Additionally, cleaning ability, general satisfaction, speech, comfort, esthetics, stability, and chewing ability were rated. Subsequently, palatal coverage was reduced, and the patients wore the overdentures for another 2 months. Patient satisfaction was obtained in the same way as above, and the evaluated parameters were compared for the two overdenture designs. There were no significant differences between implant-supported overdentures with and without palatal coverage for any of the OHIP domains. The evaluation of additional parameters revealed significantly higher patient satisfaction for esthetics (mean difference 8.8 mm ± 24.6) and taste (mean difference 28.4 mm ± 29.9) without palatal coverage, p overdentures supported by two implants were equally satisfactory with and without palatal coverage. © 2013 Wiley Periodicals, Inc.

The Efficacy of Buccal Infiltration of 4% Articaine and PSA Injection of 2% Lidocaine on Anesthesia of Maxillary Second Molars.

Science.gov (United States)

Maljaei, Ensiyeh; Pourkazemi, Maryam; Ghanizadeh, Milad; Ranjbar, Rana

2017-01-01

During the early mixed dentition period, the location of the deciduous maxillary second molar results in ineffectiveness of the infiltration technique in this area. In such cases, administration of posterior superior alveolar (PSA) nerve block is recommended; however, such a technique has some complications. The present study was undertaken to compare the effects of buccal infiltration of 4% Articaine and PSA technique with 2% Lidocaine on the success of anesthesia of maxillary deciduous second molars in 6 to 9-year old children. In the present double-blind randomized clinical trial, 56 children aged 6-9 years requiring vital pulp therapy of deciduous maxillary second molar were included. In group 1, 4% Articaine was injected using a buccal infiltration technique. In group 2, 2% Lidocaine was injected using the PSA nerve block technique. After 10 min, the caries was removed and access cavity preparation was instituted. The patients were asked to report the presence or absence of pain during the procedure. Therefore, the existence of pain was measured by the patient's self-report. Data were analyzed with descriptive statistical methods and the chi -squared test. Pain was reported by 6 (21.4%) and 9 (32.1%) subjects in the Articaine and Lidocaine groups, respectively. Chi -squared test did not reveal any significant differences between the two groups ( P =0.54). Under the limitations of the present study, there was no significant differences between the results of Articaine buccal infiltration and Lidocaine PSA technique, so Articaine buccal infiltration can be used as a substitute for the PSA technique.

Three-dimensional analysis of mesiobuccal root canal of Japanese maxillary first molar using Micro-CT

International Nuclear Information System (INIS)

Yamada, Masashi; Ide, Yoshinobu; Matsunaga, Satoru; Kato, Hiroshi; Nakagawa, Kan-Ichi

2011-01-01

The objective of this study was to three-dimensionally observe the morphological characteristics of mesiobuccal root canals of Japanese maxillary first molars using microcomputed tomography (Micro-CT) and classify root canal variations. This study used 90 maxillary first molars. Three-dimensional reconstruction was performed using data obtained by Micro-CT, and cross-sections of the root canals were observed. Moreover, the root canal morphology was classified by the configuration and root canal diameter, and was evaluated for occurrence using the classification by Weine et al. (1969) as a reference. Overall, single root canals were observed in 44.4%, incomplete separation root canals in 22.3%, and completely separate root canals (upper and lower separation root canals) in 33.3%. Mesiobuccal root canals often had intricate configurations, and accessory root canals (lateral canals and apical ramifications) were observed in most of the mesiobuccal root canals (76.7%), irrespective of whether there were ramifications of the main root canals. While there were no marked differences in the incidence of root canal ramifications between this study and earlier reports, the incidence of accessory root canals was higher in this study. This result may be explained by the far more superior visualization ability of Micro-CT than conventional methods, which allowed the detection of microscopic apical ramifications previously difficult to observe. (author)

Treatment of a Four-Rooted Maxillary Second Molar Detected with Cone-Beam Computed Tomography

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Nahid Mohammadzade Akhlaghi

2017-08-01

Full Text Available The significance of clinician’s knowledge about root canal anatomy and its possible variations cannot be overlooked. In some cases, taking advantage of complementary imaging techniques can help achieve a perfect flawless endodontic treatment. This article reports endodontic management of a second maxillary molar that had an uncommon anatomy of the chamber floor. After obtaining a cone-beam computed tomography (CBCT image, the presence of a second palatal root was confirmed. All four roots were treated and patient’s symptoms were resolved.Keywords: Cone-Beam Computed Tomography; Root Canal Therapy; Tooth Root

The efficacy of maxillary protraction protocols with the micro-implant-assisted rapid palatal expander (MARPE) and the novel N2 mini-implant-a finite element study.

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Moon, Won; Wu, Kimberley W; MacGinnis, Matthew; Sung, Jay; Chu, Howard; Youssef, George; Machado, Andre

2015-01-01

Maxillary protraction with the novel N2 mini-implant- and micro-implant-assisted rapid palatal expander (MARPE) can potentially provide significant skeletal effects without surgery, even in older patients where conventional facemask therapy has limited skeletal effects. However, the skeletal effects of altering the location and direction of force from mini-implant-assisted maxillary protraction have not been extensively analyzed. In this study, the application of the novel N2 mini-implant as an orthopedic anchorage device is explored in its ability to treat patients with class III malocclusions. A 3D cranial mesh model with associated sutures was developed from CT images and Mimics modeling software. Utilizing ANSYS simulation software, protraction forces were applied at different locations and directions to simulate conventional facemask therapy and seven maxillary protraction protocols utilizing the novel N2 mini-implant. Stress distribution and displacement were analyzed. Video animations and superimpositions were created. By changing the vector of force and location of N2 mini-implant, the maxilla was displaced differentially. Varying degrees of forward, downward, and rotational movements were observed in each case. For brachyfacial patients, anterior micro-implant-supported protraction at -45° or intermaxillary class III elastics at -45° are recommended. For dolicofacial patients, either anterior micro-implants at -15° or an intermaxillary spring at +30° is recommended. For mesofacial patients with favorable vertical maxillary position, palatal micro-implants at -30° are recommended; anterior micro-implants at -30° are preferred for shallow bites. For patients with a severe mid-facial deficiency, intermaxillary class III elastics at -30° are most effective in promoting anterior growth of the maxilla. By varying the location of N2 mini-implants and vector of class III mechanics, clinicians can differentially alter the magnitude of forward, downward, and

Pattern of maxillary and mandibular proximal enamel thickness at the contact area of the permanent dentition from first molar to first molar.

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Sarig, Rachel; Vardimon, Alexander D; Sussan, Celine; Benny, Lea; Sarne, Ofer; Hershkovitz, Israel; Shpack, Nir

2015-04-01

Proximal enamel thickness (PET) at the mesial and distal contact areas of the complete permanent dentition has not been previously reported. Anatomic investigation of PET is essential for interproximal reduction treatment. Our objectives were to measure the PETs of the complete maxillary and mandibular dentitions at the contact areas, to compare the PETs of adjacent teeth, and to evaluate the vertical position of each contact area. We evaluated 720 extracted teeth; of these, 109 intact teeth were selected. The mesial and distal contact areas were demarcated, and each tooth was embedded in transparent epoxy resin. Blocks were prepared so that the 2 demarcated contact areas were exposed, and 6 measurements were taken and statistically analyzed. Both jaws showed the same PET pattern characterized by 5 features: PET increased progressively from incisor (0.63 mm) to first molar (1.48 mm). Per tooth, mesial and distal PET did not differ. Total maxillary (26.86 mm) and mandibular (24.52 mm) PETs were similar. Paired PETs at the interproximal interface were similar, with the exception of the lateral incisor-canine interfaces. From incisor to first molar, the contact area becomes located farther gingivally. The existing guideline of maximal 0.5-mm interproximal reduction per 2 adjacent teeth should be kept in the anterior region and could be increased to 1 mm in the posterior region, when an equal amount is removed. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Long-term retrospective study of implants placed after sinus floor augmentation with fresh-frozen homologous block

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Livingstom Rubens Sousa Rocha

2017-01-01

Full Text Available Aim: The aim of this study was to analyze and follow-up implants placed in the posterior maxillary regions previously grafted with homologous bone. Materials and Methods: Forty-one grafts with homologous bone blocks were performed in maxillary sinuses, and 121 implants were placed in premolar and molar regions approximately 6 months after the grafts. Patients were followed up for periods varying from 12 to 124 months after rehabilitation. Results: The results showed two implant failures, for a 98.3% success rate during the follow-up period. Discussion: The implants placed had an average torque of 40 N-cm, regardless of the, design, diameter, and length of the implants used. Conclusion: After following up on the implants placed in this study, we concluded that those placed in regions of the maxillary sinuses previously grafted with homologous bone blocks had high long-term success rates and met the functional masticatory requirements.

Ability of mini-implant-facilitated micro-osteoperforations to accelerate tooth movement in rats.

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Cheung, Tracy; Park, Juyoung; Lee, Deborah; Kim, Catherine; Olson, Jeffrey; Javadi, Shadi; Lawson, Gregory; McCabe, James; Moon, Won; Ting, Kang; Hong, Christine

2016-12-01

Although current techniques for accelerated tooth movement often involve invasive surgical procedures, micro-osteoperforations (MOPs) using mini-implants may facilitate orthodontic tooth movement without raising flaps, reduce surgical risks, and increase patient acceptance. In this study, we evaluated the effectiveness of mini-implant-facilitated MOPs in inducing accelerated tooth movement and investigated the potential risks for root resorption. Five MOPs were placed on the left side around the maxillary first molars in 6 rats using an automated mini-implant driver, whereas the right side received no MOPs as the control. Closed-coiled springs were secured from incisors to first molars for orthodontic tooth movement. Tooth movement was measured, and samples underwent radiologic and histologic analyses. The MOP side exhibited a 1.86-fold increase in the rate of tooth movement with decreased bone density and bone volume around the first molars compared with the control side. Hematoxylin and eosin and tartrate-resistant acid phosphatase analyses showed increased numbers of osteoclasts as well as new bone formation. Three-dimensional volumetric analysis of all 5 roots of the maxillary first molars demonstrated no statistically significant difference in root volumes. Mini-implant-facilitated MOPs accelerated tooth movement without increased risk for root resorption and therefore may become a readily available and efficient treatment option to shorten orthodontic treatment time with improved patient acceptance. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Influence of implant position on clinical crown length and peri-implant soft tissue dimensions at implant-supported single crowns replacing maxillary central incisors

DEFF Research Database (Denmark)

Peng, Min; Fei, Wei; Hosseini, Mandana

2013-01-01

The aims of the present study were to evaluate the influence of implant position on clinical crown length and marginal soft tissue dimensions at implant-supported single crowns of maxillary central incisors, and to validate the papilla index score (PIS). Twenty-five patients, who had lost one of ...... abutments and did not necessarily result in an increased crown length. The distal implant papilla heightwas obviously shorter, althoughthe mesial papilla height was similar to thatof the healthy dentition.The papilla index score was tested to be a valid index for papilla fill....

Maxillary Sinus Membrane Elevation With Simultaneous Installation of Implants Without the Use of a Graft Material

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Starch-Jensen, Thomas; Schou, Søren

2017-01-01

OBJECTIVE: To compare implant treatment outcome after maxillary sinus membrane elevation with simultaneous installation of implants with or without the use of graft material applying the lateral window technique. MATERIALS AND METHODS: MEDLINE/PubMed, Cochrane Library, and Embase search in combin...

Guided tissue regeneration ensures osseointegration of dental implants placed into extraction sockets. An experimental study in monkeys

DEFF Research Database (Denmark)

Warrer, L; Gotfredsen, K; Hjørting-Hansen, E

1991-01-01

on the buccal and palatal aspects of the maxillary molars in both sides of the jaw. The second molars were then extracted and self tapping titanium implants of the screw type (Astra Dental Implants) were inserted into the sockets of the largest roots. In the coronal portion of the sockets, a void was always...... present between the implant and the socket walls. In one side of the jaw, a membrane (Gore-Tex Augmentation Material) was adjusted to cover the implant. The implant in the other side of the jaw served as control and was only covered by the tissue flaps. Microscopic analysis after 3 months of healing...... technique can secure complete osseointegration of implants inserted immediately into extraction sockets....

Maxillary implant-supported overdentures opposed by (partial) natural dentitions: a 5-year prospective case series study.

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Boven, G C; Slot, J W A; Raghoebar, G M; Vissink, A; Meijer, H J A

2017-12-01

The aim of this study was to assess the 5-year treatment outcome of maxillary implant-retained overdentures opposed by natural antagonistic teeth. Fifty consecutive patients received maxillary overdentures supported by six dental implants. Implants were placed in the anterior region, if enough bone was present (n = 25 patients) Implant were placed in the posterior region if implant placement in the anterior region was not possible (n = 25 patients). Variables assessed included survival of implants, condition of hard and soft peri-implant tissues and patients' satisfaction. The five-year implant survival rate was 97·0% and 99·3%, and mean radiographic bone loss was 0·23 and 0·69 mm in the anterior and posterior group, respectively. Median scores for plaque, calculus, gingiva, bleeding and mean scores for pocket probing depth were low and stayed low. Patients' satisfaction after treatment was high in both groups. Within the limits of this 5-year study, it is concluded that six dental implants (placed in the anterior or posterior region) connected with a bar and opposed to natural antagonistic teeth result in acceptable results for clinical parameters and good outcomes for marginal bone level changes and patient satisfaction. © 2017 John Wiley & Sons Ltd.

Displacement of a dental implant into the maxillary sinus after internal sinus floor elevation: report of a case and review of literature.

Science.gov (United States)

Ding, Xiaojun; Wang, Qing; Guo, Xuehua; Yu, Youcheng

2015-01-01

Dental implant placement in the posterior maxilla may be complicated by implant migration into the maxillary sinus. To report the clinical and radiological characteristics of a patient who experienced dental implant displacement into the maxillary sinus following sinus floor elevation, and to compare our findings with those of other published reports of the displacement of dental implants. Implant placement and maxillary sinus elevation were performed simultaneously. The location of the displaced implant was monitored for 8 years, until the ectopic implant was surgically removed using the lateral window approach. The contributing factors, treatment modality, and clinical outcome for our patient were compared with those of patients reported in the literature. The clinical characteristics of our case were similar to those of patients with displaced implants who were also asymptomatic for long periods. The clinical outcome of our case was consistent with that of patients who underwent similar surgeries. Transnasal endoscopic removal of an ectopic implant may be suitable in cases in which the ectopic implant is accessible. Transoral direct approaches are adequate in most cases in which endoscopic approaches may be confounded. The bony-window transoral technique may allow the removal of large implants.

Comparison of maxillary first molar occlusal outlines of Neandertals from the Meuse River Basin of Belgium using elliptical Fourier analysis

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Williams Frank L’Engle

2017-09-01

Full Text Available Several Neandertals derive from the karstic caves of the Meuse river tributaries of Belgium, including Engis 2, Scladina 4A-4 and Spy 1. These may form a group that is distinct in maxillary first molar occlusal outlines compared to La Quina 5 from Southwest France. Alternatively, chronological differences may separate individuals given that Scladina 4A-4 from MIS 5 is older than the others from MIS 3. Neolithic samples (n = 42 from Belgium (Maurenne Caverne de la Cave, Hastière Caverne M, Hastière Trou Garçon, Sclaigneaux and Bois Madame dated to 4.6–3.9 kyr provide a context for the Neandertals. Dental casts were prepared from dental impressions of the original maxillary molars. Crown and occlusal areas as well as mesiodistal lengths were measured by calibrated Motic 3.0 microscope cameras. Occlusal outlines of the casts were captured through photostereomicroscopy and non-landmark smooth tracing methods. Occlusal outlines were processed using elliptical Fourier analysis within SHAPE v1.3 which reduced amplitudes of the harmonics into principal components (PC axes. The first two PC axes group the Neandertals, although Scladina 4A-4 falls nearly outside the convex hull for the Neolithic sample. Neandertals are imperfectly separated from the Neolithic sample on PC3 and PC4, and completely distinct on PC5 and PC6. Scladina 4A-4 differs from the other Neandertals on most PC axes. Chronology may best explain the separation of Scladina 4A-4 from the more recent fossils, and particularly Spy 1 and La Quina 5 which are the most similar in maxillary first molar occlusal outline shape.

External and internal anatomy of third molars.

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Guerisoli, D M; de Souza, R A; de Sousa Neto, M D; Silva, R G; Pécora, J D

1998-01-01

The external and internal anatomy of 269 third molars (155 maxillary and 114 mandibular) were studied. The teeth were measured, classified according to their root number and shape and the internal anatomy was observed by the use of diaphanization. A great anatomical variability was found, with the presence of up to 5 roots in maxillary third molars and 3 roots in mandibular third molars. The number of root canals followed the same pattern.

An implant periapical lesion associated with an endodontic-periodontic lesion of an adjacent molar

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Ting-An Chou

2010-09-01

Full Text Available Adjacent natural teeth with untreated pulpal or periodontal pathology may be a potential risk for implant infection. We report a rare case of an implant periapical lesion (IPL possibly caused by direct extension of a periradicular lesion of an adjacent tooth. A 40-year-old female patient, who had previously received three implants on the edentulous areas of teeth 16, 36 and 46, had a recurrent infection over the lower left second molar area for 2 years. A periapical radiograph revealed incomplete root canal treatment and an infrabony defect on the mesial side of the lower left second molar; the defect extended to the apical third of the adjacent implant on tooth 36. Open flap debridement was performed 1 year after implant placement, but pain and swelling persisted for another year. Therefore, the second molar was extracted at the patient's request. The patient was unable to seek earlier and prompt treatment as she was abroad; therefore, we were able to observe the progression of severity in the IPL. One year after the extraction, the symptoms had subsided, and a periapical radiograph showed that the radiolucent lesion had decreased in size. She was followed for another 1.5 years and showed marked improvement. In this case, the IPL probably originated from the endodontic-periodontic problem of the adjacent molar, and the infected implant was saved by removing the infection source. We also discuss the treatment and prognosis of IPLs. To prevent the occurrence of an IPL, it is important to evaluate the pulpal and periodontal status of the teeth near the implant site when making a comprehensive treatment plan for an implant.

Unusual anatomy of a maxillary first molar with two palatal roots: a case report.

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Tomazinho, Flávia S F; Baratto-Filho, Flares; Zaitter, Suellen; Leonardi, Denise P; Gonzaga, Carla C

2010-03-01

The success of endodontic therapy is based on good endodontic access, correct cleaning and shaping, and adequate root canal obturation. However, endodontic treatment is also dependent on a sound knowledge of the internal anatomy of human teeth, especially when anatomical variations are present. Certain anatomical changes may be present to varying degrees, and it is important to report these to improve the understanding and expertise of endodontic specialists. With this aim in mind, this study reports an example of a maxillary first molar showing unusual anatomy (four roots and six root canals) and describes the endodontic treatment that was employed.

Immediate Placement of Ultrawide-Diameter Implants in Molar Sockets: Description of a Recommended Technique

NARCIS (Netherlands)

Hattingh, A.C.; Bruyn, H. de; Ackermann, A.; Vandeweghe, S.

2018-01-01

Immediate implant placement is performed less frequently in molar extraction sockets than in single root sockets. This is mainly due to the tripodal anatomical configuration of molar roots, which is perceived as complex and therefore unsuitable. The mechanical burden of molar sites, combined with

Maxillary molar distalization with the dual-force distalizer supported by mini-implants: a clinical study.

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Oberti, Giovanni; Villegas, Carlos; Ealo, Martha; Palacio, John Camilo; Baccetti, Tiziano

2009-03-01

The objective of this prospective study was to describe the clinical effects of a bone-supported molar distalizing appliance, the dual-force distalizer. The study group included 16 patients (mean age, 14.3 years) with Class II molar relationships. Study models and lateral cephalograms were taken before and after the distalizing movement to record significant dental and skeletal changes (Wilcoxon test). The average distalization time was 5 months, with a movement rate of 1.2 mm per month; the distalization amounts were 5.9 +/- 1.72 mm at the crown level and 4.4 +/- 1.41 mm at the furcation level. The average molar inclination was 5.6 degrees +/- 3.7 degrees ; this was less than the amount of inclination generated by bone-supported appliances that use single distalizing forces. The correlation between inclination and distalization was not significant, indicating predominantly bodily movement. The teeth anterior to the first molar moved distally also; the second premolars distalized an average of 4.26 mm, and the incisors retruded by 0.53 mm. The dual-force distalizer is a valid alternative distalizing appliance that generates controlled molar distalization with a good rate of movement and no loss of anchorage.

[Three dimensional finite element analysis of maxillary anterior teeth retraction with micro-implant anchorage and sliding mechanics].

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Zhang, Yi; Zhang, Lei; Fan, Yu-bo; Song, Jin-lin; Deng, Feng

2009-10-01

To investigate the biomechanical effects of micro-implant anchorage technique with sliding mechanics on maxillary anterior teeth retraction under different implant insertion heights and different retraction hook heights. The three dimensional finite element model of maxillary anterior teeth retraction force system was constructed with CT scanning and MIMICS software and the relationships between brackets, teeth, wire and micro-implant were simulating the clinical factions. Then the initial tooth displacement was calculated when the insertion heights were 4 mm and 8 mm and the retraction hook heights were 1, 4, 7, 10 mm respectively. With retraction hook height added, the anterior teeth movement changed from lingual crown tipping to labial crown tipping and the intrusion movement was more apparent when the micro-implant was inserted in a higher location. The ideal teeth movement control could be achieved by different insertion heights of micro-implant and different retraction hook heights in straight wire retraction force system.

The visibility of mandibular canal on orthoradial and oblique CBCT slices at molar implant sites

International Nuclear Information System (INIS)

Alkhader, Mustafa; Jarab, Fadi; Shaweesh, Ashraf; Hudieb, Malik

2016-01-01

The aim of the present study was to compare visibility of the mandibular canal on cone beam computed tomography (CBCT)-based orthoradial and oblique slices at molar implant sites. CBCT images for 132 mandibular molar implant sites were selected for the study. After generating orthoradial and oblique slices, two observers evaluated the visibility of the mandibular canal using three-point scoring scale (1-3, good to excellent). Wilcoxon signed-rank test compared the visibility scores of the two slices. Both orthoradial and oblique slices obtained from CBCT had only very good to excellent mandibular canal visibility scores. At 114 mandibular molar implant sites, the visibility score was equal on both orthoradial and oblique slices. Although the visibility score was higher on orthoradial slices for 12 implant sites, the visibility score was higher for six implant sites on oblique slices and the difference was not significant. Therefore, the visibility of the mandibular canal was excellent and comparable on most of orthoradial and oblique slices obtained from CBCT images

Comparison of marginal bone loss and implant success between axial and tilted implants in maxillary All-on-4 treatment concept rehabilitations after 5 years of follow-up.

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Hopp, Milena; de Araújo Nobre, Miguel; Maló, Paulo

2017-10-01

There is need for more scientific and clinical information on longer-term outcomes of tilted implants compared to implants inserted in an axial position. Comparison of marginal bone loss and implant success after a 5-year follow-up between axial and tilted implants inserted for full-arch maxillary rehabilitation. The retrospective clinical study included 891 patients with 3564 maxillary implants rehabilitated according to the All-on-4 treatment concept. The follow-up time was 5 years. Linear mixed-effect models were performed to analyze the influence of implant orientation (axial/tilted) on marginal bone loss and binary logistic regression to assess the effect of patient characteristics on occurrence of marginal bone loss >2.8 mm. Only those patients with measurements of at least one axial and one tilted implant available were analyzed. This resulted in a data set of 2379 implants (1201 axial, 1178 tilted) in 626 patients (=reduced data set). Axial and tilted implants showed comparable mean marginal bone losses of 1.14 ± 0.71 and 1.19 ± 0.82 mm, respectively. Mixed model analysis indicated that marginal bone loss levels at 5 years follow up was not significantly affected by the orientation (axial/tilted) of the implants in the maxillary bone. Smoking and female gender were associated with marginal bone loss >2.8 mm in a logistic regression analysis. Five-year implant success rates were 96%. The occurrence of implant failure showed to be statistically independent from orientation. Within the limitations of this study and considering a follow-up time of 5 years, it can be concluded that tilted implants behave similarly with regards to marginal bone loss and implant success in comparison to axial implants in full-arch rehabilitation of the maxilla. Longer-term outcomes (10 years +) are needed to verify this result. © 2017 Wiley Periodicals, Inc.

Apical root resorption in maxillary incisors when employing micro-implant and J-hook headgear anchorage: a 4-month radiographic study.

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Wang, Qingzhu; Chen, Wenjing; Smales, Roger J; Peng, Hui; Hu, Xiaokun; Yin, Lu

2012-10-01

This study evaluated, over a 4-month study period, the amount of apical root resorption occurring in maxillary central incisors following their retraction when employing either micro-implant or J-hook headgear anchorage. The prospective randomised clinical trial was conducted in Orthodontic Clinic, College of Stomatology, China from 2008-2009. Subjects are patients requiring fixed appliances on waiting list (n=20). In female Han Chinese patients aged from 16-26 years, standardized periapical radiographs from 10 randomly assigned patients with maxillary protrusions comprising the micro-implant group, and from 10 similar patients comprising the J-hook headgear group, were assessed for maxillary central incisor apical root resorption. Measurements before and after orthodontic therapy were also obtained from lateral cephalometric radiographs to calculate incisor horizontal retraction and vertical intrusion distances. Estimated retraction force vectors were calculated in horizontal and vertical directions for both treatment groups. Data analysis employed t-tests and the Pearson correlation test, with α=0.05 for statistical significance. The results showed that when compared with the J-hook group, significantly more apical root resorption shortening of the maxillary central incisors was observed in the micro-implant group (1.27 mm difference, 95% CI=0.70-1.84, Pmicro-implant group resulted in significantly more apical root resorption shortening and maxillary central incisor retraction than when intermittent J-hook retraction was employed. The employment of continuous duration orthodontic forces presents a risk for increased apical root resorption that requires careful radiographic monitoring.

Prevalence, association, and sexual dimorphism of Carabelli's molar and shovel incisor traits amongst Jordanian population.

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Khraisat, A; Taha, Sahar T; Jung, R E; Hattar, S; Smadi, L; Al-Omari, I K; Jarbawi, M

2007-09-01

The correlation between dental morphological traits can be used as an indicator to show major ethnic differences. Therefore, this study investigated the prevalence of Carabelli's molar and shovel incisor traits and tested their association and sexual dimorphism in Jordanian population. Three hundred subjects of school children at their 10th grade and of 15.5-year as an average age were involved. Alginate impressions for the maxillary arch were taken, poured, and casts were then trimmed. The selected accurate casts were of 132 male- and 155 female-students. The examined morphologic traits were Carabelli's trait on the maxillary first and second molars and shovel-shaped incisors. The relationship between different traits was investigated by Nonparametric Correlation analysis and Independent Sample t test was used to test sexual dimorphism in trait expression. The prevalence of Carabelli's trait in maxillary first molar and shovel trait in maxillary central incisor was relatively high (65.0 % and 53.0 %, respectively). The prevalence of Carabelli's trait on maxillary second molars was 3.8 %. Nonparametric Correlations revealed a strongest positive correlation between Carabelli's trait on maxillary first molar and shovel trait in males (P = 0.005). Significant sexual dimorphism was only found in the prevalence of Carabelli's trait on maxillary first molar (P = 0.013) and shovel trait (P = 0.038). The Jordanian Population had comparatively high prevalence of Carabelli's molar and shovel incisor traits. There was a positive association between Carabelli's trait on maxillary first molar and shovel trait in males. Sexual dimorphism was evident in Carabelli's trait on maxillary first molar and shovel trait.

Efficacy of Articaine and Lidocaine for Buccal Infiltration of First Maxillary Molars with Symptomatic Irreversible Pulpitis: A Randomized Double-blinded Clinical Trial

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Hosseini, Hamid Reza; Parirokh, Masoud; Nakhaee, Nouzar; V. Abbott, Paul; Samani, Syamak

2016-01-01

Introduction: The aim of the present study was to compare the efficacy of 2% lidocaine to 4% articaine in buccal infiltration of maxillary first molars with irreversible pulpitis. Moreover, the effect of root length on success of anesthesia irrespective of the type of anesthetic agent was assessed. Methods and Materials: Fifty patients suffering from painful maxillary first molars with irreversible pulpitis received an infiltration injection of either 4% articaine with 1:100000 epinephrine or 2% lidocaine with 1:80000 epinephrine. Each patient recorded their pain score in response to a cold test on a Heft-Parker visual analogue scale (VAS) before commencing the treatment, 5 min following injection, during access preparation, after pulp exposure and during root canal instrumentation. No or mild pain at any stage was considered a success. Data were analyzed using the multivariate logistic regression analysis, chi-square and t tests. Results: Finally, 47 out of 50 patients were eligible to be included in this study. The anesthetic success rates in the lidocaine and articaine groups were 56.52% and 66.67%, respectively and the difference was not significant (P=0.474). Irrespective of the anesthetic agent, the length of the palatal root (Odds Ratio=0.24, P=0.007) had an adverse effect on anesthetic success. There was an association between longer palatal root length and anesthetic failure. Conclusion: No significant difference was found between 2% lidocaine and 4% articaine in terms of anesthetic success in maxillary first molars with irreversible pulpitis. The length of the palatal root had a significant negative influence on anesthetic success. PMID:27141212

Immediate loading and customized restoration of a single implant in the maxillary esthetic zone : A clinical report

NARCIS (Netherlands)

den Hartog, Laurens; Raghoebar, Gerry M.; Stellingsma, Kees; Meijer, Henny J. A.

2009-01-01

The replacement of a single missing anterior tooth with an implant-supported crown Is a demanding therapy. This report describes a treatment in which an anterior maxillary implant was immediately restored with a provisional restoration. During the provisional phase, an optimal emergence profile was

Unsplinted implants and teeth supporting maxillary removable partial dentures retained by telescopic crowns: a retrospective study with >6 years of follow-up.

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Frisch, Eberhard; Ratka-Krüger, Petra; Wenz, Hans-Jürgen

2015-09-01

Data regarding tooth- and implant-supported maxillary removable partial dentures (TIRPDs) are scarce. The objective of this research was to perform a retrospective evaluation of the clinical long-term outcome of maxillary TIRPDs rigidly retained via telescopic crowns in patients undergoing supportive post-implant therapy (SIT). The inclusion criteria were met by 26 patients restored with maxillary TIRPDs between 1997 and 2011 in a private practice. Primary crowns (Marburg double crowns, MDCs) on teeth were cemented, whereas those on implants were screw-retained. Using patient records and data from a cross-sectional clinical examination in 2013, the survival rates of the teeth, implants and prostheses, together with the biological and technical complications, were analyzed. After 6.12 ± 3.80 (range: 2-16) years of loading, 23 non-smoking patients with 23 dentures supported by 60 implants and 66 teeth were available for assessment. Nine teeth (survival rate: 86.36%) were lost, whereas 1 implant (survival rate: 98.36%) failed because of peri-implantitis. Although 30 implants (50%) in 16 patients (69.57%) showed bleeding on probing (BOP+), no further peri-implantitis was observed. The mean peri-implant probing depth (PPD) was 3.68 ± 0.71 mm. All dentures were functional and required technical maintenance efforts amounting to 0.128 treatments per patient per year (T/P/Y). Within the limitations of this study, we conclude that TIRPDs retained via MDCs may represent a viable treatment option for patients with residual maxillary teeth. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Zirconia implants and peek restorations for the replacement of upper molars

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José María Parmigiani-Izquierdo

2017-02-01

Full Text Available Abstract Background One of the disadvantages of the zirconia implants is the lack of elasticity, which is increased with the use of ceramic or zirconia crowns. The consequences that could result from this lack of elasticity have led to the search for new materials with improved mechanical properties. Case presentation A patient who is a 45-year-old woman, non-smoker and has no medical record of interest with a longitudinal fracture in the palatal root of molar tooth 1.7 and absence of tooth 1.6 was selected in order to receive a zirconia implant with a PEEK-based restoration and a composite coating. The following case report describes and analyses treatment with zirconia implants in molars following a flapless surgical technique. Zirconia implants are an alternative to titanium implants in patients with allergies or who are sensitive to metal alloys. However, one of the disadvantages that they have is their lack of elasticity, which increases with the use of ceramic or zirconia crowns. The consequences that can arise from this lack of elasticity have led to the search for new materials with better mechanical properties to cushion occlusal loads. PEEK-based restoration in implant prosthetics can compensate these occlusal forces, facilitating cushioning while chewing. Conclusion This procedure provides excellent elasticity and resembles natural tooth structure. This clinical case suggests that PEEK restorations can be used in zirconia implants in dentistry.

Identification of possible factors impacting dental students' ability to locate MB2 canals in maxillary molars.

Science.gov (United States)

Park, Ellen; Chehroudi, Babak; Coil, Jeffrey M

2014-05-01

This study examined the effect of the access size and straight-line path of access on third-year dental students' ability to locate a second mesiobuccal (MB2) canal in maxillary first and second molars. One hundred and six third-year dental students at one Faculty of Dentistry performed simulated root canal treatment with the aid of 2x magnification loupes on extracted teeth. A postgraduate endodontic student subsequently made a reasonable search for an untreated MB2 canal with the aid of a dental operating microscope. The mesiobuccal roots were then sectioned horizontally for determination of the canal configuration. The dental students were able to treat an MB2 canal in 15.8 percent of the teeth, but this was not associated with satisfactory access criteria. The postgraduate endodontic student identified an MB2 canal in 54.7 percent of the remaining tooth samples excluding those where the MB2 canal was found by the dental students; this represented 94.3 percent of those teeth confirmed by horizontal sectioning of the root to have an MB2 canal. The postgraduate student troughed, on average, 2.6 mm before negotiating the MB2 canal. As satisfactory access criteria and straight-line path of access did not correlate with the dental students' ability to find a second mesiobuccal canal, this result has important implications for educational goals with respect to endodontic treatment of maxillary molar teeth.

A 2-year report on maxillary and mandibular fixed partial dentures supported by Astra Tech dental implants. A comparison of 2 implants with different surface textures

DEFF Research Database (Denmark)

Karlsson, U; Gotfredsen, K; Olsson, C

1998-01-01

In 50 partially edentulous patients, 133 (48 maxillary; 85 mandibular) Astra Tech dental implants of 2 different surface textures (machined; TiO-blasted) were alternately installed, supporting 52 fixed partial dentures (FPDs). Before abutment connection 2 machined implants (1 mandibular; 1...

Comparative study of longitudinal changes in peri-implant bone microstructure

International Nuclear Information System (INIS)

Suzuki, Yusuke; Matsunaga, Satoru; Abe, Shinichi; Ide, Yoshinobu; Usami, Akinobu

2010-01-01

The load applied to an implant is directly transmitted to the jaw and is considered to be one of the causes of remodeling of internal trabecular bones. However, the longitudinal changes during loading and the rearrangement of the trabecular bone structure are mostly unknown. The aim of this study was to clarify the changes in internal jaw bone structure longitudinally during natural tooth eruption as well as tooth extraction and post-implantation periods in a dog model by micro computed tomography (micro-CT). Maxillae of 16 male beagle dogs were used in this study. First, 4 dogs with all maxillary molar teeth erupted were euthanized as a control group. Next, 6 teeth consisting of the bilateral maxillary fourth premolars, and first and second molars were extracted from each of the 12 dogs. Then, 4 dogs of the tooth-extracted group were euthanized 3 months after extraction of the teeth. At this time, three implants were inserted in the left side of the maxilla of the remaining 8 dogs, and the superstructures were placed after 3 months. Four of these 8 dogs with implants were euthanized at 3 months and the other 4 at 1 year after placement of the superstructure. Then, the maxillary bone was removed from each dog as a specimen and sequential micro-CT images were taken. After reconstruction of three-dimensional images, morphological and metrical observation of the jaw trabecular bone structure was performed. A decrease of the trabecular bone in the tooth-extracted group was morphologically and morphometrically observed, whereas the implanted group showed thick, rich trabecular bone. Although a longitudinal decrease in the bone tissue volume was recognized both in the tooth-extracted and the implanted groups, the amount was smaller in the implanted group than in the tooth-extracted group. The results suggested that the application of load by implants in the case of tooth loss inhibits resorption of the alveolar bone and prevents thinning of the jaw. (author)

Genetic integration of molar cusp size variation in baboons.

Science.gov (United States)

Koh, Christina; Bates, Elizabeth; Broughton, Elizabeth; Do, Nicholas T; Fletcher, Zachary; Mahaney, Michael C; Hlusko, Leslea J

2010-06-01

Many studies of primate diversity and evolution rely on dental morphology for insight into diet, behavior, and phylogenetic relationships. Consequently, variation in molar cusp size has increasingly become a phenotype of interest. In 2007 we published a quantitative genetic analysis of mandibular molar cusp size variation in baboons. Those results provided more questions than answers, as the pattern of genetic integration did not fit predictions from odontogenesis. To follow up, we expanded our study to include data from the maxillary molar cusps. Here we report on these later analyses, as well as inter-arch comparisons with the mandibular data. We analyzed variation in two-dimensional maxillary molar cusp size using data collected from a captive pedigreed breeding colony of baboons, Papio hamadryas, housed at the Southwest National Primate Research Center. These analyses show that variation in maxillary molar cusp size is heritable and sexually dimorphic. We also estimated additive genetic correlations between cusps on the same crown, homologous cusps along the tooth row, and maxillary and mandibular cusps. The pattern for maxillary molars yields genetic correlations of one between the paracone-metacone and protocone-hypocone. Bivariate analyses of cuspal homologues on adjacent teeth yield correlations that are high or not significantly different from one. Between dental arcades, the nonoccluding cusps consistently yield high genetic correlations, especially the metaconid-paracone and metaconid-metacone. This pattern of genetic correlation does not immediately accord with the pattern of development and/or calcification, however these results do follow predictions that can be made from the evolutionary history of the tribosphenic molar. Copyright 2009 Wiley-Liss, Inc.

Immediate Implant Placement in Single-Tooth Molar Extraction Sockets: A 1- to 6-Year Retrospective Clinical Study.

Science.gov (United States)

Amato, Francesco; Polara, Giorgio

The aim of this study was to investigate the survival rate of implants immediately placed in fresh extraction sockets of molars in the maxilla and mandible with a single-stage procedure. A total of 102 patients were treated, and 107 implants (53 in the maxilla and 54 in the mandible) were placed in a fresh molar extraction socket and connected to a healing abutment. After a mean follow-up of 3 years (range: 1 to 6 years) 1 implant failed, for a cumulative success rate of 99.06% (98.11% for the mandible and 100% for the maxilla). The results of this study support placement of an implant immediately after the extraction of a molar, applying a single-stage procedure.

Angulated Dental Implants in Posterior Maxilla FEA and Experimental Verification

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Hamed A. Hamed

2018-02-01

Full Text Available AIM: This study aimed to evaluate the effect of different implant angulations in posterior maxilla on stress distribution by finite element analysis and verify its results experimentally. METHODS: Two simplified models were prepared for an implant placed vertically and tilted 25° piercing the maxillary sinus. Geometric models' components were prepared by Autodesk Inventor then assembled in ANSYS for finite element analysis. The results of finite element analysis were verified against experimental trials results which were statistically analysed using student t-test (level of significance p < 0.05. RESULTS: Implant - abutment complex absorbed the load energy in case of vertical implant better than the case of angulated one. That was reflected on cortical bone stress, while both cases showed stress levels within the physiological limits. Comparing results between FEA and experiment trials showed full agreement. CONCLUSION: It was found that the tilted implant by 25° can be utilised in the posterior region maxilla for replacing maxillary first molar avoiding sinus penetration. The implant-bone interface and peri-implant bones received the highest Von Mises stress. Implant - bone interface with angulated implant received about 66% more stresses than the straight one.

Angulated Dental Implants in Posterior Maxilla FEA and Experimental Verification.

Science.gov (United States)

Hamed, Hamed A; Marzook, Hamdy A; Ghoneem, Nahed E; El-Anwar, Mohamed I

2018-02-15

This study aimed to evaluate the effect of different implant angulations in posterior maxilla on stress distribution by finite element analysis and verify its results experimentally. Two simplified models were prepared for an implant placed vertically and tilted 25° piercing the maxillary sinus. Geometric models' components were prepared by Autodesk Inventor then assembled in ANSYS for finite element analysis. The results of finite element analysis were verified against experimental trials results which were statistically analysed using student t-test (level of significance p < 0.05). Implant - abutment complex absorbed the load energy in case of vertical implant better than the case of angulated one. That was reflected on cortical bone stress, while both cases showed stress levels within the physiological limits. Comparing results between FEA and experiment trials showed full agreement. It was found that the tilted implant by 25° can be utilised in the posterior region maxilla for replacing maxillary first molar avoiding sinus penetration. The implant-bone interface and peri-implant bones received the highest Von Mises stress. Implant - bone interface with angulated implant received about 66% more stresses than the straight one.

Partitioning the components of maxillary tooth displacement by the comparison of data from three cephalometric superimpositions.

Science.gov (United States)

Baumrind, S; Ben-Bassat, Y; Bravo, L A; Curry, S; Korn, E L

1996-01-01

Using roentgenographic cephalograms from a sample of subjects with metallic implants, appropriately superimposed tracings were used to distinguish developmental and treatment-associated displacements of the maxillary central incisor and first molar associated "local" changes within the periodontium from "secondary" changes which reflect sutural and appositional growth at more distant osseous loci. Tracings were superimposed on anterior cranial base (ACB), on the maxillary implants only (IMP_MAX), and according to the best fit of maxillary anatomic structures without reference to the implants (A_MAX). Using the IMP_MAX superimposition, one could measure total local displacement at any landmark taking into consideration the effects of all appositional and resorptive changes on the superior and anterior surfaces of the palate, whereas using the A_MAX superimposition one could measure local displacement without consideration of surface appositional and resorptive changes. If the second of these measurements were subtracted from the first, the result would be a direct measurement of the effects of surface appositional and resorptive changes as they are expressed at that particular landmark. This strategy has enabled us to quantify and report the amount of accommodation which occurs at the location of each dental landmark in association with the resorptive and appositional changes which occur through time on the superior and anterior surfaces of the hard palate.

Three-dimensional topography of the gingival line of young adult maxillary teeth: curve averaging using reverse-engineering methods.

Science.gov (United States)

Park, Young-Seok; Chang, Mi-Sook; Lee, Seung-Pyo

2011-01-01

This study attempted to establish three-dimensional average curves of the gingival line of maxillary teeth using reconstructed virtual models to utilize as guides for dental implant restorations. Virtual models from 100 full-mouth dental stone cast sets were prepared with a three-dimensional scanner and special reconstruction software. Marginal gingival lines were defined by transforming the boundary points to the NURBS (nonuniform rational B-spline) curve. Using an iterative closest point algorithm, the sample models were aligned and the gingival curves were isolated. Each curve was tessellated by 200 points using a uniform interval. The 200 tessellated points of each sample model were averaged according to the index of each model. In a pilot experiment, regression and fitting analysis of one obtained average curve was performed to depict it as mathematical formulae. The three-dimensional average curves of six maxillary anterior teeth, two maxillary right premolars, and a maxillary right first molar were obtained, and their dimensions were measured. Average curves of the gingival lines of young people were investigated. It is proposed that dentists apply these data to implant platforms or abutment designs to achieve ideal esthetics. The curves obtained in the present study may be incorporated as a basis for implant component design to improve the biologic nature and related esthetics of restorations.

Implants for orthodontic anchorage

Science.gov (United States)

Zheng, Xiaowen; Sun, Yannan; Zhang, Yimei; Cai, Ting; Sun, Feng; Lin, Jiuxiang

2018-01-01

Abstract Implantanchorage continues to receive much attention as an important orthodontic anchorage. Since the development of orthodontic implants, the scope of applications has continued to increase. Although multiple reviews detailing implants have been published, no comprehensive evaluations have been performed. Thus, the purpose of this study was to comprehensively evaluate the effects of implants based on data published in review articles. An electronic search of the Cochrane Library, Medline, Embase, Ebsco and Sicencedirect for reviews with “orthodontic” and “systematic review or meta analysis” in the title, abstract, keywords, or full text was performed. A subsequent manual search was then performed to identify reviews concerning orthodontic implants. A manual search of the orthodontic journals American Journal of Orthodontics and Dentofacial Orthopedics (AJODO), European Journal of Orthodontics (EJO), and Angle Othodontist was also performed. Such systematic reviews that evaluated the efficacy and safety of orthodontic implants were used to indicate success rates and molar movements. A total of 23 reviews were included in the analysis. The quality of each review was assessed using a measurement tool for Assessment of Multiple Systematic Reviews (AMSTAR), and the review chosen to summarize outcomes had a quality score of >6. Most reviews were less than moderate quality. Success rates of implants ranged in a broad scope, and movement of the maxillary first molar was superior with implants compared with traditional anchorage. PMID:29595673

Modified hyrax splint for rapid maxillary expansion in esthetically concerned patients

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Sarabjeet Singh Sandhu

2015-01-01

Full Text Available The orthodontic treatment of Class III malocclusion with a maxillary deficiency is often treated with maxillary protraction either with or without maxillary expansion. The routine procedure for rapid maxillary expansion includes banding on first premolars/first deciduous molars and the permanent first molars. However in some patients who are esthetically very conscious, banding of the first premolar would not be a good esthetic option. So for such circumstances we have designed a modified hyrax splint, which does not need the first premolars to be banded.

Optimizing Maxillary Aesthetics of a Severe Compromised Tooth through Orthodontic Movement and Dental Implants

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Rafael Scaf de Molon

2014-01-01

Full Text Available Treatment of severe compromised tooth in the maxillary anterior area still poses great challenge to the clinicians. Several treatment modalities have been proposed to restore the function and aesthetics in teeth with advanced periodontal disease. The present study aims to report a case of traumatic injury of a left-maxillary central incisor with ridge preservation, orthodontic movement, and implant therapy. A 45-year-old woman underwent the proposed treatment for her left central incisor: basic periodontal therapy, xenogenous bone graft, and guided bone regeneration (GBR. Six months after the graft procedure, orthodontic movement by means of alignment and leveling was made and a coronal displacement of the gingival margin and vertical bone apposition could be observed after 13 months of active movement. Afterwards, a dental implant was placed followed by a connective tissue graft and immediate provisionalization of the crown. In conclusion, orthodontic movement was effective to improve the gingival tissue and alveolar bone prior to implant placement favoring the aesthetic results. Six years postoperatively, the results revealed height and width alveolar bone gain indicating that the treatment proposed was able to restore all the functional and aesthetic parameters.

Periodontal considerations in the use of bonds or bands on molars in adolescents and adults.

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Boyd, R L; Baumrind, S

1992-01-01

This longitudinal study compared the periodontal status of bonded and banded molars in 20 adult and 40 adolescent patients before, during and after treatment with fixed orthodontic appliances. Plaque accumulation (measured by the Plaque Index), gingival inflammation (measured by the Gingival Index and the bleeding tendency), and pocket depth were assessed by one examiner at sites along the mesio-buccal line angle of the maxillary right first molar and the mandibular left first molar. Assessments were made immediately prior to the placement of fixed appliances (pretreatment), at 1, 3, 6, 9, 12 and 18 months after appliances were placed; and 3 months after appliances were removed (posttreatment). Loss of attachment between the pretreatment and posttreatment visits also was determined. At pretreatment, no significant differences were found in gingival inflammation between maxillary and mandibular banded and bonded molars. During treatment, both maxillary and mandibular banded molars showed significantly (p less than 0.05) greater gingival inflammation and plaque accumulation than did bonded molars. Three months after appliance removal, the maxillary molars that had been banded continued to show significantly more gingival inflammation and loss of attachment than did the maxillary molars that had been bonded. When all banded and bonded teeth were grouped by patient age, mean values for plaque accumulation and gingival inflammation in the maxillary molar regions were significantly greater for adolescents than for adults.

Maxillary sinus augmentation

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A B Tarun Kumar

2015-01-01

Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

Influence of the Diameter of Dental Implants Replacing Single Molars: 3- to 6-Year Follow-Up.

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Mendonça, Jose Alfredo; Senna, Plinio Mendes; Francischone, Carlos Eduardo; Francischone Junior, Carlos Eduardo; Sotto-Maior, Bruno Salles

The aim of this study was to evaluate the influence of the implant diameter on marginal bone remodeling around dental implants replacing single molars after a follow-up period of 3 to 6 years. Patients who received dental implants with an external hexagon platform in healed sites to support a single metal-ceramic crown in the molar region were recalled to the office. The implantation sites and implant length information were recorded, and the implants were divided according to the implant diameter: regular (RP) or wide (WP). Each implant was assessed by digital periapical radiography, using a sensor holder for the paralleling technique. The marginal bone remodeling was determined as the distance from the implant platform to the first bone-to-implant contact, and the known implant length was used to calibrate the images in the computer software. The follow-up measurements were compared with those obtained from the radiograph taken at the time of prosthetic loading to determine the late bone remodeling. The independent t test was used to compare data. A total of 67 implants from 46 patients were evaluated with a mean follow-up period of 4.5 ± 1.0 years. The RP group comprised 36 implants from 29 patients (mean age: 58.3 ± 10.6 years), while 31 implants from 17 patients (mean age: 56.9 ± 11.5 years) were included in the WP group. The RP group presented lower survival rates (86.1%) than the WP group (100.0%). Similar marginal bone loss (P implants exhibited lower incidence failures, the bone levels were similar after the prosthetic loading around regular- and wide-diameter implants supporting single molar crowns.

Occlusal plane change after intrusion of maxillary posterior teeth by microimplants to avoid maxillary surgery with skeletal Class III orthognathic surgery.

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Park, Hyo-Sang; Kim, Ji-Yeun; Kwon, Tae-Geon

2010-11-01

To increase stability and mandibular setback movement, surgical maxillary impaction is normally performed with mandibular setback surgery in treating adult skeletal Class III patients. This article demonstrates the use of microimplants for anchorage to intrude molars and the resultant rotation of the maxillary occlusal plane clockwise to increase the surgical mandibular setback and reduce the posterior vertical dimension instead of maxillary surgical impaction. A 21-year-old man with mandibular prognathism was treated with mandibular setback surgery that included orthodontic treatment for decompensation. Microimplants placed into the palatal alveolar bone between the maxillary first and second molars were used to intrude the maxillary posterior teeth and change the occlusal plane clockwise. This produced 4 mm more of distal movement of the chin during mandibular setback surgery compared with the surgical prediction with no change in the occlusal plane. These results were similar to those of 2-jaw surgery with maxillary posterior impaction. The intrusion of the maxillary posterior teeth with microimplants might prevent the need for maxillary surgery in adult skeletal Class III patients. Copyright © 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

The influence of resilient liner and clip attachments for bar-implant-retained mandibular overdentures on opposing maxillary ridge. A 5-year randomised clinical trial.

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Elsyad, M A; Ashmawy, T M; Faramawy, A G

2014-01-01

This study aimed to compare the influence of resilient liner and clip attachments for bar-implant-retained mandibular overdentures on opposing maxillary ridge after 5 years of denture wearing. Thirty edentulous male patients (mean age 62·5 years) received two implants in the anterior mandible after being allocated into two equal groups using balanced randomisation. After 3 months, implants were connected with resilient bars. New maxillary complete dentures were then constructed, and mandibular overdentures were retained to the bars with either clips (group I, GI) or silicone resilient liners (group II, GII). The prosthetic and soft tissue complications of the maxillary dentures were recorded 6 months (T6 m ), 1 year (T1), 3 years (T3) and 5 years (T5) after overdenture insertion. Traced rotational tomograms were used for measurements of maxillary alveolar bone loss. The proportional value between bone areas and areas of reference not subject to resorption was expressed as a ratio (R). Change in R immediately before (T0) and after 5 years (T5) of overdenture insertion was calculated. Maxillary denture relining times and frequency of flabby anterior maxillary ridge occurred significantly more often in GI compared with GII. The change of R in anterior part of maxilla was significantly higher than change of R in posterior part in both groups. GI showed significant resorption of anterior residual ridge compared with GII. Relining times and frequencies of flabby ridge were significantly correlated with change in R. Within the limitations of this study, resilient liner attachments for bar-implant-retained mandibular overdentures are associated with decreased resorption and flabbiness of maxillary anterior residual ridge and fewer maxillary denture relining times when compared with clip attachments. © 2013 John Wiley & Sons Ltd.

Use of the frontal process of the maxillary bone for implant placement to retain a nasal prosthesis: a clinical report.

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Proussaefs, Periklis

2004-01-01

Implant placement to provide support and retention for nasal prostheses has been described in the literature. The anatomic sites that have been utilized for implant placement are the nasal bones, the premaxillary area through the nasal fossae, and the anterior wall of the frontal sinus. In the patient described, after a presurgical computerized tomography scan to determine adequacy of bone volume, 1 conventional threaded hydroxyapatite-coated root-form implant, created for intraoral use, was placed in the frontal process of the maxillary bone and 2 additional conventional implants were placed in the premaxillary area through the nasal fossa. Six months after implant placement, second-stage surgery was completed. A single bar connecting the 3 implants was fabricated. The removable nasal prosthesis was retained on the bar with 2 clips. An examination 1 year postsurgery revealed no clinical signs of pathosis. Long-term clinical follow-up of this case should continue and a sufficient number of additional cases should be investigated before use of the frontal process of the maxillary bone for implant retention can be recommended on a routine basis.

Implant angulation: 2-year retrospective analysis on the influence of dental implant angle insertion on marginal bone resorption in maxillary and mandibular osseous onlay grafts.

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Ramaglia, Luca; Toti, Paolo; Sbordone, Carolina; Guidetti, Franco; Martuscelli, Ranieri; Sbordone, Ludovico

2015-05-01

The purpose of this study was to determine the existence of correlations between marginal peri-implant linear bone loss and the angulation of implants in maxillary and mandibular augmented areas over the course of a 2-year survey. Dependent variables described the sample of the present retrospective chart review. By using three-dimensional radiographs, input variables, describing the implant angulation (buccal-lingual angle [φ] and mesial-distal angle [θ]) were measured; outcome variables described survival rate and marginal bone resorption (MBR) around dental implants in autogenous grafts (10 maxillae and 14 mandibles). Pairwise comparisons and linear correlation coefficient were computed. The peri-implant MBR in maxillary buccal and palatal areas appeared less intensive in the presence of an increased angulation of an implant towards the palatal side. Minor MBR was recorded around mandibular dental implants positioned at a right angle and slightly angulated towards the mesial. Resorption in buccal areas may be less intensive as the angulation of placed implants increases towards the palatal area in the maxilla, whereas for the mandible, a greater inclination towards the lingual area could be negative. In the mandibular group, when the implant was slightly angulated in the direction of the distal area, bone resorption seemed to be more marked in the buccal area. In the planning of dental implant placement in reconstructed alveolar bone with autograft, the extremely unfavourable resorption at the buccal aspect should be considered; this marginal bone loss seemed to be very sensitive to the angulation of the dental implant.

A Peduncular Cystic Compound Odontoma on the Posterior Wall of the Maxillary Sinus

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Kang, Byung Chul [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chonam National University, Kwangju (Korea, Republic of)

1998-08-15

A cystic compound odontoma in the maxillary sinus occurred in a 13-years-old boy, who had missing right upper third molar without having the history of extraction of the wisdom tooth. He complained nasal stuffiness, headache, and pain on the affected face, resembling any sign and symptoms of the maxillary sinus problems. The cysteic compound, sized 2 x 1.5 cm in diameter was pedunculated and attached on the posterior wall of the right maxillary sinus and above the antral floor. The location of the compound odontoma in the maxillary sinus was confirmed after panoramic, waters, spiral tomographic, CT examinations and surgical exploration. Irs location was on the medical, posterior, superior to the normal position of the maxillary third molar or the maxillary dental arch. The cystic odontoma in the maxillary sinus made the patient have the sings and symptoms of maxillary sinusitis. The cystic compound odontoma might be originated from the dental lamina of the missing upper right third molar. The 'V principle' of the upper jaw growth and the pneumatization process of the maxillary sinus could explain why the compound odontoma had peduncular shape and the location of odontoma was on the medial, superior to the normal position of the maxillary dental arch.

Clinical follow-up of unilateral, fixed dental prosthesis on maxillary implants.

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Wahlström, Monica; Sagulin, Gun-Britt; Jansson, Leif E

2010-11-01

The aims of the present study were to evaluate (1) the success rate of unilateral maxillary fixed dental prosthesis (FDPs) on implants in patients at a periodontal clinic referred for periodontal treatment, (2) the prevalence of varying mechanical and biological complications and (3) effects of potential risk factors on the success rate. Fifty consecutive patients were invited to participate in a follow-up. The patients had received FDPs on implants between November 2000 and December 2003 after treatment to achieve optimal peridontal health, and the FDPs had been in function for at least 3 years. A questionnaire was sent to the patients before the follow-up examination. Forty-six patients with 116 implants were examined. The follow-up comprised clinical and radiographic examinations and evaluations of treatment outcome. Before implant treatment, 13% of the teeth were extracted; of these, 80% were extracted due to periodontal disease. No implants had been lost before implant loading. One implant in one patient fractured after 3 years of functional loading and three implants in another patient after 6.5 years. The most frequent mechanical complications were veneer fractures and loose bridge screws. Patients with peri-implant mucositis had significantly more bleeding on probing around teeth and implants. Patients with peri-implantitis at the follow-up had more deep periodontal pockets around their remaining teeth compared with individuals without peri-implantitis, but these differences were not significant. Smokers had significantly fewer teeth, more periodontal pockets ≥ 4mm and a tendency towards greater marginal bone loss at the follow-up, compared with non-smokers. In the short term, overloading and bruxism seem more hazardous for implant treatment, compared with a history of periodontitis.

Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position.

Science.gov (United States)

Jensen, Charlotte; Raghoebar, Gerry M; Kerdijk, Wouter; Meijer, Henny J A; Cune, Marco S

2016-12-01

To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region. Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position. The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support. Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region. Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region. Copyright © 2016

Mini-implants: mechanical resource for molars uprighting

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Susiane Allgayer

2013-02-01

Full Text Available INTRODUCTION: The early orthodontic treatment allows correction of skeletal discrepancies by growth control, and the elimination of deleterious habits, which are risk factors for the development of malocclusions, favoring for the correction of tooth positioning later in a second treatment stage. During development of teeth and occlusion, the mandibular second molars commonly erupt in the oral cavity after all other teeth of the anterior region. In their eruptive process there may be a condition known as tooth impaction, which precludes its complete eruption and requires proper uprighting treatment. The temporary anchorage devices allow disimpaction and movement of these teeth directly to their final position, without the need of patient compliance or reaction movements in other parts of the arch. OBJECTIVE: This paper aims at describing a case report of the treatment of a patient with Angle Class II malocclusion, performed in two phases, in which mini-implants were used for uprighting the impacted mandibular second molars.INTRODUÇÃO: o tratamento ortodôntico precoce permite a correção das discrepâncias esqueléticas por meio do controle de crescimento e a eliminação de hábitos deletérios, que são fatores de risco para o desenvolvimento de más oclusões, que favorecem a correção do posicionamento dentário mais tardiamente, em uma segunda fase do tratamento. Durante o desenvolvimento da dentição e da oclusão, normalmente o segundo molar inferior chega à cavidade bucal após todos os dentes posicionados anteriormente a ele. Durante seu processo eruptivo, pode ocorrer uma condição chamada "impacção dentária", em que sua erupção completa é interrompida, exigindo tratamento apropriado para verticalização. Os dispositivos temporários de ancoragem permitem a desimpacção e a movimentação desses dentes diretamente às suas posições finais, sem a necessidade de cooperação do paciente e sem movimento de reação nas

Immediate implant placement and provisional crown fabrication after a minimally invasive extraction of a peg-shaped maxillary lateral incisor: a clinical report.

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Turkyilmaz, Ilser; Suarez, Jose Carlos; Company, Andrea M

2009-09-01

The aim of this case report is to describe the replacement of a maxillary peg-shaped lateral incisor with the placement of an immediate implant and a provisional restoration following a minimally invasive extraction to preserve anterior esthetics. Extraction sites in the anterior maxilla can present restorative challenges with regard to esthetics. Resistance to wearing a temporary removable partial denture during healing makes immediate implant therapy an appealing alternative to patients. Implant placement into fresh extraction sockets using no flap elevation has recently become more popular due to some advantages including less bleeding, swelling, and the preservation of existing soft tissue contours. A 20-year-old woman with a peg-shaped maxillary left lateral incisor was treated using an implant placed into the fresh extraction socket using a flapless approach and immediate provisional crown fabrication. Flapless implant placement helps to preserve site morphology by protecting and supporting existing hard and soft tissues while minimizing surgical trauma to the adjacent tissues. Using a previously fabricated acrylic index, a provisional acrylic crown was fabricated on the adjusted temporary abutment and delivered to the patient the same day during the extraction visit. This report describes the diagnosis and treatment of an over-prepared peg-shaped maxillary left lateral incisor associated with multiple crown decementations. The tooth was extracted without flap elevation and an implant was inserted immediately using flapless surgery and placement of an immediate provisional single crown. Flapless implant insertion into fresh extraction sockets and placement of immediate provisional crowns in cases involving the maxillary anterior region represent a viable treatment option in appropriate clinical situations where esthetics are a high priority. The strategy preserves optimum gingival contours and papillary height may be a viable option compared to fixed partial

Removable molar power arm

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Raj Kumar Verma

2013-01-01

Full Text Available Attachment of force elements from the gingival hook of maxillary molar tubes during the retraction of the anterior teeth is very common in orthodontic practice. As the line of force passes below the center of resistance (CR of molar, it results its mesial tipping and also anchorage loss. To overcome this problem, the line of force should pass along the CR of molar. This article highlights a method to overcome this problem by attaching a removable power arm to the headgear tube of molar tube during the retraction of the anterior teeth.

Prevalence and distribution of dental anomalies: a comparison between maxillary and mandibular tooth agenesis.

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Al-Abdallah, Mariam; AlHadidi, Abeer; Hammad, Mohammad; Al-Ahmad, Hazem; Saleh, Raja'

2015-11-01

The aim of this study was to compare the pattern and prevalence of associated dental anomalies between maxillary and mandibular tooth agenesis (hypodontia). A sample of 3315 dental patients, aged 8.6 to 25.4 years, was surveyed for tooth agenesis (excluding third molars): 106 subjects were diagnosed with maxillary hypodontia (group 1) and 70 with mandibular hypodontia (group 2). Both groups were examined for the following dental anomalies: retained deciduous molars, infraocclusion of deciduous molars, impaction, microdontia of maxillary lateral incisors, supernumerary teeth, transposition, transmigration, and ectopic eruption of the permanent molars. For statistical testing, the chi-square test (P anomalies among the groups. We found that 77.5% of the patients in the mandibular hypodontia group had at least 1 dental anomaly compared with 49.5% in the maxillary hypodontia group (P dental anomaly with a significantly increased prevalence in the maxillary hypodontia group compared with the mandibular hypodontia group was microdontia of the maxillary lateral incisors (groups 1, 46.7%; group 2, 12.9%; P dental development in both jaws. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Rapid Palatal Expansion in the absence of posterior cross-bite to intercept maxillary incisor crowding in the mixed dentition: a CBCT evaluation of spontaneous changes of untouched permanent molars.

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Rosa, M; Lucchi, P; Manti, G; Caprioglio, A

2016-12-01

The aim of this study was to investigate the reaction of untouched permanent molars following RPE, anchored on deciduous teeth in the early mixed dentition, aimed to solve maxillary anterior crowding in the absence of posterior cross-bite. A prospective clinical trial comprised 35 consecutive patients (20 males and 15 females) treated by the same orthodontist (MR). All patients showed crowding of the upper permanent incisors in the early mixed dentition in the absence of posterior cross-bite. RPE was anchored on second deciduous molars and on the deciduous canines. CBCT was taken before and after the removal of the RPE appliance. The transverse linear changes in width and the variation in the torque of the permanent molars were measured in the coronal plane. Relief of incisor crowding was found in all patients. The transverse width between permanent molars increased significantly. The apices of the upper permanent molars spontaneously expanded more than the crowns, while the opposite happened on the lower permanent molars. Moreover, the untouched upper permanent molars spontaneously uprighted palatally, while the lower permanent molars spontaneously uprighted buccally. The variation in the torque of the permanent molars mirrored transverse normal growth. In the early mixed dentition and in the absence of posterior cross-bite, it is possible to expand transversally the palate while uprighting the upper permanent molars in the opposite direction. RPE anchored on the deciduous teeth in the early mixed dentition, in the absence of posterior cross-bite, provides an "anticipation of transverse growth" and could be indicated to expand the anterior portion of the maxillary arch perimeter to solve upper incisor crowding.

Study of the relationship between the indication rod of stent on implant CT and the real path of implant fixture insertion considering residual ridge

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Kim, Do Hoon; Heo, Min Suk; Lee, Sam Sun; Oh, Sung Ook; Choi, Soon Chul; Choi, Hang Moon; Jeon, In Seong

2003-01-01

To assess the relationship between the direction of the indicating rod of the radiographic stent for ideal prosthetic design and the actual possible path of implant fixture placement when residual ridge resorption is considered. The study materials considered of 326 implant sites (male 214 cases and female 112 cases) from a total of 106 patients (male 65 patients and female 41 patients) who desired implant prostheses. Computed tomography of patients were taken and reformatted using ToothPix software. Bony defects, bony sclerosis, the change of the direction of indicating rod, and root proximity of the adjacent teeth were examined on the CT-derived images. The rate of the irregular crestal cortex was relatively high on premolar and molar area of maxilla. Mandibular molar area showed relatively high rate of focal sclerosis on the area of implant fixture insertion. The position of the including rods were relatively acceptable on the molar areas of both jaws. However, the position of the indicating rods should be shifted to buccal side with lingual rotation of the apical end on maxillary anterior teeth and premolar area. Clinically determined rod direction and position of the indicating rod for implant placement was not always acceptable for insertion according to the reformatted CT images. The pre-operative treatment plan for implant should be determined carefully, considering the state of the alveolar bone using the reformatted CT images.

Four-unit fixed dental prostheses replacing the maxillary incisors supported by two narrow-diameter implants - a five-year case series.

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Moráguez, Osvaldo; Vailati, Francesca; Grütter, Linda; Sailer, Irena; Belser, Urs C

2017-07-01

(1) To determine the survival rate of 10 four-unit fixed dental prostheses (FDPs) replacing the four maxillary incisors, supported by 20 narrow-diameter implants (NDIs), (2) to assess the incidence of mechanical and biological complications, and (3) to evaluate bone level changes longitudinally after final FDP insertion. Ten patients (six women, four men), mean age 49.4 ± 12.6 years, were treated with a four-unit anterior maxillary FDP (six screw-retained; four cemented). Biological parameters, eventual technical complications, radiographic measurements, and study casts were assessed at 1 (baseline), 3, and 5 years after implant placement. A multilevel logistic regression test was performed on clinical parameters and bone level changes (significance level P four-unit FDP to replace the four missing maxillary incisors may be considered a predictable treatment modality. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Maxillary overdentures supported by anteriorly or posteriorly placed implants opposed by a natural dentition in the mandible: a 1-year prospective case series study.

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Slot, Wim; Raghoebar, Gerry M; Vissink, Arjan; Meijer, Henny J A

2014-02-01

For maxillary overdenture therapy, treatment guidelines are missing. There is a need for longitudinal studies. The purpose of this 1-year prospective case series study was to assess the treatment outcome of maxillary overdentures supported by six dental implants opposed by natural antagonistic teeth in the mandible. Fifty patients were treated with a maxillary overdenture supported by six dental implants, either placed in the anterior region (n = 25 patients) or in the posterior region (n = 25 patients). Items of evaluation were the following: survival of implants, condition of hard and soft peri-implant tissues, and patients' satisfaction. One-year implant survival rate was 98% in the anterior group and 99.3% in the posterior group. Mean radiographic bone loss in the anterior and posterior groups after 1 year of loading was 0.22 and 0.50 mm, respectively. Mean scores for plaque, calculus, gingiva, bleeding, and pocket probing depth were low, and patients' satisfaction was high, with no differences between the groups. Six dental implants placed in either the anterior region or the posterior region of the edentulous maxilla, connected with a bar, and opposed by antagonistic teeth in the mandible supply a proper base for the support of an overdenture. © 2012 Wiley Periodicals, Inc.

Micro-Computed Tomography Analysis of the Root Canal Morphology of Palatal Roots of Maxillary First Molars.

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Marceliano-Alves, Marília; Alves, Flávio Rodrigues Ferreira; Mendes, Daniel de Melo; Provenzano, José Claudio

2016-02-01

A thorough knowledge of root canal anatomy is critical for successful root canal treatments. This study evaluated the internal anatomy of the palatal roots of maxillary first molars with micro-computed tomography (microCT). The palatal roots of extracted maxillary first molars (n = 169) were scanned with microCT to determine several anatomic parameters, including main canal classification, lateral canal occurrence and location, degree of curvature, main foramen position, apical constriction presence, diameters 1 and 2 mm from the apex and 1 mm from the foramen, minor dentin thickness in those regions, canal volume, surface area, and convexity. All canals were classified as Vertucci type I. The cross sections were oval in 61% of the canals. Lateral canals were found in 25% of the samples. The main foramen did not coincide with the root apex in 95% of the cases. Only 8% of the canals were classified as straight. Apical constriction was identified in 38% of the roots. The minor and major canal diameters and minor dentin thickness were decreased near the apex. The minor dentin thickness 1 mm from the foramen was 0.82 mm. The palatal canals exhibited a volume of 6.91 mm(3) and surface area of 55.31 mm(2) and were rod-shaped. The root canals of the palatal roots were classified as type I. However, some factors need to be considered during the treatment of these roots, including the frequent ocurrence of moderate/severe curvatures, oval-shaped cross-sections, and lateral canals, noncoincidence of the apical foramen with the root apex, and absence of apical constriction in most cases. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Alternativas a la elevación de seno maxilar: rehabilitación del sector posterior del maxilar atrófico mediante implantes pterigoideos Alternatives to maxillary sinus lift: posterior area of the atrophic maxilla rehabilitation by means pterigoideal implants

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X. Rodríguez-Ciurana

2008-12-01

Full Text Available El primer y segundo molar son los dientes que se pierden más a menudo debido a la enfermedad periodontal y al exceso de fuerzas oclusales. A pesar de la frecuencia del edentulismo parcial del sector posterior raramente se ubican los implantes más allá de los premolares debido al aumento del índice de fallos. El escaso volumen óseo y la pobre mineralización del sector posterior del maxilar comprometen la viabilidad de las rehabilitaciones con implantes a largo plazo. Además, la cresta ósea a nivel del seno maxilar, en el maxilar atrófico, no suele permitir el anclaje de implantes de 10 mm. Se han propuesto varias técnicas para rehabilitar el sector posterior del maxilar atrófico: implantes cortos, extensiones protésicas, injerto sinusal, implante cigomático. El implante pterigoideo es otro de los posibles tratamientos para rehabilitar el sector posterior del maxilar atrófico. Anclado en el hueso cortical de la apófisis del esfenoides el implante pterigoideo evita la necesidad de injertar o utilizar extensiones protésicas. El objetivo de este artículo es analizar las indicaciones, la técnica, complicaciones y supervivencia del implante pterigoideo en el sector posterior del maxilar atrófico.The first and second molar are the teeth most commonly lost in the maxilla, mainly due to periodontal disease and excessive occlusal force. 1 Although partial edentulism of the posterior maxilla is common, implants are seldom placed distal to the premolars because failure rates in the posterior maxilla have historically been high. Poor volume and low density of bone are the worst conditions for long-term anchorage in the maxilla. 7 Moreover, bone under the maxillary sinus, in the atrophic maxilla, is usually insufficient to enable placement of 10 mm implants. Several techniques have been proposed to restore the atrophic posterior maxilla: short implants, prosthetic cantilevers, sinus bone graft, zigomatic fixtures. Pterygoid implants are

Agenesis of maxillary lateral incisors and associated dental anomalies.

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Garib, Daniela Gamba; Alencar, Bárbara Maria; Lauris, José Roberto Pereira; Baccetti, Tiziano

2010-06-01

The objectives of this study were to evaluate the prevalence of dental anomalies in patients with agenesis of maxillary lateral incisors and to compare the findings with the prevalence of these anomalies in the general population. A sample of 126 patients, aged 7 to 35 years, with agenesis of at least 1 maxillary lateral incisor was selected. Panoramic and periapical radiographs and dental casts were used to analyze other associated dental anomalies, including agenesis of other permanent teeth, ectopia of unerupted permanent teeth, microdontia of maxillary lateral incisors, and supernumerary teeth. The occurrence of these anomalies was compared with prevalence data previously reported for the general population. Statistical testing was performed with the chi-square test (P <0.05) and the odds ratio. Patients with maxillary lateral incisor agenesis had a significantly increased prevalence rate of permanent tooth agenesis (18.2%), excluding the third molars. The occurrence of third-molar agenesis in a subgroup aged 14 years or older (n = 76) was 35.5%. The frequencies of maxillary second premolar agenesis (10.3%), mandibular second premolar agenesis (7.9%), microdontia of maxillary lateral incisors (38.8%), and distoangulation of mandibular second premolars (3.9%) were significantly increased in our sample compared with the general population. In a subgroup of patients aged 10 years or older (n = 115), the prevalence of palatally displaced canines was elevated (5.2%). The prevalences of mesioangulation of mandibular second molars and supernumerary teeth were not higher in the sample. Permanent tooth agenesis, maxillary lateral incisor microdontia, palatally displaced canines, and distoangulation of mandibular second premolars are frequently associated with maxillary lateral incisor agenesis, providing additional evidence of a genetic interrelationship in the causes of these dental anomalies. 2010 American Association of Orthodontists. Published by Mosby, Inc. All

Retrospective radiographic study of marginal bone changes of 88 implants placed with split crest technique in the maxillary latero-posterior area

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S. Longoni

2016-04-01

Full Text Available Aim This article presents a retrospective study on the behavior of implants placed with split crest technique in lateroposterior maxillary class IV atrophy. Materials and Methods Subjects who underwent implant placement following split crest technique in the maxillary latero-posterior area were enrolled in the present retrospective study. After a mean period of 6.2 years of function implant survival and success rates were assessed. Moreover, radiographic examination was made on digital periapical radiographs and by means of a specific software. Bone level changes were measured as the difference between the peri-implants crestal bone level and the implants shoulder during the last patient’s visit recall examination. Results A total of 30 patients satisfied the inclusion criteria and were included in the study; the subjects were treated with 88 implants (64 transmucosal and 24 submerged. The observation period for all patients treated with split crest technique varied between 4 and 8 years (mean 6.2 years. The implants survival rate was 96.6% and the prostheses survival rate was 100%. Bone resorption ranged between 2.3 mm and 2.7 mm. Conclusion Implants inserted in conjunction with split crest technique seems to be a promising therapy with similar results as conventional implant surgery.

Esthetic outcome for maxillary anterior single implants assessed by different dental specialists.

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Al-Dosari, Abdullah; Al-Rowis, Ra'ed; Moslem, Feras; Alshehri, Fahad; Ballo, Ahmed M

2016-10-01

The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES ( P esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.

3D finite element analysis of immediate loading of single wide versus double implants for replacing mandibular molar

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Shrikar R Desai

2013-01-01

Full Text Available Purpose: The purpose of this finite element study was to compare the stresses, strains, and displacements of double versus single implant in immediate loading for replacing mandibular molar. Materials and Methods: Two 3D FEM (finite element method models were made to simulate implant designs. The first model used 5-mm-wide diameter implant to support a single molar crown. The second model used 3.75-3.75 double implant design. Anisotropic properties were assigned to bone model. Each model was analyzed with single force magnitude (100 N in vertical axis. Results: This FEM study suggested that micromotion can be controlled better for double implants compared to single wide-diameter implants. The Von Mises stress for double implant showed 74.44% stress reduction compared to that of 5-mm implant. The Von Mises elastic strain was reduced by 61% for double implant compared to 5-mm implant. Conclusion: Within the limitations of the study, when the mesiodistal space for artificial tooth is more than 12.5 mm, under immediate loading, the double implant support should be considered.

A three-dimensional finite element analysis of molar distalization with a palatal plate, pendulum, and headgear according to molar eruption stage

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Kang, Ju-Man; Park, Jae Hyun; Bayome, Mohamed; Oh, Moonbee; Park, Chong Ook; Mo, Sung-Seo

2016-01-01

Objective This study aimed to (1) evaluate the effects of maxillary second and third molar eruption status on the distalization of first molars with a modified palatal anchorage plate (MPAP), and (2) compare the results to the outcomes of the use of a pendulum and that of a headgear using three-dimensional finite element analysis. Methods Three eruption stages were established: an erupting second molar at the cervical one-third of the first molar root (Stage 1), a fully erupted second molar (Stage 2), and an erupting third molar at the cervical one-third of the second molar root (Stage 3). Retraction forces were applied via three anchorage appliance models: an MPAP with bracket and archwire, a bone-anchored pendulum appliance, and cervical-pull headgear. Results An MPAP showed greater root movement of the first molar than crown movement, and this was more noticeable in Stages 2 and 3. With the other devices, the first molar showed distal tipping. Transversely, the first molar had mesial-out rotation with headgear and mesial-in rotation with the other devices. Vertically, the first molar was intruded with an MPAP, and extruded with the other appliances. Conclusions The second molar eruption stage had an effect on molar distalization, but the third molar follicle had no effect. The application of an MPAP may be an effective treatment option for maxillary molar distalization. PMID:27668192

Maxillary arch rehabilitation using implant-supported computer-assisted design-computer-assisted manufacturing-milled titanium framework

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Tulika S Khanna

2017-01-01

Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

A case report of mucoid retention cyst in maxillary sinus

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Kim, Han Pyoung [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1973-11-15

The author have observed mucoid retention cyst in the right maxillary sinus of the patient, 41 year old woman, complained discharging of purulent exudate on the right maxillary molar area, and obtained the following conclusions; 1. The mucoid retention cyst in maxillary sinus casts a faint dome shaped shadow into the radiolucent image of maxillary sinus. 2. The mucoid retention cyst in maxillary sinus may occurred without the history of trauma. 3. Intraoral standard films are also valuable for the interpretation of the lesions in maxillary sinus but only extraoral roentgenograms.

Maxillary Overdentures Supported by Anteriorly or Posteriorly Placed Implants Opposed by a Natural Dentition in the Mandible : A 1-Year Prospective Case Series Study

NARCIS (Netherlands)

Slot, Jan; Raghoebar, Gerry M.; Vissink, Arjan; Meijer, Henny J. A.

Background: For maxillary overdenture therapy, treatment guidelines are missing. There is a need for longitudinal studies. Purpose: The purpose of this 1-year prospective case series study was to assess the treatment outcome of maxillary overdentures supported by six dental implants opposed by

Functional approach to a Class II patient with upper first molar impaction

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Giacomo D′Orlandi

2014-01-01

Full Text Available The lack of the left first molar maxillary and the left second molar maxillary, caused respectively by impaction and agenesis is a very rare case, which determines an important occlusal imbalance and asymmetrical mandible movement. A gnatologic and functional orthodontic approach were planned to improve the retrognathic mandible and the muscular activity using kinesiograph and electromyography.

Stresses generated by two zygomatic implant placement techniques associated with conventional inclined anterior implants

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Paulo H.T. Almeida

2018-06-01

Full Text Available Purpose: To make a comparative evaluation, by means of the finite element method, of the stress generated on supporting tissues and prosthetic system components, using zygomatic implants with the exteriorized and extramaxillary techniques, and different placement positions, associated either with inclined anterior implants, or those without inclination. Materials and methods: Eight (8 tridimensional models were created to represent the clinical situations being researched, using the dataset of scanned images of an edentulous model. The implants and prosthetic components were photographed on millimeter paper and inserted into Rhinoceros 3D modeling computer software. From the measurements made on the image, the virtual models were made. The application force was distributed on the occlusal surface of the working side of the left maxillary first molar, first and second premolars, and incisal regions of the central incisor, simulating the occlusal load during mastication, in a total of 150 N. Results: The extramaxillary technique presented considerable variation in increased tension on the prosthesis screws and bone tissue. In the exteriorized technique, the highest tension values occurred in the region of the ridge, and the lowest, on the zygomatic process; the absence of cantilever reduced the stress on bone tissue in almost all regions. Conclusion: The exteriorized technique was shown to be more favorable to the distribution of stresses on the micro-unit screws and bone tissue, with the model with zygomatic implant placed in the region of the first molar and inclined anterior implant presenting the best results. Keywords: Zygomatic implants, Atrophic maxilla, Finite element analysis, Cantilever, Inclined implant

Bimaxillary protrusion with an atrophic alveolar defect: orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.

Science.gov (United States)

Chiu, Grace S C; Chang, Chris H N; Roberts, W Eugene

2015-01-01

Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Comparison of second molar eruption patterns in patients with skeletal Class II and skeletal Class I malocclusions.

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Brin, Ilana; Camasuvi, Semin; Dali, Nasser; Aizenbud, Dror

2006-12-01

The eruptive positions of the second molars in Class I and Class II malocclusions were studied. Pretreatment records of 221 patients with a mean age of 11.3 years were evaluated. About 19% of them had skeletal Class I, 31% had skeletal maxillary Class II, and 50% had skeletal mandibular Class II malocclusions. The mean values of the dental and chronologic ages of the subjects were similar. The eruptive positions in relation to a reference line, the developmental stages of the patients' second molars and dental ages were recorded from the panoramic roentgenograms. The distribution of the various developmental stages in each malocclusion group was similar, and no association between skeletal malocclusion and dental developmental stage of the second molars was encountered. The eruptive position of the maxillary second molars was more occlusal only in the oldest maxillary Class II group, above 12 years of age (P = .02). These results support, in part, previous reports suggesting that the maxillary second molars may erupt earlier in patients with skeletal maxillary Class II malocclusions.

Complications and Clinical Considerations of the Implant-Retained Zirconia Complete-Arch Prosthesis with Various Opposing Dentitions.

Science.gov (United States)

Gonzalez, Jorge; Triplett, Robert G

To evaluate the performance of the implant-retained zirconia complete-arch prosthesis with various opposing dentitions. The 40 patients included in this retrospective case series study were treated with one or two implant-retained zirconia complete-arch prostheses (ZIRCAP) using the Zirkonzahn protocol. Prettau zirconia frames were created with strategic cutbacks in the structure to extend zirconia incisal coverage of the esthetic anterior sextants and complete monolithic zirconia in the molar areas; subsequent layers of porcelain were applied to nonfunctional and esthetic areas. Patients had three possible occlusal scenarios: (1) maxillary ZIRCAP and mandibular ZIRCAP, (2) maxillary ZIRCAP and mandibular natural dentition, and (3) maxillary ZIRCAP and mandibular conventional hybrid prosthesis. Complications were recorded during follow-up appointments 3, 6, and 12 months after definitive prosthesis delivery. The mean treatment observation period was 33 months. Eight prosthetic complications were noted for the 40 implant-retained zirconia complete-arch prostheses (18.18%), including six cases of minor porcelain chipping and two cases of debonding of the metal insert from the zirconia framework. Maxillary ZIRCAP opposing mandibular ZIRCAP and maxillary ZIRCAP opposing mandibular natural dentition occlusal scenarios presented the same complication ratio of 4. No complications were seen in the maxillary ZIRCAP opposing mandibular conventional hybrid prosthesis group, yet 16 complications were found as denture tooth fractures in 12 mandibular conventional hybrid prostheses (ratio of 0.75). The results indicate that the implant-retained zirconia complete-arch prosthesis offers acceptable performance for use as an alternative to the conventional titanium framework acrylic veneer prosthesis for complete edentulism with a lower incidence of prosthetic complications and fewer maintenance appointments. Chipping of veneering porcelain was the most common complication, but a

Radiographic evaluation of third molar development in 6 to 24 year olds

International Nuclear Information System (INIS)

Jung, Yun Hwa; Cho, Bong Hae

2014-01-01

This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females.

An implant periapical lesion associated with an endodontic-periodontic lesion of an adjacent molar

OpenAIRE

Chou, Ting-An; Chang, Yu-Liang; Yu, Ling-Min; Pan, Whei-Ling; Ju, Yuh-Ren; Chan, Chiu-Po

2010-01-01

Adjacent natural teeth with untreated pulpal or periodontal pathology may be a potential risk for implant infection. We report a rare case of an implant periapical lesion (IPL) possibly caused by direct extension of a periradicular lesion of an adjacent tooth. A 40-year-old female patient, who had previously received three implants on the edentulous areas of teeth 16, 36 and 46, had a recurrent infection over the lower left second molar area for 2 years. A periapical radiograph revealed incom...

Indian Board of Orthodontics case report: Orthodontic management of a Class II malocclusion in a growing patient with bilateral maxillary molar distalization

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Salil Sunil Nene

2016-01-01

Full Text Available C.S., a 12-year, 1-month-old male patient, presented with the chief complaint of highly placed canines and irregular teeth. On examination and analysis of relevant records, he was diagnosed as an Angle's Class II malocclusion on an underlying Class I skeletal base, severely crowded maxillary arch with high labially placed canines, mild crowding in mandibular arch, retroclined lower incisors, an impacted mesiodens with convex profile, and acute nasolabial angle. He was treated with a nonextraction treatment plan that involved bilateral maxillary molar distalization using Hilgers pendulum appliance followed by fixed mechanotherapy. The posttreatment results were highly satisfactory showing improvement in facial esthetics and occlusal traits as well as good long-term stability as was evident in the 2-year, 6-month retention photographs.

Root canal morphology of primary molars: a micro-computed tomography study.

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Fumes, A C; Sousa-Neto, M D; Leoni, G B; Versiani, M A; da Silva, L A B; da Silva, R A B; Consolaro, A

2014-10-01

This was to investigate the root canal morphology of primary molar teeth using micro-computed tomography. Primary maxillary (n = 20) and mandibular (n = 20) molars were scanned at a resolution of 16.7 μm and analysed regarding the number, location, volume, area, structured model index (SMI), area, roundness, diameters, and length of canals, as well as the thickness of dentine in the apical third. Data were statistically compared by using paired-sample t test, independent sample t test, and one-way analysis of variance with significance level set as 5%. Overall, no statistical differences were found between the canals with respect to length, SMI, dentine thickness, area, roundness, and diameter (p > 0.05). A double canal system was observed in the mesial and mesio-buccal roots of the mandibular and maxillary molars, respectively. The thickness in the internal aspect of the roots was lower than in the external aspect. Cross-sectional evaluation of the roots in the apical third showed flat-shaped canals in the mandibular molars and ribbon- and oval-shaped canals in the maxillary molars. External and internal anatomy of the primary first molars closely resemble the primary second molars. The reported data may help clinicians to obtain a thorough understanding of the morphological variations of root canals in primary molars to overcome problems related to shaping and cleaning procedures, allowing appropriate management strategies for root canal treatment.

A case report of incidental finding of fungus ball on CBCT of maxillary sinus in treatment planning of dental implant

International Nuclear Information System (INIS)

Lee, Byung Do

2010-01-01

This report was to show the radiographic appearances of the fungus ball in a paranasal sinus and to emphasize the scan area of cone beam computed tomography (CBCT) to detect the calcification in the paranasal sinus. A seventy four-year-old woman visited our department for the implant rehabilitation at both maxillary posterior edentulous region. Pre-operative radiographic examinations including the panoramic, CBCT, and multidector CT images were taken. An opacification in the right maxillary sinus was observed on the multiplanar image of CBCT, however the pre-determined scan area of CBCT in this report hardly showed the calcifications at the central portion of the maxillary sinus. The opacification in the maxillary sinus could be misdiagnosed as chronic maxillary sinusitis if the calcification of fungus ball was not simultaneously detected. The scan area of pre-operative CBCT needs to be enough to scan the paranasal sinus from top to bottom.

Terminal Posterior Tilted Implants Planned as a Sinus Graft Alternative for Fixed Full-Arch Implant-Supported Maxillary Restoration: A Case Series with 10- to 19-Year Results on 44 Consecutive Patients Presenting for Routine Maintenance.

Science.gov (United States)

Fortin, Yvan; Sullivan, Richard M

2017-02-01

Posterior maxillary tilted implants are gaining prevalence as an alternative to sinus grafts supporting fixed maxillary restorations. This paper reports long-term results after loading using this technique. Consecutive patients presenting for either routine hygiene maintenance or unplanned emergency care who had received tilted implants as a sinus graft alternative to support fixed fully implant-supported restoration of an edentulous maxilla and were followed for a minimum of 10 years from initial implant placement were included in this evaluation. Forty-four patients were identified: 40 with bilateral tilted implants and 4 with one tilted and one axial posterior implant. Eight patients received one-piece fixed porcelain-to-gold screw-retained restorations, and thirty-six patients received a fully implant-supported patient-removable Marius Bridge. Seventy-nine out of 84 originally loaded posterior tilted implants survived a minimum of 10 years loading; one tilted implant was lost at 10 years. Eight additional posterior implants were placed for either these lost tilted posterior implants or as proactive supplemental support; one of these replacement tilted implants survived for at least 10 years and is included in the data. All patients have maintained continuous fixed function throughout the follow-up period. Forty-one out of 44 patients continue with the original restoration, 33 without modification or removal of the fixed restoration or implant-connecting bar. One porcelain-to-gold and seven Marius Bridges had framework modifications to accommodate additional implants; 3 Marius Bridge restorations were replaced with a newer generation. Within the limits of this retrospective study, the results show that continuous fixed function of fully implant-supported maxillary restorations using posterior tilted implants in terminal positions of support as a sinus graft alternative combined with axial anterior implants is possible over a prolonged period. Loss of a posterior

Three dimensional analysis of impacted maxillary third molars: A cone-beam computed tomographic study of the position and depth of impaction

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De Andrade, Priscila Ferreira; Silva, Jesca Neftali Nogueira; Sotto-Maior, Bruno Sales; Devito, Karina Lopes; Assis, Neuza Maria Souza Picorelli [Faculty of Dentistry, Federal University of Juiz de Fora, Juiz de Fora (Brazil); Ribeiro, CleideGisele [Faculty of Medical and Health Sciences - SUPREMA, Juiz de Fora (Brazil)

2017-09-15

The classification of impacted maxillary third molars (IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffé post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal (n=222), vertical (n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.

Prevalence of missing and impacted third molars in adults aged 25 years and above

Energy Technology Data Exchange (ETDEWEB)

Jung, Yun Hoa; Cho, Bong Hae [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yansan (Korea, Republic of)

2013-12-15

The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health.

Prevalence of missing and impacted third molars in adults aged 25 years and above

International Nuclear Information System (INIS)

Jung, Yun Hoa; Cho, Bong Hae

2013-01-01

The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health.

CBVT analysis of canal configuration of the mesio-buccal root of maxillary first permanent molar teeth: An in vitro study.

Science.gov (United States)

Shenoi, R Pratima; Ghule, Hrishikesh M

2012-07-01

For successful endodontic treatment, it's imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a 'U' shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT) images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal) along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. Cone-Beam Volumetric Tomography (CBVT) evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3(rd), 29.16% in middle 3(rd) and 16.66% were in apical 3(rd). Within the limitations of this

CBVT analysis of canal configuration of the mesio-buccal root of maxillary first permanent molar teeth: An in vitro study

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R Pratima Shenoi

2012-01-01

Full Text Available Context: For successful endodontic treatment, it′s imperative to locate and obturate all root canals. As concluded by Ingle, the major cause for failure of root canal therapy is in ability to recognize all theexisting canals and subsequent failure in their obturation. Aim: To analyze the canal configuration of the mesio-buccal root of maxillary first permanent molar teeth. Materials and Methods: A total of 30 recently extracted human permanent maxillary first molars were collected and stored in a container with 5% Sodium Chloride solution for four days. Teeth with open apices, external resorption, improperly formed roots and teeth with previous restorations were excluded. Using the dental modeling wax, teeth were arranged in a ′U′ shaped arch with roots embedded inside the wax and occlusal surface remaining free. 10 teeth were arranged in each arch and three such sample plates were prepared. Flat surface of the base encasing enabled the plate to be mounted on flat plastic bite plate. With bite plate roughly centered in the focal trough area Axial, Coronal and Sagittal section Cone-Beam Computed Tomography (CBCT images were taken with Kodak 9000 Extra-oral Imaging System. Images displayed on a monitor were inspected by two endodontists using Kodak Dental Imaging Software 3D Module V2.2. Statistical Analysis: When the data was observed, it was found that 24 teeth out of total 30 teeth examined showed some variation (i.e. possible additional canal along the length of the mesio-buccal root canal. Out of these 24 teeth, 13 showed presence of additional canal at coronal third, 7 showed presence of additional canal at middle third and four showed presence of additional canal in apical third level. Percentage analysis was done as there was no group comparison to be done. Results: Cone-Beam Volumetric Tomography (CBVT evaluation positively identified the variations in mesio-buccal canal in 80% of samples. Out of these, 54.16% were in coronal 3 rd

Radiographic evaluation of third molar development in 6- to 24-year-olds

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Jung, Yun-Hoa

2014-01-01

Purpose This study investigated the developmental stages of third molars in relation to chronological age and compared third molar development according to location and gender. Materials and Methods A retrospective analysis of panoramic radiographs of 2490 patients aged between 6 and 24 years was conducted, and the developmental stages of the third molars were evaluated using the modified Demirjian's classification. The mean age, standard deviation, minimal and maximal age, and percentile distributions were recorded for each stage of development. A Mann-Whitney U test was performed to test the developmental differences in the third molars between the maxillary and mandibular arches and between genders. A linear regression analysis was used for assessing the correlation between the third molar development and chronological age. Results The developmental stages of the third molars were more advanced in the maxillary arch than the mandibular arch. Males reached the developmental stages earlier than females. The average age of the initial mineralization of the third molars was 8.57 years, and the average age at apex closure was 21.96 years. The mean age of crown completion was 14.52 and 15.04 years for the maxillary and the mandibular third molars, respectively. Conclusion The developmental stages of the third molars clearly showed a strong correlation with age. The third molars developed earlier in the upper arch than the lower arch; further, they developed earlier in males than in females. PMID:25279338

Maxillary sinus by-pass with tilted implants via tapered-screw bone expanders in low density bone: one year follow -up of a case series.

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Andreasi Bassi, M; Andrisani, C; Lopez, M A; Gaudio, R M; Lombardo, L; Lauritano, D

2016-01-01

In the present paper the use of tapered-screw bone expanders (TSBEs) is proposed, in combination with the placement of tilted implants in close proximity to the anterior sinus wall, solving the problem of the reduced height of the alveolar bone in the sub-antral area. The Authors named the procedure: Tilted Implant Expansion Osteotomy (TIEO). Fifteen patients (10 females and 5 males, mean age 47.8±8.15 years) with distal edentulous maxillae were enrolled in this study. For each edentulous site 2 implants were placed, the anterior implant in the area of the most anterior missing tooth while, the posterior implant, immediately in front of the maxillary sinus, with an inclined position. Adopting the aforesaid procedure, 34 cylindrical two-piece implants were placed, 17 of which were placed in tilted position, in order to by-pass the maxillary sinus. After a healing period of 4-6 months, the second stage surgery was performed. The cases were finalized by metal-ceramic cementable restorations with a variable number of elements, from 2 to 4, without any cantilever element. The post finalization follow-up was at 12 months. Survival rate was 100% since no fixtures were lost. At the one-year follow-up the clinical and radiological appearance of the soft and hard tissues was optimal and no pathological signs were recorded. TIEO is a promising surgical procedure for oral rehabilitation of maxillary edentulous sites and represents a therapeutic alternative to sinus lift techniques.

Implantation of the maxillary antrum for delivery of iridium brachytherapy and microwave induced hyperthermia

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Coughlin, C.T.; Wong, T.Z.; Geurkink, N.

1985-01-01

A 63 year-old male was referred tp Dartmouth in March 1984 for a locally advanced recurrent squamous cell carcinoma of the left maxillary antrum. This had been initially diagnosed in January 1983 by a Caldwell-Luc procedure and had failed partial resection, external radiation therapy, and multiagent chemotherapy. Our initial evaluation revealed disease replacing the left maxillary antrum, extending into the pterygomaxillary fossa, the lateral aspect of the superior alveloar ridge, and into the soft palate. He was taken to the operating room and under general anesthesia was implanted the 7 catheters through this tumor volume. Two days later a therapeutic (>42 0 C for 1 hour) hyperthermia treatment was administered followed by iridium placement. A second heating was performed upon removal of the iridium and was accomplished without major side effects. Thermometry data and follow-up are presented

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA.

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Qamheya, Ala Hassan A; Yeniyol, Sinem; Arısan, Volkan

2015-01-01

Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC) material in teeth construction to rehabilitate a complete denture wearer patient.

Prevalence of missing and impacted third molars in adults aged 25 years and above

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Jung, Yun-Hoa

2013-01-01

Purpose The purpose of this study was to determine the prevalence of missing and impacted third molars in people aged 25 years and above. Materials and Methods The study sample of 3,799 patients was chosen randomly from patients who visited Pusan National University Dental Hospital and had panoramic radiographs taken. The data collected included presence and impaction state, angulation, and depth of impaction of third molars, and radiographically detected lesions of third molars and adjacent second molars. Results A greater percentage of men than women retained at least one third molar. The incidence of third molars decreased with increasing age. The incidence of partially impacted third molars greatly declined after the age of 30. Vertically impacted maxillary third molars and horizontally impacted mandibular third molars were most frequent in all age groups. Among the maxillary third molars, those impacted below the cervical line of the second molar were most frequent in all age groups, and among the mandibular third molars, deeply impacted third molars were most frequent in those aged over 40. Dental caries was the most common radiographic lesion of the third molars. Mesioangularly impacted third molars showed radiographic lesions in 13 (9.5%) adjacent maxillary second molars and 117 (27.4%) mandibular second molars. Conclusion The number of remaining third molars decreased and the percentage of Class C depth increased with age. Caries was the most frequent lesion in third molars. Partially impacted mesioangular third molars showed a high incidence of caries or periodontal bone loss of the adjacent second molar. Regular oral examination will be essential to keep asymptomatic third molars in good health. PMID:24380060

Accuracy of implant impressions without impression copings: a three-dimensional analysis.

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Kwon, Joo-Hyun; Son, Yong-Ha; Han, Chong-Hyun; Kim, Sunjai

2011-06-01

Implant impressions without impression copings can be used for cement-retained implant restorations. A comparison of the accuracy of implant impressions with and without impression copings is needed. The purpose of this study was to evaluate and compare the dimensional accuracy of implant definitive casts that are fabricated by implant impressions with and without impression copings. An acrylic resin maxillary model was fabricated, and 3 implant replicas were secured in the right second premolar, first, and second molars. Two impression techniques were used to fabricate definitive casts (n=10). For the coping group (Group C), open tray impression copings were used for the final impressions. For the no-coping group (Group NC), cementable abutments were connected to the implant replicas, and final impressions were made assuming the abutments were prepared teeth. Computerized calculation of the centroids and long axes of the implant or stone abutment replicas was performed. The Mann-Whitney U test analyzed the amount of linear and rotational distortion between groups (α =.05). At the first molar site, Group NC showed significantly greater linear distortion along the Y-axis, with a small difference between the groups (Group C, 7.8 ± 7.4 μm; Group NC, 19.5 ± 12.2). At the second molar site, increased distortion was noted in Group NC for every linear and rotational variable, except for linear distortion along the Z-axis. Implant impression with open tray impression copings produced more accurate definitive casts than those fabricated without impression copings, especially those with greater inter-abutment distance. Copyright © 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Quantitation of maxillary remodeling. 2. Masking of remodeling effects when an "anatomical" method of superimposition is used in the absence of metallic implants.

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Baumrind, S; Korn, E L; Ben-Bassat, Y; West, E E

1987-06-01

We report the results of a study aimed at quantifying the differences in the perceived pattern of maxillary remodeling that are observed when different methods are used to superimpose maxillary images in roentgenographic cephalometrics. In a previous article, we reported cumulative changes in the positions of anterior nasal spine (ANS), posterior nasal spine (PNS), and Point A for a sample of 31 subjects with maxillary metallic implants. Measurements had been made on lateral cephalograms taken at annual intervals relative to superimposition on the implants. In the present article, we quantify the differences in the perceived displacement of the same landmarks in the same sample when a standard "anatomical best bit" rule was used in lieu of superimposition on the implants. The anatomical best fit superimposition as herein defined was found in this sample to lose important information on the downward remodeling of the superior surface of the maxilla that had been detected when the implant superimposition was used. In fact, we observed a small artifactual upward displacement of the ANS-PNS line. In the anteroposterior direction, the tendency toward backward displacement of skeletal landmarks through time that had been detected with the implant superimposition was replaced by a small forward displacement of ANS and Point A together with reduced backward displacement of PNS. To the extent that the implant superimposition is to be considered the true and correct one, the anatomical best fit superimposition appears to understate the true downward remodeling of the palate by an average of about 0.3 and 0.4 mm per year, although this value differs at different ages and timepoints. The anatomical best fit superimposition also misses entirely the small mean tendency toward backward remodeling that was observed when the implant superimposition was used. In situations in which there are no implants, clinicians and research workers must necessarily continue to use anatomically

Dual odontogenic origins develop at the early stage of rat maxillary incisor development.

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Kriangkrai, Rungarun; Iseki, Sachiko; Eto, Kazuhiro; Chareonvit, Suconta

2006-03-01

Developmental process of rat maxillary incisor has been studied through histological analysis and investigation of tooth-related gene expression patterns at initial tooth development. The tooth-related genes studied here are fibroblast growth factor-8 (Fgf-8), pituitary homeobox gene-2 (Pitx-2), sonic hedgehog (Shh), muscle segment homeobox-1 (Msx-1), paired box-9 (Pax-9) and bone morphogenetic protein-4 (Bmp-4). The genes are expressed in oral epithelium and/or ectomesenchyme at the stage of epithelial thickening to the early bud stage of tooth development. Both the histological observation and tooth-related gene expression patterns during early stage of maxillary incisor development demonstrate that dual odontogenic origins aligned medio-laterally in the medial nasal process develop, subsequently only single functional maxillary incisor dental placode forms. The cascade of tooth-related gene expression patterns in rat maxillary incisor studied here is quite similar to those of the previous studies in mouse mandibular molar, even though the origins of oral epithelium and ectomesenchyme involved in development of maxillary incisor and mandibular molar are different. Thus, we conclude that maxillary incisor and mandibular molar share a similar signaling control of Fgf-8, Pitx-2, Shh, Msx-1, Pax-9 and Bmp-4 genes at the stage of oral epithelial thickening to the early bud stage of tooth development.

Full Mouth Oral Rehabilitation by Maxillary Implant Supported Hybrid Denture Employing a Fiber Reinforced Material Instead of Conventional PMMA

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Ala Hassan A. Qamheya

2015-01-01

Full Text Available Many people have life-long problems with their dentures, such as difficulties with speaking and eating, loose denture, and sore mouth syndrome. The evolution of dental implant supported prosthesis gives these patients normal healthy life for their functional and esthetic advantages. This case report presents the fabrication of maxillary implant supported hybrid prosthesis by using Nanofilled Composite (NFC material in teeth construction to rehabilitate a complete denture wearer patient.

Detection of Second Mesiobuccal Canals in Maxillary First Molars Using a New Angle of Cone Beam Computed Tomography.

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Aktan, Ali Murat; Yildirim, Cihan; Culha, Emre; Demir, Erhan; Ertugrul Ciftci, Mehmet

2016-10-01

The localization of the additional canal orifice is one of the primary factors influencing the success of endodontic treatment. To deal with this problem, several techniques that each have their own advantages and disadvantages have been discussed in the literature. The aim of the present in vitro study was to review a new approach to localizing second mesiobuccal (MB2) canals in maxillary first molars using cone beam computed tomography (CBCT). The CBCT scans of 296 patients who were referred to the department of dentomaxillofacial radiology were included in the study. The presence of MB2 canals, the angle formed by the mesiobuccal, distobuccal, and palatal root canal orifices (∠MDP), and the angle formed by the mesiobuccal, distobuccal, and MB2 canal orifices (∠MDMB2) were evaluated on the axial section. Pearson correlation and multiple linear regression methods were used for all predictions. All of the analyses were performed using SPSS for windows version 22.0. A two-sided P value values, it was shown that the ∠MDMB2 increased by 0.420 degrees when the ∠MDP increased by 1 degree. If the ∠MDP was greater than 90.95 degrees, there was a 78% probability that MB2 canals could be found. The determination of the presence of MB2 in the maxillary first molars may be carried out using CBCT scans. If the ∠MDP was 91 degrees or greater, there was considered to be a higher probability that MB2 canals would be found in the endodontic cavity. Due to the positive correlation between the ∠MDP and the ∠MDMB2, the localization of MB2 canals may be easily performed in relation to the main MB canal.

Temporal abscess after third molar extraction in the mandible.

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de Oliveira Neto, Patrício José; de Souza Maliska, Maximiana Cristina; Sawazaki, Renato; Asprino, Luciana; de Moraes, Márcio; Moreira, Roger William Fernandes

2012-03-01

Dental infections resulting before or after third molar removal are complications in which the maxillofacial surgeon may have to initiate an earlier management. The severe dental infections resulting before or after this procedure is one of the few life-threatening complications in which the maxillofacial surgeon may have to initiate an earlier management. Infections involving the temporal space are rare and infrequently reported. Infections in this space have also been observed secondary to maxillary sinusitis, maxillary sinus fracture, temporomandibular arthroscopy, and drug injection, although more commonly associated to third molar infections. A 22-year-old man had undergone extraction of tooth 38 secondary to pericoronaritis by a general dentist. Physical examination of his face demonstrated severe trismus, pain, and swelling in temporal region. A CT scan showed an inflammatory area into the temporal space. He was started on IV cephalosporin, but the clinical course of the patient was not satisfactory. Incision and drainage were performed from an extraoral and intraoral approach. After discharged, the antibiotic was switched to clindamycin IO 600 mg. The retromaxillary and temporal infections are quite common after maxillary molar extractions but not after mandibular third molar, the spread mechanism of ascension must be involved with the virulence of microorganisms, but more studies are necessary to clarify this occurrence.

Therapeutic interaction of systemically-administered mesenchymal stem cells with peri-implant mucosa.

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Ryosuke Kondo

Full Text Available OBJECTIVES: The objective of this study was to investigate the effect of systemically transplanted mesenchymal stem cells (MSCs on the peri-implant epithelial sealing around dental implants. MATERIALS AND METHODS: MSCs were isolated from bone marrow of donor rats and expanded in culture. After recipient rats received experimental titanium dental implants in the bone sockets after extraction of maxillary right first molars, donor rat MSCs were intravenously transplanted into the recipient rats. RESULTS: The injected MSCs were found in the oral mucosa surrounding the dental implants at 24 hours post-transplantation. MSC transplantation accelerated the formation of the peri-implant epithelium (PIE-mediated mucosa sealing around the implants at an early stage after implantation. Subsequently, enhanced deposition of laminin-332 was found along the PIE-implant interface at 4 weeks after the replacement. We also observed enhanced attachment and proliferation of oral mucous epithelial cells. CONCLUSION: Systemically transplanted MSCs might play a critical role in reinforcing the epithelial sealing around dental implants.

[Delayed wound healing post molar extraction].

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Schepers, R H; De Visscher, J G A M

2009-02-01

One month post extraction of the second left maxillary molar the alveolar extraction site showed no signs of healing and was painful. The patient had been using an oral bisphosphonate during 3 years. Therefore, the lesion was diagnosed as bisphosphonate-induced maxillary osteonecrosis. Treatment was conservative. Since one month later the pain had increased and the wound healing had decreased, a biopsy was carried out. Histopathologic examination revealed a non-Hodgkin lymphoma.

Tercer molar ectópico a nivel de región infraorbitaria-seno maxilar Ectopic third molar of the maxillary sinus-infraorbital region

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C. Moreno García

2007-06-01

Full Text Available Introducción. Los cordales ectópicos son aquellos incluidos en posiciones inusuales o desplazados a distancia de su normal localización anatómica. La erupción ectópica de un diente dentro de la cavidad oral es común pero en otros lugares es raro. La erupción ectópica puede ir asociada con alteraciones en el desarrollo, procesos patológicos o yatrogenia. Caso Clínico. Mujer de 56 años de edad con tercer molar superior derecho ectópico a nivel de región infraorbitaria-seno maxilar. Presentaba dolor e inflamación hemifacial derecha de larga evolución y resistente a tratamiento médico. Se realizó exéresis quirúrgica de dicho cordal mediante abordaje de Caldwell-Luc. Discusión. En muchos casos la etiología de un cordal ectópico no puede ser identificada. La mayor parte de las veces son asintomáticos y diagnosticados mediante estudios radiológicos. Conclusión. La indicación de la exodoncia en el caso de un diente ectópico en general viene determinada por la presencia de sintomatología o en prevención de futuras complicaciones.Introduction. Ectopic third molar teeth are those that are impacted in unusual positions, or that have been displaced and are at a distance from their normal anatomic location. Ectopic eruption of a tooth within the oral cavity is common, but rare in other sites. Ectopic eruption can be associated with developmental disturbances, pathologic processes or iatrogenic activity. Case Report. Female, fifty-six years old, with an upper right ectopic third molar located in the maxillary sinus-infraorbital region. She presented with pain and inflammation of the right side of her face that she had been experiencing for along time and which had been resistant to treatment. Surgical excision was carried out of the third molar tooth using the Caldwell-Luc approach. Discussion. In many cases the etiology of ectopic third molars cannot be identified. Generally they are asymptomatic and diagnosed by radiology

Exophthalmos associated to orbital zygomatic mucocele and complex maxillary malformation in a puppy

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Alessandro Cirla

2017-08-01

Full Text Available A case of exophthalmos due to zygomatic mucocele in a puppy with ipsilateral segmental maxillary atrophy is reported. A 7-month-old, mixed breed, male dog suffered the sudden-onset of unilateral painful exophthalmos and a gradual swelling of the right temporal region. A compressing, right retrobulbar mass was observed by ultrasound. Computed tomography revealed a large multiloculated cyst-like lesion of the right zygomatic gland projecting into the orbital space, thus displacing the eyeball. The ipsilateral molar part of the maxillary bone was underdeveloped, besides showing crowded, abnormal, multiple, unerupted maxillary molar teeth in the caudal maxillary region. Modified lateral orbitotomy and a selective caudal maxillary bone access were performed. The cyst-like lesion was removed and the zygomatic gland and the wall was collected for histology, which confirmed the mucocele. Clinical and imaging examinations six months after surgery showed neither recurrence of the mucocele nor ocular abnormalities. A possible common pathogenic mechanism involving these two conditions could be hypothesized.

Early treatment of an ectopic premolar to prevent molar-premolar transposition.

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Cannavale, Rosangela; Matarese, Giovanni; Isola, Gaetano; Grassia, Vincenzo; Perillo, Letizia

2013-04-01

Orthodontic treatment is planned on an individual, case-by-case basis after thoroughly considering the patient's overall facial and dental characteristics, the expected duration of treatment, costs, patient preferences, and the orthodontist's experience. This article reports the treatment of a patient with a maxillary premolar-molar transposition in the permanent dentition that was successfully managed with orthodontic treatment. A girl, aged 10 years 2 months, came for treatment with an ectopic maxillary left premolar. Radiographic analysis indicated a developing complete transposition of the maxillary left premolar. The patient was treated with extraction of the deciduous molar and surgical exposure and ligation of the premolar. Eruption was properly guided, and the correct order of the 2 teeth was restored in the arch. This challenging treatment approach is described in detail, including the mechanics used to align the ectopic premolar. Early treatment can, in many cases, prevent a molar-premolar transposition. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Maxillary molar derotation and distalization by using a nickel-titanium wire fabricated on a setup model.

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Jung, Jong Moon; Wi, Young Joo; Koo, Hyun Mo; Kim, Min Ji; Chun, Youn Sic

2017-07-01

The purpose of this article is to introduce a simple appliance that uses a setup model and a nickel-titanium (Ni-Ti) wire for correcting the mesial rotation and drift of the permanent maxillary first molar. The technique involves bonding a Ni-Ti wire to the proper position of the target tooth on a setup model, followed by the fabrication of the transfer cap for indirect bonding and its transfer to the patient's teeth. This appliance causes less discomfort and provides better oral hygiene for the patients than do conventional appliances such as the bracket, pendulum, and distal jet. The treatment time is also shorter with the new appliance than with full-fixed appliances. Moreover, the applicability of the new appliance can be expanded to many cases by using screws or splinting with adjacent teeth to improve anchorage.

Epidemiological Status of Third Molars in an Iranian Population

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Mahnaz Sheikhi

2016-07-01

Full Text Available Background Impaction of third molars is a common phenomenon. The incidence of impacted third molars varies in different populations. Objectives The aim of this study is to assess radiographic status (root development degree, angulation, and eruption level of the third molar in Iranian population via panoramic radiographs. Patients and Methods 647 patients, ranging in age from 17 - 25, were selected from three regions of Iran. Based on their panoramic radiographs, their root development degree, angulation, and eruption levels were analyzed. Results The angulation of upper third molars were vertical (44.6%, distoangular (44.1%, mesioangular (10.7%, and horizontal (0.6%. For lower third molars, the angulation was mesioangular (44.5%, vertical (33.8%, distoangular (12.2%, and horizontal (9.5%. The eruption levels of maxillary third molars were C > A> B, and for mandibular third molars they were A > B> C. The order of root development prevalence of the maxillary and mandibular third molars was complete > 2/3 > 1/3. Conclusions The most common status of impaction of the third molars in the maxilla was vertical angulation, level C of eruption, and complete root formation. In the mandible it was mesioangular, level A of eruption, and complete root formation. Since the study sample consists of patients from the north, middle, and south of Iran, the sample can represent the whole population of Iran.

Immediate provisional restoration of an implant placed in a fresh primary maxillary canine extraction socket: a case report.

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Turkyilmaz, Ilser; Shapiro, Vladimir

2011-01-01

This study describes a clinical case in which a primary maxillary canine with both mobility and root resorption was replaced with an immediately restored dental implant placed into the fresh extraction socket. The implant achieved high primary stability, as determined by resonance frequency analysis, and it was immediately restored with a provisional acrylic resin crown with no centric occlusion. An all-ceramic permanent crown replaced the provisonal crown four months after implant surgery. The implant was stable and no periapical radiolucencies, bleeding on probing, or pathologic probing depth were recorded after one year. The peri-implant soft tissue level appeared stable, and the interdental papillae were preserved, contributing to an optimum final esthetic result. This case supports the use of single implants for the replacement of extracted primary teeth, especially in areas where esthetics is a high priority. The immediate provisional crown maintained soft tissue contours and papillary height.

Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

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Xing Zhou Qu

Full Text Available OBJECTIVES: This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy. METHODS: Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis. RESULTS: The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N. CONCLUSION: Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

Efficacy of single buccal infiltrations for maxillary first molars in patients with irreversible pulpitis: a randomized controlled clinical trial.

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Atasoy Ulusoy, Ö İ; Alaçam, T

2014-03-01

To evaluate the efficacy of a single buccal infitration using 4% articaine hydrochloride (HCl) with 1 : 100,000 epinephrine or 4% articaine HCl with 1 : 100 000 epinephrine bitartrate for obtaining adequate pulpal anaesthesia in the palatal roots of maxillary first molars associated with irreversible pulpitis. In this single-blind randomized clinical trial, fifty subjects were randomly allocated to receive maxillary buccal injections of 1.5 mL 4% articaine with 1 : 100,000 epinephrine (n = 25) or 1.5 mL 4% articaine with 1 : 100,000 epinephrine bitartrate (n = 25). Visual analogue scale (VAS) scores and pulse rate measurements were recorded during access cavity preparation and initial file placement into the mesiobuccal, distobuccal and palatal canals. Data were analysed using Duncan and t-tests. There was no significant difference between the two anaesthetic solutions regarding the VAS scores and pulse rate measurements during endodontic procedures. The mean VAS ratings of the 50 patients during file placement into the palatal canals were significantly higher compared with the other three root canal procedures (P pulpitis. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Randomized clinical trial comparing control of maxillary anchorage with 2 retraction techniques.

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Xu, Tian-Min; Zhang, Xiaoyun; Oh, Hee Soo; Boyd, Robert L; Korn, Edward L; Baumrind, Sheldon

2010-11-01

The objective of this pilot randomized clinical trial was to investigate the relative effectiveness of anchorage conservation of en-masse and 2-step retraction techniques during maximum anchorage treatment in patients with Angle Class I and Class II malocclusions. Sixty-four growing subjects (25 boys, 39 girls; 10.2-15.9 years old) who required maximum anchorage were randomized to 2 treatment techniques: en-masse retraction (n = 32) and 2-step retraction (n = 32); the groups were stratified by sex and starting age. Each patient was treated by a full-time clinic instructor experienced in the use of both retraction techniques at the orthodontic clinic of Peking University School of Stomatology in China. All patients used headgear, and most had transpalatal appliances. Lateral cephalograms taken before treatment and at the end of treatment were used to evaluate treatment-associated changes. Differences in maxillary molar mesial displacement and maxillary incisor retraction were measured with the before and after treatment tracings superimposed on the anatomic best fit of the palatal structures. Differences in mesial displacement of the maxillary first molar were compared between the 2 treatment techniques, between sexes, and between different starting-age groups. Average mesial displacement of the maxillary first molar was slightly less in the en-masse group than in the 2-step group (mean, -0.36 mm; 95% CI, -1.42 to 0.71 mm). The average mesial displacement of the maxillary first molar for both treatment groups pooled (n = 63, because 1 patient was lost to follow-up) was 4.3 ± 2.1 mm (mean ± standard deviation). Boys had significantly more mesial displacement than girls (mean difference, 1.3 mm; P <0.03). Younger adolescents had significantly more mesial displacement than older adolescents (mean difference, 1.3 mm; P <0.02). Average mesial displacement of the maxillary first molar with 2-step retraction was slightly greater than that for en-masse retraction, but the

Dental caries area of rat molar expanded by cigarette smoke exposure.

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Fujinami, Y; Nakano, K; Ueda, O; Ara, T; Hattori, T; Kawakami, T; Wang, P-L

2011-01-01

Passive smoking is the involuntary inhalation of cigarette smoke (CS) and has an adverse impact on oral health. We examined the effect of CS exposure on caries risk and experimental dental caries. Experimental dental caries was induced in rat maxillary molars which were inoculated orally with Streptococcus mutans MT8148 and maintained on a cariogenic diet (diet 2000) and high sucrose water during the experimental period. CS-exposed rats were intermittently housed in an animal chamber with whole-body exposure to CS until killed. Whole saliva was collected before CS exposure (day 0) and for 30 days after the start of CS exposure. Saliva secretion was stimulated by administration of isoproterenol and pilocarpine after anesthesia. Maxillary molars were harvested on day 31. The increase in body weight of the CS-exposed rats was less than that of the control rats. Salivary flow rate, concentration of S. mutans in the stimulated saliva and caries activity score did not significantly differ between 0 and 30 days after the start of CS exposure. Histological examination of the caries-affected area on maxillary molars 30 days after CS exposure showed expansion compared to control rats. In the electron probe microanalysis, no differences were observed between the mineral components of the CS-exposed teeth and the control teeth. These results suggest that CS exposure expands the caries-affected area in the maxillary molars of the rat. Copyright © 2011 S. Karger AG, Basel.

Eruption time of permanent first molars and incisors among female primary school children of riyadh

International Nuclear Information System (INIS)

Chohan, A.N.

2007-01-01

To determine the mean eruption time of permanent first molars, central and lateral incisors and to compare the relationship of mean eruption time with body mass index (BMI) in Saudi female primary school children from Riyadh, Saudi Arabia. The mean age of children was 89.3 (SD 9.6) months ranging from 71 months to 109 months. The maxillary right first molar had the lowest mean eruption time of 77.4 (SD 3.9) months and the maxillary right lateral incisor was the last tooth to erupt with eruption time of 98.4 (SD 6.5) months. Furthermore, the mandibular incisors erupted significantly earlier than maxillary incisors. By the age of 100 months, 97% of the girls had all their first permanent molars erupted. There was no significant correlation observed between eruption times with BMI of the studied teeth except the maxillary right lateral incisor. However, an inverse relationship may exist between the eruption times and BMI. The Saudi female primary school children showed later eruption time of permanent first molars, central and lateral incisors when compared with the reported results of other national studies. Key words: Eruption time, permanent teeth, Saudi Arabia, female children. (author)

Managing the severely proclined maxillary anteriors by extracting traumatized right maxillary central incisor

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Mahesh Jain

2014-01-01

Full Text Available A 14-year-old girl reported with severely proclined maxillary anterior teeth with fractured and discolored right maxillary central incisor with questionable prognosis. Autotransplantation of premolar to replace central incisor was considered a risky option as patient was 14-year-old with presence of advanced root development of premolar. The immediate placement of the prosthetic implant was also not possible because of patient′s age. Therefore, it was decided to use the space obtained by extracting questionable maxillary right central incisor for orthodontic purpose and also sacrificing the healthy premolar is invariably an excessive biological cost for a modest functional and aesthetic gain. Hence, the treatment plan for this case includes extraction of right maxillary central incisor and left maxillary first premolar, movement of right maxillary lateral incisor mesially, achieving normal axial inclination of maxillary anteriors with normal overjet and overbite. Mandibular arch was treated nonextraction due to congenitally missing central incisors with presence of normally inclined lower anteriors thereby maintaining Angles class I occlusion. Tipping, usually, seen in Begg mechanotherapy was used for our advantage to correct severely proclined maxillary anteriors with simultaneous bite opening mechanics. Case was completed in 19 months and posttreatment records including photographs, radiographs and study models were made. Begg wrap around the retainer was placed in the maxillary arch allowing natural settling of occlusion.

Evaluation of Stress Distribution of Mini Dental Implant-Supported Overdentures in Complete Cleft Palate Models: A Three-Dimensional Finite Element Analysis Study.

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Soğancı, Gökçe; Yazıcıoğlu, Hüseyin

2016-01-01

Mini dental implants could be an alternative treatment method for prosthetic treatment of edentulous cleft palate. The aim of this study was to analyze stress distribution around the cortical bone and different plans using a varied number of mini dental implants in edentulous unilateral complete cleft palates. Three edentulous maxillary models were modified to create unilateral complete cleft palates. Mini dental implants (2.4 × 15 mm) were located as two mini implants at the premolar region, four mini implants at the premolar and molar region, and six mini implants at the first premolar, second premolar, and first molar regions in the models, respectively. Mucosa, o-ring/ball attachments, and overdentures were simulated. Vertical and horizontal loads of 100 N were applied on both the right and left molar teeth of the overdenture for each model. Maximum and minimum principal stress values and the distribution at cortical bone around the implants and cleft palates were evaluated by finite element analysis. Stress values under vertical loads were lower than values under horizontal loadings for all models. Stress values were found to be lower in the first model than in the second and third models. The highest stress values were found around implants in the second model. The unilateral feature of a complete cleft pattern affected the stress distribution. Stresses occured mostly around implants when the overdenture was supported by six implants; however, the stress distribution around implants was low with two implants because of tissue support.

Strain characteristics of Marburg double crown-retained implant overdentures compared with bar and ball-retained implant overdentures, with and without a rigid major connector.

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Kazokoğlu, F Şehnaz; Akaltan, Funda

2014-12-01

It is hard to identify the most favorable retainer type and the denture design when considering strain levels around implants and in edentulous ridges for implant overdentures (IOVD). The purpose of this study was to evaluate the strain transmitted to the implants and edentulous ridges by Marburg double crown (MDC)-retained IOVD as opposed to bar and ball-retained IOVD and the efficiency of a rigid major connector in the maxilla. An in vitro maxillary model was prepared with 4 implants, with strain gauges placed distally to each implant and also in the anterior and posterior edentulous ridges. Five overdentures were fabricated for each MDC and each ball and bar attachment retainers. Vertical loads of 280 N were applied bilaterally on the first molar region. Then the palatal bars of each IOVD were disconnected, and loading procedures were repeated for the prostheses. No significant difference was observed among the MDC and the bar and ball-retained IOVD, with and without a rigid bar according to the data taken from both the implants and edentulous ridges. However, when the strain values attained from each strain gauge separately were considered, a slight difference was observed around the implants of ball-retained overdentures and in the edentulous ridges of MDC-retained overdentures. Within the limitations of this in vitro study, MDC-retained maxillary overdentures with 4 parallel and symmetrically placed implants can be used safely without a rigid major connector as with bar and ball-retained IOVD with regard to the strains generated in the edentulous ridge and around implants. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Age estimation using development of third molars in South Indian population: A radiological study.

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Priyadharshini, K Indra; Idiculla, Jose Joy; Sivapathasundaram, B; Mohanbabu, V; Augustine, Dominic; Patil, Shankargouda

2015-05-01

To assess the estimation of chronological age based on the stages of third molar development following the eight stages (A-H) method of Demirjian et al. in Chennai population of South India. A sample consisting of 848 individuals (471 males and 377 females) aged between 14 and 30 years was randomly selected for the clinical evaluation and 323 orthopantomograms with clinically missing third molars were taken for radiological evaluation using Demirjian's method from a Chennai population of known chronological age and sex. Statistical analysis was performed using Pearson's Chi-square test and mean values were compared between the study groups using t-test or analysis of variance (ANOVA) followed by Tukey's highly significant difference (HSD). In the present study, P age of having clinically completely erupted maxillary third molars was 22.41 years in male subjects and 23.81 years in female subjects and that of mandibular third molars was 21.49 years in male subjects and 23.34 years in female subjects. Mandibular third molars were clinically missing more often in females than in males. Eruption of mandibular third molars was generally ahead of the emergence of maxillary third molars into the oral cavity. Third molar development between male and female subjects showed statistically significant differences at calcification stage F and stage G in maxillary third molars and stage F in mandibular third molars (P third molar eruption reached Demirjian's formation stages earlier in males than in females. It is suggested that in future studies, to increase the accuracy of age determination, indications of sexual maturity and ossification should also be evaluated in addition to third molar mineralization.

Surgically assisted rapid maxillary expansion in adults.

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Pogrel, M A; Kaban, L B; Vargervik, K; Baumrind, S

1992-01-01

Twelve adults with maxillary width discrepancy of greater than 5 mm were treated by surgically assisted rapid maxillary expansion. The procedure consisted of bilateral zygomatic buttress and midpalatal osteotomies combined with the use of a tooth-borne orthopedic device postoperatively. Mean palatal expansion of 7.5 mm (range of 6 to 13 mm), measured in the first molar region, was achieved within 3 weeks in all patients. Expansion remained stable during the 12-month study period, with a mean relapse for the entire group of 0.88 +/- 0.48 mm. Morbidity was limited to mild postoperative discomfort. The results of this preliminary study indicated that surgically assisted rapid maxillary expansion is a safe, simple, and reliable procedure for achieving a permanent increase in skeletal maxillary width in adults. Further study is necessary to document the three-dimensional movements of the maxillary segments and long-term stability of the skeletal and dental changes.

Titanium and polyether ether ketone (PEEK) patient-specific sub-periosteal implants: two novel approaches for rehabilitation of the severely atrophic anterior maxillary ridge.

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Mounir, M; Atef, M; Abou-Elfetouh, A; Hakam, M M

2018-05-01

The aim of this study was to assess two new protocols for single-stage rehabilitation of the severely atrophic maxillary ridge using customized porous titanium or polyether ether ketone (PEEK) sub-periosteal implants. Ten patients with a severely atrophic anterior maxillary alveolar ridge were divided randomly into two groups (five patients in each) to receive customized sub-periosteal implants fabricated via CAD/CAM technology: group 1, porous titanium implants; group 2, PEEK implants. Prosthetic loading with fixed acrylic bridges was performed 1 month postoperative. The implants were followed-up for 12 months and evaluated for the presence of any sign of radiographic bone resorption, mobility, infection, prosthetic fracture, or implant exposure. The immediate postoperative period was uneventful except for one case complicated by wound dehiscence in group 1. At 12 months, all implants were functionally stable and the patients were comfortable with the prostheses. No signs of radiographic bone resorption, mobility, infection, or prosthetic fracture were observed. Within the limitations of this study, the application of customized porous titanium and PEEK sub-periosteal implants produced through CAD/CAM technology appears to be an acceptable method for single-stage prosthetic rehabilitation of the severely atrophic edentulous anterior maxilla. This study was awarded the best case study at the academy of osseintegration annual meeting 2017, Orlando, Florida. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Relationship between post-extraction pain and acute pulpitis: a randomised trial using third molars.

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Zhang, Wei; Dai, Yong-Bo; Wan, Peng-Cheng; Xu, Dong-Dong; Guo, Yi; Li, Zhi

2016-12-01

The aim of the present study was to examine the relationship between post-extraction pain and acute pulpitis in third molars. This study was a randomised controlled trial. Sixty patients requiring removal of a single maxillary third molar with acute pulpitis were included and randomly divided into two groups: group A (n = 30); and group B (n = 30). In group A, third molars were directly extracted, and group B received endodontic therapy (pulp chamber opening and drainage) and underwent extraction 24 hours later, aiming to eliminate the acute inflammation. Another 30 patients requiring removal of a single maxillary third molar and with the same inclusion criteria but without caries or acute pulpitis were recruited into group C, in which the maxillary third molars were also directly extracted. The level of postoperative pain reported each day among the three groups was statistically evaluated. On the first, second and third days after surgery, there was a statistically significant difference between group A and group B and between group A and group C, but there was no statistically significant difference between group B and group C. The results of the present study indicate that there is more pain when third molars with acute pulpitis are directly removed compared with the pain level of the removal of third molars without acute pulpitis. © 2016 FDI World Dental Federation.

Maintenance of class III trifurcated molars versus implant placement in regenerated extraction sockets: long-term results of 2 cases.

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Zafiropoulos, Gregory-George K; di Prisco, Manuela Occipite; Deli, Giorgio; Hoffmann, Oliver

2011-03-01

Studies to date have reached differing conclusions regarding the long-term prognosis of teeth with class III furcation involvement. Replacement of such teeth with implants could be an alternative. This report compares the treatment outcomes of 2 cases with similar disease progression: 1 treated by implant therapy and 1 maintained with nonsurgical periodontal treatment. Two patients with advanced chronic periodontitis and class III furcation involvement of all molars were treated. Case 1 received a conservative periodontal and antibiotic treatment, followed by 15 years of maintenance. In case 2, the molars were extracted and replaced with implants, and the implants were observed for 7 years. Clinical attachment level (CAL), probing attachment level (PAL), bleeding on probing, plaque index, and periodontal pathogens were recorded. Despite good compliance of case 1, periodontal pathogens were not eliminated and tissue destruction was not halted. The PAL outcomes of case 2 improved over time; mean PAL loss reached 0.35 mm/y in the first 3 years and then decreased to 0.01 mm/y. While CAL outcomes did not change in case 2, case 1 showed increased CAL loss after 8 years. Based on the limited findings of this case report, extraction of molars with class III furcation involvement and subsequent implant placement may render a better predictability of treatment outcomes than nonsurgical periodontal therapy in the cases of infection with periodontal pathogens.

Implant-retained maxillary overdentures.

Science.gov (United States)

Eckert, Steven E; Carr, Alan B

2004-07-01

Overdentures supported by osseointegrated implants overcome many of the complications observed with overdentures supported by natural teeth. Dental implants are free of biologic consequences associated with natural teeth, such as dental caries and periodontal disease. Bone undercuts adjacent to implants do not mimic those found adjacent to natural tooth roots. Implants are used to provide predictable retention, support, and stability for overdenture prostheses. When lip or facial support is required, the overdenture is the treatment of choice. Likewise the overdenture may improve phonetic deficiencies associated with alveolar bone loss.

Use of palatally inserted mini-screw for upper molar distalization: A case series

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Valliollah Arash

2015-09-01

Full Text Available  Abstract Reports have shown that molars can be distalized successfully with virtually no orthodontic anchorage loss with an intraosseous anchorage, even with fully erupted second molars. The purpose of this study was evaluating the effects of mini-screws as skeletal anchorage for upper molar distalization. In this case series, three patients needing maxillary first molar distalization, were selected. mini-screw was inserted in the anterior part of the palate. The screws were anchored to the first premolars by transpalatal arch and immediately loaded (150-160 g by 0.018-inch arch-wire and steel open-coil spring to distalize maxillary molars. The skeletal and dental changes were measured on cephalograms obtained before and after distalization. The amount of first molar distalization in the patients was 4 mm with 2°of tipping, 4 mm with 5°of tipping, and 3.5 mm with 2°of tipping respectively. Upper incisors and first premolars were stable during distalization.       

Micro-CT analyses of apical enlargement and molar root canal complexity

DEFF Research Database (Denmark)

Markvart, Merete; Darvann, Tron Andre; Larsen, Per

2012-01-01

AIM: To compare the effectiveness of two rotary hybrid instrumentation techniques with focus on apical enlargement in molar teeth and to quantify and visualize spatial details of instrumentation efficacy in root canals of different complexity. METHODOLOGY: Maxillary and mandibular molar teeth wer...

Atypical presentation of bilateral supplemental maxillary central incisors with unusual talon cusp

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Sivakumar Nuvvula

2011-01-01

Full Text Available Delayed eruption of maxillary permanent central incisors in a child poses a distressing esthetic quandary to parents, by virtue of its location in the dental architecture. Well-aligned anterior teeth add confidence to smile and have enhanced self-esteem, which is critical even in early life. Impaction of the maxillary central incisors compared to third molars or the canines is less reported; bilateral supplemental maxillary central incisors related to impacted permanent maxillary central incisors are rare and one of the supplemental central incisors showing unusual talon is still infrequent. A case of impacted maxillary permanent central incisors related to supplemental maxillary central incisors, with one of them showing an unusual talon cusp, is presented.

Second Mesiobuccal Root Canal of Maxillary First Molars in a Brazilian Population in High-Resolution Cone-Beam Computed Tomography.

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Gomes Alves, Claudia Rezende; Martins Marques, Márcia; Stella Moreira, Maria; Harumi Miyagi de Cara, Sueli Patricia; Silveira Bueno, Carlos Eduardo; Lascala, Cesar Ângelo

2018-01-01

The second canal of the mesiobuccal root (MB2) of the maxillary first molars (MFM) is difficult to detect in conventional radiographs and can be a major cause of failure in endodontic treatments. The aim of this study was to investigate the prevalence and anatomy of the MB2 by using high-resolution cone-beam computed tomography (CBCT). Three radiologists examined 414 high-resolution CBCTs. Of these, the CBCTs of 287 patients (mean age 49.43±16.76) who had at least one MFM were selected, making a total of 362 teeth. Prevalence and its relation with gender and age of the patients, side of the tooth, and Vertucci's classification were analyzed. Data were statistically analyzed ( P molars in this Brazilian population examined with high-resolution CBTCs is 68.23%, being more prevalent in young patients. Gender and the side examined are no factors for determining the presence of MB2. Although the both FOVs of the high-resolution CBTCs (FOV 8 and 5) detect the MB2 canal, smaller FOV (FOV 5) is more accurate in the analysis of the internal anatomy of such root canals, according to the Vertucci´s classification.

Nonsurgical, nonextraction management of impacted maxillary canine

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Jasneet Singh

2018-01-01

Full Text Available NS, a 12 year 2 months old female patient, presented with the chief complaint of irregular teeth. Diagnosis revealed skeletal Class II jaw base relation, with average (toward vertical growth pattern, dentoalveolar angles Class I molar relationship with severe crowding in upper and moderate crowding in the lower arch, normally positioned maxillary incisors but proclined lower incisors, “V” shape constricted maxillary arch with first premolar in crossbite, overretained deciduous molar and a high placed buccoversion canine in the first quadrant and an impacted canine in the second quadrant, constricted mandibular arch with first premolar blocked out in the third quadrant. Treatment with a nonsurgical, nonextraction treatment plan by expansion of the upper arch and taking advantage of natural eruptive forces of the tooth was planned. The final outcome solved the patient's complaints and achieved an esthetically pleasing and functionally adequate occlusal result.

Prosthetic implant treatment of the edentulous maxilla with overdenture.

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Inversini, M

2006-10-01

The literature concerning the success of prosthetic implant treatment with maxillary overdenture is reviewed, and variables affecting treatment from the implant and prosthetic standpoint are analysed. Guidelines for the fabrication of maxillary overimplants comparable to those for mandibular overimplants are still lacking, as are evidence-based prosthetic design concepts. Individual methods and techniques have been described, but evaluation standards for the outcome of maxillary prosthetic-implant treatment are lacking or individually interpreted. The biomechanics involved in the proposed system are described, together with the advantages of telescopic crowns for the retention of removable partial prosthesis supported by maxillary implants. The positive influence, in terms of long-term prognosis, of the perio-protective design of removable partial prostheses supported by maxillary overimplants is also discussed. The proposed system not only provides stability, support and retention for removable partial prostheses supported by maxillary implants, but also enables implant survival rates to be improved, both for biomechanical reasons and due to improved oral hygiene. The simplification of fabrication procedures, repair, rebasing and re-operating also reduce the cost of follow-up and improve the cost/benefit ratio. However, additional studies are needed to clarify the number and most appropriate distribution of implants, as well as the most favourable prosthetic designs for maxillary overimplants.

Cone-beam computed tomography evaluation of dental, skeletal, and alveolar bone changes associated with bonded rapid maxillary expansion

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Namrata Dogra

2016-01-01

Full Text Available Aims and Objectives: To evaluate skeletal changes in maxilla and its surrounding structures, changes in the maxillary dentition and maxillary alveolar bone changes produced by bonded rapid maxillary expansion (RME using cone-beam computed tomography (CBCT. Materials and Methods: The sample consisted of 10 patients (6 males and 4 females with age range 12 to 15 years treated with bonded RME. CBCT scans were performed at T1 (pretreatment and at T2 (immediately after expansion to evaluate the dental, skeletal, and alveolar bone changes. Results: RME treatment increased the overall skeletal parameters such as interorbital, zygomatic, nasal, and maxillary widths. Significant increases in buccal maxillary width was observed at first premolar, second premolar, and first molar level. There was a significant increase in arch width both on the palatal side and on the buccal side. Significant tipping of right and left maxillary first molars was seen. There were significant reductions in buccal bone plate thickness and increase in palatal bone plate thickness. Conclusions: Total expansion achieved with RME was a combination of dental, skeletal and alveolar bone changes. At the first molar level, 28.45% orthopedic, 16.03% alveolar bone bending, and 55.5% orthodontic changes were observed.

Radiographic prognostic factors determining spontaneous space closure after loss of the permanent first molar.

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Patel, Sameer; Ashley, Paul; Noar, Joseph

2017-04-01

Permanent first molars (PFM) with a poor prognosis are routinely extracted in children throughout the United Kingdom. National guidelines suggest that to achieve spontaneous closure for the mandibular arch, the PFM should be extracted at 8 to 10 years of age, during bifurcation formation of the second molar. The literature is of limited quality and has suggested alternative variables that may be associated with successful space closure. Our aim was to investigate the radiographic prognostic factors associated with space closure after extraction of PFM. Two objectives of the research are reported in this article: to determine factors that might predict space closure of the second molar after extraction of the PFM, and to develop a tool kit to aid clinical decision making. We assessed 148 maxillary and 153 mandibular PFM extracted from 81 participants retrospectively. Dental age, second molar developmental stage, second premolar and second molar angulations, and presence or absence of the third molar were assessed on the preextraction orthopantomograms. Outcome was assessed via visual examination, study models, or radiographs. Closure occurred in 89.9% of the maxillary and 49.0% of the mandibular quadrants. Dental age was statistically, but not clinically, significant in the maxillary arch (P space closure. The developed tool kit requires further validity testing. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Maxillary sinus floor elevation surgery with BioOss (R) mixed with a bone marrow concentrate or autogenous bone : test of principle on implant survival and clinical performance

NARCIS (Netherlands)

Rickert, D.; Vissink, A.; Slot, Jan; Sauerbier, S.; Meijer, H. J. A.; Raghoebar, G. M.

The purpose of this study was to assess implant survival and 1-year clinical performance of implants placed in the posterior maxilla that had been subjected to maxillary sinus floor elevation surgery with bovine bone mineral (BioOss (R)) mixed with autogenous bone marrow concentrate or autogenous

Outcomes of intentionally replanted molars according to preoperative locations of periapical lesions and the teeth

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WooCheol Lee

2012-06-01

Conclusions: Within the limitations of this study, IR of mandibular molars seemed to provide a higher success rate than that for maxillary molars, regardless of the presence of preoperative periapical lesions.

Maxillary reconstruction with bone transport distraction and implants after partial maxillectomy.

Science.gov (United States)

Castro-Núñez, Jaime; González, Marcos Daniel

2013-02-01

Maxillary and mandibular bone defects can result from injury, congenital defect, or accident, or as a consequence of surgical procedures when treating pathology or defects affecting jaw bones. The glandular odontogenic cyst is an infrequent type of odontogenic cyst that can leave a bony defect after being treated by aggressive surgical means. First described in 1987 by Padayachee and Van Wyk, it is a potentially aggressive entity, having a predisposition to recur when treated conservatively, with only 111 cases having been reported hitherto. Most reports emphasize its clinical, radiographic, and histologic features, including a few considerations on rehabilitation for these patients. The aim of this article is to present the case of a 24-year-old male patient who, in 2001, was diagnosed with a glandular odontogenic cyst and to focus on the surgical approach and rehabilitation scheme. We performed an anterior partial maxillectomy. The osseous defect was treated using bone transport distraction. Dental and occlusal rehabilitation was achieved with titanium implants over transported bone and an implant-supported overdenture. A 9-year follow-up shows no evidence of recurrence of the pathology, adequate shape and amount of bone, functional occlusal and dental rehabilitation, and patient's satisfaction. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Maxillary and mandibular immediately loaded implant-supported interim complete fixed dental prostheses on immediately placed dental implants with a digital approach: A clinical report.

Science.gov (United States)

Lewis, Ryan C; Harris, Bryan T; Sarno, Robert; Morton, Dean; Llop, Daniel R; Lin, Wei-Shao

2015-09-01

This clinical report describes the treatment of maxillary and mandibular immediate implant placement and immediately loaded implant-supported interim complete fixed dental prostheses with a contemporary digital approach. The virtual diagnostic tooth arrangement eliminated the need for a customized radiographic template, and the diagnostic data collection required for computer-guided surgery (digital diagnostic impressions, digital photographs, and a cone beam-computed tomography [CBCT] scan) was completed in a single visit with improved workflow efficiency. Computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated surgical templates and interim prosthesis templates were made in a dental laboratory to facilitate computer-guided surgery and the immediate loading process. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

SECOND MOLAR UPRIGHTING AFTER PREMATURE LOSS OF MANDIBULAR FIRST PERMANENT MOLAR--CASE REPORT.

Science.gov (United States)

Cernei, E R; Mavru, R B; Zetui, Irina Nicoleta

2015-01-01

Uprighting a tipped molar by using an uprighting spring is a fundamental orthodontic treatment technique. Following a weak anchorage done only by the anterior teeth the permanent lower second molar will rotate around its center of resistance, and besides the distalizing movement will occur its extrusion. Following the reaction, the mandibular anterior teeth will have a movement of intrusion. All these elements will lead to anterior open bite. Correction of vertical problems has become easier with the advent of mini-implants. U.I patient aged 24 years presenting for aesthetic and functional disorders. Clinical examination reveals intraoral Class I molar malocclusion on the right sight, upper narrowing arch with a slight overbite, and the both permanent first molars on the left side lost prematurely. The tooth 37 is inclined at 600 degrees to the plane of occlusion. To avoid front opening occlusion we used an orthodontic miniscrew inserted between the canine and the first premolar on the same side to achieve the second molar up righting. Lower second molar uprighting was achieved without unwanted movements in anterior mandibular region and without molar extrusion. Using mini implants in uprighting a tipped molar will achieve the desired tooth movement and will reduce the number of unwanted side effects and eventually to improve patient's esthetics.

Maxillary tridimensional changes after slow expansion with leaf expander in a sample of growing patients: a pilot study.

Science.gov (United States)

Lanteri, V; Gianolio, A; Gualandi, G; Beretta, M

2018-03-01

The aim of this study is to evaluate the dento-alveolar effects of slow maxillary expansion using the Leaf Expander in a sample of growing patients with maxillary transverse deficiency, unilateral cross bite and mandibular shift. The study included 10 patients, 3 male and 7 female (mean age 7.5 + 7 months), treated with Leaf Expander anchored on the upper deciduous teeth. Digital models were obtained by a lab scan of the pvs impressions at the beginning of the therapy (T1) and at the removal of the palatal expander (T2). Five parameters were measured: 1) the distance between the first upper permanent molars; 2) the distance between the upper second deciduous molars; 3) the distance between the upper canine cusps 4) the distance between the first lower permanent molars; 5) the distance of the lower canine cusps. In all patients complete correction of posterior crossbite was achieved on average in 4 months, with a spontaneous expansion of the upper first permanent molars. Significant increases in the dento-alveolar transversal diameters were obtained. Increases were also observed in the anterior mandibular arch diameter (+ 1 mm). These findings suggest that slow maxillary expansion using Leaf Expander appliance could be a reasonable alternative to conventional maxillary expansion therapy in the early mixed dentition.

Bilateral en-masse distalization of maxillary posterior teeth with skeletal anchorage: a case report

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Saeed Noorollahian

Full Text Available ABSTRACT Objective: The aim of this study was to introduce a new method for bilateral distal movement of the entire maxillary posterior segment. Case report: A 17-year-old girl with Class I skeletal malocclusion (end-to-end molar relationships, deviated midline and space deficiency for left maxillary canine was referred for orthodontic treatment. She did not accept maxillary first premolars extraction. A modified Hyrax appliance (Dentaurum Ispringen, Germany was used for bilateral distalization of maxillary posterior teeth simultaneously. Expansion vector was set anteroposteriorly. Posterior legs of Hyrax were welded to first maxillary molar bands. All posterior teeth on each side consolidated with a segment of 0.017 × 0.025-in stainless steel wire from the buccal side. Anterior legs of Hyrax were bent into eyelet form and attached to the anterior palate with two mini-screws (2 × 10 mm (Jeil Medical Corporation Seoul, South Korea. Hyrax opening rate was 0.8 mm per month. Lateral cephalometric radiographs were used to evaluate the extent of distal movement. 3.5-mm distalization of posterior maxillary teeth was achieved in five months. Results: A nearly bodily distal movement without anchorage loss was obtained. Conclusion: The mini-screw-supported modified Hyrax appliance was found to be helpful for achieving en-masse distal movement of maxillary posterior teeth.

Aspergillus in endodontic infection near the maxillary sinus

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Cinthya Cristina Gomes

2015-10-01

Full Text Available ABSTRACT INTRODUCTION: Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. OBJECTIVE: To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. METHODS: Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. RESULTS: Filamentous fungi were isolated from 6 of 60 canals (10%:Aspergillus niger (6.7%, Aspergillus versicolor (1.6%, and Aspergillus fumigatus(1.6%. CONCLUSION: Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus.

Anchorage onto deciduous teeth: effectiveness of early rapid maxillary expansion in increasing dental arch dimension and improving anterior crowding

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Mutinelli, Sabrina; Manfredi, Mario; Guiducci, Antonio; Denotti, Gloria; Cozzani, Mauro

2015-01-01

Background Anchorage onto permanent dentition is a common procedure in rapid maxillary expansion. However, replacing first permanent molars with the second deciduous molars seems to be an option to reduce some negative side effects during orthodontic treatment. The purpose of this study was to evaluate the dental effect of rapid maxillary expansion with anchorage exclusively onto deciduous teeth performed in the first period of transition. Methods Twenty patients with a lateral cross-bite tre...

Combination of straight and tilted implants for supporting screw-retained dental prostheses in atrophic posterior maxillae: A 2-year prospective study.

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Casar-Espinosa, Juan-Carlos; Castillo-Oyagüe, Raquel; Serrera-Figallo, María Ángeles; Garrido-Serrano, Roberto; Lynch, Christopher D; Menéndez-Collar, Manuel; Torres-Lagares, Daniel; Gutiérrez-Pérez, José-Luis

2017-08-01

To evaluate the two-year survival rate (SR) and marginal bone loss (MBL) of fixed dental prostheses (FDPs) supported by straight (S) and tilted (T) implants under the influence of diverse study variables. A prospective investigation comprising 21 patients provided with a total of 27 maxillary screw-retained restorations fixed to 70 dental implants was developed. Two groups of implants were considered depending on their inclination with respect to the occlusal plane: Group 1 (S, n=37): straight/axial implants and Group 2 (T, n=33): tilted/angled fixations. Each FDP was supported by a combination of S and T implants. SR and MBL were assessed at the time of loading and two years after surgery. Patient-, surgical- and/or rehabilitation-related information was gathered. Data were statistically analysed at the α=0.05 significance level. After 24 months, a 100% SR was achieved and the MBL of S and T implants were statistically similar. T implants located in the molar region showed lower MBL than did those replacing premolars (p=0.031). Upright and angled fixations inserted at posterior maxillary areas resulted in comparable survival rates and peri-implant MBL after two years. The marginal bone resorption around tilted implants depended on their location. Screw-retained restorations fixed to straight and tilted implants seem to be a safe treatment option in posterior atrophic maxillae. Copyright © 2017 Elsevier Ltd. All rights reserved.

Surgical Splint Design Influences Transverse Expansion in Segmental Maxillary Osteotomies

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Stokbro, Kasper; Aagaard, Esben; Torkov, Peter

2017-01-01

splint designs on achieving the planned transverse expansion in bimaxillary surgery with segmental maxillary procedures. Materials and Methods: Forty-two participants were included in a retrospective observational study. All participants had completed virtually planned bimaxillary surgery with 3-piece......Purpose: In segmental maxillary procedures, it is imperative to obtain as much of the planned expansion as possible. Lack of obtained expansion, in addition to late relapse after splint removal, can result in relapse of the posterior crossbite. This study investigated the influence of 2 surgical...... maxillary segmentation. The primary outcome variable was the transverse expansion obtained, measured as the expansion between the maxillary first molars on preoperative and postoperative cone-beam computed tomograms. The postoperative scan was performed 1 week after surgery with the splint still in place...

Comparison of short-term effects between face mask and skeletal anchorage therapy with intermaxillary elastics in patients with maxillary retrognathia.

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Ağlarcı, Cahide; Esenlik, Elçin; Fındık, Yavuz

2016-06-01

The aim of this study was to compare the short-term dental and skeletal effects of a face mask (FM) with those of skeletal anchorage (SA) therapy with intermaxillary elastics in prepubertal patients with skeletal Class III malocclusion. Fifty patients with skeletal Class III malocclusion and maxillary deficiency were divided into two groups. In the FM group, an FM was applied by a bite plate with a force of 400g for each side. In the SA group, mini-plates were placed between mandibular lateral incisors and canines, and mini-implants were inserted between maxillary second premolars and first molars. A bite plate was inserted into the upper arch, and Class III elastics were applied with a force of 200g between each mini-plate and mini-implant. Mean treatment durations were 0.52±0.09 years for FM and 0.76±0.09 years for SA. After the treatment, statistically significant increases in SNA°, ANB°, A-y, 1-NA, SnGoGn°, Co-A, Co-Gn, and A-Nperp, and reductions in SNB° and FH┴N-Pg were observed in both groups, and these changes were similar in both groups. In the FM group, 1-NB decreased significantly, and in the SA group, it increased significantly (P journals.permissions@oup.com.

Fusion or gemination? An unusual mandibular second molar

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Angela Jordão Camargo

2016-01-01

Full Text Available Fusion and gemination is not an uncommon finding and affected most primary dentition and the permanent maxillary incisors. These changes can develop a series of complication. A 11-year-old male presented radiography finding: an unusual mandibular second molar. A well-documented case brings a challenge for radiologists classify between fusion and gemination. In conclusion, this alteration although common in other regions, there are no case in the literature involving “second and third” molar.

Five-year outcome of a retrospective cohort study on the rehabilitation of completely edentulous atrophic maxillae with immediately loaded zygomatic implants placed extra-maxillary.

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Maló, Paulo; Nobre, Miguel de Araújo; Lopes, Armando; Ferro, Ana; Moss, Steven

2014-01-01

To report retrospectively on the 5-year follow-up results of the rehabilitation of complete edentulous atrophied maxillae, using extra-maxillary zygomatic implants alone or in combination with conventional implants. This retrospective report includes an initial cohort of 39 patients (30 women and 9 men), with a mean age of 53 years, followed for 5 years. The patients were rehabilitated with 39 fixed prostheses and 169 implants (92 zygomatic implants inserted extra-maxillary and 77 conventional dental implants). A provisional prosthesis was manufactured and attached via multiunit abutments secured to the implants on the same day as implant placement. According to patient desires and each clinical situation, either an acrylic resin, a metal-acrylic or metal-ceramic final prosthesis was inserted approximately 6 months after implant placement. Outcome measures were: prosthesis success; implant success; complications; probing pocket depths; marginal bleeding; and marginal bone levels (only for conventional implants). Data were analysed with descriptive statistics. Two patients died after 8 and 30 months of follow-up due to causes unrelated to their oral rehabilitations, and 5 patients dropped out of the study. No prosthesis was lost; one zygomatic implant was removed after 46 months of follow-up, giving cumulative success rates of 97% and 98.8% (patient and implant related, respectively). Twelve complications occurred in 12 patients: 5 sinus infections in 5 patients, all with a previous history of sinusitis and whose sinus membrane was disrupted during surgery; one oroantral communication (leading to removal of the implant), 2 all acrylic resin prostheses fractures, 1 ceramic crown fracture (on a metal-ceramic prosthesis); and 3 screw loosenings. Bleeding on probing was recorded in 6 patients (13 implants). Probing pocket depths >4 mm were present in 13 patients (23 implants) at 5 years of follow-up. The average (standard deviation) marginal bone loss on conventional

[Unerupted first deciduous molar located higher to the first premolar: a case report].

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Zhan, Y; Liu, H

2017-02-18

Tooth eruption is defined as the movement of a tooth from its site of development within the alveolar process to its functional position in the oral cavity. The process of tooth eruption can be divided into different phases: pre-eruptive bone stage, alveolar bone stage, mucosal stage, preocclusal stage, occlusal stage and maturation stage. Any disturbance in these phases can lead to eruptive anomalies. The incidence of unerupted teeth is usually higher among permanent teeth than among deciduous ones. Of the primary teeth reported as unerupted, second deciduous molars are the teeth most frequently involved, followed by primary central incisors. At present almost no coverage is seen about the impaction of the first deciduous molar. In this case, a 4-year-old boy who presented with an impacted left maxillary first deciduous molar came to the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology. This tooth, located higher to the left maxillary first premolar, was well near to the maxillary sinus. The family and medical histories were noncontributory and his physical findings were within normal limits. The mother was reported as having experienced no illness or other complications and taken no medications during pregnancy. His clinical extraoral examination was noncontributory. His clinical intra-oral examination revealed that the maxillary left first primary molar was not present. No enlargement of the area was apparent visually or on palpation. The remaining primary dentition was well aligned and in good condition. His oral hygiene was good, although there were incipient occlusal carious lesions in the mandibular second primary molars. There was no history or evidence of dental trauma. A diagnosis of a left maxillary first deciduous molar was made on the basis of the clinical and radiographic evidence. Numerous local etiologic factors have been described for impacted teeth. These include anomalous teeth, malposition, fusion with

Esthetic evaluation of maxillary single-tooth implants in the esthetic zone

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Cho, Hae-Lyung; Lee, Jae-Kwan; Um, Heung-Sik

2010-01-01

Purpose The aim of this study is to assess the influence exerted by the observer's dental specialization and compare patients' opinion with observers' opinion of the esthetics of maxillary single-tooth implants in the esthetic zone. Methods Forty-one adult patients, who were treated with a single implant in the esthetic zone, were enrolled in this study. Eight observers (2 periodontists, 2 prosthodontists, 2 orthodontists and 2 senior dental students) applied the pink esthetic score (PES)/white esthetic score (WES) to 41 implant-supported single restorations twice with an interval of 4 weeks. We used a visual analog scale (VAS) to assess the patient's satisfaction with the treatment outcome from an esthetic point of view. Results In the PES/WES, very good and moderate intraobserver agreements were noted between the first and second rating. The mean total PES/WES was 11.19 ± 3.59. The mean PES was 5.17 ± 2.29 and mean WES was 6.02 ± 1.96. In the total PES/WES, the difference between the groups was not significant. However, in the WES, the difference between the groups was significant and prosthodontists were found to have assigned poorer ratings than the other groups. Periodontists gave higher ratings than prosthodontists and senior dental students. Orthodontists were clearly more critical than the other observers. The statistical analysis revealed statistically significant correlation between patients' esthetic perception and dentists' perception of the anterior tooth. However, the correlation between the total PES/WES and the VAS score for the first premolar was not statistically significant. Conclusions The PES/WES is an objective tool in rating the esthetics of implant supported single crowns and adjacent soft tissues. Orthodontists were the most critical observers, while periodontists were more generous than other observers. The statistical analysis revealed a statistically significant correlation between patients' esthetic perception and dentists

Finite element analysis and clinical complications in mandibular implant-overdentures opposing maxillary dentures.

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Khuder, Tameem; Yunus, Norsiah; Sulaiman, Eshamsul; Dabbagh, Ali

2017-11-01

Denture fracture is a common clinical complication caused by improper material selection, design, or fabrication technique. This study aimed to investigate the effect of two attachment systems on fracture risk of the implant-overdentures (IOD) via finite element analysis (FEA), using the force distributions obtained from patients' occlusal analyses and to compare the obtained results with the clinical complications associated with these attachments. A three-dimensional jaw model comprised of the edentulous bones was constructed. Three types of mandibular prostheses including complete denture (CD) (model LCD), IOD with Locator attachment (model LID-L), and IOD with telescopic attachment (model LID-T), as well as a maxillary CD (model UCD) were assembled. The vertical occlusal forces at anterior and posterior quadrants were obtained from the patients wearing mandibular CDs or IODs. The FEA results were further compared with the mechanical failures of different prostheses observed at patient recalls. In overall, the fracture risk of mandibular prostheses was lower than the maxillary compartments. The UCD opposing LCD underwent higher strains than that opposing LID-L and LID-T, which was mostly concentrated at the anterior mid-palatal polished surface. On the other hand, LID-L showed the lowest strain, followed by LID-T, and LCD. The obtained results were consistent with the clinical complications observed in the patient recalls. Copyright © 2017 Elsevier Ltd. All rights reserved.

Aspergillus in endodontic infection near the maxillary sinus.

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Gomes, Cinthya Cristina; Pinto, Larissa Christina Costa; Victor, Fernanda Loretti; Silva, Erlange Andrade Borges da; Ribeiro, Apoena de Aguiar; Sarquis, Maria Inês de Moura; Camões, Isabel Coelho Gomes

2015-01-01

Diseases of the maxillary sinus have been associated with dental roots near the maxillary sinus that have undergone endodontic treatment. To investigate the presence of filamentous fungi in patients with dental roots near the maxillary sinus who had apical periodontitis treated endodontically, and to alert practitioners that this could be a possible avenue of contamination of the sinus in patients who develop maxillary sinus infection. Cross-sectional study in 60 palatal roots of the first maxillary molars near the maxillary sinus, that underwent endodontic treatment for apical periodontitis. After removal of the filling material, dentin shavings were collected and placed in test tubes containing Sabouraud dextrose agar and chloramphenicol. The phenotype was determined by macroscopic and microscopic examination of the colonies. For polymerase chain reaction, the primers ITS-5 and ITS-4 were used. The sequences obtained were compared with those deposited at GenBank using the Basic Local Alignment Search Tool program. Filamentous fungi were isolated from 6 of 60 canals (10%): Aspergillus niger (6.7%), Aspergillus versicolor (1.6%), and Aspergillus fumigatus (1.6%). Root canals near the maxillary sinus with endodontic treatment and apical periodontitis may exhibit positive cultures for filamentous fungi. Interested professionals should be alert, because these microorganisms have pathogenic characteristics that can cause disease of odontogenic origin in the maxillary sinus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

Análise do movimento inicial de molares superiores submetidos a forças extrabucais: estudo 3D Analysis of initial movement of maxillary molars submitted to extraoral forces: a 3D study

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Giovana Rembowski Casaccia

2010-10-01

Full Text Available OBJETIVO: analisar pelo método dos elementos finitos o deslocamento dos molares superiores frente a três diferentes inclinações do arco externo do aparelho extrabucal na tração do tipo cervical. MÉTODOS: maxila, dentes montados em má oclusão de Classe II e aparelho foram modelados através de formulação variacional e seus valores reproduzidos em coordenadas X, Y e Z. Foram realizadas simulações em microcomputador tipo PC, utilizando o programa ANSYS versão 8.1. Cada modelo de arco externo reproduziu linhas de força que passaram (1 acima (AcCR, (2 abaixo (AbCR e (3 no centro de resistência (CR do molar permanente superior de um mesmo modelo portador de má oclusão de Classe II. A avaliação restringiu-se ao movimento inicial dos molares frente à força extrabucal de 4 Newtons. RESULTADOS: o movimento distal inicial dos molares, tendo como ponto de referência a mesial do tubo, foi maior na coroa do modelo AbCR (0,47x10-6, e maior na raiz do modelo AcCR (0,32x10-6, provocando inclinações da coroa para distal e mesial, respectivamente. No modelo CR, os pontos na coroa (0,15x10-6 e raiz (0,12x10-6 deslocaram-se para distal equilibradamente, resultando em movimento de translação. Em todos os modelos, numa vista oclusal, houve tendência de rotação distal inicial da coroa, porém no modelo CR esse movimento foi muito pequeno. No sentido vertical (Z, todos os modelos revelaram movimento extrusivo (AbCR= 0,18x10-6; CR= 0,62x10-6; AcCR= 0,72x10-6. CONCLUSÃO: a simulação computacional do uso de aparelho extrabucal com tração cervical revelou a ocorrência de movimento extrusivo e distal, podendo ser por inclinação distal de coroa, de raiz ou movimento de translação.OBJECTIVE: To analyze maxillary molar displacement by applying three different angulations to the outer bow of cervical-pull headgear, using the finite element method (FEM. METHODS: Maxilla, teeth set up in Class II malocclusion and equipment were modeled

LARGE DENTIGEROUS CYST IN THE MAXILLARY SINUS LEADING TO DIPLOPIA AND NASAL OBSTRUCTION: CASE REPORT*

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M. İsa KARA

2015-04-01

Full Text Available Dentigerous cysts are the most common developmental odontogenic cyst of the jaws. They are more frequent in males and although most often affected teeth are maxillary canines and mandibular third molars, they may also be related with supernumerary or an ectopically erupted tooth. Our aim was to report the management of ectopic third molar tooth related with a dentigerous cyst in maxillary sinus. 16 years old girl referred to our clinic with a complaint of painful swelling over her right cheek since past six months. All permanent teeth were present except the right upper third molar. External examination showed that the face was gently asymmetrical; levels of eye globes were abnormal. Radiographic examination revealed a cystic lesion related with ectopic third molar which located in the roof of the left maxillary sinus. Under local anesthesia, hard drain was inserted into the hole and the cystic pressure was decreased. After the six month of followup, the operation was performed under general anesthesia. The patient’s symptoms were resolved completely after surgery and remained symptom-free for over a postoperative follow-up period of 3 year. To avoid unwanted effects of a dentigerous cyst, unerupted tooth should be observed with radiographic imaging. Some untreated dentigerous cysts may grow large and have a potential to develop into an odontogenic tumor.

Myxoid Type of Malignant Fibrous Histiocytoma of the Maxillary Sinus: A Case Report

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Amir Hossein Jafarian

2011-04-01

Full Text Available Introduction: Myxofibrosarcoma was originally described as the myxoid variant of Malignant Fibrous Histiocytoma (MFH, a high-grade and aggressive sarcoma, which is very uncommon in the head and neck region, with about 100 cases reported up to now. MFH occurring in the maxillary sinus is so rare that only 23 cases have been reported. We hereby report a case of myxofibrosarcoma in the maxillary sinus. Case Report: The case was a 54-year-old male with symptoms of toothache in the right posterior maxillary teeth, a swelling adjacent to maxillary molar region and symptoms of chronic maxillary sinusitis. In clinical examination, the teeth were sensitive to percussion and palpation, but no caries and restoration was detected on his molar teeth. He was suffering from local pain and tenderness over his midface and mild fever, fatigue and some nonspecific vague pain. CT scan showed a mass lesion involving right nasal cavity, maxillary and ethmoidal sinuses. A low-grade malignancy arising from the right maxillary sinus was highly suspected. A surgery was done to remove the mass. The histological and immunohistochemical studies proved the diagnosis of myxoid variant of Malignant Fibrous Histiocytoma. Therefore radiotherapy and chemotherapy was started for the patient but six months later the symptoms returned and CT scan showed a right maxillary and ethmoidal mass that extended to base of the skull. Maxillectomy and ethmoidectomy were performed for the patient, but 2 months later he died because of the extension of the tumor, which confirmed the necessity of early diagnosis. Conclusion: Amplified radical surgery is the first choice of treatment. The second surgery has special value to the recurrent patients. Radiotherapy alone or chemotherapy alone is not effective to MFH of head and neck region

Wear of the Primary WaveOne single file when shaping vestibular root canals of first maxillary molar.

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Aracena, Daniel; Borie, Eduardo; Betancourt, Pablo; Aracena, Angella; Guzmán, Mario

2017-03-01

It is very important for a clinician to know the increased wear of mechanized files when establishing endodontic therapy. The aim of this study was to check the wear of the Primary WaveOne file upon shaping two, four and six maxillary molar vestibular canals. The deterioration of 40 files, divided into four groups, was evaluated microscopically: group 1, control (unused); group 2, two canals; group 3, four canals; and group 4, six canals. After instrumentation, the files were embedded in resin and sectioned at their apical third into three equal parts. To analyze the wear of edges in the different sections, AutoCAD software was used and analysis of variance (ANOVA) was then performed to compare the mean rake angles. The files with two and four uses showed slight wear, whereas those with six applications showed significant wear ( p <0.05). Primary WaveOne files can be used in up to four root canals without their edges losing effectiveness. Key words: Files wear, reciprocating motion, shaping capacity, WaveOne.

Quantitation of maxillary remodeling. 1. A description of osseous changes relative to superimposition on metallic implants.

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Baumrind, S; Korn, E L; Ben-Bassat, Y; West, E E

1987-01-01

Lateral skull radiographs for a set of 31 human subjects were examined using computer-aided methods in an attempt to quantify modal trends of maxillary remodeling during the mixed dentition and adolescent growth periods. Cumulative changes in position of anterior nasal spine (ANS), posterior nasal spine (PNS), and Point A are reported at annual intervals relative to superimposition on previously placed maxillary metallic implants. This in vivo longitudinal study confirms at a high level of confidence earlier findings by Enlow, Björk, Melsen, and others to the effect that the superior surface of the maxilla remodels downward during the period of growth and development being investigated. However, the inter-individual variability is relatively large, the mean magnitudes of change are relatively small, and the rate of change appears to diminish by 13.5 years. For the 19 subjects for whom data were available for the time interval from 8.5 to 15.5 years, mean downward remodeling at PNS was 2.50 mm with a standard deviation of 2.23 mm. At ANS, corresponding mean value was 1.56 mm with a standard deviation of 2.92 mm. Mean rotation of the ANS-PNS line relative to the implant line was 1.1 degree in the "forward" direction. However, this rotational change was particularly variable with a standard deviation of 4.6 degrees and a range of 11.3 degrees "forward" to 6.7 degrees "backward." The study provides strong evidence that the palate elongates anteroposteriorly mainly by the backward remodeling of structures located posterior to the region in which the implants were placed. There is also evidence that supports the idea of modal resorptive remodeling at ANS and PNS, but here the data are somewhat more equivocal. It appears likely, but not certain, that there are real differences in the modal patterns of remodeling between treated and untreated subjects. Because of problems associated with overfragmentation of the sample, sex differences were not investigated.

Natural reversal of tooth discoloration and pulpal response to testing following removal of a miniscrew implant for orthodontic anchorage: a case report.

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Qin, Y J; Zhang, G D; Zhang, Y; Ping, Y F; Zhao, C Y

2016-04-01

To highlight the reversal of signs suggesting pulpal necrosis following removal of a mini-implant without endodontic intervention. A 23-year-old woman presented with a class III malocclusion, with crowded and malformed teeth and excessive gingival display. During orthodontic treatment, a Tomas orthodontic miniscrew was placed between the root apices of the maxillary central incisors. This was carried out by an orthodontic specialist who had treated more than 700 patients (with more than 2000 mini-implants) over the past 9 years. After 2 weeks of treatment, the right maxillary central incisor discoloured and did not respond to electrical pulp tests (EPT) but was sensitive to endo-ice. The miniscrew was removed under local anaesthesia. Teeth 11 and 21 were fixed with ligation wire, and glass-ionomer cement (GIC) was added to the occlusal surfaces of the first and second maxillary molars to heighten the occlusion and disclude the maxillary anterior teeth. After 4 months, the colour and pulp reactions to EPT and endo-ice of tooth 11 returned to normal. Because the use of a miniscrew had appeared to damage the pulp, subsequent a conservative orthodontic treatment using, traditional 'J' hooks was used and achieved satisfactory results. After 23 months of orthodontic treatment, the treatment was complete and a 15-month follow-up showed a successful outcome. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Immediate occlusal loading of single lower molars using Brånemark System® Wide Platform TiUnite™ implants: a 5-year follow-up report of a prospective clinical multicenter study.

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Calandriello, Roberto; Tomatis, Massimiliano

2011-12-01

Although not essential, molars hold their importance in terms of functional jaw stability, antagonist opposition, and support of facial height. Therefore, implant therapy is an attractive concept in molar areas. However, especially in the posterior mandible, the conventional two-stage surgical approach to implant therapy was reported to cause higher bone loss and/or higher implant failures with machined implants because of the peculiar anatomic and physiologic conditions of this area. As the TiUnite™ (Nobel Biocare AB, Göteborg, Sweden) surface results in faster bone healing than with machined-surface implants, it was hypothesized that this surface would also improve the performance of wide implants in posterior mandibles. Based on these assumptions, a protocol for immediately loaded implants for single molar replacement was developed. This paper aimed to report on the clinical and radiological performance of Brånemark System® TiUnite Wide Platform implants supporting single molars in the lower jaw, loaded immediately and followed for up to 5 years, and to assess if the benefit delivered by oxidized surfaces in the short run is also present after 5 years. The study includes 33 consecutive patients treated between March 2001 and September 2003 and monitored until September 2008 in two private dental offices. A total of 40 Brånemark System TiUnite Wide Platform MK III implants were placed. All implants were provided with provisional crowns in full centric occlusion at the time of surgery. Patients were clinically and radiologically followed up for up to 5 years. Two implant failed so that the cumulative success rate at 5 years was 95.0%. The mean marginal bone remodeling (n = 38) expressed as mesial plus distal value averages was -1.17 mm (SD ± 0.90) at the 5-year time point. Although limited by the number of patients treated in accordance with the protocol described, 5-year results encourage the use of immediately loaded single lower molars supported by Br

Microleakage of stainless steel crowns placed on intact and extensively destroyed primary first molars: an in vitro study.

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Seraj, Bahman; Shahrabi, Mahdi; Motahari, Pouria; Ahmadi, Rahil; Ghadimi, Sara; Mosharafian, Shahram; Mohammadi, Kaveh; Javad Kharazifard, Mohammad

2011-01-01

The purpose of this investigation was to evaluate the effect of residual tooth structure on the microleakage of stainless steel crowns cemented with glass ionomer on primary maxillary and mandibular first molars. Thirty extracted primary molars were divided into 2 groups: group 1 included intact teeth; and group 2 included extensively carious samples. Each tooth received standard preparation, and each crown was luted with G-CEM on its specific specimen. Teeth were loaded vertically and transferred to distilled water. After thermocycling and immersing in methylene blue solution, the teeth were sectioned and examined microscopically for microleakage. Data were analyzed using Mann-Whitney U and Wilcoxon signed-rank tests. All specimens (intact and damaged teeth) had microleakage, although most of these presented only minimum microleakage. No statistically significant differences were found in the microleakage of sound and extensively carious teeth on either the buccal (P=.62) or lingual (P=.65) side. Buccal (P=.73) and lingual (P=.63) surfaces showed similar microleakage scores in primary maxillary and mandibular molars. There was no significant difference in the microleakage of sound or extensively carious teeth and primary maxillary or mandibular first molars.

A radiographic study on the morphology of the maxillary sinus in adolescents and adults

International Nuclear Information System (INIS)

Ko, Kang Joon; Lee, Sang Rae

1984-01-01

The purpose of this study was radiographic analysis of the morphology of maxillary sinus in adolescents and adults. In order to analyze the morphology of maxillary sinus in view point of anteroposterior width of medial wall, vertical distance between antral floor and nasal floor level, anterior extension, distance between antral floor and maxillary 1st molar apex, and types of lower border of maxillary sinus, specialized maxillary projection and periapical view with paralleling technique was taken. The author examined orthopantomograms and intraoral standard views taken from 400 adolescents and adults ranged 15-65 years-old. The obtained results were as follows: 1. The antero-posterior width of medial wall of maxillary sinus was 32.80 mm in 15-19 year-old group, 33.86 mm in 20-24 year-old group, 34.09 mm in 25-29 year-old group, and 33.67 mm in 30-65 year-old group, and left maxillary sinus was somewhat smaller than the right. 2. The vertical distance between antral floor and nasal floor level was 8.49 mm in 15-19 year-old group, 9.05 mm i n 20-24 year-old group, 8.95 mm in 25-29 year-old group, and 8.32 mm in 30-65 year-old group. 3. The order of anterior extension of maxillary sinus were distal half of canine, mesial half of canine, mesial half of 1st premolar, and distal half of 1st premolar. 4. The distance between antral floor and maxillary 1st molar were 4.36 mm in 15-19 year-old group, 4.77 mm in 20-24 yea r-old group, 3.58 mm in 25-29 year-old group, and 2.33 mm in 30-65 year-old group. 5. The order of the types of lower border of maxillary sinus were entire downward type, close type, partially downward type, waving type, separating type, and indistinct. In the types of antral floor, there was a tendency to increase the separating type with age.

Titanium Granules for Augmentation of the Maxillary Sinus

DEFF Research Database (Denmark)

Lyngstadaas, Ståle Petter; Verket, Anders; Pinholt, Else Marie

2015-01-01

BACKGROUND: Biomaterials are commonly used to augment the maxillary sinus floor prior to or in conjunction with dental implant installation. Recently, porous titanium granules (PTGs) have been used in oral implant surgery to stabilize implants and function as an osteoconductive matrix. PURPOSE...... in the study. RESULTS: One immobile implant was removed. The mean marginal bone loss was 0.5 mm and 0.8 mm, on the mesial and distal side, respectively. Histologically, all biopsies demonstrated bone ingrowth. CONCLUSIONS: The results suggest that PTG can be safely and effectively used as augmentation material...

Distances from the root apices of posterior teeth to the maxillary sinus and mandibular canal in patients with skeletal open bite: A cone-beam computed tomography study

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Kosumarl, Werinpimol [Dental Division, Suan Phueng Hospital, Ratchaburi (Thailand); Patanaporn, Virush; Jotikasthira, Dhirawat; Janhom, Apirum [Faculty of Dentistry, Chiang Mai University, Chiang Mai (Thailand)

2017-09-15

This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances (MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances (MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group.

Distances from the root apices of posterior teeth to the maxillary sinus and mandibular canal in patients with skeletal open bite: A cone-beam computed tomography study

International Nuclear Information System (INIS)

Kosumarl, Werinpimol; Patanaporn, Virush; Jotikasthira, Dhirawat; Janhom, Apirum

2017-01-01

This study determined and compared the distances from the maxillary root apices of posterior teeth to the floor of the maxillary sinus, or maxillary sinus distances (MSDs), and the distances from the mandibular root apices of the posterior teeth to the mandibular canal, or mandibular canal distances (MCDs), in Thai subjects with skeletal open bite and skeletal normal bite. Pretreatment cone-beam computed tomography (CBCT) images were obtained from 30 Thai orthodontic patients (15 patients with skeletal normal bite and 15 with skeletal open bite) whose ages ranged from 14 to 28 years. The CBCT images of the patients were processed and measured using the Romexis Viewer program. The MSDs and MCDs from the root apices of the maxillary and mandibular second premolar, first molar, and second molar to the maxillary sinus floor or the mandibular canal were measured perpendicularly to the occlusal plane. The Student t test was used for comparisons between the 2 groups. The greatest mean MSDs were from the root apex of the second premolars in both groups, whereas the least mean MSDs were from the mesiobuccal root apex of the second molars. The greatest mean MCDs were from the mesial root apex of the first molars, whereas the least mean MCDs were from the distal root apex of the second molars. There were no differences in the mean MSDs or the mean MCDs between the skeletal normal bite group and the skeletal open bite group

Analysis of maxillary anterior teeth proportion in relationship with lower facial height and malocclusion

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Rajesh Gyawali

2017-07-01

Full Text Available Background & Objectives: Maxillary anterior tooth to tooth proportion has a special value in dental esthetics. This study aimed to assess the apparent proportion of maxillary anteriors and possible association with lower anterior facial height and malocclusion type. Materials & Methods: One-hundred and sixty samples with well aligned maxillary dentition were selected and the lower anterior facial height was measured with digital caliper. Molar relationship was examined and intraoral frontal photograph was taken for digital measurement of tooth proportion. The ratio of maxillary canine to lateral and lateral to central incisors were measured and compared between gender and the sides. These ratios were further compared among various malocclusion type using ANOVA and its association with lower anterior facial height was evaluated with Pearson’s correlation.Results: Most of the samples had Class I molar relationship (70% followed by Class II (23% and Class III (7%. The mean lower anterior facial height was 62.82mm and ratio of maxillary lateral to central incisor and canine to lateral incisor was 0.68 and 0.76 respectively. No statistically significant difference was found when the ratio was compared between the gender and the sides. These ratios were statistically different from the golden ratio and has no significant correlation with lower anterior facial height. These mean ratios were also found similar across the malocclusion type.Conclusion: Ratio of apparent dimension of maxillary canine to lateral incisor and lateral to central incisor was different from the golden ratio and showed no association with lower anterior facial height and malocclusion type.

The Use of Recombinant Human Platelet-Derived Growth Factor for Maxillary Sinus Augmentation.

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Kubota, Atsushi; Sarmiento, Hector; Alqahtani, Mohammed Saad; Llobell, Arturo; Fiorellini, Joseph P

The maxillary sinus augmentation procedure has become a predictable treatment to regenerate bone for implant placement. The purpose of this study was to evaluate the effect of recombinant human platelet-derived growth factor BB (rhPDGF-BB) combined with a deproteinized cancellous bovine bone graft for sinus augmentation. The lateral window approach was used for maxillary sinuses with minimal residual bone. After a healing period of 4 months, dental implants were placed and then restored following a 2-month osseointegration period. The result demonstrated increased bone height and ISQ values and a 100% survival rate. This study indicates that the addition of rhPDGF-BB to deproteinized cancellous bovine bone accelerated the healing period in maxillary sinuses with minimal native bone.

A 2D panoramic surgical stent imaging: Complete arch mandibular implant fixed prosthesis along with bar supported maxillary over denture

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Mukesh Kumar Singhal

2017-01-01

Full Text Available Successful rehabilitation of a patient should restore function, esthetic, and speech by prosthesis. Treatment modalities vary from patient to patient. Semi-precision attachments and implants offer several advantages over the traditional approach. The aim and objective of this report was to assess a case of a 55-year-old female patient who had lost all her teeth, except maxillary canines #13 and #23 and with severe bone loss in the mandible. Tooth-supported bar attachment was planned for maxilla, and a total of five dental implants were placed in the mandible using a flapless approach aided by radiographic gutta-percha surgical stents over panoramic two-dimensional imaging. Customized, radiographic stents help for the placement of implant in the view of paralleling and flapless surgery, completely. An immediate loading protocol is adopted as from day of the surgery to 6 weeks along with implant supported full arch fixed dentures after 4 months. The outcome of the treatment was impressive, and the patient gave a positive response with superb esthetics and functions.

Partial maxillary osteotomy following an unsuccessful forced eruption of an impacted maxillary canine: 10 year follow-up. Review and case report

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Edela Puricelli

2012-12-01

Full Text Available The maxillary canines are amongst the most frequently impacted teeth, second only to the third molars. Several conservative orthodontic and surgical techniques are available to position the teeth properly in the dental arch, even in severe cases. However, when an extraction is necessary, it often leaves a critical alveolar defect of difficult management. The authors present the technique of Partial Maxillary Osteotomy, in which a dento-alveolar segment is moved mesially, hence closing the remaining space, allowing for the formation of healthy periodontium and resulting in an adequate functional and aesthetic outcome. A case report is presented with a 10 year follow-up, proving the technique's stability in the long term.

Radiological age estimation: based on third molar mineralization and eruption in Turkish children and young adults.

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Karadayi, Beytullah; Kaya, Ahsen; Kolusayın, Melek Ozlem; Karadayi, Sükriye; Afsin, Hüseyin; Ozaslan, Abdi

2012-11-01

Radiographic evaluation of mineralization and eruption stages of third molars using dental panoramic radiographies can be an efficient tool for chronological age estimation in both forensic sciences and legal medicine. The third molar tooth is utilized for dental age estimation about the age span of 15-23 years because it represents the only tooth still in development. The aim of this study is to obtain and analyze data regarding third molar development and eruption in Turkish population for dental age estimation. A total of 744 dental panoramic radiographies of 394 female and 350 male subjects aged between 8 and 22 years were examined. Third molar development was determined according to the Nolla classification system, and eruption was assessed relative to the alveolar bone level. Mandibular and maxillary third molars were generally found at similar stages of development on both sides. Nolla stage 6 (completed crown calcification) was reached at around the age of 15 in both maxillary and mandibular third molars in both sexes. Alveolar emergence was at around the age of 16 in males and around age of 17 in females. Although third molars' eruption shows greater variability than development of third molars, data which were obtained from this study about eruption of these teeth can be supportive to development data for age estimation.

A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion

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Akyalcin, Sercan; Englih, Jeryl D.; Stephens, Claude R.; Winkelmann, Sam [Dept. of Orthodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Schaefer, Jeffrey S. [Todd Hughes Orthodontics, Houston (United States)

2013-06-15

This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.

A comparative study on the stress distribution around dental implants in three arch form models for replacing six implants using finite element analysis.

Science.gov (United States)

Zarei, Maryam; Jahangirnezhad, Mahmoud; Yousefimanesh, Hojatollah; Robati, Maryam; Robati, Hossein

2018-01-01

Dental implant is a method to replacement of missing teeth. It is important for replacing the missed anterior teeth. In vitro method is a safe method for evaluation of stress distribution. Finite element analysis as an in vitro method evaluated stress distribution around replacement of six maxillary anterior teeth implants in three models of maxillary arch. In this in vitro study, using ABAQUS software (Simulia Corporation, Vélizy-Villacoublay, France), implant simulation was performed for reconstruction of six maxillary anterior teeth in three models. Two implants were placed on both sides of the canine tooth region (A model); two implants on both sides of the canine tooth region and another on one side of the central incisor region (B model); and two implants on both sides of the canine tooth region and two implants in the central incisor area (C model). All implants evaluated in three arch forms (tapered, ovoid, and square). Data were analyzed by finite analysis software. Von Mises stress by increasing of implant number was reduced. In a comparison of A model in each maxillary arch, the stress created in the cortical and cancellous bones in the square arch was less than ovoid and tapered arches. The stress created in implants and cortical and cancellous bones in C model was less than A and B models. The C model (four-implant) reduced the stress distribution in cortical and cancellous bones, but this pattern must be evaluated according to arch form and cost benefit of patients.

eRME - Rapid Maxillary Expansion in the economic way

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Sonali Mahadevia

2011-01-01

Full Text Available Aim and Objectives: Rapid Maxillary Expansion constitutes a routine clinical procedure in orthodontics, involving separation of mid-palatine suture which is usually done with help of the Hyrax screw. However, because of its high cost, the use has been limited, especially in institutions. So, the purpose of this study was to construct an economical device which can expand the maxillary arch in growing patients. Materials and Methods: Six patients having constricted maxilla and posterior skeletal crossbite were randomly selected from the Department of Orthodontics. A unique, easy and simple alternative device for expanding the maxillary arch called economic Rapid Maxillary Expander (eRME has been fabricated at about one-tenth the cost of the conventional Hyrax. Pre- and post-treatment effects were statistically tested by using paired t-test at 0.05 level of significance. Results and Conclusion: The study results showed an average expansion in canine, premolar and molar regions of 4.4 mm, 6.8 mm and 9.4 mm, respectively, having significant difference pre-and post-treatment. Thus, it shows that maxillary expansion is efficiently possible with the application of this newly constructed device named eRME. This appliance also acts as a fixed retainer to avoid relapse, hence negating the need for a separate retainer.

Maxillary sagittal growth evaluated on dry skulls from children and adolescents

DEFF Research Database (Denmark)

Damgaard, Christian; Caspersen, Louise Miltenburg; Kjær, Inger

2011-01-01

Abstract Objective. The hypothesis of the present study is that the inter-relationship between the greater palatine foramen (stable structure) and the first maxillary molar, which is located in the growing and forward-moving maxilla, expresses the longitudinal growth of the maxilla. Materials...... foramina and another connecting the lingual interlobal incisions in the first permanent molars. The perpendicular distance (T) between these two lines expressed the distance between the foramen and the first molar. Results. The T-distance increased markedly between the stages where the first, second....... Conclusion. This study shows that the greater palatine foramen is located close to the most posterior located and erupted permanent molar in normally developed dentitions without agenesis. This information may be valuable for dentists when applying local anesthetics. Furthermore, the study revealed a growth...

Nasopalatine duct cyst associated with dental implant treatment: A case report

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Shintaro Sukegawa, DDS, PhD

2015-09-01

Full Text Available Maxillary anterior implants are associated with the risk of nasopalatine canal damage. Here we present the case of a 37-year-old man who developed a nasopalatine duct cyst after maxillary implant placement. The patient received an implant 3 months after the extraction of a fractured maxillary right central incisor. At a maintenance visit 9 years after the procedure, he complained of swelling and mild pain in the palatal region of the implant. A panoramic radiograph and computed tomography (CT scan revealed a large, well-circumscribed, periapical radiolucency surrounding the apical portion of the implant and extending to the nasopalatine duct. We removed the entire lesion without removing the implant. Histopathologic examination of the resected specimen revealed a nasopalatine duct cyst. Accidental contact with the nasopalatine canal during implant surgery may have led to the development of the nasopalatine duct cyst. Careful planning using a preoperative CT scan prior to implant placement may prevent such complications.

Maxillary unicystic ameloblastoma: a case report.

Science.gov (United States)

Agani, Zana; Hamiti-Krasniqi, Vjosa; Recica, Jehona; Loxha, Mergime Prekazi; Kurshumliu, Fisnik; Rexhepi, Aida

2016-10-18

Ameloblastoma is a benign epithelial odontogenic tumor. It is often aggressive and destructive, with the capacity to attain great size, erode bone and invade adjacent structures. Unicystic ameloblastoma is a rare odontogenic lesion, with clinical, radiographic and gross features of jaw cysts. The lesion histologically shows typical ameloblastomatous epithelium lining part of the cyst cavity with or without and/or mural tumor growth. Unicystic ameloblastoma usually presents in posterior mandibular ramus region, while it is rare and atypical in posterior maxillary region. . We report a case of 16 year old Kosovar male, Albanian ethnicity, who presented with a swelling located in right maxillary region. Clinical examination revealed a painless swelling extending from the maxillary right central incisor to the maxillary right first molar tooth. Panoramic radiograph disclosed a well corticated unilocular radiolucent lesion approximately 5 × 5 cm in diameter which was in contact with the roots of the teeth present inferiorly and with the maxillary sinus superiorly. Maxillary right canine impaction was noted and unerupted lateral incisor tooth was present inside the radiolucency. Preoperative diagnosis of the lesion was made as dentigerous cyst based on the age of the patient, location of the swelling, clinical and radiographic findings, but the unicystic ameloblastoma was also taken into consideration. The patient was treated by surgical enucleation of the lesion and extraction of lateral incisor tooth which was present inside the lesion. The histopathological examination of the lesion revealed confirmed finding for unicystic ameloblastoma mural form. No recurrence was observed in 1 year follow-up. Maxillary region is considered a rare and atypical location for unicystic ameloblastoma. We emphasize the importance of differential diagnosis of an odontogenic lesion with common clinical and radiological features that will impact the treatment planning and follow up

Evaluation of possible prognostic factors for the success, survival, and failure of dental implants.

Science.gov (United States)

Geckili, Onur; Bilhan, Hakan; Geckili, Esma; Cilingir, Altug; Mumcu, Emre; Bural, Canan

2014-02-01

To analyze the prognostic factors that are associated with the success, survival, and failure rates of dental implants. Data including implant sizes, insertion time, implant location, and prosthetic treatment of 1656 implants have been collected, and the association of these factors with success, survival, and failure of implants was analyzed. The success rate was lower for short and maxillary implants. The failure rate of maxillary implants exceeded that of mandibular implants, and the failure rate of implants that were placed in the maxillary anterior region was significantly higher than other regions. The failure rates of implants that were placed 5 years ago or more were higher than those that were placed later. Anterior maxilla is more critical for implant loss than other sites. Implants in the anterior mandible show better success compared with other locations, and longer implants show better success rates. The learning curve of the clinician influences survival and success rates of dental implants.

Correction of complete maxillary crossbite with severe crowding using Hyrax expansion and fixed appliance.

Science.gov (United States)

Wangsrimongkol, Tasanee; Manosudprasit, Montian; Pisek, Poonsak; Leelasinjaroen, Pornnapha

2013-09-01

An 18-year-old Thai man who presented with a secondary cleft palate, maxillary hypoplasia and severe crowding was treated by rapid maxillary expansion and fixed orthodontic appliances. Initial assessment found skeletal Class III malrelationship and dental Class II malocclusion with anterior and bilateral posterior crossbites. Camouflage orthodontic treatment was planned using a rapid maxillary expansion appliance and correcting crowding with extraction all four premolar teeth. A Hyrax appliance and vertical loop arch wire were placed for maxillary arch expansion of 9.5 mms at first molars and canines, and 5.5 mms at the premolars and obtained positive overjet. Both acceptable skeletal and soft tissue relationships and satisfactory occlusion were produced. After 14 months of postoperative follow-up, the occlusal result was stable and no skeletal reversals could be detected.

Group A T-loop for differential moment mechanics: an implant study.

Science.gov (United States)

Martins, Renato Parsekian; Buschang, Peter H; Gandini, Luiz Gonzaga

2009-02-01

When anchorage control is critical and compliance is less than ideal, efficient treatment depends on differential tooth movements. The purpose of this study was to evaluate the distal tipping of partially retracted canines and the mesial movement of the molars. Eleven patients had their maxillary and mandibular canines partially retracted with TMA (Ormco Corp, Orange, Calif) T-loop springs with 45 degrees gable bends distal to the loops preactivated for group A (maximum anchorage). Metallic bone markers served as references. The canines were retracted until enough space was available for alignment of the incisors without proclination. Oblique (45 degrees) radiographs were taken immediately before the initial activation and after partial retraction. The radiographs were scanned, superimposed on the bone markers, and measured digitally. The mandibular canine crowns were retracted (4.1 +/-1.9 mm) and intruded (0.7 +/- 0.3 mm) by uncontrolled tipping. In contrast, the maxillary canine crowns were retracted (3.2 +/- 1.4 mm) by controlled tipping. The maxillary and mandibular molars crowns were protracted by similar amounts (1.0 +/- 0.6 and 1.2 +/-1.2 mm, respectively) by controlled tipping, without significant extrusion. The molars were protracted approximately 0.3 mm for every 1 mm of canine retraction. The T-loop spring used in this investigation produced controlled tipping of the maxillary canines, but it did not produce controlled tipping of the mandibular canines or translation of the molar as expected.

Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report

OpenAIRE

Paduano, Sergio; Cioffi, Iacopo; Rongo, Roberto; Cupo, Antonello; Bucci, Rosaria; Valletta, Rosa

2014-01-01

This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants.

Mandibular third molar development after mantle radiation in long-term survivors of childhood Hodgkin's disease

International Nuclear Information System (INIS)

McGinnis, J.P. Jr.; Hopkins, K.P.; Thompson, E.I.; Hustu, H.O.

1987-01-01

Sequential panoramic radiographs were assessed for mandibular third molar development in 47 long-term survivors of childhood Hodgkin's disease after treatment with 37 Gy mantle field radiation. To make a comparison, panoramic radiographs of 149 healthy, nonirradiated children were reviewed for the presence of mandibular third molars. In children between the ages of 7 and 12 years, bilateral agenesis of mandibular third molars was more frequent in patients who had been treated with mantle radiation than in nonirradiated patients. Unilateral agenesis, crown hypoplasia, and root growth impairment of mandibular third molars were also found. Similar, apparent, radiation-induced developmental anomalies were noted in maxillary third molars of the irradiated patients

Molar-incisor-hypomineralisation (MIH). Retrospective clinical study in Greek children. I. Prevalence and defect characteristics.

Science.gov (United States)

Lygidakis, N A; Dimou, G; Briseniou, E

2008-12-01

This was to evaluate the prevalence and the clinical characteristics of MIH in a group of Greek children. During the years 2003--2005, all MIH cases diagnosed according to the recently set criteria were selected from the new patients clinic of a Community Dental Centre for Children (Athens). Age, gender and teeth involved were recorded. The severity of MIH was determined collectively by dividing the affected teeth in two groups; a) mild defect (demarcated opacities) and b) moderate/severe defect (enamel breakdown and atypical restorations). Evaluation of the distribution of the affected teeth within MIH cases was performed in a separate group of 225 affected children aged 8-12 years with their entire 12 'index' teeth erupted. From the 3,518, 5.5 to 12 year old children that were examined, there were 360 (10.2%) children with MIH, 211 (58.6%) females and 149 (41.4%) males, with 1,926 affected teeth, 1,231 molars and 695 incisors. In the molars group, maxillary molars were more frequently affected (87.8/90.3%) than mandibular (81.7/82.2%). In the central incisor group, maxillary teeth were also more frequently affected (50/55%) than mandibular (24.4/25%), while laterals were the least affected. In all there were 37.9% molars with moderate/severe defects as compared with 4.9% incisors, the remaining 62.1% and 95.1% respectively being mild. The various associations between the affected teeth were evaluated in the sub-group of 225 MIH children with all 'index' teeth erupted (1,286 affected teeth, 776 molars and 510 incisors), with mean number of affected teeth per child being 5.7; separately for molars 3.4 and for incisors 2.2. In these cases 28.4% of the children had only molars affected and 71.6% had both molars and incisors. In descending order the associations of affected teeth more frequently found were: 4 molars/2 incisors (23.5%), 4 molars/4 incisors (16.8%), 4 molars alone (15.1%) and 2 molars alone (9.7%), the remaining being much less. As age increased the

[Reconstruction of maxillary sinus superior wall fractures with calcium phosphate cement/recombinant human bonemorphogenetic protein 7 compound implanted material in rabbit].

Science.gov (United States)

Zhang, Qunhui; Yu, Feng; Zhang, Haoliang; Gong, Huicheng; Lin, Ying

2015-11-01

To evaluate the osteogenetic character and repairing maxillary sinus superior wall fractures capability of calcium phosphate cement (CPC) before and after combined with recombinant human bone morphogenetie protein-7(rhBMP-7). A 10 mmX5 mm bone defect in the maxillary sinus superior wall was induced by surgery in all 24 New Zealand white rabbits. These 24 rabbits were randomly divided into two groups. The defects were repaired with CPC group (n = 12) and CPC/rhBMP-7 group (n = 12). The osteogenesis of bone defect was monitored by gro'ss observation, histological examination, observation under scanning electron microscope and measurement of ALP activity at 6 and 12 weeks after the implantation. In group CPC,new bone was found to form slowly and little by little. In group CPC/rhBMP-7, however, new bone was observed to form early and massively. The ALP activity in group CPC showed significant statistical difference with that of group CPC/rhBMP-7 (P < 0.05). The CPC/rhBMP-7 composite has osteoconductibility and osteoinductibility, comparing the use of CPC/rhBMP-7 with CPC for the repair of orbital fracture, the former show obvious advantage repairing ability in maxillary sinus superior wall defect.

Estimation of soft- and hard-tissue thickness at implant sites

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Anil Kumar

2014-01-01

Full Text Available Introduction: Anchorage control is a critical consideration when planning treatment for patients with dental and skeletal malocclusions. To obtain sufficient stability of implants, the thickness of the soft tissue and the cortical-bone in the placement site must be considered; so as to provide an anatomical map in order to assist the clinician in the placement of the implants. Objective: The aim of this study is to evaluate the thickness of soft- and hard-tissue. Materials and Methods: To measure soft tissue and cortical-bone thicknesses, 12 maxillary cross-sectional specimens were obtained from the cadavers, which were made at three maxillary mid-palatal suture areas: The interdental area between the first and second premolars (Group 1, the second premolar and the first molar (Group 2, and the first and second molars (Group 3. Sectioned samples along with reference rulers were digitally scanned. Scanned images were calibrated and measurements were made with image-analysis software. We measured the thickness of soft and hard-tissues at five sectional areas parallel to the buccopalatal cementoenamel junction (CEJ line at 2-mm intervals and also thickness of soft tissue at the six landmarks including the incisive papilla (IP on the palate. The line perpendicular to the occlusal plane was made and measurement was taken at 4-mm intervals from the closest five points to IP. Results: (1 Group 1:6 mm from CEJ in buccal side and 2 mm from CEJ in palatal side. (2 Group 2:8 mm from CEJ in buccal side and 4 mm from CEJ in palatal side. (3 Group 3:8 mm from CEJ in buccal side and 8 mm from CEJ in palatal side. Conclusions: The best site for placement of implant is with thinnest soft tissue and thickest hard tissue, which is in the middle from CEJ in buccal side and closest from CEJ in palatal side in Group 1 and faraway from CEJ in buccal side and closest from CEJ in palatal side in Group 2 and faraway from CEJ in buccal side and faraway from CEJ in palatal

Orthodontic Management of Congenitally Missing Maxillary Lateral Incisors: A Case Report

Directory of Open Access Journals (Sweden)

Sergio Paduano

2014-01-01

Full Text Available This case report describes the orthodontic treatment of a woman, aged 15 years, with permanent dentition, brachyfacial typology, with congenitally missing maxillary lateral incisors. Multibracket straightwire fixed appliance was used to open the space for dental implant placement, and treat the impaired occlusion. The missing lateral incisors were substituted with oral implants.

Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars

OpenAIRE

Chang, Hao-Hueng; Lee, Ming-Shu; Hsu, You-Chyun; Tsai, Shang-Jye; Lin, Chun-Pin

2015-01-01

Impacted third molars can be extracted by regular surgery or piezosurgery. The aim of this study was to compare clinical parameters and device-produced noise levels between regular surgery and piezosurgery for the extraction of impacted third molars. Methods: Twenty patients (18 women and 2 men, 17–29 years of age) with bilateral symmetrical impacted mandibular or maxillary third molars of the same level were included in this randomized crossover clinical trial. The 40 impacted third molar...

Prediction of changes due to mandibular autorotation following miniplate-anchored intrusion of maxillary posterior teeth in open bite cases.

Science.gov (United States)

Kassem, Hassan E; Marzouk, Eiman S

2018-05-14

Prediction of the treatment outcome of various orthodontic procedures is an essential part of treatment planning. Using skeletal anchorage for intrusion of posterior teeth is a relatively novel procedure for the treatment of anterior open bite in long-faced subjects. Data were analyzed from lateral cephalometric radiographs of a cohort of 28 open bite adult subjects treated with intrusion of the maxillary posterior segment with zygomatic miniplate anchorage. Mean ratios and regression equations were calculated for selected variables before and after intrusion. Relative to molar intrusion, there was approximately 100% vertical change of the hard and soft tissue mention and 80% horizontal change of the hard and soft tissue pogonion. The overbite deepened two folds with 60% increase in overjet. The lower lip moved forward about 80% of the molar intrusion. Hard tissue pogonion and mention showed the strongest correlations with molar intrusion. There was a general agreement between regression equations and mean ratios at 3 mm molar intrusion. This study attempted to provide the clinician with a tool to predict the changes in key treatment variables following skeletally anchored maxillary molar intrusion and autorotation of the mandible.

An analysis of reliability and validity of the papilla index score of implant-supported single crowns of maxillary central incisors

DEFF Research Database (Denmark)

Peng, Min; Fei, Wei; Hosseini, Mandana

2012-01-01

Objectives: To test the reliability and validity of the papilla index scores of the implant-supported single crowns (ISSCs) of maxillary central incisors. Materials and Methods: Twenty-five patients with 25 ISSCs were included. Two prosthodontists evaluated the papilla index score (PIS) of three...... inter-observer agreement. The PIS score demonstrated significant correlation to the corresponding PP value (rs=.567, p=.000). Conclusions: The feasibility, reliability and validity of the PIS made the parameter useful for quality control of the pri-implant soft tissue of ISSCs....... fill percent (PP) was calculated. The validity of PIS was tested against the corresponding papilla fill percent (PP) by using the Spearman correlation analysis. Results: The intra-observer agreement was >70% in 4/5 and >50% in all observations, the pooled Cohen’s ¿ was 0.64 and 0.70 for two observers...

Pendulum Therapy of Molar Distalization in Mixed Dentition.

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Patil, Raju Umaji; Prakash, Amit; Agarwal, Anshu

2016-01-01

Early and timely pedo-orthodontic treatment is aimed at eliminating the disturbances of skeletal or dentoalveolar development, to harmonize the stomatognathic system before the full eruption of all permanent teeth. The advantages of pendulum appliance are its minimal dependence on patient's compliance (child cooperation), ease of fabrication, onetime activation and adjustment of the springs if necessary to correct minor transverse and vertical molar positions. This article reports a successful treatment method of class II malocclusion with pendulum appliance in mixed dentition phase. Distalization of maxillary molar was done, followed by guidance of canine impaction orthodontically and other dental correction using 0.022 MBT appliances. Posttreatment results were stable and remarkable. How to cite this article: Patil RU, Prakash A, Agarwal A. Pendulum Therapy of Molar Distalization in Mixed Dentition. Int J Clin Pediatr Dent 2016;9(1):67-73.

Association Between the Lateral Wall Thickness of the Maxillary Sinus and the Dental Status: Cone Beam Computed Tomography Evaluation

International Nuclear Information System (INIS)

Khajehahmadi, Saeedeh; Rahpeyma, Amin; Hoseini Zarch, Seyed Hosein

2014-01-01

Assessment of the lateral wall thickness of the maxillary sinus is very important in decision making for many surgical interventions. The association between the thickness of the lateral wall of the maxillary sinus and the dental status is not well identified. To compare the thickness of the lateral wall of the maxillary sinus in individuals with and without teeth to determine if extraction of the teeth can lead to a significant reduction in the thickness of the maxillary sinus lateral wall or not. In a retrospective study on fifty patients with an edentulous space, the thickness of the lateral wall of the maxillary sinus,one centimeter above the sinus floor in the second premolar (P2), first molar (M1) and second molar (M2) areas was determined by cone beam computed tomography scans(CBCTs) and a digital ruler in Romexis F software (Planmeca Romexis 2.4.2.R) and it was compared with values measured in fifty dentated individuals. Three way analysis of variance was applied for comparison after confirmation of the normal distribution of data. The mean of the wall thickness in each of these points was lower in patients with edentulous spaces; however it was not significant. There was no association between gender and the thickness of the lateral wall of the maxillary sinus, but location was associated with different thicknesses. The differences in the thickness based on the location and dental status necessitates assessment of the wall thickness of the maxillary sinus in addition to the current evaluation of bone thickness between the sinus floor and the edentulous crest before maxillary sinus surgery

Morphological study of maxillary canine region based on CT

International Nuclear Information System (INIS)

Yamada, Maiko; Takamori, Hitoshi; Ide, Yoshiaki; Yosue, Takashi

2010-01-01

The maxilla is generally known as a site where anatomical limitations make it difficult to obtain sufficient bone volume. A large amount of bone exists in the canine region between the anterior margin of the maxillary sinus and the piriform aperture margin. Although this region is crucial for implant treatments, there have not been any reports on morphological studies of the region. In this study, we investigated the morphology of the canine region based on CT, and also the morphology and position of the maxillary sinus located posterior to the canine region. The results were as follows: In the area above the anterior nasal spine, the higher the level, the smaller the mesio-distal length and the bucco-lingual width tended to become. In the area above the anterior nasal spine, the mesio-distal length and the bucco-lingual width tended to be smaller in female patients than in male patients. In the area above the anterior nasal spine, no significant differences in mesio-distal length and bucco-lingual width were observed between dentulous and edentulous jaws. The morphology of the maxillary sinus was mainly of an inverse-trapezoidal, circular, or triangular form. The position of the anterior wall of the maxillary sinus was most frequently found at the site corresponding to the second premolar. Through this study, we have reconfirmed that the canine region is vital for implant treatments in the maxilla. (author)

A 3-year clinical and radiographic study of implants placed simultaneously with maxillary sinus floor augmentations using a new nanocrystalline hydroxyapatite.

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Heinemann, F; Mundt, T; Biffar, R; Gedrange, T; Goetz, W

2009-12-01

The aims of this case series was to evaluate the success rate of implants and their restorations, the sinus bone graft resorption, and the marginal bone loss around the implants when nanocristalline HA embedded in a silica matrix was exclusively used as grafting material. In 13 partially edentulous patients of a private practice having missing teeth in the posterior maxilla and a subantral bone height between 3 and 7 mm, 19 sinus augmentations (100% Nanobone, Artoss, Rostock, Germany) by the lateral lift technique were performed. The implants (Tiolox/Tiologic Implants, Dentaurum, Ispringen, Germany) were simultaneously placed. After 6 to 9 months 37 implants were restored with fixed dental prostheses. The clinical evaluation included peri-implant parameters, periotest measurements and the restorations. The radiographic bone heights over time were estimated with linear mixed models. The implant success rate was 100% after three years. The periotest values (between -7 and -6) after implant abutment connection indicated a solid osseointegration. The mean rates of the marginal bone loss over the first year were higher (mesial: -0.55, distal: -0.51 mm) than the annual rates thereafter (mesial: -0.09 mm, distal: -0.08 mm). The mean rates of changes in the total bone height were neglectable (<0.2 mm) and not significant. The prosthodontic and esthetic evaluation revealed a successful outcome. Within the limits of this clinical report it may be concluded that maxillary sinus augmentation using 100% nanocristalline HA embedded in a silica matrix to support implants is a reliable procedure.

Accurate pre-surgical determination for self-drilling miniscrew implant placement using surgical guides and cone-beam computed tomography.

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Miyazawa, Ken; Kawaguchi, Misuzu; Tabuchi, Masako; Goto, Shigemi

2010-12-01

Miniscrew implants have proven to be effective in providing absolute orthodontic anchorage. However, as self-drilling miniscrew implants have become more popular, a problem has emerged, i.e. root contact, which can lead to perforation and other root injuries. To avoid possible root damage, a surgical guide was fabricated and cone-beam computed tomography (CBCT) was used to incorporate guide tubes drilled in accordance with the planned direction of the implants. Eighteen patients (5 males and 13 females; mean age 23.8 years; minimum 10.7, maximum 45.5) were included in the study. Forty-four self-drilling miniscrew implants (diameter 1.6, and length 8 mm) were placed in interradicular bone using a surgical guide procedure, the majority in the maxillary molar area. To determine the success rates, statistical analysis was undertaken using Fisher's exact probability test. CBCT images of post-surgical self-drilling miniscrew implant placement showed no root contact (0/44). However, based on CBCT evaluation, it was necessary to change the location or angle of 52.3 per cent (23/44) of the guide tubes prior to surgery in order to obtain optimal placement. If orthodontic force could be applied to the screw until completion of orthodontic treatment, screw anchorage was recorded as successful. The total success rate of all miniscrews was 90.9 per cent (40/44). Orthodontic self-drilling miniscrew implants must be inserted carefully, particularly in the case of blind placement, since even guide tubes made on casts frequently require repositioning to avoid the roots of the teeth. The use of surgical guides, fabricated using CBCT images, appears to be a promising technique for placement of orthodontic self-drilling miniscrew implants adjacent to the dental roots and maxillary sinuses.

Narrow- (3.0 mm) Versus Standard-Diameter (4.0 and 4.5 mm) Implants for Splinted Partial Fixed Restoration of Posterior Mandibular and Maxillary Jaws: A 5-Year Retrospective Cohort Study.

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Pieri, Francesco; Forlivesi, Caterina; Caselli, Ernesto; Corinaldesi, Giuseppe

2017-04-01

Evidence concerning predictability of narrow-diameter implants (NDIs) (3.0 mm) and standard-diameter implants (SDIs) (4.0 to 4.5 mm) supporting fixed partial dentures (FPDs) in posterior mandibular and maxillary jaws. All patients treated with at least two adjacent NDIs or SDIs according to available bone thickness and with a minimum follow-up of 5 years after placement were invited to undergo a clinical and radiologic examination. Outcome measures were implant and FPD failures, biologic and prosthetic complications, and marginal bone loss. A total of 107 out of 127 patients attended the examination: 49 (113 implants) of the NDI group, and 58 (126 implants) of the SDI group. Two NDIs failed in one patient versus four SDIs in four patients (P = 0.37). One FPD failed in the NDI group versus two FPDs in the SDI group (P >0.99). Nine biologic complications occurred in the NDI group and twelve in the SDI group (P = 0.81). Twelve prosthetic complications occurred in the NDI group and only two in the SDI group (P = 0.001). Peri-implant marginal bone loss at 5 years was 0.95 ± 0.84 mm for the NDI group and 1.2 ± 0.86 mm for the SDI group (P = 0.06). Five-year data indicate that FPD treatment in posterior mandibular and maxillary jaws with NDIs was as reliable as with SDIs, although NDIs showed a higher risk of prosthetic complications.

Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants

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Sankalp Mittal

2018-01-01

Full Text Available Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany’s classification maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS. The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

Accuracy of implant transfer with open-tray and closed-tray impression techniques and surface detail reproduction of the tooth during impression

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Hakimeh Siadat

2012-01-01

Full Text Available Background and Aims: Accurate recording of implant location is required to achieve passive fit and have the implants without stress concentration. The aim of this in-vitro study was to evaluate the dimensional and angular accuracy of open-tray and closed-tray impression techniques using polyether impression material and also to assess the surface detail reproduction of the tooth while impression making.Materials and Methods: One reference metal model with 2 implants (Implantium on the position of the maxillary second premolar and first molar and one molar tooth for evaluation of surface details was prepared. 27 polyether impressions of these models were made (9 using open-tray, 9 using closed-tray techniques and 9 were made just of the surface of the teeth without any implants. Impressions were poured with ADA type IV stone. Coordinate Measuring Machine was used for measuring the dimensional accuracy and video measuring machine for surface detail reproduction. All of these measurements were compared with the measurements on the reference model. Data were analyzed by and compared by T-test and One-way ANOVA.Results: There was a significant statistical difference between open-tray and closed-tray techniques (P0.05.Conclusion: The accuracy of open-tray impression technique was more than closed-tray technique. The surface detail reproduction of the tooth was not affected by impression technique.

Five years experience with a new intraoral maxillary distraction device (RID).

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Picard, Arnaud; Diner, Patrick A; Galliani, Eva; Tomat, Catherine; Vazquez, Ma rie Paule; Carls, Friedrich P

2011-10-01

Maxillary distraction osteogenesis is well established for the treatment of severe retromaxilla. We report our experience since 2004 of the treatment of 19 patients using a new intraoral maxillary distraction device. Maxillary advancement was successful in all patients with mean advancement of 9.6mm (range 4-17) measured at a point in lateral cephalograms. The new device limited surgical exposure and the amount of materials implanted, and improved control in every phase of the distraction. It was psychologically accepted by patients and was more comfortable than existing devices. Copyright © 2010 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Ultrasonic implant site preparation using piezosurgery: a multicenter case series study analyzing 3,579 implants with a 1- to 3-year follow-up.

Science.gov (United States)

Vercellotti, Tomaso; Stacchi, Claudio; Russo, Crescenzo; Rebaudi, Alberto; Vincenzi, Giampaolo; Pratella, Umberto; Baldi, Domenico; Mozzati, Marco; Monagheddu, Chiara; Sentineri, Rosario; Cuneo, Tommaso; Di Alberti, Luca; Carossa, Stefano; Schierano, Gianmario

2014-01-01

This multicenter case series introduces an innovative ultrasonic implant site preparation (UISP) technique as an alternative to the use of traditional rotary instruments. A total of 3,579 implants were inserted in 1,885 subjects, and the sites were prepared using a specific ultrasonic device with a 1- to 3-year follow-up. No surgical complications related to the UISP protocol were reported for any of the implant sites. Seventy-eight implants (59 maxillary, 19 mandibular) failed within 5 months of insertion, for an overall osseointegration percentage of 97.82% (97.14% maxilla, 98.75% mandible). Three maxillary implants failed after 3 years of loading, with an overall implant survival rate of 97.74% (96.99% maxilla, 98.75% mandible).

Management of compromised anterior maxillary edentulous arch with symphyseal bone graft

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Sunil Kumar Mishra

2018-01-01

Full Text Available Achieving optimal aesthetics, function and phonetics with implant-supported restorations depends largely on the amount of bone present at the site where implant has to be placed. Sometimes, patient reports with compromised conditions which makes the implant placement difficult. Today, reconstruction procedures such as autogenous bone graft and guided bone regeneration make the implant placement possible in different ridge deficient cases. This case report describes step-by-step procedure of restoring the missing maxillary right central incisor with implant-supported prostheses. In missing left central incisor region, the alveolar bony defect was corrected by autogenous bone graft obtained from symphysis region, for restoration with implant prostheses.

Skeletal and dental stability after maxillary distraction with a rigid external device in adult cleft lip and palate patients.

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Aksu, Muge; Saglam-Aydinatay, Banu; Akcan, Cenk Ahmet; El, Hakan; Taner, Tulin; Kocadereli, Ilken; Tuncbilek, Gokhan; Mavili, Mehmet Emin

2010-02-01

To evaluate skeletal and dental stability in adult cleft lip and palate patients treated with a rigid external distraction system at the end of distraction and during the postdistraction period. Lateral cephalograms of 7 patients were obtained before distraction, at the end of distraction, and during the postdistraction period. The mean age before distraction was 21.56 +/- 4.73 years. The mean follow-up was 37.3 +/- 12.4 months. The assessment of findings showed that skeletal maxillary sagittal movement was achieved in a superoanterior direction. The maxillary depth angle and effective maxillary length increased significantly (2 degrees and 9 mm, respectively) after distraction, whereas the palatal plane angle increased by 8 degrees , resulting in an anterior movement of the maxilla with a counterclockwise rotation. The lower facial height showed no significant changes after distraction. The sagittal movement of the upper incisors and the angulation of the upper first molars increased significantly (4.5 mm and 5.5 degrees , respectively). During the postdistraction period, the maxilla showed a slight relapse (22%). The effective maxillary length decreased by 2 mm. The palatal plane angle almost returned to its original position, showing 7 degrees of clockwise rotation. The lower facial height remained stable. The upper incisors moved anteriorly and the upper first molars showed a significant mesioangular change during follow-up. After distraction, significant maxillary advancement was achieved with a counterclockwise rotation. The upper incisors moved labially, and the upper first molars angulated mesially. After 3 years, a 22% relapse rate was seen in the maxilla. The counterclockwise rotation of the maxilla was returned to its original position. The upper incisors moved more anteriorly. Copyright 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Transverse effects on the nasomaxillary complex one year after rapid maxillary expansion as the only intervention: A controlled study

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Carolina da Luz Baratieri

2014-10-01

Full Text Available The aim of this study was to assess by means of cone-beam computed tomography (CBCT scans the transverse effects on the nasomaxillary complex in patients submitted to rapid maxillary expansion (RME using Haas expander in comparison to untreated individuals. This prospective controlled clinical study assessed 30 subjects (18 boys and 12 girls with mixed dentition and during pubertal growth. The treated group was submitted to RME with Haas expander, retention for six months and a six-month follow-up after removal. The control group matched the treated group in terms of age and sex distribution. CBCT scans were taken at treatment onset and one year after the expander was activated. Maxillary first molars (U6 width, right and left U6 angulation, maxillary alveolar width, maxillary basal width, palatal alveolar width, palatal base width, right and left alveolar angulation, palatal area, nasal base width, nasal cavity width and inferior nasal cavity area on the posterior, middle and anterior coronal slices were measured with Dolphin Imaging Software(r 11.5, except for the first two variables which were performed only on the posterior slice. All transverse dimensions increased significantly (P 0.05. Results suggest that increase of molar, maxillary, palatal and nasal transverse dimensions was stable in comparison to the control group one year after treatment with RME.

Comparison of micro-computerized tomography and cone-beam computerized tomography in the detection of accessory canals in primary molars.

Science.gov (United States)

Acar, Buket; Kamburoğlu, Kıvanç; Tatar, İlkan; Arıkan, Volkan; Çelik, Hakan Hamdi; Yüksel, Selcen; Özen, Tuncer

2015-12-01

This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

Influence of custom-made implant designs on the biomechanical performance for the case of immediate post-extraction placement in the maxillary esthetic zone: a finite element analysis.

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Chen, Jianyu; Zhang, Zhiguang; Chen, Xianshuai; Zhang, Xiao

2017-05-01

Due to the increasing adoption of immediate implantation strategies and the rapid development of the computer aided design/computer aided manufacturing technology, a therapeutic concept based on patient-specific implant dentistry has recently been reintroduced by many researchers. However, little information is available on the designs of custom-made dental implant systems, especially their biomechanical behavior. The influence of the custom-made implant designs on the biomechanical performance for both an immediate and a delayed loading protocol in the maxillary esthetic zone was evaluated by means of the finite element (FE) method. FE models of three dental implants were considered: a state of the art cylindrical implant and two custom-made implants designed by reverse engineering technology, namely a root-analogue implant and a root-analogue threaded implant. The von Mises stress distributions and micro-motions around the bone-implant interfaces were calculated using ANSYS software. In a comparison of the three implant designs for both loading protocols, a favorable biomechanical performance was observed for the use of root-analogue threaded implant which approximated the geometry of natural anterior tooth and maintained the original long-axis. The results indicated that bone-implant interfacial micro-motion was reduced and a favorable stress distribution after osseointegration was achieved.

Impacted maxillary central incisor: surgical exposure and orthodontic treatment.

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Pinho, Teresa; Neves, Manuel; Alves, Célia

2011-08-01

This case report describes the treatment of a patient with a horizontally impacted maxillary central incisor, a canine in the same quadrant, and an inclusion tendency. Due to severe crowing in the maxilla and the Class II molar relationship on the impaction side, a 2-stage treatment plan was developed. In the first stage, the right first premolar and deciduous canine were extracted; this allowed enough space for the eruption of the maxillary right permanent canine. The second stage included surgical exposure and traction of the impacted central incisor with a fixed orthodontic appliance. An excisional uncovering technique was needed to expose the impacted incisor. After it erupted, an apically positioned partial-thickness flap was used to add keratinized attached gingiva in the area surrounding the crown, initially located in an area of unattached gingiva. The patient finished treatment with a normal and stable occlusion between the maxillary and mandibular arches and an adequate width of attached gingiva. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Fracture strength and failure mode of maxillary implant-supported provisional single crowns: a comparison of composite resin crowns fabricated directly over PEEK abutments and solid titanium abutments.

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Santing, Hendrik Jacob; Meijer, Henny J A; Raghoebar, Gerry M; Özcan, Mutlu

2012-12-01

Polyetheretherketone (PEEK) temporary abutments have been recently introduced for making implant-supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant-supported restorations. The objectives of this study were to evaluate the fracture strength of implant-supported composite resin crowns on PEEK and solid titanium temporary abutments, and to analyze the failure types. Three types of provisional abutments, RN synOcta Temporary Meso Abutment (PEEK; Straumann), RN synOcta Titanium Post for Temporary Restorations (Straumann), and Temporary Abutment Engaging NobRplRP (Nobel Biocare) were used, and provisional screw-retained crowns using composite resin (Solidex) were fabricated for four different locations in the maxilla. The specimens were tested in a universal testing machine at a crosshead speed of 1 mm/minute until fracture occurred. The failure types were analyzed and further categorized as irreparable (Type 1) or reparable (Type 2). No significant difference was found between different abutment types. Only for the position of the maxillary central incisor, composite resin crowns on PEEK temporary abutments showed significantly lower (p Provisional crowns on PEEK abutments showed similar fracture strength as titanium temporary abutments except for central incisors. Maxillary right central incisor composite resin crowns on PEEK temporary abutments fractured below the mean anterior masticatory loading forces reported to be approximately 206 N. © 2010 Wiley Periodicals, Inc.

Dental Implant Placement with Simultaneous Anterior Maxillary Reconstruction with Block and Particulate Fresh Frozen Allograft Bone: A Case Report with 24-Month Follow-Up Data

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J. S. Vieira

2017-01-01

Full Text Available Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery. Ten months subsequent to this procedure, provisional fixed prosthesis was installed on the implants. Four months later (postoperative month 14, the final fixed prosthesis was installed and the clinical success was observed. The insertion of dental implants followed immediately by a placement of fresh frozen allograft is a safe and efficient process that results in the successful return of dental function and aesthetic rehabilitation for the patient.

A 3-year prospective clinical study of telescopic crown, bar, and locator attachments for removable four implant-supported maxillary overdentures.

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Zou, Duohong; Wu, Yiqun; Huang, Wei; Wang, Feng; Wang, Shen; Zhang, Zhiyong; Zhang, Zhiyuan

2013-01-01

To evaluate telescopic crown (TC), bar, and locator attachments used in removable four implant-supported overdentures for patients with edentulous maxillae. A total of 30 maxillary edentulous patients were enrolled in a 3-year prospective study. Ten patients (group A) were treated with overdentures supported by TCs, 10 patients (group B) with overdentures supported by bar attachments, and 10 patients (group C) with overdentures supported by locator attachments. A total of 120 implants were used to restore oral function. During the 3-year follow-up period, implant survival and success rates, biologic and mechanical complications, prosthodontic maintenance efforts, and patient satisfaction were evaluated. All 30 patients were available for the 3-year follow-up and exhibited 100% implant survival and success rates. Peri-implant marginal bone resorption was not statistically significant for the three groups. There were lower plaque, bleeding, gingiva, and calculus indices in group C compared with groups A and B. The number of prosthodontic maintenance visits revealed eight complications in the TC group, seven complications in the bar group, and four complications in the locator group. However, there were no differences in the clinical effects of the overdentures in the three groups. Within the limits of this prospective study, it was concluded that the locator system produced superior clinical results compared with the TC and bar attachments in terms of peri-implant hygiene parameters, the frequency of prosthodontic maintenance measures, cost, and ease of denture preparation. However, longer-term prospective studies are required to confirm these results.

Facial and occlusal esthetic improvements of an adult skeletal Class III malocclusion using surgical, orthodontic, and implant treatment

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de Almeida Cardoso, Mauricio; de Avila, Erica Dorigatti; Guedes, Fabio Pinto; Battilani Filho, Valter Antonio Ban; Capelozza Filho, Leopoldino; Correa, Marcio Aurelio; Nary Filho, Hugo

2016-01-01

The aim of this clinical report is to describe the complex treatment of an adult Class III malocclusion patient who was disappointed with the outcome of a previous oral rehabilitation. Interdisciplinary treatment planning was performed with a primary indication for implant removal because of marginal bone loss and gingival recession, followed by orthodontic and surgical procedures to correct the esthetics and skeletal malocclusion. The comprehensive treatment approach included: (1) implant removal in the area of the central incisors; (2) combined orthodontic decompensation with mesial displacement and forced extrusion of the lateral incisors; (3) extraction of the lateral incisors and placement of new implants corresponding to the central incisors, which received provisional crowns; (4) orthognathic surgery for maxillary advancement to improve occlusal and facial relationships; and finally, (5) orthodontic refinement followed by definitive prosthetic rehabilitation of the maxillary central incisors and reshaping of the adjacent teeth. At the three-year follow-up, clinical and radiographic examinations showed successful replacement of the central incisors and improved skeletal and esthetic appearances. Moreover, a Class II molar relationship was obtained with an ideal overbite, overjet, and intercuspation. In conclusion, we report the successful esthetic anterior rehabilitation of a complex case in which interdisciplinary treatment planning improved facial harmony, provided gingival architecture with sufficient width and thickness, and improved smile esthetics, resulting in enhanced patient comfort and satisfaction. This clinical case report might be useful to improve facial esthetics and occlusion in patients with dentoalveolar and skeletal defects. PMID:26877982

Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

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Meyer Ulrich

2007-01-01

Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

Impact of caries experience in the deciduous molars on the emergence of the successors.

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Leroy, Roos; Bogaerts, Kris; Lesaffre, Emmanuel; Declerck, Dominique

2003-04-01

The purpose of this study was to evaluate the effect of caries experience in a primary molar (decayed and/or restored vs. extracted) on the timing of emergence of its successor. Data were obtained from a longitudinal epidemiological study in a sample of 4468 Flemish children. Survival analyses with log-logistic distribution were performed to calculate median emergence ages and 95% confidence intervals (CI); caries experience was added as a covariate. The results indicate that the emergence of the maxillary and mandibular premolars was accelerated by 2-8 months when its predecessor had been decayed and or restored but had not been extracted. Premature loss of maxillary primary molars resulted in a significant acceleration of the emergence of the premolars; this was not observed in the mandible. In conclusion, when considering permanent tooth emergence ages, caries experience in the primary dentition should be taken into account.

Maxillary Sinus Impaction of a Core Carrier Causing Sustained Apical Periodontitis, Sinusitis, and Nasal Stenosis

DEFF Research Database (Denmark)

Bjørndal, Lars; Amaloo, Catharina; Markvart, Merete

2016-01-01

diagnosis and correct endodontic retreatment of a maxillary right first molar. A 36-year-old man presented in 2012 with complaints from the right nostril region. Medical treatment with antibiotics and surgical procedures because of nasal stenosis resulted only in partial improvement. Five years earlier...

Accuracy of a digital impression system based on parallel confocal laser technology for implants with consideration of operator experience and implant angulation and depth.

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Giménez, Beatriz; Özcan, Mutlu; Martínez-Rus, Francisco; Pradíes, Guillermo

2014-01-01

To evaluate the accuracy of a digital impression system based on parallel confocal red laser technology, taking into consideration clinical parameters such as operator experience and angulation and depth of implants. A maxillary master model with six implants (located bilaterally in the second molar, second premolar, and lateral incisor positions) was fitted with six polyether ether ketone scan bodies. One second premolar implant was placed with 30 degrees of mesial angulation; the opposite implant was positioned with 30 degrees of distal angulation. The lateral incisor implants were placed 2 or 4 mm subgingivally. Two experienced and two inexperienced operators performed intraoral scanning. Five different interimplant distances were then measured. The files obtained from the scans were imported with reverse-engineering software. Measurements were then made with a coordinate measurement machine, with values from the master model used as reference values. The deviations from the actual values were then calculated. The differences between experienced and inexperienced operators and the effects of different implant angulations and depths were compared statistically. Overall, operator 3 obtained significantly less accurate results. The angulated implants did not significantly influence accuracy compared to the parallel implants. Differences were found in the amount of error in the different quadrants. The second scanned quadrant had significantly worse results than the first scanned quadrant. Impressions of the implants placed at the tissue level were less accurate than implants placed 2 and 4 mm subgingivally. The operator affected the accuracy of measurements, but the performance of the operator was not necessarily dependent on experience. Angulated implants did not decrease the accuracy of the digital impression system tested. The scanned distance affected the predictability of the accuracy of the scanner, and the error increased with the increased length of the

The Palatal Window for Treating an Incompletely Augmented Maxillary Sinus.

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Florio, Salvatore; Suzuki, Takanori; Cho, Sang-Choon

2017-04-01

Maxillary sinus augmentation through a lateral window is reported as one of the most predictable bone augmentation procedures before implant placement. The elevation of the membrane represents a delicate and crucial step that allows the creation of the space for the bone graft material. If the elevation is not completed, the regenerated bone might be inadequate for the implant placement. In this case, a new intervention will be necessary to complete the bone augmentation. Reaccessing from a lateral window, however, would be challenging due to thickness of the buccal boney wall because of the first grafting procedure; therefore, a different approach has to be used. The aim of this case report is to present the palatal window technique for treating incompletely augmented maxillary sinus. The detailed step-by-step diagnostic and surgical procedures are described, and the advantages and limitations of the technique are discussed through a review of the literature.

Maxillary molar distalization or mandibular enhancement: a cephalometric comparison of comprehensive orthodontic treatment including the pendulum and the Herbst appliances.

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Burkhardt, Donald R; McNamara, James A; Baccetti, Tiziano

2003-02-01

Several methods of Class II treatment that do not rely on significant patient compliance have become popular during the last decade, including several versions of the Herbst appliance and the pendulum or Pendex molar-distalization appliances. Yet, these 2 general approaches theoretically have opposite treatment effects, one presumably enhancing mandibular growth, and the other moving the maxillary teeth posteriorly. This study examined the treatment effects produced by 2 types of the Herbst appliance (acrylic splint and stainless-steel crown) followed by fixed appliances, and the pendulum appliance followed by fixed appliances. For each of the 3 treatment groups, lateral cephalograms were analyzed before the start of treatment (T1) and after the second phase of treatment (T2). Patients were matched according to age and sex. The comprehensive treatment time for the pendulum group was 31.6 months, and the acrylic and crowned Herbst groups were treated for 29.5 months and 28.0 months, respectively. Overall from T1 to T2, there were no statistically significant differences in mandibular growth among the 3 groups. Skeletal changes accounted for a larger portion of molar correction in the Herbst treatment groups than in the pendulum group. Patients in the pendulum group had an increase in the mandibular plane angle. Conversely, the mandibular plane angle in patients treated with either Herbst appliance closed slightly from T1 to T2. At T2, the chin points (pogonion) of patients in both Herbst groups, however, were located slightly more anteriorly than were the chin points of the pendulum patients. It is likely that the slight downward and backward rotation of the mandible occurring during treatment in the pendulum patients accounted for much of this difference. The treatment effects produced by the 2 types of Herbst appliance were similar at T2, in spite of their differences in design. It is important not to generalize the findings of this comparison beyond the appliance

Treating Intraradicular Pockets of molars

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H. Lotfizade

1987-10-01

Full Text Available It appears that until bone graft has not achieved 100% success, intraradicular diseases remain controversial and therefore, different treatment plans are suggested for them. Treating intraradicular diseases depend on many factors: maxillary molars are more prone to bone loss and have worse prognosis. To assess prognosis more carefully these factors should be considered: 1 bone loss: its apical depth, local or generalized 2 bone condition: buccal, lingual, mesial and distal aspects 3 tooth mobility: grades 2 and 3 have not good prognosis. Crown root ratio is also important. 4 the angle of divergence of roots: the more the roots are divergent, the better the prognosis would be. 5adjacent teeth health 6tooth position in jaws 7 age and general health of the patients 8 oral hygiene In general, teeth with 2 roots can be treated more effectively than 3 root ones. Maxillary first premolars are exceptions that do not respond to the treatments positively. We should look forward to the future investigations and findings.

Treatment stability in patients with Class II malocclusion treated with 2 maxillary premolar extractions or without extractions.

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Janson, Guilherme; Camardella, Leonardo Tavares; Araki, Janine Della Valle; de Freitas, Marcos Roberto; Pinzan, Arnaldo

2010-07-01

The purpose of this study was to compare the occlusal stability of Class II malocclusion treatment with and without extraction of 2 maxillary premolars. A sample of 59 records from patients with complete Class II malocclusion was used. This sample was divided into 2 groups with the following characteristics: group 1, comprising 29 patients treated without extractions, and group 2, comprising 30 patients treated with extraction of 2 maxillary premolars. Dental cast measurements were obtained before and after treatment and at a minimum of 2.4 years after treatment. The pretreatment, posttreatment, and postretention occlusal statuses were evaluated with the peer assesment rating index. The occlusal indexes at the postretention stage and the posttreatment changes and percentages of posttreatment changes were compared with t tests. The nonextraction and the 2 maxillary premolar extraction treatment protocols of complete Class II malocclusions had no statistically significant differences in occlusal stability. Finishing Class II malocclusion treatment with the molars in a Class II relationship has similar occlusal stability as finishing with the molars in a Class I relationship. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Comparison of micro-computerized tomography and cone-beam computerized tomography in the detection of accessory canals in primary molars

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Acar, Buket; Kamburoglu, Kivanc [Dept. of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara (Turkmenistan); Tatar, Ilkan [Dept. of Anatomy, Faculty of Medicine, Hacettepe University, Ankara (Turkmenistan); Arikan, Volkan [Dept. of Anatomy, Faculty of Medicine, Hacettepe University, Ankara (Turkmenistan); Celik, Hakan Hamid [Dept. of Pediatric Dentistry, Faculty of Dentistry, Kirikkale Unversity, Ankara (Turkmenistan); Yuksel, Selcen [Dept. of Biostatistics, Faculty of Medicine, Yildirim Beyazit University, Ankara (Turkmenistan); Ozen, Tuncer [Dept. of Dentomaxillofacial Radiology, Gulhane Military Hospital, Dental Clinics, Ankara (Turkmenistan)

2015-12-15

This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images.Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.

Comparison of micro-computerized tomography and cone-beam computerized tomography in the detection of accessory canals in primary molars

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Acar, Buket; Kamburoglu, Kivanc; Tatar, Ilkan; Arikan, Volkan; Celik, Hakan Hamid; Yuksel, Selcen; Ozen, Tuncer

2015-01-01

This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images.Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth

CLINICAL USE OF MODERN FLUOROQUINOLONES IN DENTAL IMPLANTATION AND MAXILLARY SINUS LIFTING

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S.A. Novikov

2009-03-01

Full Text Available New fluoroquinolones like levofloxacine, with broad-spectrum of effect which is also active against anaerobic bacteria, is a prospective drug for the prevention of the inflammatory complications in implant dentistry and maxillary sinus augmentation. 34 patients have been selected for this study, including 16 women and 18 men aged 18-65. All the patients have been classified into the main and control groups. Patiens of the first group have been prescribed 500 mg of levofloxacine before and after the operation two times a day for 10 days. Patients of the control group have been treated with amocxicilline. In the control group, which has used amoxicilline, Streptococcus sanguis, Streptococcus salivarius and anaerobic bacteria have been identified. The amount of Prevotella intermedia is insignificant. The same picture has been found with Fusobacterium spp. The rate of Actinomyces spp. was insignificant over the whole period of study. Patients of the experimental group had a slightly different distribution of bacteria. On the 10th day after the operation in the main patient group no periodontal pathogenesis, which may cause inflammatory complications have been identified. During the early post-operative period no significant differences have been observed among the patients of both groups.

Changes in resonance frequency analysis assessed by Osstell mentor during osseointegration: comparison between immediately loaded implants and control implants without load

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M. González-Jaranay

2014-10-01

Full Text Available Aim: The aim of this prospective clinical study was to evaluate the changes in resonance frequency analysis (RFA, assessed by Osstell Mentor, obtaining information on the implant stability quotient (ISQ during implants tissue integration for immediately loaded and non-loaded control implants. Materials and methods: A total of 40 implants, 20 implants with no immediate loading (control and 20 immediately loaded implants (test, were placed in 15 patients. ISQ implants was evaluated at baseline and at 6 and 8 weeks. Provisional crowns were removed at 8 weeks, when the definitive restoration was placed. Data of control and test implants and maxillary and mandibular areas were statistically compared. Results: At 8 weeks, all implants were integrated and there were no major postoperative complications. A statistically significant difference was found only at baseline between test and control maxillary implants (p=0.009 but not at 6 or 8 weeks (p>0.05. Conclusion: Immediate loading procedures may be applied with primary stability ISQ values >60 and inserted with a force of ≥30 N. The Osstell Mentor RFA may offer an objective method to determine when implant stability is adequate for immediate loading.

Distraction Osteogenesis Maxillary Expansion (DOME) for Adult Obstructive Sleep Apnea Patients with High Arched Palate.

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Liu, Stanley Yung-Chuan; Guilleminault, Christian; Huon, Leh-Kiong; Yoon, Audrey

2017-08-01

A narrow maxilla with high arched palate characterizes a phenotype of obstructive sleep apnea (OSA) patients that is associated with increased nasal resistance and posterior tongue displacement. Current maxillary expansion techniques for adults are designed to correct dentofacial deformity. We describe distraction osteogenesis maxillary expansion (DOME) tailored to adult patients with OSA with narrow nasal floor and high arched palate without soft tissue redundancy. DOME is performed with placement of maxillary expanders secured by mini-implants along the midpalatal suture. This minimizes the maxillary osteotomies necessary to re-create sutural separation for reliable expansion at the nasal floor and palatal vault. We report the safety and efficacy profile of the first 20 patients at Stanford who underwent DOME.

Maxillary sinus augmentation using sinus membrane elevation without grafts - A Systematic Review

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Rakshith Hegde

2016-01-01

Full Text Available Implants have a predictable outcome and are the foremost treatment modality for prosthetic rehabilitation of edentulous patients. Due to loss of bone after extraction and pneumatization of maxillary sinus, there is insufficient bone volume for implant placement. The direct maxillary sinus lift procedure has been performed with different grafting materials (autogenous bone grafts, alloplasts, allografts, and xenografts and without grafting material, having new bone formation around the implant. There is no evidence to prove the need for grafting material in all direct sinus lift procedures, hence the need for this review. Previous meta-analysis showed that survival rates of implants placed in grafted maxillary sinuses had similar survival rates whether autogenous, allogenous, or alloplastic grafts were used. This paper aims to review scientific data on the direct sinus elevation technique without use of any grafting material, volume of new bone formed, and also mechanism behind this technique. Articles were searched from 1997 to October 2014 in PubMed, Google Scholar, and Cochrane CENTRAL. The study eligibility criteria were (1 direct sinus lift procedure without any graft material during implant placement and (2 human or animal studies with a minimum follow-up of 6 months or more. Two authors independently scrutinized the literature and if any controversy was raised, third author's opinion was sought to arrive at a mutual consensus for including the study in the review. Due to the heterogeneity across all studies in all study designs, the data were not pooled and a meta-analysis was not performed. Taking into consideration all factors reviewed in this regard along with the outcomes, the direct sinus lift technique without grafting can be suggested as a viable treatment option keeping in mind the limitations involved. The average bone gain was seen across all studies ranging from 2.37 to 10 mm and with an implant survival rate ranging from 79

Electroconvulsive therapy after maxillofacial metallic implants.

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Freeman, G Mark; Perry, Matthew T; Manatt, George S; Cristancho, Pilar

2014-03-01

A growing body of literature suggests that electroconvulsive therapy (ECT) can be safely utilized in patients with craniofacial metallic implants. Here we provide radiographic images and the clinical course of a 49-year-old woman with both maxillary and mandibular metallic implants who safely received ECT.

Treatment of ectopically erupting maxillary permanent first molars with a distal extended stainless steel crown.

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Roberts, M W

1986-01-01

The exaggerated mesial eruption of the permanent first molar can result in the tooth becoming impacted, or the premature atypical resorption and exfoliation of the primary molar, with a resultant loss of space. A stainless steel crown with a distal guide plane was placed on a primary molar to correct the aberrant eruption angle of the permanent tooth. This procedure can be used successfully for both partially and totally tissue-impacted teeth, and is described in this report.

Relationship between the maxillary transverse dimension and palatally displaced canines: A cone-beam computed tomographic study.

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Hong, Wei-Hsin; Radfar, Rebecca; Chung, Chun-Hsi

2015-05-01

To examine the relationship between palatally displaced maxillary canines (PDC) and the maxillary transverse dimension using cone-beam computed tomography (CBCT). Thirty-three patients (11 males and 22 females, mean age 18.2 years) with PDC were matched to 66 patients (22 males and 44 females, mean age 18.1 years) without PDC (control) by gender, age, and posterior occlusion. A CBCT image was taken on all the patients prior to any orthodontic treatment. For each patient the maxillary basal bone widths and interdental widths at the maxillary first molars and first and second premolars were measured on axial and coronal sections of CBCT images. In addition, the presence of permanent tooth agenesis and the widths of maxillary incisors were recorded. Similar maxillary transverse dimensions, both skeletally and dentally, were found between the PDC and control groups. In the PDC group, the number of patients with permanent tooth agenesis was six times higher than in the control group. In addition, the maxillary lateral incisors on PDC-affected sides were smaller than those of control group (P transverse dimension, both skeletally and dentally, had no effect on the occurrence of PDC. The higher prevalence of permanent tooth agenesis was found in the PDC group. Moreover, the mean mesiodistal width of maxillary lateral incisors in the PDC group was significantly smaller than in the control group (P < .05).

A prospective study of the short-term treatment effects of the acrylic-splint rapid maxillary expander combined with the lower Schwarz appliance.

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Wendling, Lisa K; McNamara, James A; Franchi, Lorenzo; Baccetti, Tiziano

2005-01-01

This prospective clinical study evaluated the short-term treatment effects of acrylic-splint rapid maxillary expander in conjunction with lower Schwarz appliance (RME-Sz) therapy to the acrylic-splint rapid maxillary expansion alone (RME-only group). Pretreatment and posttreatment lateral cephalograms were analyzed for 25 RME patients and 19 RME-Sz patients. The average time between films ranged between nine and 12 months. Statistical comparisons of the treatment changes in the RME-only and RME-Sz groups were performed by means of independent sample t-tests (P < .05). The largest difference between the two groups was in lower anterior facial height (LAFH). The normally occurring increase in LAFH was not observed in the RME-only group during the treatment period, indicating that the acrylic-splint expander had a posterior "bite block effect" on the developing craniofacial complex. LAFH increased by 1.7 mm in the RME-Sz group, a value similar to that observed in untreated individuals. Slight forward displacement of the maxilla was observed when RME was used alone, and the sagittal position of the maxilla remained unchanged in the RME-Sz group. A significant amount of intrusion of the maxillary molars (-0.8 mm) was noted in the RME-only group, whereas the maxillary molars were prevented from erupting in the RME-Sz group. The lower dentition showed a significantly greater amount of extrusion in the RME-Sz group than in the RME-only group. Finally, the Sz appliance prevented the mesial movement of the lower molars during the treatment period.

Alveolar ridge and maxillary sinus augmentation using rhBMP-2: a systematic review.

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Freitas, Rubens Moreno de; Spin-Neto, Rubens; Marcantonio Junior, Elcio; Pereira, Luís Antônio Violin Dias; Wikesjö, Ulf M E; Susin, Cristiano

2015-01-01

The aim of this systematic review was to evaluate clinical and safety data for recombinant human bone morphogenetic protein-2 (rhBMP-2) in an absorbable collagen sponge (ACS) carrier when used for alveolar ridge/maxillary sinus augmentation in humans. Clinical studies/case series published 1980 through June 2012 using rhBMP-2/ACS were searched. Studies meeting the following criteria were considered eligible for inclusion: >10 subjects at baseline and maxillary sinus or alveolar ridge augmentation not concomitant with implant placement. Seven of 69 publications were eligible for review. rhBMP-2/ACS yielded clinically meaningful bone formation for maxillary sinus augmentation that would allow placement of regular dental implants without consistent differences between rhBMP-2 concentrations. Nevertheless, the statistical analysis showed that sinus augmentation following autogenous bone graft was significantly greater (mean bone height: 1.6 mm, 95% CI: 0.5-2.7 mm) than for rhBMP-2/ACS (rhBMP-2 at 1.5 mg/mL). In extraction sockets, rhBMP-2/ACS maintained alveolar ridge height while enhancing alveolar ridge width. Safety reports did not represent concerns for the proposed indications. rhBMP-2/ACS appears a promising alternative to autogenous bone grafts for alveolar ridge/maxillary sinus augmentation; dose and carrier optimization may expand its efficacy, use, and clinical application. © 2013 Wiley Periodicals, Inc.

Permanent first molar extraction in adolescents and young adults and its effect on the development of third molar.

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Halicioglu, Koray; Toptas, Orcun; Akkas, Ismail; Celikoglu, Mevlut

2014-01-01

The aim of the present study was to determine the prevalence of permanent first molar (P1M) extraction among Turkish adolescents and young adult subpopulation, and to investigate the effects of P1M extraction on development of the third molars (3Ms) in the same quadrant. A retrospective study including 2,925 panoramic radiographs (PRs) taken from patients (aged 13-20 years) who were examined to identify cases of had at least one maxillary or mandibular P1Ms extracted was performed. Additionally, 294 PRs with the maxillary or mandibular unilateral loss of a P1M were used to assess the developmental grades of the 3Ms. Statistical analyses were performed by means of parametric tests after performing a Shapiro-Wilks normality test to the data. A total of 945 patients (32.3 %) presented with at least one P1M extraction with no gender difference (P = 0.297). There were more cases of mandibular P1Ms extracted (784 patients, 1,066 teeth) than maxillary P1Ms extracted (441 patients, 549 teeth) (P development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated when compared with the contralateral teeth (P = 0.000, P = 0.000, respectively). No statistically significant differences were found in the differences in the developmental of the 3Ms between the maxilla and mandible (P = 0.718). High prevalence of P1Ms extraction among Turkish adolescents and young adults shows a need for targeted dental actions, including prevention and treatment. The development of the 3Ms on the extraction side, in the both maxilla and mandible, was significantly accelerated. To date, no information about prevalence of P1Ms extraction among Turkish adolescents and young adults is documented. In addition, the present study has a larger population and complementary information about 3Ms development than previous studies.

Two-Implant-Supported Mandibular Overdentures: Do Clinical Denture Quality and Inter-Implant Distance Affect Patient Satisfaction?

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Alfadda, Sara A; Al Amri, Mohammad D; Al-Ohali, Amal; Al-Hakami, Arwa; Al-Madhi, Noura

To investigate the following three null hypotheses in patients rehabilitated with a mandibular overdenture supported by two unsplinted implants: (1) patient satisfaction is not related to the clinical quality of the dentures; (2) inter-implant distance (IID) has no effect on the clinical quality of the dentures; and (3) IID does not influence patient satisfaction. Forty edentulous patients who were rehabilitated with a two-implant-supported mandibular overdenture participated in the study. Independent investigators evaluated the dentures on the basis of five clinical criteria using the validated Denture Quality Evaluation Form, and the patients completed the validated Denture Satisfaction Scale. Irreversible hydrocolloid impressions of the mandible were made and poured immediately in die stone. The IID was measured by adapting an orthodontic wire to the mandibular alveolar ridge crest, extending from the center of one implant to the center of the other. Spearman correlation analyses were used to identify possible correlations, with a significance level set at P overdenture and of the maxillary conventional complete denture was significantly related to satisfaction (r = 0.389 and r = 0.44, respectively). Significant associations were found between the mandibular stability items and satisfaction with both maxillary and mandibular dentures. The stability of the maxillary denture was significantly associated with patient satisfaction with mandibular denture retention, stability, and comfort. None of the 12 denture satisfaction items were significantly associated with IID. Similarly, IID did not have an effect on the quality of either denture in terms of retention, stability, or occlusion. Denture stability was the feature that had the most influence on patient satisfaction with the mandibular overdenture and with the maxillary conventional denture. IID had no effect on the clinical quality of either denture and did not influence patient satisfaction.

Prosthodontic maintenance of overdentures on zirconia implants: 1-year results of a randomized controlled trial.

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Osman, Reham B; Ma, Sunyoung

2014-01-01

The purpose of this study was to determine the prosthodontic outcomes of one-piece zirconia implants and their attachment systems in edentulous participants with maxillary and mandibular overdentures after 1 year of a randomized controlled trial. Random allocation of 24 edentulous participants (age range: 45 to 86 years) into titanium (control) or zirconia (test) groups using onepiece implants and a planned unsplinted prosthodontic design was performed. Four maxillary implants (one midpalatal; three anterior crestal) and three mandibular implants (one midsymphyseal; two bilateral distal) were conventionally loaded with the overdentures. Similar attachment systems were used throughout: ball abutment-type patrices (diameter: 2.25 to 3.1 mm as part of the one-piece implants) and custommade plastic matrices (with or without metal housings depending on the patrix size). Prosthodontic outcomes were documented during the first year of the clinical trial. Following three deaths and two dropouts, there were 19 participants who were available at the 1-year recall. Of these participants, 3 had early maxillary implant failure and had to be converted to conventional maxillary complete dentures opposing mandibular implant overdentures. There were 79 maintenance events, 34 in the titanium (control) group and 45 in the zirconia (test) group. Patrix loss occurred as a result of three zirconia implant fractures (one mandibular and two crestal maxillary implants). Maintenance events were principally the replacement of matrices and overdenture fracture. Although relines and replacement overdentures also occurred, overall there were no significant differences in prosthodontic maintenance between the control and test groups. A six-field prosthodontic-success analysis table showed no statistically significant difference between the two groups; however, 50% of participants in each group were allocated to the retreatment (repair) field, which produced a low prosthodontic success rate

Autogenous Transplantation for Replacing a Hopeless Tooth.

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Zakershahrak, Mehrsa; Moshari, Amirabbas; Vatanpour, Mehdi; Khalilak, Zohreh; Jalali Ara, Afsoon

2017-01-01

Autogenous tooth transplantation (ATT) is a simple and reasonable choice for replacing the missing teeth when a proper donor tooth is available. This report presents a case of successful ATT of a maxillary right third molar for replacement of mandibular right second molar with a concomitant endodontic-periodontal disease. The mandibular second molar was believed to be hopeless due to a severe damage to coronal tooth structure, inappropriate root canal treatment and apical radiolucency. After extraction of mandibular second molar and maxillary third molar (the donor), the tooth was re-implanted into the extracted socket of second molar site. Root canal therapy was then performed. After 3 years, clinical and radiographic examinations revealed satisfying results, with no signs and symptoms. The patient is asymptomatic and the transplanted tooth is still functional with no signs of marginal periodontal pathosis. Radiographies showed bone regeneration in the site of previous extensive periapical lesion, normal periodontal ligament with no signs of root resorption.

One-stage tooth-borne distraction versus two stage bone-borne distraction in surgically assisted maxillary expansion (SARME).

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Seeberger, Robin; Abe-Nickler, Dorothee; Hoffmann, Jürgen; Kunzmann, Kevin; Zingler, Sebastian

2015-12-01

To evaluate and compare the effects of tooth-borne and bone-borne distraction devices in surgically assisted maxillary expansion (SARME) on dental and skeletal structures. A sample of 33 skeletally mature patients with transverse maxillary deficiencies was examined with cone beam computed tomography (CBCT) before and 3 months after surgery. Fourteen patients were treated with tooth-borne devices and 19 patients with bone-borne devices. Dental crown expansion in the first premolars did not differ significantly between the two groups, and median expansion was 5.55 mm (interquartile range [IQR] 5.23) in the tooth-borne device group and 4.6 mm (IQR 3.4) in the bone-borne device group. In the first molars, crown expansion and lateral tipping were significantly greater in the tooth-borne device group (P ≤ .02). The median skeletal nasal isthmus increase was significantly more in the bone-borne device group at 3.0 mm than in the tooth-borne device group at 0.98 mm (P ≤ .02). Both tooth-borne and bone-borne devices are effective treatment modalities to correct maxillary transverse deficiencies. Bone-borne devices produced greater widening of the skeletal nasal floor and fewer dental side effects in the first molars. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparison of anchorage reinforcement with temporary anchorage devices or a Herbst appliance during lingual orthodontic protraction of mandibular molars without maxillary counterbalance extraction.

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Metzner, Rebecca; Schwestka-Polly, Rainer; Helms, Hans-Joachim; Wiechmann, Dirk

2015-06-20

Orthodontic protraction of mandibular molars without maxillary counterbalance extraction in cases of aplasia or extraction requires stable anchorage. Reinforcement may be achieved by using either temporary anchorage devices (TAD) or a fixed, functional appliance. The objective was to compare the clinical effectiveness of both methods by testing the null-hypothesis of no significant difference in velocity of space closure (in mm/month) between them. In addition, we set out to describe the quality of posterior space management and treatment-related factors, such as loss of anchorage (assessed in terms of proportions of gap closure by posterior protraction or anterior retraction), frequencies of incomplete space closure, and potential improvement in the sagittal canine relationship. Twenty-seven subjects (15 male/12 female) with a total of 36 sites treated with a lingual multi-bracket appliance were available for retrospective evaluation of the effects of anchorage reinforcement achieved with either a Herbst appliance (n(subjects) = 15; 7 both-sided/8 single-sided Herbst appliances; n(sites) = 22) or TADs (n(subjects )= 12; 2 both-sided; 10 single-sided; n(sites) = 14). Descriptive analysis was based on measurements using intra-oral photographs which were individually scaled to corresponding plaster casts and taken on insertion of anchorage mechanics (T1), following removal of anchorage mechanics (T2), and at the end of multi-bracket treatment (T3). The null-hypothesis was rejected: The rate of mean molar protraction was significantly faster in the Herbst-reinforced group (0.51 mm/month) than in the TAD group (0.35). While complete space closure by sheer protraction of posterior teeth was achieved in all Herbst-treated cases, space closure in the TAD group was achieved in 76.9% of subjects by sheer protraction of molars, and it was incomplete in 50% of cases (mean gap residues: 1 mm). Whilst there was a deterioration in the canine relationship towards

Effects of ionizing radiation on wound healing of alveolar bone socket after extraction of rat maxillary molars

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Iwata, Hiroshi; Yosue, Takashi [Nippon Dental Univ., Tokyo (Japan). School of Dentistry; Nasu, Masanori

2001-05-01

The purpose of this study was to examine the effects of radiation on the healing process of tooth extraction wounds. X-ray doses of 10 Gy or 20 Gy were delivered, once, to the maxillofacial area of Wistar-strain rats. Then, 24 hours after irradiation, the maxillary first molars were extracted bilaterally. The animals were sacrificed 3, 7, 10, 14, 21, 42, and 84 days after tooth extraction, and the maxilla were sliced, to make thin sections. These specimens were then double stained with alkaline phosphatase (ALP) and tartrate resistant acid phosphatase (TRAP). The ratio of bone area to socket area (bone formation ratio), the ratio of bone length to ALP positive area length (ALP positive ratio), and the number of TRAP-positive cells, were evaluated. The results showed: The bone formation ratios at days 3 and 7 after tooth extraction were significantly low in both irradiation groups, compared with those for the non-irradiation group. The ALP positive reaction ratio peaked 7 days after in the non-irradiation group. In both irradiation groups, the ratios that were worked out at 3 days and 7 days after were significantly lower than those in the non-irradiation group. There was no significant difference in the number of TRAP-positive cells between the non-irradiation group and the 10 Gy irradiation group. In the 20 Gy irradiation group, the TRAP-positive cell count plummeted to a significantly low level at 3 days after tooth extraction, compared with that in the non-irradiation group. (author)

Effects of ionizing radiation on wound healing of alveolar bone socket after extraction of rat maxillary molars

International Nuclear Information System (INIS)

Iwata, Hiroshi; Yosue, Takashi; Nasu, Masanori

2001-01-01

The purpose of this study was to examine the effects of radiation on the healing process of tooth extraction wounds. X-ray doses of 10 Gy or 20 Gy were delivered, once, to the maxillofacial area of Wistar-strain rats. Then, 24 hours after irradiation, the maxillary first molars were extracted bilaterally. The animals were sacrificed 3, 7, 10, 14, 21, 42, and 84 days after tooth extraction, and the maxilla were sliced, to make thin sections. These specimens were then double stained with alkaline phosphatase (ALP) and tartrate resistant acid phosphatase (TRAP). The ratio of bone area to socket area (bone formation ratio), the ratio of bone length to ALP positive area length (ALP positive ratio), and the number of TRAP-positive cells, were evaluated. The results showed: The bone formation ratios at days 3 and 7 after tooth extraction were significantly low in both irradiation groups, compared with those for the non-irradiation group. The ALP positive reaction ratio peaked 7 days after in the non-irradiation group. In both irradiation groups, the ratios that were worked out at 3 days and 7 days after were significantly lower than those in the non-irradiation group. There was no significant difference in the number of TRAP-positive cells between the non-irradiation group and the 10 Gy irradiation group. In the 20 Gy irradiation group, the TRAP-positive cell count plummeted to a significantly low level at 3 days after tooth extraction, compared with that in the non-irradiation group. (author)

Effects of framework design and layering material on fracture strength of implant-supported zirconia-based molar crowns.

Science.gov (United States)

Kamio, Shingo; Komine, Futoshi; Taguchi, Kohei; Iwasaki, Taro; Blatz, Markus B; Matsumura, Hideo

2015-12-01

To evaluate the effects of framework design and layering material on the fracture strength of implant-supported zirconia-based molar crowns. Sixty-six titanium abutments (GingiHue Post) were tightened onto dental implants (Implant Lab Analog). These abutment-implant complexes were randomly divided into three groups (n = 22) according to the design of the zirconia framework (Katana), namely, uniform-thickness (UNI), anatomic (ANA), and supported anatomic (SUP) designs. The specimens in each design group were further divided into two subgroups (n = 11): zirconia-based all-ceramic restorations (ZAC group) and zirconia-based restorations with an indirect composite material (Estenia C&B) layered onto the zirconia framework (ZIC group). All crowns were cemented on implant abutments, after which the specimens were tested for fracture resistance. The data were analyzed with the Kruskal-Wallis test and the Mann-Whitney U-test with the Bonferroni correction (α = 0.05). The following mean fracture strength values (kN) were obtained in UNI design, ANA design, and SUP design, respectively: Group ZAC, 3.78, 6.01, 6.50 and Group ZIC, 3.15, 5.65, 5.83. In both the ZAC and ZIC groups, fracture strength was significantly lower for the UNI design than the other two framework designs (P = 0.001). Fracture strength did not significantly differ (P > 0.420) between identical framework designs in the ZAC and ZIC groups. A framework design with standardized layer thickness and adequate support of veneer by zirconia frameworks, as in the ANA and SUP designs, increases fracture resistance in implant-supported zirconia-based restorations under conditions of chewing attrition. Indirect composite material and porcelain perform similarly as layering materials on zirconia frameworks. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Autotransplantation of Mandibular Third Molar: A Case Report

Directory of Open Access Journals (Sweden)

Pabbati Ravi kumar

2012-01-01

Full Text Available Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38 without anatomical variances is used to replace a mandibular left second molar (37. The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment.

Lower molar and incisor displacement associated with mandibular remodeling.

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Baumrind, S; Bravo, L A; Ben-Bassat, Y; Curry, S; Korn, E L

1997-01-01

The purpose of this study was to quantify the amount of alveolar modeling at the apices of the mandibular incisor and first molar specifically associated with appositional and resorptive changes on the lower border of the mandible during growth and treatment. Cephalometric data from superimpositions on anterior cranial base, mandibular implants of the Björk type, and anatomical "best fit" of mandibular border structures were integrated using a recently developed strategy, which is described. Data were available at annual intervals between 8.5 and 15.5 years for a previously described sample of approximately 30 children with implants. The average magnitudes of the changes at the root apices of the mandibular first molar and central incisor associated with modeling/remodeling of the mandibular border and symphysis were unexpectedly small. At the molar apex, mean values approximated zero in both anteroposterior and vertical directions. At the incisor apex, mean values approximated zero in the anteroposterior direction and averaged less than 0.15 mm/year in the vertical direction. Standard deviations were roughly equal for the molar and the incisor in both the anteroposterior and vertical directions. Dental displacement associated with surface modeling plays a smaller role in final tooth position in the mandible than in the maxilla. It may also be reasonably inferred that anatomical best-fit superimpositions made in the absence of implants give a more complete picture of hard tissue turnover in the mandible than they do in the maxilla.

Long-term follow-up after maxillary distraction osteogenesis in growing children with cleft lip and palate.

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Huang, Chiung-Shing; Harikrishnan, Pandurangan; Liao, Yu-Fang; Ko, Ellen W C; Liou, Eric J W; Chen, Philip K T

2007-05-01

To evaluate the changes in maxillary position after maxillary distraction osteogenesis in six growing children with cleft lip and palate. Retrospective, longitudinal study on maxillary changes at A point, anterior nasal spine, posterior nasal spine, central incisor, and first molar. The University Hospital Craniofacial Center. Cephalometric radiographs were used to measure the maxillary position immediately after distraction, at 6 months, and more than 1 year after distraction. After maxillary distraction with a rigid external distraction device, the maxilla (A point) on average moved forward 9.7 mm and downward 3.5 mm immediately after distraction, moved backward 0.9 mm and upward 2.0 mm after 6 months postoperatively, and then moved further backward 2.3 mm and downward 6.8 mm after more than 1 year from the predistraction position. In most cases, maxilla moved forward at distraction and started to move backward until 1 year after distraction, but remained forward, as compared with predistraction position. Maxilla also moved downward during distraction and upward in 6 months, but started descending in 1 year. There also was no further forward growth of the maxilla after distraction in growing children with clefts.

Two-stage implant systems.

Science.gov (United States)

Fritz, M E

1999-06-01

Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

Root canal treatment of a maxillary first premolar with three roots

OpenAIRE

Mathew, Josey; Devadathan, Aravindan; Syriac, Gibi; Shamini, Sai

2015-01-01

Successful root canal treatment needs a thorough knowledge of both internal and external anatomy of a tooth. Variations in root canal anatomy constitute an impressive challenge to the successful completion of endodontic treatment. Undetected extra roots and canals are a major reason for failed root canal treatment. Three separate roots in a maxillary first premolar have a very low incidence of 0.5?6%. Three rooted premolars are anatomically similar to molars and are sometimes called ?small mo...

Presence of third molars in orthodontic patients from northern Greece

Directory of Open Access Journals (Sweden)

Barka G

2012-05-01

Full Text Available Georgia Barka,1 Georgios Tretiakov,1 Theodosios Theodosiou,2 Ioulia Ioannidou-Marathiotou31School of Dentistry, 2Biostatistics, Department of Informatics, School of Natural Sciences, 3Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, GreeceObjective: The purpose of the present study was to investigate the frequency of presence of third molar teeth and their distribution in each jaw and each side, according to sex, in a group of orthodontic patients with permanent dentition from northern Greece.Methods: The sample included panoramic radiographs from 220 patients with permanent dentition (mean age 13.62 ± 1.81. The Χ2 test was used to assess the relationships between the variables, and the Fisher's exact test was used in cases where the expected frequencies in each cell were <5.Results: The frequency of third molar presence was 79.1%, and 20.9% was the frequency of third molar agenesis. Intersexual differences in the number of third molars was not statistically significant. There was a correlation between the distribution of third molars on the right and the left side (Fisher's exact test = 100.788; P = 0. The two sides showed the same tendency toward the presence or absence of third molars. A correlation was also found between the distribution of maxillary and mandibular third molars (Fisher's exact test = 24.372; P = 0. In each jaw, the presence or absence of third molars was highly related to the number of third molars found in the other jaw.Conclusion: The present results showed that in this orthodontic group of northern Greek patients, presence accounted for 79.1% and agenesis for 20.9%. No significant difference was found between the frequencies of third molar presence on the left and right sides in either the maxilla or mandible.Keywords: third molars, presence, orthodontic population, Greeks

Three-dimensional analysis of third molar development to estimate age of majority.

Science.gov (United States)

Márquez-Ruiz, Ana Belén; Treviño-Tijerina, María Concepción; González-Herrera, Lucas; Sánchez, Belén; González-Ramírez, Amanda Rocío; Valenzuela, Aurora

2017-09-01

Third molars are one of the few biological markers available for age estimation in undocumented juveniles close the legal age of majority, assuming an age of 18years as the most frequent legal demarcation between child and adult status. To obtain more accurate visualization and evaluation of third molar mineralization patterns from computed tomography images, a new software application, DentaVol©, was developed. Third molar mineralization according to qualitative (Demirjian's maturational stage) and quantitative parameters (third molar volume) of dental development was assessed in multi-slice helical computed tomography images of both maxillary arches displayed by DentaVol© from 135 individuals (62 females and 73 males) aged between 14 and 23years. Intra- and inter-observer agreement values were remarkably high for both evaluation procedures and for all third molars. A linear correlation between third molar mineralization and chronological age was found, with third molar maturity occurring earlier in males than in females. Assessment of dental development with both procedures, by using DentaVol© software, can be considered a good indicator of age of majority (18years or older) in all third molars. Our results indicated that virtual computed tomography imaging can be considered a valid alternative to orthopantomography for evaluations of third molar mineralization, and therefore a complementary tool for determining the age of majority. Copyright © 2017 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

Comparison of implant component fractures in external and internal type: A 12-year retrospective study.

Science.gov (United States)

Yi, Yuseung; Koak, Jai-Young; Kim, Seong-Kyun; Lee, Shin-Jae; Heo, Seong-Joo

2018-04-01

The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials

DEFF Research Database (Denmark)

Starch-Jensen, Thomas; Mordenfeld, Arne; Becktor, Jonas Peter

2018-01-01

OBJECTIVE: To test the hypotheses of no differences in implant treatment outcome after maxillary sinus floor augmentation (MSFA) with synthetic bone substitutes (SBS) compared with other grafting materials applying the lateral window technique. MATERIALS AND METHODS: A MEDLINE/PubMed, Embase and ...