Orthodontic management of bilateral maxillary canine-first premolar transposition and bilateral agenesis of maxillary lateral incisors: a case report.

Science.gov (United States)

Di Palma, Elena; Di Giuseppe, Biagio; Tepedino, Michele; Chimenti, Claudio

2015-01-01

Maxillary canine-first premolar transposition (Mx.C.P1) is an uncommon dental positional anomaly that may create many orthodontic problems from both esthetic and functional points of view. In this report we show the orthodontic management of a case of Mx.C.P1 associated with bilateral maxillary lateral incisor agenesis and unilateral mandibular second premolar agenesis The patient was treated with a multibracket appliance and the extraction of the lower premolar. treatment was completed without the need for any prosthetic replacement.

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.

Brief communication: Population variation in human maxillary premolar accessory ridges (MxPAR).

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Burnett, Scott E; Hawkey, Diane E; Turner, Christy G

2010-02-01

The purpose of this brief communication is to report the results of an analysis of maxillary premolar accessory ridges (MxPAR), a common but understudied accessory ridge that may occur both mesial and distal to the central ridge of the buccal cusp of upper premolars. We developed a new five-grade scoring plaque to better categorize MxPAR variation. Subsequently, we conducted a population analysis of MxPAR frequency in 749 dental casts of South African Indian, American Chinese, Alaskan Eskimo, Tohono O'odham (Papago), Akimel O'odham (Pima), Solomon Islander, South African Bantu, and both American and South African Whites. Northeast Asian and Asian-derived populations exhibited the highest MxPAR frequencies while Indo-European samples (South African Indians, American and South African Whites) exhibited relatively low frequencies. The Solomon Islanders and South African Bantu samples exhibited intermediate frequencies. Our analysis indicates that statistically significant differences in MxPAR frequency exist between major geographic populations. As a result, the MxPAR plaque has now been added to the Arizona State University Dental Anthropology System, an important contribution as maxillary premolar traits are underrepresented in analyses of dental morphology. 2009 Wiley-Liss, Inc.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation.

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Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-09-01

This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (proot resorption (proot resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

Flare-up with associated paresthesia of a mandibular second premolar with three root canals.

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Glassman, G D

1987-07-01

A case report is presented that deals with mental nerve paresthesia resulting from the "flare-up" of a mandibular second premolar with three root canals. A review of the literature and discussion follow, which suggest possible mechanisms that may be responsible for paresthesia as well as treatment regimens that may be used to minimize the incidence of this unexpected but occasional post-treatment endodontic sequela.

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.

Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population

International Nuclear Information System (INIS)

Yu, Xuan; Guo, Bin; Li, Ke-Zeng; Zhang, Ru; Tian, Yuan-Yuan; Wang, Hu; DDS, Tao Hu

2012-01-01

Traditional radiography is limited in its ability to give reliable information on the number and morphology of root canals. The application of cone-beam computed tomography (CBCT) provides a non-invasive three-dimensional confirmatory diagnosis as a complement to conventional radiography. The aim of this study was to evaluate the root and canal morphology of mandibular premolars in a western Chinese population using CBCT scanning. The sample included 149 CBCT images comprising 178 mandibular first premolars and 178 second premolars. The tooth position, number of roots and canals, and canal configuration according to Vertucci’s classification were recorded. The results showed that 98% of mandibular first premolars had one root and 2% had two roots; 87.1% had one canal, 11.2% had two canals and 0.6% had three canals. The prevalence of C-shaped canals was 1.1%. All mandibular second premolars had one root; 97.2% had one canal and 2.2% had two canals. The prevalence of C-shaped canals was 0.6%. The prevalence of multiple canals in mandibular first premolars was mainly of Type V, and mandibular second premolars had a low rate of canal variation in this western Chinese population. Root canal bifurcation occurred at the middle or apical third in most bicanal mandibular premolars. CBCT scanning can be used in the management of mandibular premolars with complex canal morphology

Cone Beam Computed Tomography Assisted Endodontic Management of a Rare Case of Mandibular First Premolar with Three Roots

OpenAIRE

Balakasireddy, K; Kumar, K Pavan; John, Gijo; Gagan, C

2015-01-01

Understanding the morphological anatomy of the root and root canal systems of the teeth increases the success rate of endodontic therapy. Advanced diagnostic imaging techniques like cone beam computed tomography (CBCT) are an essential aid in understanding the anatomy of teeth especially in mandibular premolars. Most commonly mandibular first and second premolars have a single root and a single canal. However, multiple root and canals have also been reported. The present case report discusses...

Surface chemical composition of human maxillary first premolar as assessed by X-ray photoelectron spectroscopy (XPS)

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Lou, Leo; Nelson, Alan E.; Heo, Giseon; Major, Paul W.

2008-08-01

The surface chemical composition of dental enamel has been postulated as a contributing factor in the variation of bond strength of brackets bonded to teeth, and hence, the probability of bracket failure during orthodontic treatment. This study systematically investigated the chemical composition of 98 bonding surfaces of human maxillary premolars using X-ray photoelectron spectroscopy (XPS) to ascertain compositional differences between right and left first premolars. The major elements detected in all samples were calcium, phosphorus, oxygen, nitrogen and carbon. Surface compositions were highly variable between samples and several elements were found to be highly correlated. No statistical significant difference in the chemical composition of the maxillary right and left first premolars was found ( p > 0.05). Knowledge of the chemical composition of enamel surfaces will facilitate future studies that relate this information to the variations in dental enamel bond strength.

Surface chemical composition of human maxillary first premolar as assessed by X-ray photoelectron spectroscopy (XPS)

Energy Technology Data Exchange (ETDEWEB)

Lou, Leo [Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta (Canada); Nelson, Alan E. [Department of Chemical and Materials Engineering, University of Alberta (Canada)], E-mail: aenelson@dow.com; Heo, Giseon [Department of Statistics, Department of Dentistry, University of Alberta (Canada); Major, Paul W. [Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta (Canada)

2008-08-30

The surface chemical composition of dental enamel has been postulated as a contributing factor in the variation of bond strength of brackets bonded to teeth, and hence, the probability of bracket failure during orthodontic treatment. This study systematically investigated the chemical composition of 98 bonding surfaces of human maxillary premolars using X-ray photoelectron spectroscopy (XPS) to ascertain compositional differences between right and left first premolars. The major elements detected in all samples were calcium, phosphorus, oxygen, nitrogen and carbon. Surface compositions were highly variable between samples and several elements were found to be highly correlated. No statistical significant difference in the chemical composition of the maxillary right and left first premolars was found (p > 0.05). Knowledge of the chemical composition of enamel surfaces will facilitate future studies that relate this information to the variations in dental enamel bond strength.

Surface chemical composition of human maxillary first premolar as assessed by X-ray photoelectron spectroscopy (XPS)

International Nuclear Information System (INIS)

Lou, Leo; Nelson, Alan E.; Heo, Giseon; Major, Paul W.

2008-01-01

The surface chemical composition of dental enamel has been postulated as a contributing factor in the variation of bond strength of brackets bonded to teeth, and hence, the probability of bracket failure during orthodontic treatment. This study systematically investigated the chemical composition of 98 bonding surfaces of human maxillary premolars using X-ray photoelectron spectroscopy (XPS) to ascertain compositional differences between right and left first premolars. The major elements detected in all samples were calcium, phosphorus, oxygen, nitrogen and carbon. Surface compositions were highly variable between samples and several elements were found to be highly correlated. No statistical significant difference in the chemical composition of the maxillary right and left first premolars was found (p > 0.05). Knowledge of the chemical composition of enamel surfaces will facilitate future studies that relate this information to the variations in dental enamel bond strength

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

Energy Technology Data Exchange (ETDEWEB)

Nanekrungsan, Kamonporn [Dept. of Dentistry, Overbrook Hospital, Chiang Rai (Thailand); Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus [Dept. of Chiang Mai University, Chiang Mai (Thailand)

2012-09-15

This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39{+-}1.27 (8.24{+-}7.22%) and 1.69{+-}1.14 mm (10.16{+-}6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

External apical root resorption in maxillary incisors in orthodontic patients: associated factors and radiographic evaluation

International Nuclear Information System (INIS)

Nanekrungsan, Kamonporn; Patanaporn, Virush; Janhom, Apirum; Korwanich, Narumanus

2012-01-01

This study was performed to evaluate the incidence and degree of external apical root resorption of maxillary incisors after orthodontic treatment and to evaluate particular associated factors related to external apical root resorption. The records and maxillary incisor periapical radiographs of 181 patients were investigated. Crown and root lengths were measured and compared on the pre- and post-treatment periapical radiographs. Crown length was measured from the center of the incisal edge to the midpoint of the cemento-enamel junction (CEJ). Root length was measured from the CEJ midpoint to the root apex. A correction factor for the enlargement difference was used to calculate root resorption. The periapical radiographs of 564 teeth showed that the average root resorption was 1.39±1.27 (8.24±7.22%) and 1.69±1.14 mm (10.16±6.78%) for the maxillary central and lateral incisors, respectively. The results showed that the dilacerated or pointed roots, maxillary premolar extraction cases, and treatment duration were highly significant factors for root resorption (p<0.001). Allergic condition was a significant factor at p<0.01. Age at the start of treatment, large overjet, and history of facial trauma were also factors significantly associated with root resorption (p<0.05). There was no statistically significant difference in root resorption among the factors of gender, overbite, tongue-thrusting habit, types of malocclusion, and types of bracket. These results suggested that orthodontic treatment should be carefully performed in pre-treatment extraction patients who have pointed or dilacerated roots and need long treatment duration.

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.

Science.gov (United States)

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.

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...

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

Energy Technology Data Exchange (ETDEWEB)

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

Root Canal Configuration of Mandibular First and Second Premolars in an Iranian Population

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Nemat Eskandarzadeh

2007-08-01

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 aim of this study was to determine the canal configuration and the prevalence of C-shaped canals in mandibular first and second premolars in a North-Western Iranian population.

Materials and methods. A total of 163 extracted mandibular first and 103 mandibular second premolars were injected with India ink and demineralized . They were made clear and transparent with methyl salicylate and the anatomy of their canal(s was studied.

Results. The results showed that 98% of mandibular first premolars had one root, 2% had two roots, 70.6% had one canal, 27.8% had two canals, 1.2% had three canals and the prevalence of C-shaped canals was 2.4%. All mandibular second premolars had one root, 80.5% had one canal, 17.5% had two canals and the prevalence of C-shaped canals was 2%.

Conclusion. It is important that clinicians, before treatment of mandibular first and second premolars, pay complete attention to radiographs, have a true concept of the number of root(s and canal(s, and prepare a correct access cavitiy.

Root Anatomy and Root Canal Configuration of Human Permanent Mandibular Premolars: A Systematic Review

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Jojo Kottoor

2013-01-01

Full Text Available Introduction. Mandibular premolars have been reported with complex anatomical aberrations, making them one of the most difficult teeth to manage endodontically. Methodology. An exhaustive search was undertaken to identify associated anatomic studies of mandibular premolars through MEDLINE/PubMed database using keywords, and a systematic review of the relevant articles was performed. Chi-square test with Yates correction was performed to assess the statistical significance of any anatomic variations between ethnicities and within populations of the same ethnicity. Documented case reports of variations in mandibular premolar anatomy were also identified and reviewed. Results. Thirty-six anatomic studies were analyzed which included 12,752 first premolars and nineteen studies assessing 6646 second premolars. A significant variation in the number of roots, root canals, and apical foramen was observed between Caucasian, Indian, Mongoloid, and Middle Eastern ethnicities.The most common anatomic variation was C-shaped canals in mandibular first premolars with highest incidence in Mongoloid populations (upto 24% while dens invaginatus was the most common developmental anomaly. Conclusions. A systematic review of mandibular premolars based on ethnicity and geographic clusters offered enhanced analysis of the prevalence of number of roots and canals, their canal configuration, and other related anatomy.

Treatment stability in patients with Class II malocclusion treated with 2 maxillary premolar extractions or without extractions.

Science.gov (United States)

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.

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)

Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report

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Thikamphaa Bertrand

2016-02-01

Full Text Available This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT. C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

Premolar root and canal variation in extant non-human hominoidea.

Science.gov (United States)

Moore, N Collin; Hublin, Jean-Jacques; Skinner, Matthew M

2015-08-11

The premolar sub-cervical region in four non-human extant ape genera are examined to: 1) define a classification scheme for the premolar root system in order to rigorously characterize, quantify and document variation in root and canal, form, number and configuration; 2) compare this variation within and between genera; and 3) test the hypotheses that sex and size (i.e., the "size/number continuum," Shields, ) of the premolar are determinants of root/canal form and/or number. Microtomography and 3D visualization software are utilized to examine a large sample of Hylobates, Pan, Gorilla, and Pongo (n = 951 teeth). Each premolar root system is examined to ascertain the expected level of variability for each taxon. Cervical surface area (mm 2 ) serves as a metric proxy for tooth size. A Chi-square test of independence is used to assess for variability differences between and within each taxon, and Mann-Whitney U tests are employed to assess the predicted relationship between tooth size and variation within each taxon. Our findings indicate that root and canal configurations, non-metric root traits and tooth size can distinguish between extant ape genera. Within the four ape taxa, premolar size variation is generally, but not always, correlated with canal/root number. Our results indicate that males and females within genera differ in tooth size but not in canal/root form and number. We report previously undocumented variation in the study taxa. Our results are discussed within the context of Miocene Apes as well as the developmental and systematic implications. Am J Phys Anthropol, 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

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

Science.gov (United States)

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.

Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1.

Science.gov (United States)

Estrela, Carlos; Serpa, Giuliano C; Alencar, Ana Helena G; Bruno, Kely F; Barletta, Fernando B; Felippe, Wilson T; Estrela, Cyntia R A; Souza, João B

2017-01-01

The aim of this study was to determine oxygen saturation levels in the dental pulp of maxillary premolars in different age groups. A total of 120 human maxillary premolars with normal dental pulps were selected covering the following age groups: 20-24, 25-29, 30-34, 35-39 and 40-44 years (n=24 each group). Oxygen saturation was assessed using pulse oximetry. Analysis of variance was used to assess differences in oxygen saturation levels and Tukey's test was used to identify the age groups that differed from each other. Significance was set at 0.05. Mean oxygen saturation of 120 premolars was 86.20% considering all age groups. Significantly reduced levels were found in the oldest group compared to the other groups: 40 to 44 years - 80.00% vs. 89.71, 87.67, 88.71, and 84.80% for age groups 20-24, 25-29, 30-34, 35-39 years, respectively. The mean oxygen saturation levels were similar between 20 and 39 years of age (86.20%) in the whole sample, but reduced significantly in the 40-44-year age group, suggesting that older patients present lower oxygen saturation results even in the absence of pulp tissue injury.

NEED OF PREVENTION STEPS AGAINST IMPACTION OF MANDIBULAR AND MAXILLARY PREMOLARS.

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Hristina Arnautska

2015-11-01

Full Text Available Lower second premolars, closely followed by upper premolars, are regarded as the third most common teeth prone to impaction, after wisdom teeth and upper canines. Objective of this article is to show the possibility for spontaneous eruption of impacted premolars upon extraction of deciduous molars and removal of the follicular cyst as described in several clinical cases. The present paper reports four clinical cases supporting the thesis that regardless of the reason behind impacted premolars, undertaking preventive measures significantly improves the position of the germ of those teeth. Conclusions: The early extraction of the deciduous molar, monitoring the patient and reserving the space for the succeeding impacted premolar can lead to non-invasive or relatively short orthodontic treatment (secondary prevention.If root development is incomplete yet there is a good growth potential which could lead to spontaneous eruption (primary prevention. Age specifics particular to children such as the great regenerative abilities of the bone, provide a good prognosis for spontaneous eruption or significant improvement in the position of impacted premolars and facilitate the orthodontic treatment.

Evaluation of the implantation position of mini-screws for orthodontic treatment in the maxillary molar area by a micro CT

International Nuclear Information System (INIS)

Ishii, Takenobu; Nojima, Kunihiko; Nishii, Yasushi; Takaki, Takashi; Yamaguchi, Hideharu

2004-01-01

The interalveolar septum between the upper first molar and the second premolar of the separated human maxillary bone was three-dimensionally observed by micro CT to evaluate the appropriate mini-screw type implant placement position by considering the relationship between the tooth roots and the maxillary sinus. After taking micro CTs of 5 human maxillary bones, horizontally sectioned images of the interalveolar septum area 2, 4, 6, 8, 10, and 12 mm deep from the crest of the alveolar ridge were reconstructed by three-dimensional reconstruction software. The bucco-lingual and mesio-distal lengths and area in each sectioned interalveolar septum were measured using digital image measurement software. Using the results, the interalveolar septum area between the upper first molar and the second premolar approximately 6-8 mm deep from the alveolar crest in the tooth root apical direction was determined to be the safest position for mini-screw implantation. Furthermore, lateral implantation from the palatal side was deduced to be the safest approach. (author)

Retreatment of a mandibular second premolar with two canals in two roots

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Chiara Fossati

2018-06-01

Full Text Available Aim: To present a case of retreatment in mandibular second premolar with two canals in two roots. Summary: Locating, cleaning and shaping the entire root canal system may represent a difficult challenge particularly in mandibular premolars, because of their complex canal systems.For this reason mandibular premolars are often considered the most difficult of all teeth on which to perform successful endodontic treatment. Vertucci stated that the second premolar has one root canal at the apex in 97.5% of the teeth studied and two canals in only 2.5%.1 The following case report describes the diagnosis and retreatment of a second premolar with two canal in two roots.Key learning points: (1 The major cause of failure in root canal therapy is the inability to localize and treat all of the canals of the root canal system. (2 Mandibular premolars have complex canal systems. (3 Mandibular premolars have a high risk of missed anatomy. (4 Preoperative radiograph interpretation is essential to evaluate and detect uncommon anatomies. (5 The operating microscope and CBCT interpretation are fundamental in confirming and preventing mistakes about the configuration of mandibular premolars. Riassunto: Obiettivi: Presentare un caso clinico di ritrattamento canalare di un secondo premolare mandibolare con due canali e due radici. Riassunto: Individuare, sagomare, detergere l’intero sistema radicolare presenta una sfida difficile in ambito endodontico e in particolar modo nei premolari mandibolari per il loro complesso sistema canalare. I premolari mandibolari sono spesso considerati i denti più difficili in cui effettuare una terapia endodontica.Vertucci riscontrò che i secondi premolari mandibolari hanno una radice e un canale nel 97.5% e due canali in solo il 2.5%.1Il case report seguente descrive la diagnosi e il ritrattamento di un secondo premolare con due canali in due radici.Punti chiave di apprendimento: 1. La maggior causa di fallimento endodontico �

Root Length and Anatomy of Impacted Maxillary Canines in Patients with Unilateral Maxillary Canine Impaction

OpenAIRE

Mostfa Shahabi; Maryam Omidkhoda; Seyedeh Haniyeh Omidi; Seyed Hosein Hoseini Zarch

2017-01-01

Introduction: Canine impaction is a common occurrence. In this study, we sought to investigate the root anatomy and length of impacted canines and lateral incisor adjacent to impacted maxillary canine. Materials and Methods: In this retrospective study, three-dimensional tomographic imaging was performed on 26 patients with unilateral maxillary canine impaction. In this study, we evaluated root length and anatomy of impacted canines, in terms of resorption intensity and curvature, with Planme...

Orthodontic correction of a transposed maxillary canine and first premolar in the permanent dentition.

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Nishimura, Kazuaki; Nakao, Kimihisa; Aoki, Taijyu; Fuyamada, Mariko; Saito, Keisuke; Goto, Shigemi

2012-10-01

The patient was a 16-year-old Japanese girl whose chief complaints were crowding and transposition of the maxillary canine and first premolar. A setup model was used to preoperatively align the teeth in their transposed positions. The amount of postoperative reshaping was estimated for the occlusal surfaces of the teeth. However, the patient did not wish to have her teeth reduced by reshaping or to have composite materials for restorative camouflage. Because she strongly expected alignment of her teeth in the correct intra-arch position, her transposed teeth were corrected without extraction of the transposed teeth. Cone-beam computed tomography was used to obtain more detailed information about the transposition, and the direction of tooth movement was examined. Although the duration of the treatment was long, both the crowns and the roots of the transposed teeth were aligned correctly. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

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...

[Root canal treatment of mandibular first premolar with 4 root canals: a case report].

Science.gov (United States)

Liu, Xin-yang; Zhan, Fu-Liang

2015-10-01

The mandibular first premolar can be considered one of the most challenging teeth to treat, due to the complexity of its root canal morphology and increased incidence of multiple canals. A case of endodontic treatment of a mandibular first premolar exhibiting a total of 4 distinct root canals and 4 apical foramina was described. Anatomic variation of root canal morphology should be considered in endodontic treatment to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation might allow the flow of sealer into the narrowed but unprepared part of the canal, thereby facilitating optimum chemo-mechanical debridement of the root canal system.

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.

[A maxillary premolar reconstruction with a glass fiber reinforced post].

Science.gov (United States)

Viţalariu, Anca Mihaela; Antohe, Magda; Bahrim, Delia; Tatarciuc, Monica

2006-01-01

This paper presents the case of a 37 years old female patient who needed a reconstruction of an endodontic treated' second maxillary premolar. The patient presented large areas of occlusal abrasion caused by bruxism, therefore the solution consisted of a reconstruction with a non-metallic post reinforced with glass fibers. In such cases, the excessive occlusal forces developed by bruxism can produce a radicular fracture if the tooth would be reconstructed with a rigid metallic post. The glass-fiber reinforced post has some important qualities, which render it more suitable in most clinical cases: it is easy to use; has the ability to bond with restorative resins; decreases the risk of tooth fracture and provides better esthetics.

Maxillary canine-first premolar bilateral transposition in a Class III patient: A case report.

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Potrubacz, Maciej Iancu; Tepedino, Michele; Chimenti, Claudio

2016-05-01

Tooth transposition is a rare dental anomaly that often represents a challenge for the clinician. The case of a girl with skeletal Class III malocclusion and concomitant maxillary canine-first premolar bilateral transposition, followed from 7 to 17 years of age, is presented. After a first phase of treatment aimed at resolving the Class III malocclusion, the transposition was maintained and the case finalized with a multibracket appliance.

Cone beam computed tomography analysis of root and canal morphology of mandibular premolars in a Spanish population

International Nuclear Information System (INIS)

Llena, Carmen; Ortolani, Pablo Sebastian; Forner, Leopoldo; Fernandez, Jaime

2014-01-01

This study aimed to investigate the clinical anatomy of lower premolar roots in a Spanish population by using cone-beam computed tomography (CBCT), correlating findings with patient gender and tooth type. Using 70 CBCT images, we evaluated 126 healthy, untreated, well-developed lower premolars. The number and morphology of roots and root canals, and the foramina number were assessed. Results for gender and tooth type were compared using the chi-squared and ANOVA tests. The average length of teeth and roots was significantly higher in men (p=0.00). All 126 premolars had a single root. One canal was found in 83.3% of the premolars, with no gender or tooth type differences; Vertucci configuration types I and V were the most prevalent. The first premolars showed significantly greater variability than the second premolars (p=0.03). A single apical foramen was found in 89.7% of the premolars, with no differences by tooth type. Women had a significantly higher prevalence of two apical foramina than men (p=0.04). Some degree of curvature was observed in 65% of the premolars, with no differences by gender or tooth type. A root angle of more than 20 degrees was found in 12.98% of the premolars, without any differences by gender or tooth. All premolars were single-rooted. One canal had the most prevalent morphology. More variability in canal anatomy was found in the first premolars. Curvatures greater than 20 degrees were found at less than 5 mm from the apex.

A case of unusual root morphology: Maxillary canine with two roots

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Nagesh Bolla

2009-01-01

Full Text Available The case describes a 3 months follow-up of the treatment of a maxillary canine with two roots. Clinical examination revealed a maxillary canine with a large carious lesion and an exaggerated response to cold thermal tests. Radiographic examination revealed a large distal carious lesion that appeared to invade the pulp chamber. The radiograph also revealed what appeared to be an extra root in this permanent maxillary canine.

Bilateral Maxillary Central Incisor Impaction associated with Developing Supernumerary Premolars in the Mandibular Arch

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Mitali Mishra

2014-01-01

We report a case of 15-year-old girl with bilaterally impacted supernumeraries in the premaxilla region associated with asymptomatic impacted developing supernumerary premolars in the mandibular arch. The supernumeraries of premaxilla region impeded the eruption of the permanent maxillary central incisors. The impacted supernumerary tooth was surgically removed and brackets bonded to the central incisors to apply orthodontic extrusive force which brought the central incisors down to their proper position in the dental arch.

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.

Root canal morphology and variations of mandibular premolars by clearing technique: an in vitro study.

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Parekh, Vaishali; Shah, Nimisha; Joshi, Hardik

2011-07-01

The aim of this study was to compare internal anatomy between first and second mandibular premolars and to study different percentage variations of root canal morphology of mandibular premolars in Gujarat population based on Vertucci's classification by clearing technique. A total of 80 extracted intact permanent mandibular premolars (40 each mandibular first premolar and mandibular second premolar) with fully formed apices were collected. Access cavity was prepared with endo access kit, all samples were placed in 2.5% sodium hypochlorite for 48 hours, after that all samples were washed in running water for 2 hours. After washing, all samples were transferred to 5% nitric acid, for decalcification, for 72 hours, with the acid being changed every 24 hours and stirred once every 8 hours. All samples were washed in running water and dehydrated using ascending grades (70%, 80%, 90% and 100%) of isopropyl alcohol for 2 days. Finally, they were rendered transparent by immersion in methyl salicylate for 15 minutes and then India ink dye was injected into the access cavity. The anatomy of the root canal was observed and classified based on the Vertucci's classification. Parametric Z-test was used to compare the variation between mandibular first and second premolars. In mandibular first premolar, type 1 was found in 20%, type 2 was 5%, type 3 was 5%, type 4 was 25%, type 5 was 12.5% and type 6 was 2.5% of total samples. Whereas, in mandibular second premolar, type 1 was found in 80% out of all samples, type 4 was 2.5%, type 5 was 17.5%. Type 2, type 3, type 6, type 7 and type 8 were not found in this study. Mandibular first premolar showed higher variation (75%) compared to mandibular second premolar (37.5%). The knowledge of variations in the root canal morphology of the mandibular premolars can enhance the level of endodontic treatment of mandibular premolars. Root canal morphology, Vertucci's classification, Clearing technique. How to cite this article: Parekh V, Shah N

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

Science.gov (United States)

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.

Influence of crosshead speed on failure load and failure mode of restored maxillary premolars

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Lucas Zago NAVES

2016-01-01

Full Text Available We analyzed the effect of the crosshead speed of an applied load on failure load and failure mode of restored human premolars. Fifty intact, noncarious human premolars were selected. Class II mesio-occlusodistal preparations were made with a water-cooled high-speed preparation machine, and the teeth were restored with composite resin. The specimens were divided into five groups (n = 10 each and tested individually in a mechanical testing machine, in which a 6.0-mm-diameter steel cylinder was mounted to vary the crosshead speed: v0.5: 0.5 mm/min; v1: 1.0 mm/min; v2.5: 2.5 mm/min; v5: 5.0 mm/min; and v10: 10.0 mm/min. The cylinder contacted the facial and lingual ridges beyond the margins of the restorations. Peak load to fracture was measured for each specimen (N. The means were calculated and analyzed with one-way analysis of variance followed by Tukey's test (a = 0.05. The mean load at failure values were (N as follows: v0.5, 769.4 ± 174.8; v1, 645.2 ± 115.7; v5, 614.3 ± 126.0; v2.5, 609.2 ± 208.1; and v10, 432.5 ± 136.9. The fracture modes were recorded on the basis of the degree of the tooth structural and restorative damage: (I fracture of the restoration involving a small portion of the tooth; (II fractures involving the coronal portion of the tooth with cohesive failure of the composite resin; (III oblique tooth and restoration fracture with periodontal involvement; and (IV vertical root and coronal fracture. Varying crosshead speeds of 0.5–5.0 mm/min did not influence the failure load of restored maxillary premolars; however, increasing the crosshead speed to 10 mm/min decreased the failure load values and the degree of tooth structural damage.

The effect of a manual instrumentation technique on five types of premolar root canal geometry assessed by microcomputed tomography and three-dimensional reconstruction

International Nuclear Information System (INIS)

Li, Ke-Zeng; Gao, Yuan; Zhang, Ru; Hu, Tao; Guo, Bin

2011-01-01

Together with diagnosis and treatment planning, a good knowledge of the root canal system and its frequent variations is a necessity for successful root canal therapy. The selection of instrumentation techniques for variants in internal anatomy of teeth has significant effects on the shaping ability and cleaning effectiveness. The aim of this study was to reveal the differences made by including variations in the internal anatomy of premolars into the study protocol for investigation of a single instrumentation technique (hand ProTaper instruments) assessed by microcomputed tomography and three-dimensional reconstruction. Five single-root premolars, whose root canal systems were classified into one of five types, were scanned with micro-CT before and after preparation with a hand ProTaper instrument. Instrumentation characteristics were measured quantitatively in 3-D using a customized application framework based on MeVisLab. Numeric values were obtained for canal surface area, volume, volume changes, percentage of untouched surface, dentin wall thickness, and the thickness of dentin removed. Preparation errors were also evaluated using a color-coded reconstruction. Canal volumes and surface areas were increased after instrumentation. Prepared canals of all five types were straightened, with transportation toward the inner aspects of S-shaped or multiple curves. However, a ledge was formed at the apical third curve of the type II canal system and a wide range in the percentage of unchanged canal surfaces (27.4-83.0%) was recorded. The dentin walls were more than 0.3 mm thick except in a 1 mm zone from the apical surface and the hazardous area of the type II canal system after preparation with an F3 instrument. The 3-D color-coded images showed different morphological changes in the five types of root canal systems shaped with the same hand instrumentation technique. Premolars are among the most complex teeth for root canal treatment and instrumentation techniques

The effect of a manual instrumentation technique on five types of premolar root canal geometry assessed by microcomputed tomography and three-dimensional reconstruction

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Hu Tao

2011-06-01

Full Text Available Abstract Background Together with diagnosis and treatment planning, a good knowledge of the root canal system and its frequent variations is a necessity for successful root canal therapy. The selection of instrumentation techniques for variants in internal anatomy of teeth has significant effects on the shaping ability and cleaning effectiveness. The aim of this study was to reveal the differences made by including variations in the internal anatomy of premolars into the study protocol for investigation of a single instrumentation technique (hand ProTaper instruments assessed by microcomputed tomography and three-dimensional reconstruction. Methods Five single-root premolars, whose root canal systems were classified into one of five types, were scanned with micro-CT before and after preparation with a hand ProTaper instrument. Instrumentation characteristics were measured quantitatively in 3-D using a customized application framework based on MeVisLab. Numeric values were obtained for canal surface area, volume, volume changes, percentage of untouched surface, dentin wall thickness, and the thickness of dentin removed. Preparation errors were also evaluated using a color-coded reconstruction. Results Canal volumes and surface areas were increased after instrumentation. Prepared canals of all five types were straightened, with transportation toward the inner aspects of S-shaped or multiple curves. However, a ledge was formed at the apical third curve of the type II canal system and a wide range in the percentage of unchanged canal surfaces (27.4-83.0% was recorded. The dentin walls were more than 0.3 mm thick except in a 1 mm zone from the apical surface and the hazardous area of the type II canal system after preparation with an F3 instrument. Conclusions The 3-D color-coded images showed different morphological changes in the five types of root canal systems shaped with the same hand instrumentation technique. Premolars are among the most

Root abnormalities, talon cusps, dentes invaginati with reduced alveolar bone levels: case report.

LENUS (Irish Health Repository)

McNamara, C M

1998-03-01

This is a case report of a Caucasian female who presented with an unusual combination of dental anomalies: short roots on the maxillary central incisors and premolars, talon cusps, dentes invaginati, low alveolar bone heights, tubercles of Carabelli on the maxillary first and second permanent molars, with pyramidal root morphology in three of the second permanent molars. None of the anomalies alone are particularly uncommon but they have not previously been reported together. The occurrence of the anomalies is probably incidental as the conditions are aetiologically unrelated.

Unusual anatomy of maxillary central incisor with two roots

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T S Ashwini Shivakumar

2012-01-01

Full Text Available Introduction: Knowledge of root canal morphology is essential for successful endodontic therapy. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Case Report: This case report describes the successful endodontic treatment of the maxillary central incisor with unusual anatomy of two roots and two root canals. A 23-year-old male patient was referred for dental consultation with discoloration of the maxillary right central incisor with periapical lesion, which revealed unusual anatomy of root on radiographic examination, and was confirmed upon exploration. Discussion: As described by Vertucci, the maxillary central incisor presents a single root and single root canal in 100% of the cases. However, few cases of maxillary central incisors with two canals were reported in the literature, most of which were associated with developmental anomalies like fusion, germination or dens invaginatus. Clinician should be aware of the unusual anatomical variations that should be detected by the different diagnostic resources available.

Unusual root canal morphology of mandibular second premolars: A case series and review

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Snehal Sonarkar

2017-01-01

Full Text Available Mandibular second premolars (MSPs have varied anatomy ranging from 1 to 3 roots and 1–5 canals. Successful endodontic treatment is achieved by proper access opening, cleaning, and shaping and three-dimensional obturation. This case series describes five cases in which MSPs have been diagnosed with aberrant canal system. The Case 1 and 5 has one root with Vertucci's Type V canal configuration. The Case 2 has two roots with two canals, the Case 3 has one root with Vertucci's Type IV canal configuration, whereas the Case 4 has three roots with three canals. This case series also describes a classification for describing the root configuration. The clinical implications of this paper are first to reach at appropriate diagnosis of canal system using diagnostic aids (angulated radiographs and dental operating microscope. Second, to use advanced endodontic instruments for achieving successful endodontic therapy (NiTi rotary instruments.

Orthodontic treatment of the transposition of a maxillary canine and a first premolar: a case report.

Science.gov (United States)

Teresa, Dinoi Maria; Stefano, Mummolo; Annalisa, Monaco; Enrico, Marchetti; Vincenzo, Campanella; Giuseppe, Marzo

2015-03-01

Transposition is an anomaly of tooth position, the most frequent of which involves the canine and the first maxillary premolar. We describe the orthodontic treatment of a unilateral transposition of an upper canine and an upper right first premolar in the permanent dentition. A 12-year-old Caucasian boy presented with transposition of his upper right canine and upper right first premolar. He had combined surgical-orthodontic treatment to correct the transposition and to obtain a Class I relationship between the molar and canine. This treatment resolved the dental crowding and achieved good functional and aesthetic results. In transposition, the choice of the most suitable treatment depends on the occlusion, level of dental crowding, aesthetics, position of the radicular apices, and the specific needs of the patient. In this case, orthodontic alignment of the transposed teeth into their physiological position achieved all of our objectives and our patient was satisfied with the aesthetic results obtained.

Management of a Two-rooted Maxillary Central Incisor Using Cone-beam Computed Tomography: Importance of Three-dimensional Imaging

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Saurabh Kumar Gupta

2015-09-01

Full Text Available We report a rare case of a two-rooted maxillary central incisor, stressing the importance of three-dimensional imaging in treatment planning and conservative approach of management. Endodontic treatment of this central incisor was carried out with a successful outcome.

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 canine-first premolar transposition in the permanent dentition: treatment considerations and a case report.

LENUS (Irish Health Repository)

Synodinos, Philippos N

2010-12-01

Transposition is defined as the interchange of position between two adjacent teeth within the same quadrant of the dental arch. Permanent maxillary canine-premolar transposition is the most commonly observed transposition in the human dentition. Its prevalence is relatively low and its aetiology remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. Treatment is selected on an individual case basis after thoroughly considering the overall facial and dental characteristics, duration of treatment, cost, patient preference and the orthodontist\\'s experience. This article provides a case report of maxillary canine transposition in the permanent dentition, successfully managed with orthodontic treatment.

[Chronic periapical periodontitis of left maxillary first premolar with localized mineralized structure at periapical region: a case report].

Science.gov (United States)

Dong, Wei; Li, Ren; Wen, Liming; Qi, Mengchun

2013-04-01

Chronic periapical periodontitis is characterized by destruction of periapical tissue and demonstrates translucent feature under X-ray examination. In this article, a localized mineralized structure, which showed high density under X-ray examination, was reported in a patient with chronic periapical periodontitis of left maxillary first premolar. Possible causes of the structure were analyzed and relevant literatures were reviewed.

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

OpenAIRE

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...

Unusual anatomy of maxillary central incisor with two roots

OpenAIRE

T S Ashwini Shivakumar; Saleem Makandar; Ajay Kadam

2012-01-01

Introduction: Knowledge of root canal morphology is essential for successful endodontic therapy. Failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Case Report: This case report describes the successful endodontic treatment of the maxillary central incisor with unusual anatomy of two roots and two root canals. A 23-year-old male patient was referred for dental consultation with discoloration of the maxillary right central incisor with periapical les...

Changes in root lengths of maxillary incisors during orthodontic retention period

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Ravanmehr H

2006-01-01

Full Text Available Background and Aim: External apical root resorption is a common iatrogenic consequence of orthodontic treatment. Much controversy exists in the literature about changes in root lengths at post treatment periods. Although many practitioners believe that resorption becomes stable after active treatment, quantitative data are scarce. The purpose of this study was to determine quantitative changes in root lengths of maxillary incisors during fixed orthodontic post treatment period, and to assess if it is influenced by gender and factors related to active treatment. Materials and Methods: This was a case cross over study, performed on 80 patients (52 females and 28 males aged between 13 and 22 years. At debonding stage and beginning of retention phase of fixed orthodontic treatment, Hawley type retainer was fabricated for maxillary arch. Periapical radiographs of maxillary incisors using standard parallel technique were obtained immediately after debonding, and 3 and 7 months later. Crown and root lengths of maxillary incisors were measured using computer program. Changes in root lengths were calculated considering correction factors. Also associations between some factors and the change in root lengths during post treatment periods were assessed. These included gender, type of treatment plan (non extraction/extraction, technique (standard edgewise/straight-wire edgewise and duration of active treatment (less than 2 years/2 years and more. T-test and 4-way ANOVA were used for statistical analysis with P0.05 as the limit of significance. Results: No significant relation was found between apical root resorption of maxillary central incisors and time elapsed after treatment. Significant relation was observed between apical root resorption of maxillary lateral incisors and the length of post treatment period. No significant relation was found between root length changes of maxillary incisors during post treatment period and gender, type of treatment

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.

Root canal morphology of mandibular first premolar in a Gujarati population - An in vitro study

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Atul Jain

2011-01-01

Full Text Available Background: Knowledge about root canal morphology and its frequent variations can exert considerable influence on the success of endodontic treatment. The aim of this study was to survey the root canal morphology of mandibular first premolar teeth in a Gujarati population by decalcification and clearing technique. Methods : One hundred thirty eight extracted mandibular first premolar teeth were collected from a Gujarati population. After decalcifying and clearing, the teeth were examined for tooth length, number of cusps and roots, number and shape of canal orifices and canal types. Results: The average length of mandibular first premolar teeth was 21.2 mm. All the teeth had 2 cusps. One hundred thirty four teeth (97.1% had one root, and just 4 teeth (2.89% had two roots. Mesial invagination of root was found in 21 teeth (15.21%. One canal orifice was found in 122 teeth (88.4% and two canal orifices in 16 teeth (11.59%. Shape of orifices was found to be round in 46 teeth (33.33%, oval in 72 teeth (52.17% and flattened ribbion in 20 teeth (14.49%. According to Vertucci′s classification, Type I canal system was found in 93 teeth (67.39%, Types II,III,IV,V,and VI in 11 teeth (7.97%, 5 teeth (3.62%, 4 teeth (2.89%, 24 teeth (17.39%, and 1 tooth (0.72% respectively. Conclusion: Mandibular first premolar teeth were mostly found to have one root and Type I canal system.

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

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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.

Three-dimensional evaluation of root canal morphology in lower second premolars of early and middle Pleistocene human populations from Atapuerca (Burgos, Spain).

Science.gov (United States)

Prado-Simón, Leyre; Martinón-Torres, María; Baca, Pilar; Olejniczak, Anthony J; Gómez-Robles, Aida; Lapresa, María; Luis Arsuaga, Juan; María Bermúdez de Castro, José

2012-03-01

The aim of this study is to describe the morphology of the roots and root canals of permanent lower second premolars (LP4s) with fully developed roots of five hominin groups: Homo sp. (ATE9-1 specimen) from Atapuerca-Sima del Elefante locality, H. antecessor (ATD6-4 and ATD6-125) from Atapuerca-Gran Dolina TD6 locality, H. heidelbergensis from Atapuerca-Sima de los Huesos locality, H. neanderthalensis from Krapina, Regourdou, and Abri Bourgeois-Delaunay localities, and two contemporary H. sapiens groups. The teeth were scanned by means of microtomography. The roots were divided into three virtual segments by three planes: cemento-enamel junction (CEJ), mid-root (MR), and mid-apex (MA). Volumetric and planar direct measurements of the whole teeth and each segment were taken. Descriptive statistical analyses and nonparametric Mann-Whiney test were performed to test for significant differences (P Huesos sample which may reflect a particularity of this population. Our study demonstrates the potential of hominin roots and root canals as untapped sources of taxonomic information when the tooth crown is fragmented. Future studies, including more fossil specimens and species will shed light in the polarity of the morphologies observed. Copyright © 2012 Wiley Periodicals, Inc.

Roentgenographic study of two root canal incidence in mandibular first premolars

International Nuclear Information System (INIS)

Leite, H.F.; Simoes, S.; Niccoli Filho, W.D.; Madeira, M.C.; Oliveira, J.A. de; Martins, Ariovaldo A.

1984-01-01

The root canal number in 1,632 mandibular first premolars were studied by roentgenograms taken from mesiodistal direction. A second canal exists in at least 27.08 per cent of all the teeth examined. Two comprehensive tables were taken: one was prepared to summarize all the data which were classified by root morphology. The second compares the results taken by other authors. (M.A.C.) [pt

Bilaterally impacted mandibular supernumerary premolars associated with unusual clinical complications

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Zameer Pasha

2013-01-01

Full Text Available Supernumerary teeth are extra teeth in comparison to the normal dentition. Their prevalence varies between 0.1% and 3.8%. Supernumeraries are more common in permanent dentition and its incidence is higher in maxillary incisor region, followed by maxillary third molar and mandibular molar, premolar, canine, and lateral incisor. The prevalence of supernumerary premolars is between 0.075-0.26%, and they may occur in single or multiple numbers Bilateral occurrence is uncommon and large percentage of supernumerary premolars remains impacted, unerupted, and usually asymptomatic; radiograph plays an important role in diagnosis of these. The present paper reports a case of bilaterally impacted completely developed supernumerary premolars associated with common clinical complication in unusual manner along with taurodontism of the upper and lower molars.

Determination of permanent premolars eruption ages among public school children in Lahore, Pakistan

International Nuclear Information System (INIS)

Jokhio, A.L.; Soomro, S.H.; Khuhawar, S.R.

2015-01-01

Objective: To determine mean eruption age, range and sequence of permanent maxillary and mandibular premolars in public schools of Lahore, Pakistan so as to provide a reference for planning orthodontic treatment and in pediatric dentistry. Methodology: This is a cross sectional study consisting of multistage random sampling and included 4000 children, with ages in between 9-14 years of different public schools in Lahore. Participants were examined and tooth numbering was noted by two-digit system of FDI (Federation Dentaire Internationale). Emergence was divided into three stages depending on eruption level. SPSS version 18 was used for statistical analysis. Results: Out of 4000 children, 1960 were boys and 2031 were girls. In both genders maxillary premolars erupted before mandibular counterparts. All premolars erupted earlier in females than the males. The sequence of emergence for both genders was P1, P2 in upper as well as in lower arch. Conclusion: Eruption of premolar in females was earlier than males but delayed in both genders while compared with Western standard. (author)

Simplified Model Surgery Technique for Segmental Maxillary Surgeries

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Namit Nagar

2011-01-01

Full Text Available Model surgery is the dental cast version of cephalometric prediction of surgical results. Patients having vertical maxillary excess with prognathism invariably require Lefort I osteotomy with maxillary segmentation and maxillary first premolar extractions during surgery. Traditionally, model surgeries in these cases have been done by sawing the model through the first premolar interproximal area and removing that segment. This clinical innovation employed the use of X-ray film strips as separators in maxillary first premolar interproximal area. The method advocated is a time-saving procedure where no special clinical or laboratory tools, such as plaster saw (with accompanying plaster dust, were required and reusable separators were made from old and discarded X-ray films.

[Congenitally missing maxillary lateral incisors: long-term periodontal and functional evaluation after orthodontic space closure with first premolar intrusion and canine extrusion].

Science.gov (United States)

Rosa, Marco; Lucchi, Patrizia; Ferrari, Simona; Zachrisson, Bjørn U; Caprioglio, Alberto

2017-12-01

The aims of this investigation were to evaluate associations between orthodontic space closure (including first premolar intrusion and canine extrusion for esthetic reasons) and periodontal tissue deterioration over a 10-year period in subjects with one or both missing maxillary lateral incisors and to investigate the occurrence of signs or symptoms of temporomandibular disorder (TMD). This was a retrospective cohort study comprising patients treated by the same orthodontist. The agenesis group included 26 consecutive adolescent and young adult patients (9 male, 17 female) treated with space closure. The control group consisted of 32 orthodontic patients (12 male, 20 female) with no missing teeth and no need for extractions. In the agenesis group, full-mouth probing pocket depths and bleeding on probing were recorded at six locations for each of 657 teeth (3942 periodontal sites). In the control group, comparative data were collected for the maxillary first molars, premolars, canines, and lateral incisors, a total of 264 teeth (1584 periodontal sites). Mobility and gingival recession were also evaluated. Patients in both groups completed questionnaires concerning symptoms related to TMD. The full-mouth assessments in the agenesis group generally demonstrated periodontally healthy conditions, with probing depths below 4 mm and few bleeding sites. Some slight recessions were found, mostly on molars and second premolars, and there was normal mobility of first premolars that substituted for canines. Comparisons between the agenesis and control groups showed no statistically significant differences for the maxillary teeth regarding increased pocket depth (≥ 4 mm) or increased mobility. Interproximal sites in the agenesis group showed less bleeding on probing than in the control group; this was statistically significant. Anterior teeth in the agenesis group did not show any more recession than in the controls. In addition, we observed no

Congenitally missing maxillary lateral incisors: Long-term periodontal and functional evaluation after orthodontic space closure with first premolar intrusion and canine extrusion.

Science.gov (United States)

Rosa, Marco; Lucchi, Patrizia; Ferrari, Simona; Zachrisson, Bjørn U; Caprioglio, Alberto

2016-03-01

The aims of this investigation were to evaluate associations between orthodontic space closure (including first premolar intrusion and canine extrusion for esthetic reasons) and periodontal tissue deterioration over a 10-year period in subjects with one or both missing maxillary lateral incisors and to investigate the occurrence of signs or symptoms of temporomandibular disorder (TMD). This was a retrospective cohort study comprising patients treated by the same orthodontist. The agenesis group included 26 consecutive adolescent and young adult patients (9 male, 17 female) treated with space closure. The control group consisted of 32 orthodontic patients (12 male, 20 female) with no missing teeth and no need for extractions. In the agenesis group, full-mouth probing pocket depths and bleeding on probing were recorded at 6 locations for each of 657 teeth (3942 periodontal sites). In the control group, comparative data were collected for the maxillary first molars, premolars, canines, and lateral incisors, a total of 264 teeth (1584 periodontal sites). Mobility and gingival recession were also evaluated. Patients in both groups completed questionnaires concerning symptoms related to TMD. The full-mouth assessments in the agenesis group generally demonstrated periodontally healthy conditions, with probing depths below 4 mm and few bleeding sites. Some slight recessions were found, mostly on molars and second premolars, and there was normal mobility of first premolars that substituted for canines. Comparisons between the agenesis and control groups showed no statistically significant differences for the maxillary teeth regarding increased pocket depth (≥4 mm) or increased mobility. Interproximal sites in the agenesis group showed less bleeding on probing than in the control group; this was statistically significant. Anterior teeth in the agenesis group did not show any more recession than in the controls. In addition, we observed no difference in signs or symptoms

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.

Root Length and Anatomy of Impacted Maxillary Canines in Patients with Unilateral Maxillary Canine Impaction

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Mostfa Shahabi

2017-09-01

Full Text Available Introduction: Canine impaction is a common occurrence. In this study, we sought to investigate the root anatomy and length of impacted canines and lateral incisor adjacent to impacted maxillary canine. Materials and Methods: In this retrospective study, three-dimensional tomographic imaging was performed on 26 patients with unilateral maxillary canine impaction. In this study, we evaluated root length and anatomy of impacted canines, in terms of resorption intensity and curvature, with Planmeca Romexis Viewer 4.0. Furthermore, crown shape as well as root length and anatomy of the lateral incisors adjacent to impacted canines were investigated and compared with the other side on the dental arch, where canine eruption was normal. Results: Root length of impacted canines was significantly lower than that of normal canines (P=0.011. There were no significant differences between root length of lateral incisors adjacent to impacted canines and root length of lateral incisors adjacent to normal canines (P=0.221. Moreover, the resorption intensity of the adjacent lateral incisors was higher than that of the impacted canines. No significant differences were noted in root resorption intensity between the lateral incisors adjacent to the imacted canines and the lateral incisors adjacent to normal canines (P=0.36. In addition, resorption intensity was significantly higher in impacted canines than in normal canines (P=0.024. Root anatomy of impacted canines was not significantly different from that of normal canines (P=0.055. The crown shape of the lateral incisors adjacent to impacted canines was not significantly different from that of the lateral incisors adjacent to normal canines (P=0.052. Conclusion: Impaction can probably affect root length and canine resorption severity. However, root and crown shape of lateral incisors cannot always be associated with canine impaction.

Physical properties of root cementum: Part 26. Effects of micro-osteoperforations on orthodontic root resorption: A microcomputed tomography study.

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Chan, Emmanuel; Dalci, Oyku; Petocz, Peter; Papadopoulou, Alexandra K; Darendeliler, M Ali

2018-02-01

Studies have demonstrated the potential efficacy of micro-osteoperforations in accelerating tooth movement by amplifying the expression of inflammatory markers. The aim of this investigation was to examine the effects of micro-osteoperforations on orthodontic root resorption with microcomputed tomography. This prospective controlled clinical trial involved 20 subjects requiring extraction of the maxillary first premolars as part of their orthodontic treatment. A buccal tipping force of 150 g was applied to both premolars. Using the Propel appliance (Propel Orthodontics, San Jose, Calif), micro-osteoperforations were applied at a depth of 5 mm on the mesial and distal aspects in the midroot region of the experimental side of the first premolar root; the contralateral side served as the control. After 28 days, both premolars were extracted. The teeth were scanned under microcomputed tomography, and the volumes of root resorption craters were calculated and compared. Premolars treated with micro-osteoperforation exhibited significantly greater average total amounts of root resorption than did the control teeth (0.576 vs 0.406 mm 3 ). The total average volumetric root loss of premolars treated with micro-osteoperforation was 42% greater than that of the control teeth. This 28-day trial showed that micro-osteoperforations resulted in greater orthodontic root resorption. However, these results should be verified in patients who are undergoing full-length orthodontic treatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Maxillary lateral incisors with two canals and two separate curved roots

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Ajit George Mohan

2012-01-01

Full Text Available Variation in the roots and root canal anatomy seems to be the norm rather than an exception. For a successful endodontic treatment, a clinician should have a thorough knowledge of the internal and external dental anatomy and its variations. Maxillary lateral incisors usually exhibit single canal with a single root. In this case, clinical examination and radiographs clearly demonstrates the presence of two root canals with two separate curved roots. This case report emphasizes the need for attention during endodontic management of maxillary lateral incisors.

Autotransplantation and Orthodontic Treatment after Maxillary Central Incisor Region Trauma: A 13-Year Follow-Up Case Report Study.

Science.gov (United States)

Piroozmand, Farzad; Hessari, Hossein; Shirazi, Mohsen; Khazaei, Pegah

2018-01-01

The anterior maxilla is the most prone region to the trauma during childhood, and tooth loss sometimes happens due to trauma. Replacing the missing teeth has always been one of the dentists' challenges in children and adolescents, since their dentofacial growth is not complete. Autotransplantation of mandibular premolars with two-thirds or three-quarters of root formation provides the best prognosis for the tooth survival. This case report describes the management of a 10-year-old boy suffering a severe dental injury who received the autotransplantation of the premolars from mandible to restore the space caused by trauma in maxillary central incisor region and a 13-year follow-up of the autotransplantation.

Morphology of root canal surface: A reflection on the process of cementation of the composite relined glass fiber post

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Yasmine Mendes Pupo

2017-01-01

Full Text Available Background: The present study was conducted to evaluate the bond strength in the different root thirds (premolars and maxillary central incisors of composite relined glass fiber posts compared to untreated glass fiber posts cemented with dual- or chemical-cure cements. Materials and Methods: Sixty human single-rooted premolars (flat canal (n = 15 and 12 maxillary central incisors were used (round canal (n = 3. The teeth were sectioned, and the roots received endodontic treatment. The standardized preparation of the canals was carried out, and the roots were randomly divided into four groups according to the cementation systems: G1: cemented posts (dual: Ambar/Allcem; G2: relined posts (dual: Ambar/Allcem; G3: cemented posts (chemical: Fusion Duralink/Cement Post; and G4: relined posts (chemical: Fusion Duralink/Cement Post. The roots were cut to give two slices of each third of the root canal per specimen. Push-out test was conducted at a speed of 0.5 mm/min. Data were analyzed by analysis of variance and Tukey's post hoc test (α = 0.05. Results: There was no statistically significant difference between groups for the premolars (flat canal (P = 0.959. There was a significant difference in the central incisors between the middle and apical thirds in the cemented group when using the dual system (P = 0.04 and between the middle and apical thirds (P = 0.003 and cervical and apical thirds (P = 0.033 when using the chemical system. Conclusion: Due to the anatomy of the root canal, flat canal of the premolars does not require relining, but round canal of the maxillary central incisors demands it for more secure in the bond strength.

[Current situation of clinical research on impacted premolars].

Science.gov (United States)

Liu, Ran-Ran; Tian, Jun

2018-04-01

Teeth impaction is a common developmental malformation in oral diseases. Impacted teeth are usually the canines, third molar, central incisors, premolars, and second molars. The prevalence of impaction of maxillary canines and mandibular wisdom teeth is higher than that of other teeth. Most recent studies have focused on the canines and third molars, but research on impacted premolars is limited. In clinical practice, the majority of orthodontic patients require premolar extraction. Thus, impacted premolars play important roles in orthodontic design and prognosis. This article provides an overview of recent research on impacted premolars and summarizes epidemiological features, localizations, and treatments, with the aim of guiding practitioners on orthodontic design and therapy.

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.

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

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Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de, E-mail: sousanet@forp.usp.br [Universidade de São Paulo (USP), Ribeirao Preto, SP (Brazil). Departamento de Odontologia Restauradora; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi [Universidade de Ribeirão Preto (UNAERP), Ribeirão Preto, SP (Brazil). Departmento de Endodontia

2017-09-15

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm{sup 3}, 58.51 mm{sup 2}, and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Micro-CT evaluation of root and canal morphology of mandibular first premolars with radicular grooves

International Nuclear Information System (INIS)

Boschetti, Emanuele; Mazzi-Chaves, Jardel Francisco; Versiani, Marco Aurélio; Pécora, Jesus Djalma; Saquy, Paulo Cesar; Sousa Neto, Manoel Damião de; Silva-Sousa, Yara Terezinha Correa; Leoni, Graziela Bianchi

2017-01-01

The aim of this study was to evaluate morphological features of 70 single-rooted mandibular first premolars with radicular grooves (RG) using micro-CT technology. Teeth were scanned and evaluated regarding the morphology of the roots and root canals as well as length, depth and percentage frequency location of the RG. Volume, surface area and Structure Model Index (SMI) of the canals were measured for the full root length. Two-dimensional parameters and frequency of canal orifices were evaluated at 1, 2, and 3 mm levels from the apical foramen. The number of accessory canals, the dentin thickness, and cross-sectional appearance of the canal at different root levels were also recorded. Expression of deep grooves was observed in 21.42% of the sample. Mean lengths of root and RG were 13.43 mm and 8.5 mm, respectively, while depth of the RG ranged from 0.75 to 1.13 mm. Mean canal volume, surface area and SMI were 10.78 mm 3 , 58.51 mm 2 , and 2.84, respectively. Apical delta was present in 4.35% of the sample and accessory canals were observed mostly at the middle and apical thirds. Two-dimensional parameters indicated an oval-shaped cross-sectional appearance of the root canal with a high percentage frequency of canal divisions (87.15%). Canal configuration type V (58.57%) was the most prevalent. C-shaped configuration was observed in 13 premolars (18.57%), whereas dentin thickness ranged from 1.0 to 1.31 mm. Radicular grooves in mandibular first premolars was associated with the occurrence of several anatomical complexities, including C-shaped canals and divisions of the main root canal. (author)

Root resorption after orthodontic intrusion and extrusion:.

NARCIS (Netherlands)

Han, G.; Huang, S.; Hoff, J.W. Von den; Zeng, X.; Kuijpers-Jagtman, A.M.

2005-01-01

The aim of this investigation was to compare root resorption in the same individual after application of continuous intrusive and extrusive forces. In nine patients (mean age 15.3 years), the maxillary first premolars were randomly intruded or extruded with a continuous force of 100 cN for eight

C-shaped root canal configuration in mandibular second premolar: Report of an unusual case and its endodontic management

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Dipali Y Shah

2012-01-01

Full Text Available The C-shaped root canal system is an aberration of the root canal system in which a characteristic fin or web connects individual canals, resulting in a C-shaped cross section. This configuration has been rarely reported in the mandibular second premolar. The only other known reported case of a C-shaped canal, with its configuration, in relation to mandibular second premolar is of an extracted tooth. The purpose of this report is to describe the diagnosis, configuration and endodontic management of C-shaped root canal in mandibular second premolar. Clinical techniques to addresses the challenges in endodontic disinfection as well as cleaning and shaping of the C-shaped canal, which is prone to endodontic mishaps, are also discussed in this case report. Reporting of this case emphasizes the need and added advantage of using the dental operating microscope hand in hand with conventional radiography in management of the C-shaped root canal configuration.

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.

The management of premolar supernumeraries in three orthodontic cases.

LENUS (Irish Health Repository)

McNamara, C M

1997-01-01

This paper reviews the incidence, etiology and location of supernumerary teeth with emphasis on premolar supernumeraries and examines the management of supernumerary premolars of three patients undergoing orthodontics. These cases demonstrate that the management of premolars is assessed individually and treatments based on potential complications, which may occur during the orthodontic and surgical management of the dentition. Progress and posttreatment radiographs are recommended for the assessment of late forming supernumerary teeth.

Physical properties of root cementum: Part 16. Comparisons of root resorption and resorption craters after the application of light and heavy continuous and controlled orthodontic forces for 4, 8, and 12 weeks.

Science.gov (United States)

Paetyangkul, Anchalee; Türk, Tamer; Elekdağ-Türk, Selma; Jones, Allan S; Petocz, Peter; Cheng, Lam L; Darendeliler, M Ali

2011-03-01

Orthodontic force duration can affect the severity of root resorption. The aim of this clinical study was to investigate the amounts of root resorption volumetrically after the application of controlled light and heavy forces in the buccal direction for 4, 8, and 12 weeks. The sample consisted of 54 maxillary first premolars in 36 patients (mean age, 14.9 years; 21 girls, 15 boys) who required first premolar extractions as part of their orthodontic treatment. The teeth were allocated into 3 groups that varied in the duration of force application: 4, 8, or 12 weeks. The right or left first premolars were randomly selected to receive 2 levels of forces. A light buccally directed orthodontic force of 25 g was applied to the experimental tooth on 1 side, while a heavy orthodontic force of 225 g was applied on the contralateral premolar. At the end of the experimental period, the teeth were extracted and scanned with the microcomputed-tomography x-ray system. Resorption crater analysis was performed with specially designed software for direct volumetric measurements. Significant differences in the extent of root resorption were found between 4, 8, and 12 weeks of force application (P resorption in the longer force duration groups. The light force produced significantly less root resorption than did the heavy force. After 4, 8, or 12 weeks of buccally directed orthodontic forces applied on the maxillary first premolars, the volumes of root resorption craters were found to be related to the duration and the magnitude of the forces. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

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

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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...

Orthodontic-surgical retreatment of facial asymmetry with occlusal cant and severe root resorption: A 3-year follow-up.

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Lisboa, Cinthia de Oliveira; Borges, Marlon Sampaio; Medeiros, Paulo José D'Albuquerque; Motta, Alexandre Trindade; Mucha, José Nelson

2017-08-01

Our objective was to report the orthodontic and surgical retreatment of a patient who had undergone a prolonged orthodontic treatment with extractions, but who had unsatisfactory results and persistent side effects. The man, aged 25 years 3 months, sought treatment with major complaints of facial and smile asymmetries. The clinical examination showed a mandibular deviation to the right and a maxillary occlusal cant. A Class II Division 1 subdivision right was observed. Radiographic examination showed extensive root resorptions in the maxillary second premolars and absence of the 4 first premolars. The maxillary midline was deflected 2 mm to the left, and the mandibular midline was shifted 5 mm to the right. Aligning and leveling were performed with orthodontic fixed appliances, with a standard edgewise system (0.022 × 0.028 in), followed by LeFort I maxillary impaction and bilateral sagittal split osteotomy with asymmetrical advancement. Retreatment showed outstanding results that remained stable after 3 years of follow-up. Root resorption in the second premolars did not seem to increase. Orthodontic-surgical intervention is the main choice for correcting esthetic and functional problems in facial asymmetry, particularly in cases of retreatment. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

The application of X-ray microtomography for the assessement of root resorption caused by the orthodontic treatment of premolars.

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Sawicka, Monika; Bedini, Rossella; Pecci, Raffaella; Pameijer, Cornelis Hans; Kmiec, Zbigniew

2012-01-01

The purpose of this study was to demonstrate potential application of micro-computed tomography in the morphometric analysis of the root resorption in extracted human first premolars subjected to the orthodontic force. In one patient treated in the orthodontic clinic two mandibular first premolars subjected to orthodontic force for 4 weeks and one control tooth were selected for micro-computed tomographic analysis. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072). The morphology of root's surfaces was assessed by TView and Computer Tomography Analyzer (CTAn) softwares (SkyScan, bvba) which allowed analysis of all microscans, identification of root resorption craters and measurement of their length, width and volume. Microscans showed in details the surface morphology of the investigated teeth. The analysis of microscans allowed to detect 3 root resorption cavities in each of the orthodontically moved tooth and only one resorption crater in the control tooth. The volumes of the resorption craters in orthodontically-treated teeth were much larger than in a control tooth. Micro-computed tomography is a reproducible technique for the three-dimensional non-invasive assessment of root's morphology ex vivo. TView and CTan softwares are useful in accurate morphometric measurements of root's resorption.

Penatalaksanaan Kasus Maloklusi dengan Agenesis Insisif Lateral Atas dan Premolar Dua Bawah pada Periode Gigi Bercampur

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Ratri Anandita

2012-10-01

Full Text Available In orthodontic practice, orthodontist frequently face the patients with congenitally missing maxillary lateral incisors and mandibular second premolar. There are some treatment options for patients with congenitally missing second premolar such as keeping the deciduous second molar, extracting the molars and allowing space to close spontaneously, prosthetic replacement, autotransplantation and orthodontic space closure. Instead of treatment option for congenitally maxillary lateral incisor are orthodontic space opening for future restoration or orthodontic space closure using canines to replace missing maxillary lateral incisors. There are some factors must be consider before making a decision, such as the facial profile, dentoalveolar protrusion, the tooth size-arch length discrepancy, inclination and position of canine, dental esthetic of canines, occlusion, the dental relationship, patient’s age, the stage of development of the adjacent teeth and the condition of the deciduous predecessors with regard to root resorption and infracclusion. In this paper it will be discussed about the indications, advantages and disadvantages of both treatment modalities to help clinicians to cope with the malocclusion cases with congenital missing teeth. In this regard it needed teamwork among the orthodontist, prosthodontist, dental surgeon and restorative dentist to analyzing some factors related to individual patients and establishing overall treatment plans.DOI: 10.14693/jdi.v16i1.18

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.

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.

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.

Clinical management of a fused upper premolar with supernumerary tooth: a case report

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Kyu-Min Cho

2014-11-01

Full Text Available n dentistry, the term 'fusion' is used to describe a developmental disorder of dental hard tissues. In the permanent dentition, fusion of a normal tooth and a supernumerary tooth usually involves the incisors or canines. However, a few cases of fusion involving premolars have also been reported to date. We present a rare case in which fusion of the maxillary left second premolar and a supernumerary tooth in a 13-year-old girl was diagnosed using cone beam computed tomography (CBCT, Alphard-3030, Asahi Roentgen Ind. Co., Ltd.. The tooth was bicuspidized after routine nonsurgical root canal treatment, and the separated teeth underwent appropriate restoration procedures. The second premolar and supernumerary tooth remained asymptomatic without any signs of inflammation after a follow-up period of 9 years. Identification of anatomical anomalies is important for treatment in cases involving fusion with supernumerary tooth, and therefore the microscopic examinations and CBCT are essential for the diagnosis. Fused teeth can be effectively managed by the comprehensive treatment which includes both endodontic and periodontal procedures.

A Mandibular Second Premolar with Three Canals and Atypical Orifices

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Neha Agarwal

2013-01-01

Full Text Available Background: Mandibular second premolars with three canals (Type V, Vertucci and separate foramina are very rare. The anatomy of the pulp chamber floor in these premolars usually reveals one lingual and two buccal orifices at the same level. This case report describes a second premolar with three canals and an unusual pulpal floor anatomy with one mesiobuccal and one distobuccal orifice at the same level and an orifice on the distolingual wall. Very careful examination of the pulpal space with an optical device and preoperative spiral computed tomography is recommended to locate any unusual orifices.

The timing of tooth eruption and root development of permanent canine and premolars in Korean children

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Cheong, Chang Shin; Jung, Yun Hoa; Cho, Bong Hae [Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

2010-09-15

The aim of this study was to investigate the timing and sequence of eruption of permanent canine and premolars, and to evaluate tooth calcification stage on emergence in Korean children. The sample was comprised of 1,266 children (male 720, female 546) aged from 7-13 years. Tooth eruption and calcification stages were determined through oral and panoramic radiographic examination, respectively. Probit analysis was used to calculate the timing of tooth eruption and tooth calcification stage from these cross-sectional data. In both males and females, eruption occurred around the time when one third of tooth root or more was formed. The sequence was as follows: first premolar, canine, and second premolar in maxilla, and canine, first premolar and second premolar in mandible. Tooth eruption occurred earlier in girls compared with boys, averaging 0.63 years. Eruption sequence is identical in males and females with a trend for females to erupt earlier than males. Tooth eruption becomes earlier over the past decades in Korean children.

The timing of tooth eruption and root development of permanent canine and premolars in Korean children

International Nuclear Information System (INIS)

Cheong, Chang Shin; Jung, Yun Hoa; Cho, Bong Hae

2010-01-01

The aim of this study was to investigate the timing and sequence of eruption of permanent canine and premolars, and to evaluate tooth calcification stage on emergence in Korean children. The sample was comprised of 1,266 children (male 720, female 546) aged from 7-13 years. Tooth eruption and calcification stages were determined through oral and panoramic radiographic examination, respectively. Probit analysis was used to calculate the timing of tooth eruption and tooth calcification stage from these cross-sectional data. In both males and females, eruption occurred around the time when one third of tooth root or more was formed. The sequence was as follows: first premolar, canine, and second premolar in maxilla, and canine, first premolar and second premolar in mandible. Tooth eruption occurred earlier in girls compared with boys, averaging 0.63 years. Eruption sequence is identical in males and females with a trend for females to erupt earlier than males. Tooth eruption becomes earlier over the past decades in Korean children.

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.

Maxillary sinusitis and periapical abscess following periodontal therapy: a case report using three-dimensional evaluation.

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Huang, Chih-Hao; Brunsvold, Michael A

2006-01-01

Maxillary sinusitis may develop from the extension of periodontal disease. In this case, reconstructed three-dimensional images from multidetector spiral computed tomographs were helpful in evaluating periodontal bony defects and their relationship with the maxillary sinus. A 42-year-old woman in good general health presented with a chronic deep periodontal pocket on the palatal and interproximal aspects of tooth #14. Probing depths of the tooth ranged from 2 to 9 mm, and it exhibited a Class 1 mobility. Radiographs revealed a close relationship between the root apex and the maxillary sinus. The patient's periodontal diagnosis was localized severe chronic periodontitis. Treatment of the tooth consisted of cause-related therapy, surgical exploration, and bone grafting. A very deep circumferential bony defect at the palatal root of tooth #14 was noted during surgery. After the operation, the wound healed without incidence, but 10 days later, a maxillary sinusitis and periapical abscess developed. To control the infection, an evaluation of sinus and alveolus using computed tomographs was performed, systemic antibiotics were prescribed, and endodontic treatment was initiated. Two weeks after surgical treatment, the infection was relieved with the help of antibiotics and endodontic treatment. Bilateral bony communications between the maxillary sinus and periodontal bony defect of maxillary first molars were shown on three-dimensional computed tomographs. The digitally reconstructed images added valuable information for evaluating the periodontal defects. Three-dimensional images from spiral computed tomographs (CT) aided in evaluating and treating the close relationship between maxillary sinus disease and adjacent periodontal defects.

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.

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

Endodontic and periodontal treatments of a geminated mandibular first premolar.

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Aryanpour, S; Bercy, P; Van Nieuwenhuysen, J-P

2002-02-01

To describe a rare case of gemination involving a mandibular first premolar. The complex morphology of geminated teeth renders their endodontic and periodontal management difficult. Root canal and periodontal treatments were performed on a geminated mandibular first premolar with three canals. Clinical examination showed two separated crowns with united roots. Radiographically, two distinct pulp chambers with two joined and a third independent canal were seen. Conventional root canal treatment resulted in complete healing of the apical lesion. However, the occurrence of a vertical fracture led to the extraction of the mesial segment. At the follow-up visit, the distal segment was clinically healthy and continued to satisfy functional demands.

Extraction of Maxillary Central Incisors: An Orthodontic-Restorative Treatment

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Hedayati, Zohreh; Zare, Maryam; Bahramnia, Fateme

2014-01-01

Malformed central incisors with poor prognosis could be candidates for extraction especially in crowded dental arches. This case report refers to a 12-year-old boy who suffered from malformed upper central incisors associated with severe attrition. Upper lateral incisors were positioned palatally and canines were rotated and positioned in the high buccal area. The patient had class II malocclusion and space deficiency in both dental arches. Due to incisal wear and malformed short maxillary central incisors and the need for root canal therapy with a major crown build-up, these teeth were extracted. The maxillary lateral incisors were substituted. Thus the maxillary canines were substituted for lateral incisors and the first premolars were substituted for canines. In the lower dental arch the first bicuspids were extracted. Composite resin build-up was performed on the maxillary lateral incisors and canines. This allowed for the crowding and the malocclusion to be corrected. Subsequent gingivectomy improved the patient's gingival margins and smile esthetics one month after orthodontic therapy. PMID:25400954

Comparison of relationship between antral floor and maxillary root apex in bisecting and panoramic techniques

International Nuclear Information System (INIS)

You, Dong Soo; Kim, In Soo

1986-01-01

This study was performed to compare the difference of intraoral bisecting and panoramic techniques in evaluating the relationship of antral floor and maxillary roots. The vertical distances form maxillary root apices to antral floor were measured on both orthopantomograms and bisecting projections obtained form fifth subjects. The results were as follows: 1. Tooth lengths measured on orthopantomogram were larger than on bisecting projection and the magnification ratios were 1.08-1.17. 2. The dimensions from maxillary root apices to antral floor measured on orthopantomogram were larger than on bisecting projection. 3. The above results held true regardless of age and sex.

Evaluating the Amount of Tooth Movement and Root Resorption during Canine Retraction with Friction versus Frictionless Mechanics Using Cone Beam Computed Tomography.

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Makhlouf, Mohamed; Aboul-Ezz, Amr; Fayed, Mona Salah; Hafez, Hend

2018-02-15

The current study was carried out to compare the amount of tooth movement during canine retraction comparing two different retraction mechanics; friction mechanics represented by a NiTi closed coil spring versus frictionless mechanics represented by T - loop, and their effect on root resorption using Cone Beam Computed Tomography (CBCT). Ten patients were selected in a split-mouth study design that had a malocclusion that necessitates the extraction of maxillary first premolars and retraction of maxillary canines. The right maxillary canines were retracted using T - loops fabricated from 0.017 X 0.025 TMA wires. The left maxillary canines received NiTi coil spring with 150 gm of retraction force. Pre retraction and post retraction Cone Beam Computed Tomography were taken to evaluate the amount of tooth movement and root resorption using three-dimensional planes. T - loop side showed statistically significant higher mean anteroposterior measurement than NiTi coil spring side, indicating a lower amount of canine movement pre and post a canine retraction. Concerning the root resorption, there was no statistically significant change in the mean measurements of canine root length post retraction. The NiTi coil spring side showed more distal movement more than the T-loop side. Both retraction mechanics with controlled retraction force, do not cause root resorption.

Distally displaced premolars: A dental anomaly associated with palatally displaced canines.

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Baccetti, Tiziano; Leonardi, Maria; Giuntini, Veronica

2010-09-01

The aim of this study was to evaluate the significance of association between distally displaced premolars (DDP) and palatally displaced canines (PDC) in the pattern of associated phenotypes of dental developmental disturbance. A sample of 2811 subjects (mean age, 9 years 7 months +/- 1 year 3 months) was divided randomly into 2 groups. The first group of 500 subjects was the control group. The reference prevalence rates for the examined parameters were calculated for this group: DDP (measured with the distal angle theta and the premolar-molar angle gamma); PDC; and other dental anomalies, specifically, aplasia of the third molars, aplasia of the contralateral mandibular second premolar, aplasia of the maxillary lateral incisors, and small maxillary lateral incisors. Of the remaining 2311 subjects, the first 100 with a diagnosis of DDP of at least 1 mandibular second premolar comprised experimental group 1 (DDP group). In addition to sex distribution, the same variables that were examined in the control group were analyzed. In the subgroup with the concurrent DDP and PDC (experimental group 2, or DDP-PDC group), the presence of other dental anomalies was investigated. The prevalence rate for PDC in experimental group 1 was compared with that in the control group. The same was done for the prevalence rates for the 4 other dental anomalies in the PDC-DDP group (experimental group 2) vs the prevalence rates for these anomalies in the control group. All comparisons were performed with chi-square tests with the Yates correction (P <0.05), as were the comparisons between the sexes in experimental groups 1 and 2. The values for theta and gamma angles in experimental group 1 were compared with the values for these angles in experimental group 2, as well as with those in the control group. These statistical comparisons were made with analysis of variance (ANOVA) with the Bonferroni post-hoc test (P <0.05). The prevalence rate for PDC in experimental group 1 (28%) was

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.

Orthodontic Treatment of Maxillary Incisors with Severe Root Resorption Caused by Bilateral Canine Impaction in a Class II Division 1 Patient.

Science.gov (United States)

Chang, Na-Young; Park, Jae Hyun; Lee, Mi-Young; Cho, Jin-Woo; Cho, Jin-Hyoung; An, Ki-Yong; Chae, Jong-Moon

2016-01-01

This case report shows the successful alignment of bilateral impacted maxillary canines. A 12-year-old male with the chief complaint of the protrusion of his maxillary anterior teeth happened to have bilateral maxillary canine impaction on the labial side of his maxillary incisors. Four maxillary incisors showed severe root resorption because of the impacted canines. The patient was diagnosed as skeletal Class II malocclusion with proclined maxillary incisors. The impacted canine was carefully retracted using sectional buccal arch wires to avoid further root resorption of the maxillary incisors. To distalize the maxillary dentition, two palatal miniscrews were used. After 25 months of treatment, the maxillary canines were well aligned without any additional root resorption of the maxillary incisors.

The application of X-ray microtomography for the assessement of root resorption caused by the orthodontic treatment of premolars

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Monika Sawicka

2012-01-01

Full Text Available The purpose of this study was to demonstrate potential application of micro-computed tomography in the morphometric analysis of the root resorption in extracted human first premolars subjected to the orthodontic force. In one patient treated in the orthodontic clinic two mandibular first premolars subjected to orthodontic force for 4 weeks and one control tooth were selected for micro-computed tomographic analysis. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072. The morphology of root’s surfaces was assessed by TView and Computer Tomography Analyzer (CTAn softwares (SkyScan, bvba which allowed analysis of all microscans, identification of root resorption craters and measurement of their length, width and volume. Microscans showed in details the surface morphology of the investigated teeth. The analysis of microscans allowed to detect 3 root resorption cavities in each of the orthodontically moved tooth and only one resorption crater in the control tooth. The volumes of the resorption craters in orthodontically-treated teeth were much larger than in a control tooth. Micro-computed tomography is a reproducible technique for the three-dimensional non-invasive assessment of root’s morphology ex vivo. TView and CTan softwares are useful in accurate morphometric measurements of root’s resorption.

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

Science.gov (United States)

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.

Type II dens evaginatus of maxillary central incisor: An alternative approach

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Mansour Alrejaie

2015-01-01

Full Text Available Dens evaginatus is the developmental anomaly of tooth that exhibits protrusion of a tubercle from occlusal surfaces of premolar, and lingual surfaces of maxillary central incisor and lateral incisors. Dens evaginatus is common in Caucasian population. Saudi Arabia is also well evidenced of such cases. These tubercles have an enamel layer covering dentin core containing a thin extension of pulp. These cusp-like protrusions are susceptible to pulp exposure from wear or fracture because of malocclusion. Type II dens evaginatus involves normal pulp with immature root apex. Materials to enhance the pulpal recession or pulpotomy procedures indicated in such cases require long time and efforts to ensure pulpal recession or root maturity, respectively. Also prolonged treatment has risk of fracture of the cusp and reinfection and requires patient commitment for the follow-up procedures. Present case describes the use of mineral trioxide aggregate (MTA in type II dens evaginatus of maxillary central incisor.

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

Science.gov (United States)

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.

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.

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.

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.

Assessment of three root canal preparation techniques on root canal geometry using micro-computed tomography: In vitro study

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Shaikha M Al-Ali

2012-01-01

Full Text Available Aim: To assess the effects of three root canal preparation techniques on canal volume and surface area using three-dimensionally reconstructed root canals in extracted human maxillary molars. Materials and Methods: Thirty extracted Human Maxillary Molars having three separate roots and similar root shape were randomly selected from a pool of extracted teeth for this study and stored in normal saline solution until used. A computed tomography scanner (Philips Brilliance CT 64-slice was used to analyze root canals in extracted maxillary molars. Specimens were scanned before and after canals were prepared using stainless steel K-Files, Ni-Ti rotary ProTaper and rotary SafeSiders instruments. Differences in dentin volume removed, the surface area, the proportion of unchanged area and canal transportation were calculated using specially developed software. Results: Instrumentation of canals increased volume and surface area. Statistical analysis found a statistically significant difference among the 3 groups in total change in volume (P = 0.001 and total change in surface area (P = 0.13. Significant differences were found when testing both groups with group III (SafeSiders. Significant differences in change of volume were noted when grouping was made with respect to canal type (in MB and DB (P < 0.05. Conclusion: The current study used computed tomography, an innovative and non destructive technique, to illustrate changes in canal geometry. Overall, there were few statistically significant differences between the three instrumentation techniques used. SafeSiders stainless steel 40/0.02 instruments exhibit a greater cutting efficiency on dentin than K-Files and ProTaper. CT is a new and valuable tool to study root canal geometry and changes after preparation in great details. Further studies with 3D-techniques are required to fully understand the biomechanical aspects of root canal preparation.

Assessment of the rate of premolar extraction space closure in the maxillary arch with the AcceleDent Aura appliance vs no appliance in adolescents: A single-blind randomized clinical trial.

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Miles, Peter; Fisher, Elizabeth; Pandis, Nikolaos

2018-01-01

The purpose of this 2-arm parallel trial was to assess the effect of the AcceleDent Aura appliance (OrthoAccel Technologies, Houston, Tex) on the rate of maxillary premolar extraction space closure in adolescent patients. Forty Class II adolescents treated with full fixed appliances and maxillary premolar extractions participated in this randomized clinical trial. They were recruited in a private practice and treated by 1 clinician. Randomization was accomplished in blocks of 10 patients assigned to either a no-appliance group or the AcceleDent Aura appliance group with the allocations concealed in opaque, sealed envelopes. Both the operator and the outcome assessor were blinded; however, it was not feasible to blind the patients. Models were taken of the maxillary arch at the start of space closure and just before complete space closure. The space was measured parallel to the occlusal plane from the cusp tips of the teeth mesial and distal to the extraction spaces. There was no clinically (0.05 mm per month; 95% confidence interval [CI], -0.24, 0.34) or statistically significant difference in the rate of space closure (P = 0.74). In both the univariable and multivariable analyses, the mean rate of tooth movement was slower by 0.13 mm per month (95% CI, -.26, .005) on the left side compared with the right side, but this was not statistically significant (P = 0.06). The AcceleDent Aura appliance had no effect on the rate of maxillary premolar extraction space closure. Only a few participants were considered to be good compliers with the appliance. However, the rate of space closure in the good compliers was similar to the overall group and did not appear to influence the result. This trial was not registered. The protocol was not published before trial commencement. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Morphologic study of the maxillary molars. Part II: Internal anatomy.

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Pécora, J D; Woelfel, J B; Sousa Neto, M D; Issa, E P

1992-01-01

The internal anatomy of three hundred and seventy (370) decalcified and cleared human maxillary molars was studied. Seventy-five percent of the first molars, 58% of the second molars and 68% of the third molars studied presented three (3) root canals and 25% of the first molars, 42% of the second molars and 32% of the third molars presented four (4) root canals. The authors observed that the incidence of two root canals in the mesiobuccal root was higher in second maxillary molars than in first maxillary molars.

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth.

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Bodanezi, Augusto; Munhoz, Etiene Andrade; Capelozza, Ana Lúcia Álvares; Bernardineli, Norberti; Moraes, Ivaldo Gomes de; Garcia, Roberto Brandão; Bramante, Clovis Monteiro

2012-01-01

This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer), and a longitudinal void was simulated in half of the specimens from each group (n=8). Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05). Significantly lower sensitivity levels (p<0.05) were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05) in the coronal and apical portions of fillings. The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

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

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.

Effect of Nanocrystalline Hydroxyapatite Socket Preservation on Orthodontically Induced Inflammatory Root Resorption

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Seifi, Massoud; Arayesh, Ali; Shamloo, Nafise; Hamedi, Roya

2015-01-01

Objective Orthodontically induced inflammatory root resorption (OIIRR) is considered to be an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM. Materials and Methods This experimental study was conducted on four male dogs. In each dog, four defects were created at the mesial aspects of the maxillary and mandibular first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically evaluated. The three-way ANOVA statistical test was used for comparison. Results The mean root resorption in the synthetic bone substitute group was 22.87 ± 11.25×10-4mm2 in the maxilla and 21.41 ± 11.25×10-4mm2 in the mandible. Statistically, there was no significant difference compared to the control group (p>0.05). Conclusion The use of a substitution graft in the nano particle has some positive effects in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed osteoblastic activity and remodeling environment of nanoparticles in NanoBone®. PMID:25685742

Effect of nanocrystalline hydroxyapatite socket preservation on orthodontically induced inflammatory root resorption.

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Seifi, Massoud; Arayesh, Ali; Shamloo, Nafise; Hamedi, Roya

2015-01-01

Orthodontically induced inflammatory root resorption (OIIRR) is considered to be an important sequel associated with orthodontic tooth movement (OTM). OTM after Socket preservation enhances the periodontal condition before orthodontic space closure. The purpose of this study is to investigate the histologic effects of NanoBone®, a new highly nonsintered porous nano-crystalline hydroxyapatite bone on root resorption following OTM. This experimental study was conducted on four male dogs. In each dog, four defects were created at the mesial aspects of the maxillary and mandibular first premolars. The defects were filled with NanoBone®. We used the NiTi closed coil for mesial movement of the first premolar tooth. When the experimental teeth moved approximately halfway into the defects, after two months, the animals were sacrificed and we harvested the area of interest. The first premolar root and adjacent tissues were histologically evaluated. The three-way ANOVA statistical test was used for comparison. The mean root resorption in the synthetic bone substitute group was 22.87 ± 11.25×10(-4)mm(2) in the maxilla and 21.41 ± 11.25×10(-4)mm(2) in the mandible. Statistically, there was no significant difference compared to the control group (p>0.05). The use of a substitution graft in the nano particle has some positive effects in accessing healthy periodontal tissue following orthodontic procedures without significant influence on root resorption (RR). Histological evaluation in the present study showed osteoblastic activity and remodeling environment of nanoparticles in NanoBone®.

Incidence and severity of root resorption in orthodontically moved premolars in dogs.

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Maltha, J C; van Leeuwen, E J; Dijkman, G E H M; Kuijpers-Jagtman, A M

2004-05-01

To study treatment-related factors for external root resorption during orthodontic tooth movement. An experimental animal study. Department of Orthodontics and Oral Biology, University Medical Centre Nijmegen, The Netherlands. Twenty-four young adult beagle dogs. Mandibular premolars were bodily moved with continuous or intermittent controlled orthodontic forces of 10, 25, 50, 100, or 200 cN according to standardized protocols. At different points in time histomorphometry was performed to determine the severity of root resorption. Prevalence of root resorptions, defined as microscopically visible resorption lacunae in the dentin. Severity of resorption was defined by the length, relative length, depth, and surface area of each resorption area. The incidence of root resorption increased with the duration of force application. After 14-17 weeks of force application root resorption was found at 94% of the root surfaces at pressure sides. The effect of force magnitude on the severity of root resorption was not statistically significant. The severity of root resorption was highly related to the force regimen. Continuous forces caused significantly more severe root resorption than intermittent forces. A strong correlation (0.60 < r < 0.68) was found between the amount of tooth movement and the severity of root resorption. Root resorption increases with the duration of force application. The more teeth are displaced, the more root resorption will occur. Intermittent forces cause less severe root resorption than continuous forces, and force magnitude is probably not decisive for root resorption.

Spiral computed tomography in the evaluation of relations of the impacted maxillary canines and the adjacent incisor roots

International Nuclear Information System (INIS)

Siegel, R.; Stos, W.; Dyras, M.; Urbanik, A.; Wojciechowski, W.; Sztuk, S.

2009-01-01

Background: The relations of the crowns of impacted maxillary canines and the roots of adjacent incisors are difficult to evaluate on conventional radiographs due to superimposition of shadows of these structures. The aim of this study was to analyse the relations between the crowns of impacted canines and the roots of adjacent incisors with the use of computed tomography. Material/Methods: The study involved a group of 65 patients suspicious for an impacted maxillary permanent canine. All the patients underwent pantomography. In 44 individuals in the age of 13-31 years (mean age 17.1 ± 4.5) the examination revealed shadows of the impacted crowns superimposed on the roots of incisors. These patients were subjected to CT. On the basis of those CT examinations (including multiplanar and three-dimensional reconstructions) we defined the location of the impacted canines as buccal, palatal and horizontal. Likewise, the relations between the crowns of impacted canines and the roots of lateral or/and central incisors were studied. Results: From among 54 impacted maxillary canines, 41 (75.9%) were located palatally, 10 (18.5%) buccally, and 3 (5.6%) horizontally. In 14 cases (29.5%), the impacted canine remained in various kind of contact with both adjacent incisors. In addition to those aforementioned 14 cases, the impacted maxillary canine remained in contact with adjacent root of the lateral incisor in 34 cases (in total: 48 cases of contact). We found 17 cases (35.4%) of adherence without features of root resorption and 31 cases (64.4%) of resorption. Among the cases of resorption, there were 18 instances of deep resorption (58.1%) and 13 instances of light resorption (41.9%). There were also 18 cases (33.3%) of contact between the impacted canine and the root of the central incisor, including 10 instances (55.6%) of adjacency without root resorption and 8 cases (44.4%) of resorption. Conclusions: Computed tomography allows for a precise localisation of the impacted

Influence of root canal sealer on the radiographic appearance of filling voids in maxillary single-rooted teeth

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Augusto Bodanezi

2012-08-01

Full Text Available OBJECTIVE: This study compared the influence of three epoxy resin-based sealers with distinct radiopacities on the observers' ability to detect root canal filling voids during radiographic analysis. MATERIAL AND METHODS: The root canals of 48 extracted maxillary canines were prepared and divided into three groups. Each group was laterally condensed with one sealer (AH Plus®, Acroseal® or a non-radiopaque sealer, and a longitudinal void was simulated in half of the specimens from each group (n=8. Buccolingual radiographs were obtained and randomly interpreted for voids by a radiologist and an endodontist in a blinded fashion. Teeth were cut and inspected under a microscope to confirm the position of void. Differences in sensitivity and specificity between groups and examiners were compared using the Fisher's Exact and McNemar tests, respectively (α=0.05. RESULTS: Significantly lower sensitivity levels (p<0.05 were observed in the coronal portion of fillings performed with both radiopaque sealers. Specificity values for Acroseal® were significantly higher (p<0.05 in the coronal and apical portions of fillings. CONCLUSIONS: The type of root canal sealer can affect the observers' ability to detect root canal filling voids during radiographic analysis of upper single-rooted teeth.

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

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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.

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study.

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Brusveen, Elin Marie Gravdal; Brudvik, Pongsri; Bøe, Olav Egil; Mavragani, Maria

2012-04-01

The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

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

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

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

A Case of Maxillary Protrusion with Congenitally Missing Canine Teeth in the Mandible

OpenAIRE

松井, 啓至; 酒徳, 明彦

1996-01-01

A patient that had a maxillary protrusion with congenitally missing canine teeth in the mandible was successfully treated with the extraction of the maxillary first premolars. The patient's cooperation in wearing headgear appliance was highly favorable. Her profile changes were pronounced and esthetically pleasing. A review of her post-treatment records revealed an excellent esthetic and occlusal result even though the first premolars were aligned instead of the canine teeth in the mandible. ...

Effect of piezocision on root resorption associated with orthodontic force: A microcomputed tomography study.

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Patterson, Braydon M; Dalci, Oyku; Papadopoulou, Alexandra K; Madukuri, Suman; Mahon, Jonathan; Petocz, Peter; Spahr, Axel; Darendeliler, M Ali

2017-01-01

The purpose of this study was to investigate the effect of piezocision on orthodontically induced inflammatory root resorption. Fourteen patients were included in this split-mouth study; 1 side was assigned to piezocision, and the other side served as the control. Vertical corticotomy cuts of 4 to 5 mm in length were performed on either side of each piezocision premolar, and 150-g buccal tipping forces were applied to the premolars. After 4 weeks, the maxillary first premolars were extracted and scanned with microcomputed tomography. There was a significantly greater total amount of root resorption seen on the piezocision sides when compared with the control sides (P = 0.029). The piezocision procedure resulted in a 44% average increase in root resorption. In 5 patients, there was noticeable piezocision-related iatrogenic root damage. When that was combined with the orthodontic root resorption found on the piezocision-treated teeth, there was a statistically significant 110% average increase in volumetric root loss when compared with the control side (P = 0.005). The piezocision procedure that initiates the regional acceleratory phenomenon may increase the iatrogenic root resorption when used in conjunction with orthodontic forces. Piezocision applied close to the roots may cause iatrogenic damage to the neighboring roots and should be used carefully. Copyright © 2017.

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.

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.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology

OpenAIRE

Nicola M. Grande; Gianluca Plotino; Gianluca Gambarini; Luca Testarelli; Ferdinando D’Ambrosio; Raffaella Pecci; Rossella Bedini

2012-01-01

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware...

Root resorption of permanent incisors during three months of active orthodontic treatment.

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Batool, Iffat; Abbas, Hasnain; Abbas, Assad; Abbas, Iram

2010-01-01

Root resorption is one of the most common and undesirable sequelea of orthodontic treatment. The aim of this study was to evaluate the amount of root resorption in permanent incisors during 3 month active period of fixed orthodontic appliance therapy using periapical radiographs. Periapical radiographs of a total of 138 permanent teeth (n = 138, mandibular n1 = 52, maxillary n2 = 86) were evaluated for root resorption. All patients were treated with 3M MBT multi-bonded, pre-adjusted appliances with 0.022 inch slots. Initial levelling and alignment was achieved with 0.0175 inch co-axial wires. All four incisors (maxillary and mandibular) were measured for any change in root length. The change in root length between T0 (pre-treatment) and T1 (post-treatment) was measured in millimetres and expressed in terms of percentage of original root length. The mean pre treatment (T0) root length for the maxillary teeth (n1 = 62) was 19.27 +/- 2.86 mm and 20.01 +/- 2.57 mm for the mandibular teeth (n2 = 31). The post-treatment (T1) root length for the maxillary teeth was 18.96 +/- 2.85 mm and 19.49 +/- 2.4 mm for the mandibular teeth showing a mean resorption of 0.31 mm and 0.52 mm for the maxillary and mandibular teeth respectively. Root resorption was strongly correlated with active orthodontic appliance therapy with maxillary and mandibular incisors being most susceptible. It was found that root resorption can be detected even in the early levelling and alignment stages of orthodontic treatment.

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.

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.

Interrelationships in the Variability of Root Canal Anatomy among the Permanent Teeth: A Full-Mouth Approach by Cone-Beam CT.

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Monsarrat, Paul; Arcaute, Bertrand; Peters, Ove A; Maury, Elisabeth; Telmon, Norbert; Georgelin-Gurgel, Marie; Maret, Delphine

2016-01-01

In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The aim of this study was to assess using CBCT acquisitions regarding whether one root canal anatomy of a tooth is associated with a specific anatomy of another tooth. A total of 106 CBCT acquisitions were obtained using a CBCT scanner with 200μm voxel size. Numbers of roots and canals of the entire dentition were described. Bivariate analyses and logistic regressions were conducted to explore root canal anatomy on one tooth according to age, gender, jaw, side and the others teeth. Multiple correspondence analysis (MCA) was performed to correlate the different numbers of canals profiles. A total of 2424 teeth were analyzed. Independently from the other variables, the presence of an additional root canal on a mandibular incisor increases the risk of having an additional root canal on a mandibular premolar (OR [95%] 3.7 [1.0;13.2]). The mandibular molar variability increases in women compared to men (OR [95%] 0.4 [0.1; 0.9]). MCA showed correspondence between 2-canals maxillary incisor and canines and 5-canals maxillary molars, and some correlation between additional canal on maxillary and mandibular premolars. Although CBCT examinations are conducted in the first intention of making a diagnosis or prognostic evaluation, medium FOV acquisitions could be used as an initial database thus furnishing preliminary evaluations and information. In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The visualization of all canals is considered essential in endodontic therapy. The use of multi-correspondence analysis for statistics in endodontic research is a new approach as a prognostic tool.

Interrelationships in the Variability of Root Canal Anatomy among the Permanent Teeth: A Full-Mouth Approach by Cone-Beam CT.

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Paul Monsarrat

Full Text Available In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The aim of this study was to assess using CBCT acquisitions regarding whether one root canal anatomy of a tooth is associated with a specific anatomy of another tooth.A total of 106 CBCT acquisitions were obtained using a CBCT scanner with 200μm voxel size. Numbers of roots and canals of the entire dentition were described. Bivariate analyses and logistic regressions were conducted to explore root canal anatomy on one tooth according to age, gender, jaw, side and the others teeth. Multiple correspondence analysis (MCA was performed to correlate the different numbers of canals profiles.A total of 2424 teeth were analyzed. Independently from the other variables, the presence of an additional root canal on a mandibular incisor increases the risk of having an additional root canal on a mandibular premolar (OR [95%] 3.7 [1.0;13.2]. The mandibular molar variability increases in women compared to men (OR [95%] 0.4 [0.1; 0.9]. MCA showed correspondence between 2-canals maxillary incisor and canines and 5-canals maxillary molars, and some correlation between additional canal on maxillary and mandibular premolars.Although CBCT examinations are conducted in the first intention of making a diagnosis or prognostic evaluation, medium FOV acquisitions could be used as an initial database thus furnishing preliminary evaluations and information. In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The visualization of all canals is considered essential in endodontic therapy. The use of multi-correspondence analysis for statistics in endodontic research is a new approach as a prognostic tool.

Root canal treatment of mandibular second premolar tooth with taurodontism

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Vujašković Mirjana

2008-01-01

Full Text Available INTRODUCTION Taurodontism is a morphoanatomical change in the shape of a tooth. An enlarged body of a tooth with smaller than usual roots is a characteristic feature. Internal tooth anatomy correlates with this appearance, which means that a taurodontal tooth has a large pulp chamber and apically positioned furcations. This dental anomaly may be associated with different syndromes and congenital discoders. CASE OUTLINE The case report presents the patient of a rare case of taurodontism in the mandibular second premolar with chronic periodontitis. Endodontic treatment was performed after dental history and clinical examination. Special care is required in all segments of endodontic treatment of a taurodontal tooth from the identification orifice, canal exploration, determining working length, cleaning and shaping and obturation of the root canal. Precurved K-file was used for canal exploration and location of the furcation. One mesial and one distal canal with the buccal position were identified in the apical third of the root canal. The working lengths of two canals were determined by radiographic interpretation with two K-files in each canal and verified with the apex locator. During canal instrumentation, the third canal was located in the disto-lingual position. The working length of the third canal was established using the apex locator. CONCLUSION Thorough knowledge of tooth anatomy and its variations can lead to lower percentage of endodontic failure. Each clinical case involving these teeth should be investigated carefully, clinically and radiographically to detect additional root canals. High quality radiographs from different angles and proper instrumentarium improve the quality of endodontic procedure.

Physical properties of root cementum: Part 18. The extent of root resorption after the application of light and heavy controlled rotational orthodontic forces for 4 weeks: a microcomputed tomography study.

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Wu, Andy T J; Turk, Tamer; Colak, Canan; Elekdağ-Turk, Selma; Jones, Allan S; Petocz, Peter; Darendeliler, M Ali

2011-05-01

The aim of this prospective randomized clinical trial was to quantitatively measure and compare the locations, dimensions, and volume of root resorption craters in human premolars after the application of controlled light and heavy rotational orthodontic forces over a 28-day (4-week) period. Fifteen patients requiring bilateral extraction of maxillary first premolars as part of their orthodontic treatment were recruited for this study. Each patient received a heavy (225 g) rotational force on 1 premolar and a light (25 g) rotational force on the contralateral premolar. Orthodontic rotational forces were applied over 28 days with buccal and palatal cantilever springs; 0.016-inch beta-titanium molybdenum alloys were used to apply the light force and 0.018-inch stainless steel was used for the heavy force. After the 28-day experimental period, the upper first premolars were extracted under stringent protocols to prevent root surface damage. The samples were then scanned using a microcomputed tomography (micro-CT) scan x-ray system (SkyScan 1072, Skyscan, Aartselaar, Belgium), and analyzed using convex hull algorithm (CHULL2D; University of Sydney, Sydney, Australia) software to obtain direct volumetric measurements. The mean volume of resorption craters was 0.42 in the light force group and 0.51 in the heavy force group (P = 0.013). When separated at the root level, the difference in volume of root resorption craters between the 2 groups was significantly different only at the midlevel (P = 0.001). Root resorption craters were consistently detected at the boundaries between the buccal and distal surfaces and the mesial and lingual surfaces. The result supports our hypothesis that positive areas develop significantly more root resorption craters at all 3 levels, as compared with minimal areas (paired t test root resorption than light rotational forces and compression areas (buccal-distal and lingual-mesial surfaces in this study) showed significantly higher root

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.

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

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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.

Evaluation of efficacy of a novel resorbable collagen membrane for root coverage of Miller's Class I and Class II recession in the maxillary anteriors and premolars

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Krutika Kapare

2016-01-01

Full Text Available Background: There are several surgical techniques in literature that have been used to perform root coverage (RC. Currently, the use of a resorbable collagen membrane (RCM as a guided tissue regenerative material is one of the highly sought treatment modalities. The present study aimed at evaluating the clinical outcome of RC in the treatment of Miller's Class I and II recession defects in maxillary anteriors and premolars by coronally advanced flap (CAF with and without RCM. Materials and Methods: This split-mouth study (bilateral buccal recession defects was randomized to include 15 test (CAF + membrane and 15 control (CAF alone sites. Clinical parameters included gingival recession depth (RD, probing pocket depth (PPD, clinical attachment level (CAL, and keratinized tissue height (KTH measured at baseline and 9 months postoperatively. Results: Both test and control groups showed statistically significant (P < 0.05 reductions in RD (1.54 ± 0.46 mm and 1.60 ± 0.07 mm, PPD (0.53 ± 0.15 mm and 0.94 ± 0.10 mm, increase in KTH (0.67 ± 0.90 mm and 0.73 ± 0.14 mm and CAL (1.94 ± 0.27 mm and 2.60 ± 0.19 mm when comparing the 9-month data from baseline. The present study showed that mean improvement in RD was 1.60 ± 0.507 and 1.53 ± 0.64 mm in both test and control groups, respectively. Mean percent RC was 58.33% ±12.19% and 56.22% ±10.22% for test and control groups, respectively. However, there were no statistically significant differences between groups for RD, PPD, KTH, and CAL. Conclusion: The results of this study suggest that both the groups CAF (control and CAF and RCM (test could be successfully used to treat Miller's Class I and II gingival recession defects and also demonstrated an overall significant improvement in all the assessed clinical parameters. However, there was a greater reduction of gingival RD with the use of RCM when compared with the group of CAF alone.

Evaluation of anatomy and morphology of human mandibular premolar teeth by cone-beam computed tomography in Iranian population

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Amin Sobhani Mohhsen

2013-08-01

Full Text Available   Background and Aims: Successful root canal therapy requires knowledge of tooth anatomy and root canal morphology. For permanent mandibular premolars, great variety in size, shape and number of roots and root fusion expression has been reported in the literature. There is a wide variety of methods used in studies for evaluating the root canal morphology. One of these methods is Cone-beam Computed tomography (CBCT that reduces the limitations of two-dimensional X-ray imaging, with less exposure in comparison with other 3D radiographies. Thus, this study was designed to evaluate the differences in the root and canal morphology of permanent mandibular premolars in an Iranian population by means of CBCT images.   Materials and Methods: We searched a database of CBCT scans and evaluated 400 (20-60 years old patients who met the inclusion criteria and teeth in this images (CBCT were evaluated in three dimensions (Axial, Coronal and Sagital. Tooth length, number of roots, number of canals, canal type, root curvature and the effect of gender on any of the items mentioned were evaluated. Data were analyzed using T-test.   Results: The average length of the first premolar of mandibular was 22.27 mm and second premolar was 22.28 mm. 98.4% of the first premolar and 98.2% of the second premolar were single root., and 87.3% and 93.1% were single channel. The incidence of number of canals based on vertochy divisions were:type 1: 90.7% and 90.8%, type 0: 2.2% and 2.8%, type 4: 3.3% and 3.1%, type 6: 1.4% and 2.1% and type 3: 2.5% and 1.5% respectively. In any case, there was no significant difference between males and females (P<0.001.   Conclusion: Results indicate that dentists can obtain valuable information about the anatomy and morphology of the root canals using CBCT.

Physical properties of root cementum: part 20. Effect of fluoride on orthodontically induced root resorption with light and heavy orthodontic forces for 4 weeks: a microcomputed tomography study.

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Karadeniz, Ersan Ilsay; Gonzales, Carmen; Nebioglu-Dalci, Oyku; Dwarte, Dennis; Turk, Tamer; Isci, Devrim; Sahin-Saglam, Aynur M; Alkis, Huseyin; Elekdag-Turk, Selma; Darendeliler, M Ali

2011-11-01

The major side effect of orthodontic treatment is orthodontically induced inflammatory root resorption. Fluoride was previously shown to reduce the volume of the root resorption craters in rats. However, the effect of fluoride on orthodontically induced inflammatory root resorption in humans has not yet been investigated. The aim of this study was to investigate the effect of high and low amounts of fluoride intake from birth on orthodontically induced inflammatory root resorption under light (25 g) and heavy (225 g) force applications. Forty-eight patients who required maxillary premolar extractions as part of their orthodontic treatment were selected from 2 cities in Turkey with high and low fluoride concentrations in the public water of ≥ 2 and ≤ 0.05 ppm, respectively. The patients were randomly separated into 4 groups of 12 each: group 1, high fluoride intake and heavy force; group 2, low fluoride intake and heavy force; group 3, high fluoride intake and light force; and group 4, low fluoride intake and light force. Light or heavy buccal tipping orthodontic forces were applied on the maxillary first premolars for 28 days. At day 28, the teeth were extracted, and the samples were analyzed with microcomputed tomography. Fluoride reduced the volume of root resorption craters in all groups; however, this effect was significantly different with high force application (P = 0.015). It was also found that light forces caused less root resorption than heavy forces. There was no statistical difference in the amount of root resorption observed on root surfaces (buccal, lingual, mesial, and distal) in all groups. However, the middle third of the roots showed the least root resorption. With high fluoride intake and heavy force application, less root resorption was found in all root surfaces and root thirds. Fluoride may reduce the volume of root resorption craters. This effect is significant with heavy force applications (P root showed significantly greater root

Analysis of the root position of the maxillary incisors in the alveolar bone using cone-beam computed tomography

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Jung, Yun Hoa; Cho, Bong Hee [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of); Hwang, Jae Jun [Dept. of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul (Korea, Republic of)

2017-09-15

The purpose of this study was to measure the buccal bone thickness and angulation of the maxillary incisors and to analyze the correlation between these parameters and the root position in the alveolar bone using cone-beam computed tomography (CBCT). CBCT images of 398 maxillary central and lateral incisors from 199 patients were retrospectively reviewed. The root position in the alveolar bone was classified as buccal, middle, or palatal, and the buccal type was further classified into subtypes I, II, and III. In addition, the buccolingual inclination of the tooth and buccal bone thickness were evaluated. A majority of the maxillary incisors were positioned more buccally within the alveolar bone, and only 2 lateral incisors (0.5%) were positioned more palatally. The angulation of buccal subtype III was the greatest and that of the middle type was the lowest. Most of the maxillary incisors exhibited a thin facial bone wall, and the lateral incisors had a significantly thinner buccal bone than the central incisors. The buccal bone of buccal subtypes II and III was significantly thinner than that of buccal subtype I. A majority of the maxillary incisor roots were positioned close to the buccal cortical plate and had a thin buccal bone wall. Significant relationships were observed between the root position in the alveolar bone, the angulation of the tooth in the alveolar bone, and buccal bone thickness. CBCT analyses of the buccal bone and sagittal root position are recommended for the selection of the appropriate treatment approach.

Aspergilloma of the maxillary sinus: report of a case

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Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan; Yu, Jae Jung

2010-01-01

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

Impacted maxillary canines and root resorption of adjacent teeth: A retrospective observational study.

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Guarnieri, R; Cavallini, C; Vernucci, R; Vichi, M; Leonardi, R; Barbato, E

2016-11-01

The prevalence of impacted maxillary canine is reported to be between 1% and 3%. The lack of monitoring and the delay in the treatment of the impacted canine can cause different complications such as: displacement of adjacent teeth, loss of vitality of neighbouring teeth, shortening of the dental arch, follicular cysts, canine ankylosis, recurrent infections, recurrent pain, internal resorption of the canine and the adjacent teeth, external resorption of the canine and the adjacent teeth, combination of these factors. An appropriate diagnosis, accurate predictive analysis and early intervention are likely to prevent such undesirable effects. The objective is to evaluate, by means of a retrospective observational study, the possibility of carrying out a predictive analysis of root resorption adjacent to the impacted canines by means of orthopantomographs, so as to limit the prescription of additional 3D radiography. 120 subjects with unilateral or bilateral maxillary impacted canine were examined and 50 patients with 69 impacted maxillary canine (22 male, 28 female; mean age: 11.7 years) satisfied the inclusion criteria of the study. These patients were subjected to a basic clinical and radiographic investigation (orthopantomographs and computerized tomography). All panoramic films were viewed under standardized conditions for the evaluation of two main variables: maxillary canine angulations (a, b, g angles) and the overlapping between the impacted teeth and the lateral incisor (Analysis of Lindauer). Binary logistic regression was used to estimate the likelihood of resorbed lateral incisors depending on sector location and angle measurements. Results indicated that b angle has the greatest influence on the prediction of root resorption (predictive value of b angle = 76%). If β angle <18° and Lindauer = I, the probability of resorption is 0.06. Evaluation of b angle and superimposition lateral incisor/impacted canine analysed on orthopantomographs could be one of

Influence of reinforcement on strains within maxillary implant overdentures.

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Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu

2015-01-01

The purpose of this study was to examine the influence of reinforcement of an embedded cast on the strains within maxillary implant overdentures. A maxillary edentulous model with implants placed bilaterally in the canine positions, dome-shaped copings, and experimental overdentures was fabricated. Rosette-type strain gauges were attached in the canine positions and at three points along the midline of the polished surface of the denture and connected to the sensor interface controlled by a personal computer. Experimental dentures with five different reinforcements were tested: without reinforcement; with a cast cobalt-chrome reinforcement over the residual ridge and the tops of the copings; with the same reinforcement from first molar to first molar, over the residual ridge and the tops of the copings; with the same reinforcement over the residual ridge and the sides of the copings; and with the same reinforcement from first molar to first molar, over the residual ridge and the sides of the copings. A vertical occlusal load of 49 N was applied to the first premolar and then to the first molar, and the strains were measured and compared by analysis of variance. In both loading situations, significantly less strain was recorded in dentures with reinforcement than in those without reinforcement. When the first premolar was loaded on dentures with and without palatal reinforcement at the first premolars, the strains on the denture with reinforcement over the tops of the copings were significantly lower than on the denture with reinforcement over the sides of the copings at the canine position. Cast reinforcement over the residual ridge and the top of copings embedded in an acrylic base reduced the strain from occlusal stress on maxillary implant overdentures.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology.

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Grande, Nicola M; Plotino, Gianluca; Gambarini, Gianluca; Testarelli, Luca; D'Ambrosio, Ferdinando; Pecci, Raffaella; Bedini, Rossella

2012-01-01

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Present and future in the use of micro-CT scanner 3D analysis for the study of dental and root canal morphology

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Nicola M. Grande

2012-01-01

Full Text Available The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium. A specific software ResolveRT Amira (Visage Imaging was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Use of reconstructed CT images for evaluation of the position of screw-type temporary anchorage devices implanted in the maxillary molar region

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Hashimoto, Kazuya

2007-01-01

Temporary anchorage devices (TAD) have recently been employed for orthodontic treatment. I attempted to find the safest position for placing the screw-type TAD in the maxillary molar region. Using reconstructed CT images, I investigated the buccolingual and mesiodistal lengths of the interalveolar septums between the maxillary first premolar, second premolar, first molar, and the second molar. For the first and second molars, I measured the distance from the alveolar crest to the maxillary sinus. The results indicated that the safest position for placing a screw-type TAD was the interalveolar septum between the maxillary first molar and the second premolar at about a depth of 4-6 mm from the alveolar crest on the buccal side, and at about a depth of 2-6 mm from the alveolar crest on the palatal side. (author)

Unusal canal configuration in maxillary and mandibular second molars

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Ramachandran Ragunathan

2016-01-01

Full Text Available This clinical article describes three different case reports of maxillary and mandibular second molars with the unusual anatomy of single root with a single canal and their endodontic management. An unusual case of bilateralism is observed in the first two cases in the form of single-rooted second mandibular molars in both the quadrant of the same patient. The presence of maxillary second molar with single root and single canal in the third case is unusual.

Pengaruh Pencabutan Premolar Terhadap Overall Bolton Ratio Pada Maloklusi Klas I di RSGMP FKG USU

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Nasution, Mutia Amalia

2017-01-01

137160008 Introduction : In orthodontics treatment,to obtain a good and stable occlusion, there should be an harmony between the combined mesiodistal widths of maxillary teeth and those of mandibular teeth. Extraction of premolars is routinely carried out in orthodontic treatment, but the extraction can lead to the changes of the overall Bolton ratio and the changes are influenced by different extraction combinations. The purpose of this study is to investigate the effects of premolar extr...

Positional relationship between the maxillary sinus floor and the apex of the maxillary first molar using cone beam computed tomograph

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Kim, Kyung Hwa; Koh, Kwang Joon

2008-01-01

To assess the positional relationship between the maxillary sinus floor and the apex of the maxillary first molar using cone beam computed tomograph (CBCT). CBCTs from 127 subjects were analysed. A total of 134 maxillary first molars were classified according to their vertical and horizontal positional relationship to the maxillary sinus floor and measured according to the distance between the maxillary sinus floor and the maxillary first molar. Type III (The root projected laterally on the sinus cavity but its apex is outside the sinus boundaries) was dominated between 10 and 19 years and type I (The root apex was not in contact with the cortical borders of the sinus) was dominated (P<0.05) between 20 and 72 years on the vertical relationship between the maxillary sinus floor and the apex of the maxillary first molar. The maxillary sinus floor was located more at the apex (78.2%) than at the furcation (21.3%) for the palatal root. The distance from the root apex to the maxillary sinus floor confined to type I was increased according to the ages (P<0.05). Type M (The maxillary sinus floor was located between the buccal and the palatal root) was most common (72.4%) on the horizontal relationship between the maxillary sinus floor and the apex of the maxillary first molar. CBCT can provide highly qualified images for the maxillary sinus floor and the root apex of the maxillary first molar.

Periapical abscess of the maxillary teeth and its fistulizations: Multi-detector CT study

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Sherif A. Shama

2013-09-01

Full Text Available Aim: The aim of this study was to assess the role of MDCT and the dedicated dental software in assessment of the periapical abscesses of the maxillary teeth and in detection of abnormal fistula as well as post intervention complications. Materials and methods: This study was conducted on 20 patients with periapical abscess of the maxillary teeth. MDCT machines were used in examination of all patients. Workstation was used for manipulation of data. Dedicated dental software was used in the evaluation of all diseased teeth. Results: Fourteen patients had their abscesses involving the maxillary molar and premolar teeth, six of them showed associated oro-antral fistula (42.8%. Four patients had their abscesses surrounding the apices of the incisors, two of them showed associated oro-nasal fistula (50%. None of the patients with periapical abscesses surrounding the roots of the canine teeth (n = 2 showed abnormal fistulization. Nine cases (45% showed missing crowns and retained roots due to previous trials of extractions. Two cases (10% of fracture of the maxillary alveolar process complicating trials of previous extraction were also encountered. Conclusion: The MDCT with its outstanding image quality of the bony structures supported by its 3-D and VR capabilities can detect the periapical dental abscess in a 3-D fashion, accurately define its location, size and extent and is excellent in evaluation of possible fistula. As compared to panorama X-ray, MDCT was more accurate in diagnosis of abnormal fistula and associated fracture of the alveolar process of the maxillary bone. KEYWORDS: Periapical abscess, MDCT, Oro-antral fistula, Oro-nasal fistula

Effect of Attachment Type on Denture Strain in Maxillary Implant Overdentures: Part 1. Overdenture with Palate.

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Takahashi, Toshihito; Gonda, Tomoya; Maeda, Yoshinobu

This study examined the effects of attachments on strain in maxillary implant overdentures supported by two or four implants. A maxillary edentulous model with implants inserted into anterior, premolar, and molar areas was fabricated, and three types of unsplinted attachments-ball, locator, and magnet-were set on the implants distributed under various conditions. Maxillary experimental dentures were fabricated, and two strain gauges were attached at the anterior midline on the labial and palatal sides. A vertical occlusal load of 98 N was applied and shear strain of the dentures was measured. On both sides, magnet attachments resulted in the lowest shear strain, while ball attachments resulted in the highest shear strain under most conditions. However, differences in shear strain among the three attachment types were not significant when supported by four implants, especially molar implants. Shear strain of the maxillary implant overdenture was lowest when using magnet attachments. Magnet attachments mounted on four implants are recommended to prevent denture complications when using maxillary implant overdentures.

Aspergilloma of the maxillary sinus: report of a case

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Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [School of Dentistry, Kung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung [Kangdong Scared Heart Hospital, Hallym Medical Center, Seoul (Korea, Republic of)

2010-12-15

Aspergilloma of the paranasal sinus is a non-invasive form of aspergillosis, most often in the maxillary sinus. This case presents an 86-year-old female with aspergilloma of the left maxillary sinus. The patient's chief complaint was intermittent pain on the left maxillary first premolar area. A radiopacification of the left maxillary sinus was observed on the panoramic radiograph. Cone-beam computed tomography revealed complete radiopacification of the left maxillary sinus and scattered multiple radiopaque mass inside the lesion. Biopsy was performed under local anesthesia. On microscopic examination, numerous fungal hyphae, which branch at acute angle, were observed. The diagnosis was made as an aspergilloma based on the histopathologic examination.

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

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.

Extraction of maxillary canines: Esthetic perceptions of patient smiles among dental professionals and laypeople.

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Thiruvenkatachari, Badri; Javidi, Hanieh; Griffiths, Sarah Elizabeth; Shah, Anwar A; Sandler, Jonathan

2017-10-01

Maxillary canines are generally considered important both cosmetically and functionally. Most claims on the importance of maxillary canines, however, have been based on expert opinions and clinician-based studies. There are no scientific studies in the literature reporting on their cosmetic importance or how laypeople perceive a smile treated by maxillary canine extractions. Our objective was to investigate whether there is any difference in the perceptions of patients' smiles treated by extracting either maxillary canines or first premolars, as judged by orthodontists, dentists, and laypeople. This retrospective study included 24 participants who had unilateral or bilateral extraction of maxillary permanent canines and fixed appliances in the maxillary and mandibular arches to comprehensively correct the malocclusion, selected from orthodontic patients treated at Chesterfield Royal Hospital NHS trust in the United Kingdom over the last 20 years. The control group of patients had extraction of maxillary first premolars followed by fixed appliances and finished to an extremely high standard judged by the requirement that they had been submitted for the Membership in Orthodontics examination. The finished Peer Assessment Rating scores for this group were less than 5. The end-of-treatment frontal extraoral smiling and frontal intraoral views were presented for both groups. The photographs were blinded for extraction choice and standardized for size and brightness using computer software (Adobe Photoshop CC version 14.0; Adobe Systems, San Jose, Calif). The work file was converted to an editable pdf file and e-mailed to the assessors. The assessor panel consisted of 30 members (10 orthodontists, 10 dentists, and 10 laypeople), who were purposely selected. The measures were rated on a 10-point Likert scale. The attractiveness ratings were not statistically significantly different between the canine extraction and premolar extraction groups, with a mean difference of 0

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.

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.

Fracture Resistance and Failure Mode of Endodontically Treated Premolars Restored with Different Adhesive Restorations

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Nasrin Sarabi

2015-03-01

Full Text Available Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20. Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I. Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74 than the other groups (P

Root Canal Transportation and Centering Ability of Nickel-Titanium Rotary Instruments in Mandibular Premolars Assessed Using Cone-Beam Computed Tomography.

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Mamede-Neto, Iussif; Borges, Alvaro Henrique; Guedes, Orlando Aguirre; de Oliveira, Durvalino; Pedro, Fábio Luis Miranda; Estrela, Carlos

2017-01-01

The aim of this study was to evaluate, using cone-beam computed tomography (CBCT), transportation and centralization of different nickel-titanium (NiTi) rotary instruments. One hundred and twenty eight mandibular premolars were selected and instrumented using the following brands of NiTi files: WaveOne, WaveOne Gold, Reciproc, ProTaper Next, ProTaper Gold, Mtwo, BioRaCe and RaCe. CBCT imaging was performed before and after root canal preparation to obtain measurements of mesial and distal dentin walls and calculations of root canal transportation and centralization. A normal distribution of data was confirmed by the Kolmogorov-Smirnov and Levene tests, and results were assessed using the Kruskal-Wallis test. Statistical significance was set at 5%. ProTaper Gold produced the lowest canal transportation values, and RaCe, the highest. ProTaper Gold files also showed the highest values for centering ability, whereas BioRaCe showed the lowest. No significant differences were found across the different instruments in terms of canal transportation and centering ability (P > 0.05). Based on the methodology employed, all instruments used for root canal preparation of mandibular premolars performed similarly with regard to canal transportation and centering ability.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion.

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Peixoto, Adriano Porto; dos Santos Pinto, Ary; Garib, Daniela Gamba; Gonçalves, João Roberto

2014-01-01

This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between changes in centroid and gingival points suggested that upper and lower premolars buccaly proclined during the pre-surgical period. Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods.

Trans-sinusoidal maxillary distraction in three cleft patients.

NARCIS (Netherlands)

Wenghoefer, M.H.; Martini, M.; Nadjmi, N.; Schutyser, F.A.C.; Jagtman, A.K.; Bergé, S.J.

2006-01-01

The trans-sinusoidal maxillary distractor (TS-MD) was used to achieve maxillary advancement in three patients with repaired cleft lip and palate. After preoperative computer-aided planning of the distraction vectors, each TS-MD was bent on a stereolithographic model of the maxilla of the patient.

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments.

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Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

2015-01-01

Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (PProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems.

Three-dimensional dental arch changes of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusion

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Adriano Porto Peixoto

2014-08-01

Full Text Available INTRODUCTION: This study assessed the three-dimensional changes in the dental arch of patients submitted to orthodontic-surgical treatment for correction of Class II malocclusions at three different periods. METHODS: Landmarks previously identified on upper and lower dental casts were digitized on a three-dimensional digitizer MicroScribe-3DX and stored in Excel worksheets in order to assess the width, length and depth of patient's dental arches. RESULTS: During orthodontic preparation, the maxillary and mandibular transverse dimensions measured at the premolar regions were increased and maintained throughout the follow-up period. Intercanine width was increased only in the upper arch during orthodontic preparation. Maxillary arch length was reduced during orthodontic finalization, only. Upper and lower arch depths were stable in the study periods. Differences between centroid and gingival changes suggested that upper and lower arch premolars buccaly proclined during the pre-surgical period. CONCLUSIONS: Maxillary and mandibular dental arches presented transverse expansion at premolar regions during preoperative orthodontic preparation, with a tendency towards buccal tipping. The transverse dimensions were not altered after surgery. No sagittal or vertical changes were observed during the follow-up periods.

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

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Sonal Soi

2015-09-01

Full Text Available Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no peri-apical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical fo-ramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal prepa-ration using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30. The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calcu-lated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001. The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg. Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a sig-nificantly higher amount of debris than GT and RaCe systems.

In Vitro Comparison of Apically Extruded Debris during Root Canal Preparation of Mandibular Premolars with Manual and Rotary Instruments

Science.gov (United States)

Soi, Sonal; Yadav, Suman; Sharma, Sumeet; Sharma, Mohit

2015-01-01

Background and aims. During root canal preparation, debris extruded beyond the apical foramen may result in periapical inflammation and postoperative pain. To date no root canal preparation method has been developed that extrudes no periapical debris. The purpose of this study was to identify a system leading to minimal extrusion of debris from the apical foramen. The study was conducted to comparatively evaluate the amount of apical extrusion of debris during root canal preparation using hand ProTaper and GT rotary and RaCe rotary instruments using crown-down technique. Materials and methods. Ninety freshly extracted human single-rooted mandibular premolars were equally assigned to three groups (n=30). The root canals were instrumented using hand ProTaper, GT rotary and RaCe rotary systems. Debris and irrigant extruded from the apical foramen were collected into vials. The mean weight of the remaining debris was calculated for each group and subjected to statistical analysis. Results. ANOVA was used to compare the mean dry weights of the debris extruded in the three groups, followedby post hoc Tukey tests for multiple comparisons the between groups. Highly significant differences were found in the amount of debris extruded among all the groups (P<0.001). The ProTaper group exhibited the highest mean debris weight (0.8293±0.05433 mg) and the RaCe system exhibited the lowest mean debris weight (0.1280±0.01606 mg). Conclusion. All the systems tested resulted in apical extrusion of debris. However, the hand ProTaper files extruded a significantly higher amount of debris than GT and RaCe systems. PMID:26697144

Maxillary Central Incisor with Two Roots: A Case Report

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L. Khojastehpour

2005-06-01

Full Text Available A 16 year old female was referred to an oral and maxillofacial radiologist for evaluation of a radiolucent area at mesial radicular aspect of right maxillary central incisor which was detected accidentally during pre-orthodontic treatment check ups. Clinicalexamination showed no particular signs or symptoms except for slightly tenderness to lateral percussion. Second radiograph with altered horizontal angulations showed a mesial supernumerary root which the radiolucency seemed to be associated with that. Inorder to treat the tooth, the composite filling was removed and canals were cleaned,shaped, and obturated by lateral condensation technique.

Endodontic Management of a Maxillary Lateral Incisor with 4 Root Canals and a Dens Invaginatus Tract.

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Nosrat, Ali; Schneider, S Craig

2015-07-01

Dens invaginatus (DI) is associated with complex internal anatomy. This article represents a maxillary lateral incisor with 5 root canals including DI. The treatment was planned and performed using cone-beam computed tomographic (CBCT) imaging. After clinical and radiographic evaluations, tooth #7 was diagnosed with DI and pulp necrosis with symptomatic apical periodontitis. Periapical radiographs of the tooth showed 2 roots and complex internal anatomy. CBCT evaluation revealed tooth #7 had 5 separate canals (4 root canals and 1 DI canal extending through the root to the periodontal ligament), communication between DI and the root canal system, and severe and multiple curvatures of the palatal canals. Root canal treatment was completed in 2 visits. Modified access openings were required to safely treat the dilacerated palatal canals. At the 6-month re-evaluation, the patient reported he had remained asymptomatic and his tooth had remained functional since the treatment was completed. Clinical examination showed tooth #7 had no sensitivity to percussion or palpation, probe depths within normal limits (≤3 mm), and no mobility. Radiographic assessment of the tooth showed significant osseous healing of the preoperative lesion. Three-dimensional imaging is a valuable tool for endodontic management of teeth with complex internal anatomy. Three-dimensional imaging is recommended for evaluating and treatment planning cases with DI. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of fiber post length and abutment height on fracture resistance of endodontically treated premolars prepared for zirconia crowns.

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Lin, Jie; Matinlinna, Jukka Pekka; Shinya, Akikazu; Botelho, Michael George; Zheng, Zhiqiang

2018-04-01

The purpose of this study was to compare the fracture resistance, mode of fracture, and stress distribution of endodontically treated teeth prepared with three different fiber post lengths and two different abutment heights, using both experimental and finite element (FE) approaches. Forty-eight human maxillary premolars with two roots were selected and endodontically treated. The teeth were randomly distributed into six equally sized groups (n = 8) with different combinations of post lengths (7.5, 11, and 15 mm) and abutment heights (3 and 5 mm). All the teeth restored with glass fiber post (Rely X Fiber Post, 3M ESPE, USA) and a full zirconia crown. All the specimens were thermocycled and then loaded to failure at an oblique angle of 135°. Statistical analysis was performed for the effects of post length and abutment height on failure loads using ANOVA and Tukey's honestly significant difference test. In addition, corresponding FE models of a premolar restored with a glass fiber post were developed to examine mechanical responses. The factor of post length (P abutment height (P > 0.05) did not have a significant effect on failure load. The highest mean fracture resistance was recorded for the 15 mm post length and 5 mm abutment height test group, which was significantly more resistant to fracture than the 7.5 mm post and 5 mm abutment height group (P abutment heights.

Dental size reduction in Indonesian Homo erectus: Implications for the PU-198 premolar and the appearance of Homo sapiens on Java.

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Polanski, Joshua M; Marsh, Hannah E; Maddux, Scott D

2016-01-01

The recent recovery of a hominin maxillary third premolar, PU-198, within the faunal collections from Punung Cave (East Java) has led to assertions that Homo sapiens appeared on Java between 143,000 and 115,000 years ago. The taxonomic assignment of PU-198 to H. sapiens was based predominantly on the small size of the specimen, following an analysis which found little to no overlap in premolar size between Homo erectus and terminal Pleistocene/Holocene H. sapiens. Here, we re-evaluate the use of size in the taxonomic assignment of PU-198 in light of 1) new buccolingual and mesiodistal measurements taken on the fossil, 2) comparisons to a larger sample of H. erectus and H. sapiens maxillary third premolars, and 3) evidence of a diachronic trend in post-canine dental size reduction among Javan H. erectus. Our results demonstrate PU-198 to be slightly larger than previously suggested, reveal substantial overlap in premolar size between H. erectus and H. sapiens, and indicate a statistically significant reduction in premolar size between early and late Javan H. erectus. Our findings cast doubt on the assignment of PU-198 to H. sapiens, and accordingly, question the appearance of H. sapiens on Java between 143,000 and 115,000 years ago. Copyright © 2015 Elsevier Ltd. All rights reserved.

A patient with protrusion and multiple missing teeth treated with autotransplantation and space closure.

Science.gov (United States)

Ko, Jeong-Min; Paik, Cheol-Ho; Choi, Simon; Baek, Seung-Hak

2014-05-01

To present a patient treated with submerging autotransplantation (SA) of an immature premolar and subsequent orthodontic space closure (OSC) and to report a 10-year follow-up result. A 10-year-old boy had multiple missing premolars with an asymmetric pattern (maxillary right first and second premolars, teeth 14 and 15; maxillary left second premolar, tooth 25; and mandibular right second premolar, tooth 45). After considering several treatment options, tooth 35 with immature root development underwent SA into the missing site of tooth 15 at a depth 5 mm below the occlusal plane and was stabilized with sutures to create a symmetric missing condition of the premolars in the four quadrants. Three months after autotransplantation, spontaneous eruption of the transplanted tooth was observed. Nine months after autotransplantation, presence of the lamina dura of the transplanted tooth was confirmed with a periapical radiograph. Active orthodontic treatment was initiated to reduce lip protrusion by closing the missing spaces of teeth 14, 25, 35, and 45 and to correct dental midline deviation. After 33 months of active orthodontic treatment, Class I canine and molar relationships were obtained. During the 10-year follow-up, the pulp vitality of the transplanted tooth was maintained without any pathologic findings, including root resorption or pulp canal obliteration. In a patient with lip protrusion and multiple congenitally missing premolars with an asymmetric pattern, SA of one premolar from the normal quadrant into the quadrant missing two premolars with subsequent OSC of the missing sites of the other premolars can be an effective treatment modality.

The effect of buccal corticotomy on accelerating orthodontic tooth movement of maxillary canine

Science.gov (United States)

Jahanbakhshi, Mohammad Reza; Motamedi, Ali Mohammad Kalantar; Feizbakhsh, Masoud; Mogharehabed, Ahmad

2016-01-01

Background: Selective alveolar corticotomy is defined as an intentional injury to cortical bone. This technique is an effective means of accelerating orthodontic tooth movement. The aim of this study is to evaluate the effect of buccal corticotomy in accelerating maxillary canine retraction. Materials and Methods: The sample in this clinical trial study consisted of 15 adult female patients with therapeutic need for extraction of maxillary first premolars and maximum canine retraction. By use of split-mouth design, at the time of premolars extraction, buccal corticotomy was performed around the maxillary first premolar, randomly on one side of maxilla, and the other side was reserved as the control side. Canine retraction was performed by use of friction – less mechanic with simple vertical loop. Every 2 weeks, distance between canines and second premolars was measured until complete space closure. The velocity of space closure was calculated to evaluate the effect of this technique in accelerating orthodontic tooth movement. The obtained data were statistically analyzed using independent t-test, and the significance was set at 0.05. Results: The rate of canine retraction was significantly higher on the corticotomy side than the control side by an average of 1.8 mm/month versus 1.1 mm/month in the corticotomy side and control side, respectively (P orthodontic tooth movement about two times faster than conventional orthodontics and it is significant in early stages after surgical porsedure. Therefore Buccal corticotomy is a useful adjunct technique for accelerating orthodontic tooth movement. PMID:27605986

Autotransplantation of two maxillary premolars in a free vascularized fibula reconstructed mandible

NARCIS (Netherlands)

Mensink, G.; Karagozoglu, K. H.; Strackee, S. D.; van Teeseling, R. A.; Smeele, L. E.; Becking, A. G.

2011-01-01

A 10-year-old female patient with a fibula transplant in her left hemimandible due to ameloblastoma treatment was referred for combined orthodontic and surgical planning and treatment to observe and prevent expected asymmetric facial development and malocclusion, because the premolars and molars on

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

Science.gov (United States)

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.

Effect of bulk-fill base material on fracture strength of root-filled teeth restored with laminate resin composite restorations.

Science.gov (United States)

Taha, N A; Maghaireh, G A; Ghannam, A S; Palamara, J E

2017-08-01

To evaluate the effect of using a bulk-fill flowable base material on fracture strength and fracture patterns of root-filled maxillary premolars with MOD preparations restored with laminate restorations. Fifty extracted maxillary premolars were selected for the study. Standardized MOD cavities with endodontic treatment were prepared for all teeth, except for intact control. The teeth were divided randomly into five groups (n=10); (Group 1) sound teeth, (Group 2) unrestored teeth; (Group 3) MOD cavities with Vitrebond base and resin-based composite (Ceram. X One Universal); (Group 4) MOD cavities with 2mm GIC base (Fuji IX GP) and resin-based composite (Ceram. X One Universal) open laminate, (Group 5) MOD cavities were restored with 4mm of bulk-fill flowable base material (SDR) and resin-based composite (Ceram. X One Universal). All teeth were thermocycled and subjected to a 45° ramped oblique load in a universal testing machine. Fracture load and fracture patterns were recorded. Data were analyzed using one-way ANOVA and Dunnett's T3 test. Restoration in general increased the fracture strength compared to unrestored teeth. The fracture strength of group 5 (bulk-fill) was significantly higher than the fracture strength of the GIC laminate groups and not significantly different from the intact teeth (355±112N, P=0.118). The type of failure was unfavorable for most of the groups, with the majority being mixed failures. The use of a bulk-fill flowable base material significantly increased the fracture strength of extracted root-filled teeth with MOD cavities; however it did not improve fracture patterns to more favorable ones. Investigating restorative techniques that may improve the longevity of root-filled premolar teeth restored with direct resin restorations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Large Reactional Osteogenesis in Maxillary Sinus Associated with Secondary Root Canal Infection Detected Using Cone-beam Computed Tomography.

Science.gov (United States)

Estrela, Carlos; Porto, Olavo César Lyra; Costa, Nádia Lago; Garrote, Marcel da Silva; Decurcio, Daniel Almeida; Bueno, Mike R; Silva, Brunno Santos de Freitas

2015-12-01

Inflammatory injuries in the maxillary sinus may originate from root canal infections and lead to bone resorption or regeneration. This report describes the radiographic findings of 4 asymptomatic clinical cases of large reactional osteogenesis in the maxillary sinus (MS) associated with secondary root canal infection detected using cone-beam computed tomographic (CBCT) imaging. Apical periodontitis, a consequence of root canal infection, may lead to a periosteal reaction in the MS and osteogenesis seen as a radiopaque structure on imaging scans. The use of a map-reading strategy for the longitudinal and sequential slices of CBCT images may contribute to the definition of diagnoses and treatment plans. Root canal infections may lead to reactional osteogenesis in the MS. High-resolution CBCT images may reveal changes that go unnoticed when using conventional imaging. Findings may help define initial diagnoses and therapeutic plans, but only histopathology provides a definitive diagnosis. Surgical enucleation of the periapical lesion is recommended if nonsurgical root canal treatment fails to control apical periodontitis. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study

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Ivor M D′Souza

2015-01-01

Full Text Available Introduction: Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation between transverse expansion and changes in the arch perimeter, arch width and arch length. Methods: For this purpose, 10 subjects (five males, five females were selected who had been treated by rapid maxillary expansion (RME using hyrax rapid palatal expander followed by fixed mechanotherapy (PEA. Pretreatment (T1, postexpansion (T2, and posttreatment (T3 dental models were compared for dental changes brought about by RME treatment and its stability at the end of fixed mechanotherapy. After model measurements were made, the changes between T1-T2, T2-T3 and T1-T3 were determined for each patient. The mean difference between T1-T2, T2-T3 and T1-T3 were compared to assess the effects of RME on dental arch measurements. Results are expressed as mean ± standard deviation and are compared by repeated measures analysis of variance followed by a post-hoc test. Arch perimeter changes are correlated with changes in arch widths at the canine, premolar and molar

Canal configuration of mandibular first premolars in an Egyptian population

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Hatem A. Alhadainy

2013-03-01

Full Text Available The purpose of this study was to investigate canal configuration of mandibular first premolars in an Egyptian population. Two hundred fifty human extracted mandibular first premolars were collected from Egyptian patients and a small hole in the center of the occlusal surface of each tooth was made perforating the roof of the pulp chamber. Teeth were decalcified by immersing in nitric acid and dehydrated in ascending concentrations of ethyl alcohol. A waterproof black ink was passively injected from the occlusal hole into pulp system and stained teeth were immersed in methyl salicylate solution for clearing. Standardized pictures of the cleared teeth were obtained and anatomical features of the root canal were observed. The average length of the mandibular first premolar teeth was 22.48 ± 1.74 mm, one-rooted teeth were 96.8% and the two-rooted were 3.2%. Vertucci Type I canal configuration represented the highest percentage (61.2% followed by Type V (16.4%, Type IV (13.2%, Type II (5.6% and Type III (2.8%. Vertucci Type VI canal configuration represented the lowest percentage (0.4% and a complex configuration was found in one tooth. Accessory canals were detected in 22.8% and inter-canal connections were observed in 24.8% while 54% showed apical delta. Such knowledge is clinically useful for localization and negotiation of canals of mandibular first premolar, as well as their subsequent management in Egyptian population.

A demographic analysis of vertical root fractures.

Science.gov (United States)

Cohen, Stephen; Berman, Louis H; Blanco, Lucia; Bakland, Leif; Kim, Jay S

2006-12-01

Teeth with vertical root fractures (VRFs) have complete or incomplete fractures that extends through the enamel, dentin and pulp, down the long axis of the tooth. Several different variables were investigated and statistically evaluated as to their correlation with the presence of VRFs. Specifically analyzed were gender, tooth location, age, radiographic and clinical findings, bruxism, and pulpal status. The data were collected from three different endodontists, from three different geographic locations, comprising a total of 227 teeth. Although VRFs may occur in conjunction with any of the parameters investigated, only certain factors were found to occur in a significant number of cases. The results indicate that VRFs are statistically more prevalent in mandibular molars and maxillary premolars. They are associated with periradicular bone loss, pain to percussion, extensive restorations, and seem to occur more often in females and older patients. However, VRFs are not necessarily related to periapical bone loss, a widening of the periodontal ligament space, associated periodontal pockets, a sinus tract, particular pulpal status, or bruxism.

endodontic treatment of unusually long discolored maxillary central ...

African Journals Online (AJOL)

a few cases of dual–rooted maxillary central incisor have been reported in literature1-5. Maxillary central incisors vary in root ... The following case report describes the endodontic management of a patient with an unusually long maxillary central incisor in our environment. CASE PROFILE. A 31 year-old male was referred ...

Odontogenic maxillary sinusitis diagnosed using conebeam x-ray CT

International Nuclear Information System (INIS)

Sato, Kiminori

2007-01-01

We evaluated the usefulness of conebeam x-ray CT in the diagnosis of odontogenic maxillary sinusitis in 21 patients. Among teeth causing odontogenic maxillary sinusitis, 95% had apical lesions after root canal treatment. Most root canals were filled with filling materials incompletely. Apical lesions in inappropriately treated teeth thus caused odontogenic maxillary sinusitis. Conebeam CT involves 3-dimensional isotropic voxel image date in up to 512 frames for transaxial, coronal, and sagittal planes, so resolution in imaging on the body axis was especially high. Multiplanar reconstruction and volume rendering images at any optional plane could be obtained without interpolation. The relationship between causative teeth and the maxillary sinus could be observed and measured, and odontogenic maxillary sinusitis accurately diagnosed. In addition to the accurate diagnosis of apical lesions, maxilla, and maxillary sinus, periodontal ligament space, lamina dura, pulp cavity, root canal, canal-treated root, apical periodontitis, alveolar ostitis, marginal periodontitis of causative teeth could be observed. Metal artifacts were minimized, making conebeam CT useful in the diagnosis of periodontal tissue and causative teeth, including root-canal-treated and crown-restored teeth. (author)

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.

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.

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.

Orthodontic tooth movement after extraction of previously autotransplanted maxillary canines and ridge augmentation.

Science.gov (United States)

Collett, A R; Fletcher, B

2000-12-01

A case report is detailed in which autotransplanted maxillary canines were removed and the spaces closed. Substantial surrounding bone loss was associated with the upper right canine, and a bone graft was needed to reestablish normal dentoalveolar ridge morphology. Bone was taken from the maxillary tuberosity and placed in the canine extraction site, fixed with a bone screw, and covered with GoreTex. Seven months after placement of the bone graft, the GoreTex and stabilizing screw were removed to allow for consolidation of the bone. The upper left canine and lower second premolars were extracted, and fixed appliances were placed in both arches to align the teeth and close the spaces. Protraction of the upper right first premolar and retraction of the lateral incisor into the graft site were kept slow and constant with continued periodontal assessment. During the space closure, there was some concern that the bone in the graft site might resorb, leaving the teeth with compromised periodontal support. However, no significant periodontal attachment loss occurred despite ongoing concern about the amount of keratinized tissue. Perhaps the relatively slow rate of tooth movement provided for bone to be maintained and recreated ahead of the tooth. Almost complete closure of the upper canine extraction spaces was achieved. The upper premolars were substituted for the maxillary canines, and unfavorable prosthetic options were thus avoided. The lower arch was aligned, and the extraction spaces completely closed.

Diagnostic Accuracy of Periapical Radiography and Cone-beam Computed Tomography in Identifying Root Canal Configuration of Human Premolars.

Science.gov (United States)

Sousa, Thiago Oliveira; Haiter-Neto, Francisco; Nascimento, Eduarda Helena Leandro; Peroni, Leonardo Vieira; Freitas, Deborah Queiroz; Hassan, Bassam

2017-07-01

The aim of this study was to assess the diagnostic accuracy of periapical radiography (PR) and cone-beam computed tomographic (CBCT) imaging in the detection of the root canal configuration (RCC) of human premolars. PR and CBCT imaging of 114 extracted human premolars were evaluated by 2 oral radiologists. RCC was recorded according to Vertucci's classification. Micro-computed tomographic imaging served as the gold standard to determine RCC. Accuracy, sensitivity, specificity, and predictive values were calculated. The Friedman test compared both PR and CBCT imaging with the gold standard. CBCT imaging showed higher values for all diagnostic tests compared with PR. Accuracy was 0.55 and 0.89 for PR and CBCT imaging, respectively. There was no difference between CBCT imaging and the gold standard, whereas PR differed from both CBCT and micro-computed tomographic imaging (P < .0001). CBCT imaging was more accurate than PR for evaluating different types of RCC individually. Canal configuration types III, VII, and "other" were poorly identified on CBCT imaging with a detection accuracy of 50%, 0%, and 43%, respectively. With PR, all canal configurations except type I were poorly visible. PR presented low performance in the detection of RCC in premolars, whereas CBCT imaging showed no difference compared with the gold standard. Canals with complex configurations were less identifiable using both imaging methods, especially PR. Copyright © 2017 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

Science.gov (United States)

Llamas-Carreras, José María; Amarilla, Almudena; Espinar-Escalona, Eduardo; Castellanos-Cosano, Lizett; Martín-González, Jenifer; Sánchez-Domínguez, Benito; López-Frías, Francisco Javier

2012-05-01

The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Aspergillus in endodontic infection near the maxillary sinus.

Science.gov (United States)

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.

Anatomical Variation of the Maxillary Sinus in Cone Beam Computed Tomography

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Marcelo Lupion Poleti

2014-01-01

Full Text Available Purpose. The aim of this paper is to report a case in which the cone beam computed tomography (CBCT was important for the confirmation of the presence of maxillary sinus septum and, therefore, the absence of a suspected pathologic process. Case Description. A 27-year-old male patient was referred for the assessment of a panoramic radiograph displaying a radiolucent area with radiopaque border located in the apical region of the left upper premolars. The provisional diagnosis was either anatomical variation of the maxillary sinuses or a bony lesion. Conclusion. The CBCT was important for an accurate assessment and further confirmation of the presence of maxillary septum, avoiding unnecessary surgical explorations.

Relationship between the maxillary transverse dimension and palatally displaced canines: A cone-beam computed tomographic study.

Science.gov (United States)

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).

Parallel post-space preparation in different tooth types ex vivo : deviation from the canal centre and remaining dentine thickness

NARCIS (Netherlands)

Huysmans, M. C. D. N. J. M.; Klein, M. H. J.; Kok, G. F.; Whitworth, J. M.

2007-01-01

Aim To determine the deviation of parallel-sided twist-drills during post-channel preparation and relate this to tooth type and position. Methodology Human teeth with single root canals were selected: maxillary second premolars (group i); maxillary lateral incisors (group ii); mandibular canines

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 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.

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

Directory of Open Access Journals (Sweden)

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

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

African Journals Online (AJOL)

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 ...

Effect of fluoride on root resorption following heavy and light orthodontic force application for 4 weeks and 12 weeks of retention.

Science.gov (United States)

Karadeniz, Ersan I; Gonzales, Carmen; Turk, Tamer; Isci, Devrim; Sahin-Saglam, Aynur M; Alkis, Huseyin; Elekdag-Turk, Selma; Darendeliler, M Ali

2013-05-01

To evaluate the null hypothesis that fluoride intake via drinking water has no effect on orthodontic root resorption in humans after orthodontic force application for 4 weeks and 12 weeks of retention. Forty-eight patients who required maxillary premolar extractions as part of their orthodontic treatment were selected from two cities in Turkey. These cities had a high and low fluoride concentration in public water of ≥2 pm and ≤0.05 pm, respectively. The patients were randomly separated into four groups of 12 each: group 1HH, high fluoride (≥2 ppm) and heavy force (225 g); group 2LH, low fluoride (≤0.05 ppm) and heavy force; group 3HL, high fluoride and light force (25 g); and group 4LL, low fluoride and light force. Light or heavy buccal tipping force was applied on the upper first premolars for 28 days. At day 28, the left premolars were extracted (positive control side); the right premolars (experimental side) were extracted after 12 weeks of retention. The samples were analyzed with microcomputed tomography. On the positive control side, under heavy force application, the high fluoride groups exhibited less root resorption (P  =  .015). On the experimental side, it was found that fluoride reduced the total volume of root resorption craters; however, this effect was not statistically significant (P  =  .237). Moreover, the results revealed that under heavy force application experimental teeth exhibited more root resorption than positive control groups. The null hypothesis could not be rejected. High fluoride intake from public water did not have a beneficial effect on the severity of root resorption after a 4-week orthodontic force application and 12 weeks of passive retention.

Perbandingan Tinggi Tulang Maksila dan Mandibula di Regio Interisisivi Sentral antara Pra dan Pasca Perawatan Ortodontik dengan Pencabutan ke Empat Gigi Premolar Pertama (Kajian pada Foto Panoramik

Directory of Open Access Journals (Sweden)

Wayan Ardhana

2012-12-01

Full Text Available Latar belakang. Perawatan ortodontik pada kasus-kasus gigi berjejal dan protusif sering membutuhkan pencabutan gigi premolar untuk penyediaan ruang agar gigi berjejal dapat dirapikan dan gigi depan yang protusif dapat diundurkan. Gigi insisivus sentral merupakan salah satu gigi yang paling banyak mengalami pergerakan selama proses retrusi. Pergerakan gigi insisivus mengakibatkan terjadinya perubahan pada puncak tulang alveolar selama perawatan yang mungkin akan mempengaruhi tinggi tulang maksila dan mandibula pasca perawatan. Tujuan penelitian. Membandingkan tinggi tulang maksila dan mandibula di daerah interdental gigi insisivi sentral pada foto panoramic antara pra dan pasca perawatan maloklusi dengan pencabutan ke empat gigi premolar pertama. Metode penelitian. Digunakan 30 pasang foto panoramic pra dan pasca perawatan yang dipilih sesuai dengan kriteria penelitian dari pasien-pasien peneliti yang telah selesai mendapat perawatan aktif dengan teknik edgewise. Analisis Kolmogorov-Smirnov dan Shaviro-Wilk digunakan untuk uji normalitas dan Student t-test data berpasangan digunakan untuk menguji perbedaan tinggi tulang maksila dan mandibula antara pra dan pasca perawatan. Hasil Penelitian. Tidak didapatkan perbedaan (p>0,05 tinggi tulang maksila dan amndibula antara pra dan pasca perawatan ortodontik dengan pencabutan keempat gigi premolar pertama.   Background. In orthodontic treatment, premolar extractions are often needed in crowding and prostrusive cases to provide space for the teeth can be aligned and retracted to their desire position. Central incisor teeth are the teeth that mostly undergone more movement during retrusion. The change of the alveolar bone crest in this incisors might affect the maxillary and mandibular bone height post-treatment. Research objectives. The present study aimed to compare the bone height in the interdental maxillary and mandibular central incisors regions before and after orthodontic treatment with four

Estimation of the failure risk of a maxillary premolar with different crack depths with endodontic treatment by computer-aided design/computer-aided manufacturing ceramic restorations.

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Lin, Chun-Li; Chang, Yen-Hsiang; Hsieh, Shih-Kai; Chang, Wen-Jen

2013-03-01

This study evaluated the risk of failure for an endodontically treated premolar with different crack depths, which was shearing toward the pulp chamber and was restored by using 3 different computer-aided design/computer-aided manufacturing ceramic restoration configurations. Three 3-dimensional finite element models designed with computer-aided design/computer-aided manufacturing ceramic onlay, endocrown, and conventional crown restorations were constructed to perform simulations. The Weibull function was incorporated with finite element analysis to calculate the long-term failure probability relative to different load conditions. The results indicated that the stress values on the enamel, dentin, and luting cement for endocrown restorations exhibited the lowest values relative to the other 2 restoration methods. Weibull analysis revealed that the overall failure probabilities in a shallow cracked premolar were 27%, 2%, and 1% for the onlay, endocrown, and conventional crown restorations, respectively, in the normal occlusal condition. The corresponding values were 70%, 10%, and 2% for the depth cracked premolar. This numeric investigation suggests that the endocrown provides sufficient fracture resistance only in a shallow cracked premolar with endodontic treatment. The conventional crown treatment can immobilize the premolar for different cracked depths with lower failure risk. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Three-dimensional quantification of orthodontic root resorption with time-lapsed imaging of micro-computed tomography in a rodent model.

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Yang, Chongshi; Zhang, Yuanyuan; Zhang, Yan; Fan, Yubo; Deng, Feng

2015-01-01

Despite various X-ray approaches have been widely used to monitor root resorption after orthodontic treatment, a non-invasive and accurate method is highly desirable for long-term follow up. The aim of this study was to build a non-invasive method to quantify longitudinal orthodontic root resorption with time-lapsed images of micro-computed tomography (micro-CT) in a rodent model. Twenty male Sprague Dawley (SD) rats (aged 6-8 weeks, weighing 180-220 g) were used in this study. A 25 g orthodontic force generated by nickel-titanium coil spring was applied to the right maxillary first molar for each rat, while contralateral first molar was severed as a control. Micro-CT scan was performed at day 0 (before orthodontic load) and days 3, 7, 14, and 28 after orthodontic load. Resorption of mesial root of maxillary first molars at bilateral sides was calculated from micro-CT images with registration algorithm via reconstruction, superimposition and partition operations. Obvious resorption of mesial root of maxillary first molar can be detected at day 14 and day 28 at orthodontic side. Most of the resorption occurred in the apical region at distal side and cervical region at mesiolingual side. Desirable development of molar root of rats was identified from day 0 to day 28 at control side. The development of root concentrated on apical region. This non-invasive 3D quantification method with registration algorithm can be used in longitudinal study of root resorption. Obvious root resorption in rat molar can be observed three-dimensionally at day 14 and day 28 after orthodontic load. This indicates that registration algorithm combined with time-lapsed images provides clinic potential application in detection and quantification of root contour.

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

Early Orthodontic Tooth Movement into Regenerative Bony Defects: A Case Report.

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Tsai, Hui-Chen; Yao, Chung-Chen Jane; Wong, Man-Ying

Early orthodontic tooth movement following regenerative surgery is controversial. In this case, during protraction of the maxillary right first premolar to substitute for the long-term missing maxillary right canine, Bio-Oss and Bio-Gide were used for lateral ridge augmentation at the area of the maxillary right lateral incisor and to cover the denuded surface at the buccal side of the first premolar. Orthodontic tooth movement (OTM) commenced 2 weeks after regenerative surgery. After 8 months, new bone formation was observed on the root surface of the first premolar during implant surgery. A cone beam computed tomography scan taken 1.5 years postsurgery revealed good maintenance of regenerative bone at the same site. This satisfactory outcome of early OTM following regenerative surgery suggests biomechanical stimulation may not jeopardize the regenerative effect.

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

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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

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.

A novel root analogue dental implant using CT scan and CAD/CAM: selective laser melting technology.

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Figliuzzi, M; Mangano, F; Mangano, C

2012-07-01

Direct laser metal forming (DLMF) is a new technique which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. Modern computed tomography (CT) acquisition and 3D image conversion, combined with the DLMF process, allows the fabrication of custom-made, root-analogue implants (RAI), perfect copies of the radicular units that need replacing. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CT images of the residual non-restorable root of a right maxillary premolar were acquired and modified with specific software into a 3D model. From this model, a custom-made, root-analogue, DLMF implant was fabricated. Immediately after tooth extraction, the root-analogue implant was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the custom-made implant showed almost perfect functional and aesthetic integration. The possibility of fabricating custom-made, root-analogue DLMF implants opens new interesting perspectives for immediate placement of dental implants. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

[Finite element analysis of the maxillary central incisor with crown lengthening surgery and post-core restoration in management of crown-root fracture].

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Zhen, Min; Hu, Wen-jie; Rong, Qi-guo

2015-12-18

To construct the finite element models of maxillary central incisor and the simulations with crown lengthening surgery and post-core restoration in management of different crown-root fracture types, to investigate the stress intensity and distributions of these models mentioned above, and to analyze the indications of crown lengthening from the point of view of mechanics. An extracted maxillary central incisor and alveolar bone plaster model were scanned by Micro-CT and dental impression scanner (3shape D700) respectively. Then the 3D finite element models of the maxillary central incisor and 9 simulations with crown lengthening surgery and post-core restoration were constructed by Mimics 10.0, Geomagic studio 9.0 and ANSYS 14.0 software. The oblique static force (100 N) was applied to the palatal surface (the junctional area of the incisal 1/3 and middle 1/3), at 45 degrees to the longitudinal axis, then the von Mises stress of dentin, periodontal ligament, alveolar bone, post and core, as well as the periodontal ligament area, were calculated. A total of 10 high-precision three-dimensional finite element models of maxillary central incisor were established. The von Mises stress of models: post>dentin>alveolar bone>core>periodontal ligament, and the von Mises stress increased linearly with the augmentation of fracture degree (besides the core). The periodontal ligament area of the crown lengthening was reduced by 12% to 33%. The von Mises stress of periodontal ligament of the B2L2c, B2L3c, B3L1c, B3L2c, B3L3c models exceeded their threshold limit value, respectively. The maxillary central incisors with the labial fracture greater than three-quarter crown length and the palatal fracture deeper than 1 mm below the alveolar crest are not the ideal indications of the crown lengthening surgery.

Comparison of 2 root surface area measurement methods: 3-dimensional laser scanning and cone-beam computed tomography

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Tasanapanont, Jintana; Apisariyakul, Janya; Wattanachai, Tanapan; Jotikasthira, Dhirawat; Sriwilas, Patiyut; Midtboe, Marit

2017-01-01

The aim of this study was to compare the use of 3-dimensional (3D) laser scanning and cone-beam computed tomography (CBCT) as methods of root surface measurement. Thirty teeth (15 maxillary first premolars and 15 mandibular first premolars) from 8 patients who required extractions for orthodontic treatment were selected. Before extraction, pre-treatment CBCT images of all the patients were recorded. First, a CBCT image was imported into simulation software (Mimics version 15.01; Materialise, Leuven, Belgium) and the root surface area of each tooth was calculated using 3-Matic (version 7.01, Materialise, Leuven, Belgium). After extraction, all the teeth were scanned and the root surface area of each extracted tooth was calculated. The root surface areas calculated using these 2 measurement methods were analyzed using the paired t-test (P<.05). Correlations between the 2 methods were determined by calculating the Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to assess intraobserver reliability. The root surface area measurements (230.11±41.97 mm"2) obtained using CBCT were slightly greater than those (229.31±42.46 mm2) obtained using 3D laser scanning, but not significantly (P=.425). A high Pearson correlation coefficient was found between the CBCT and the 3D laser scanner measurements. The intraobserver ICC was 1.000 for 3D laser scanning and 0.990 for CBCT. This study presents a novel CBCT approach for measuring the root surface area; this technique can be used for estimating the root surface area of non-extracted teeth

Comparison of 2 root surface area measurement methods: 3-dimensional laser scanning and cone-beam computed tomography

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Tasanapanont, Jintana; Apisariyakul, Janya; Wattanachai, Tanapan; Jotikasthira, Dhirawat [Dept. of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Chiang Mai University, Chiang Mai (Thailand); Sriwilas, Patiyut [Dept. of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok (Thailand); Midtboe, Marit [Dept. of Clinical Dentistry - Orthodontics, Faculty of Medicine and Dentistry, University of Bergen, Bergen (Norway)

2017-06-15

The aim of this study was to compare the use of 3-dimensional (3D) laser scanning and cone-beam computed tomography (CBCT) as methods of root surface measurement. Thirty teeth (15 maxillary first premolars and 15 mandibular first premolars) from 8 patients who required extractions for orthodontic treatment were selected. Before extraction, pre-treatment CBCT images of all the patients were recorded. First, a CBCT image was imported into simulation software (Mimics version 15.01; Materialise, Leuven, Belgium) and the root surface area of each tooth was calculated using 3-Matic (version 7.01, Materialise, Leuven, Belgium). After extraction, all the teeth were scanned and the root surface area of each extracted tooth was calculated. The root surface areas calculated using these 2 measurement methods were analyzed using the paired t-test (P<.05). Correlations between the 2 methods were determined by calculating the Pearson correlation coefficient. The intraclass correlation coefficient (ICC) was used to assess intraobserver reliability. The root surface area measurements (230.11±41.97 mm{sup 2}) obtained using CBCT were slightly greater than those (229.31±42.46 mm2) obtained using 3D laser scanning, but not significantly (P=.425). A high Pearson correlation coefficient was found between the CBCT and the 3D laser scanner measurements. The intraobserver ICC was 1.000 for 3D laser scanning and 0.990 for CBCT. This study presents a novel CBCT approach for measuring the root surface area; this technique can be used for estimating the root surface area of non-extracted teeth.

Transmigration of mandibular second premolar in a patient with cleft lip and palate--case report.

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Alves, Daniel Berretta Moreira; Pedrosa, Esio Fortaleza Nascimento Chaves; Andreo, Jesus Carlos; de Carvalho, Izabel Maria Marchi; Rodrigues, Antonio de Castro

2008-01-01

Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP), Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

Endodontic management of a maxillary lateral incisor with an unusual root dilaceration diagnosed with cone beam computed tomography

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Mahmoud Mohammed Eid Mahgoub

2017-01-01

Full Text Available Anterior teeth may have aberrant anatomical variations in the roots and root canals. Root dilaceration is an anomaly characterized by the displacement of the root of a tooth from its normal alignment with the crown which may be a consequence of injury during tooth development. This report aims to present a successful root canal treatment of a maxillary lateral incisor with unusual palatal root dilaceration (diagnosed with cone beam computed tomography in which the access cavity was prepared from the labial aspect of the tooth to provide a straight line access to the root canal system which was instrumented using OneShape rotary file system and precurved K-files up to size 50 under copious irrigation of 2.5% NaOCl using a side-vented irrigation tip. The canal was then obturated using the warm vertical compaction technique.

Progressive immediate loading of a perforated maxillary sinus dental implant: a case report

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Al-Juboori MJ

2015-01-01

Full Text Available Mohammed Jasim Al-Juboori Department of Oral Surgery, MAHSA University, Kuala Lumpur, Malaysia Abstract: The displacement of a dental implant into the maxillary sinus may lead to implant failure due to exposure of the apical third or the tip of the implant beyond the bone, resulting in soft tissue growth. This case report discusses dental implant placement in the upper first molar area with maxillary sinus involvement of approximately 2 mm. A new technique for progressive implant loading was used, involving immediately loaded implants with maxillary sinus perforation and low primary stability. Follow-up was performed with resonance frequency analysis and compared with an implant placed adjacent in the upper second premolar area using a conventional delayed loading protocol. Implants with maxillary sinus involvement showed increasing stability during the healing period. We found that progressive implant loading may be a safe technique for the placement of immediately loaded implants with maxillary sinus involvement. Keywords: progressive implant loading, resonance frequency analysis, implant stability, provisional crown, bone density, maxillary sinus

Endodontic and Prosthetic Management of a Mid-Root and Crown Fracture of a Maxillary Central Incisor

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Koidou Vasiliki P.

2014-11-01

Full Text Available Root fractures are relatively uncommon among other dental traumas and mostly affect the anterior dentition. This case report presents the endodontic and prosthodontic management of a maxillary central incisor with a combined fracture in the middle third of the root and the crown, as well as the 7-year follow up of the case. The healing potential of a horizontal root fracture in the middle third of the root is highlighted when appropriate treatment is applied. MTA used for obturation of the coronal fragment, induced hard tissue formation apically and promoted healing in the area, while the 2mm MTA left as apical barrier at the second stage of re-treatment and obturation with gutta-percha prevented its extrusion. The multidisciplinary approach in the management of such cases ensures a long term survival.

Multidisciplinary management of subgingival crown-root fracture of an immature permanent maxillary central incisor

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Samir Zahedpasha

2012-01-01

Full Text Available This case report describes the multidisciplinary management of subgingival horizontal crown-root fracture of an immature permanent maxillary central incisor in a 10-year-old boy. After removal of the fractured fragment, pulpotomy was performed within 48 h from the injury to promote apexogenesis. The tooth was orthodontically extruded until the fracture line was located above the alveolar bone level. Frenectomy, supracrestal fiberotomy, and crown lengthening were performed after adequate stabilization of the extruded tooth for 5 months. Finally, the tooth was restored with composite resin by using the acid etch technique. This report highlights that a multidisciplinary treatment approach with strict cooperation among specialists to manage a complicated crown-root fracture can save and restore a traumatized immature permanent tooth.

A radiographic study of external apical root resorption in patients treated with single-phase fixed orthodontic therapy.

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Agarwal, S S; Chopra, S S; Kumar, Prasanna; Jayan, B; Nehra, K; Sharma, Mohit

2016-12-01

External apical root resorption (EARR) is one of the most common iatrogenic consequences of orthodontic tooth movement. Many factors like gender, duration, orthodontic force and duration of orthodontic treatment have been implicated to cause EARR. Pre- and post-treatment OPGs of 60 orthodontic patients (30 males and 30 females) who had undergone treatment with a single phase of fixed orthodontic therapy were randomly selected from institutional archives. The root apices were evaluated for EARR by a single operator on an radiograph viewing box at a standardized source of light using a four-grade ordinal scale. Anterior EARR was measured on the maxillary and mandibular canines. Posterior EARR was measured on premolars, mesiobuccal and distobuccal roots of maxillary first molars and mesial and distal roots of mandibular first molars. The results were compiled and subjected to statistical analysis. The cases in which the patients underwent therapeutic extraction had a relatively higher amount of EARR compared to the cases in which the patients were treated by non-extraction therapy ( P  orthodontic treatment ( P  > 0.05). Therapeutic extraction is an important determinant of post-treatment EARR. Gender and duration of orthodontic treatment may not be important variables in the causation of EARR according to the findings of this study. However, longitudinal studies with larger sample size are required to validate the results of this study.

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.

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.

Unilateral maxillary molar distalization with zygoma-gear appliance.

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Kilkis, Dogan; Bayram, Mehmet; Celikoglu, Mevlut; Nur, Metin

2012-08-01

The aim of this study was to present the orthodontic treatment of a 15-year-old boy with a unilateral maxillary molar distalization system, called the zygoma-gear appliance. It consisted of a zygomatic anchorage miniplate, an inner bow, and a Sentalloy closed coil spring (GAC International, Bohemia, NY). A distalizing force of 350 g was used during the distalization period. The unilateral Class II malocclusion was corrected in 5 months with the zygoma-gear appliance. The maxillary left first molar showed distalization of 4 mm with an inclination of 3°. The maxillary premolars moved distally with the help of the transseptal fibers. In addition, there were slight decreases in overjet (-0.5 mm) and maxillary incisor inclination (-1°), indicating no anchorage loss from the zygoma-gear appliance. Preadjusted fixed appliances (0.022 × 0.028-in, MBT system; 3M Unitek, Monrovia, Calif) were placed in both arches to achieve leveling and alignment. After 14 months of unilateral distalization with the zygoma-gear appliance and fixed appliances, Class I molar and canine relationships were established with satisfactory interdigitation of the posterior teeth. Acceptable overjet and overbite were also achieved. This article shows that this new system, the zygoma-gear appliance, can be used for unilateral maxillary molar distalization without anchorage loss. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Combined orthodontic-restorative management of maxillary central incisors lost following traumatic injury: a case report.

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Fleming, Padhraig S; Seehra, Jadbinder; Dibiase, Andrew T

2011-01-01

A history of traumatic dental injury to the maxillary central incisors during preadolescence or adolescence is common and may result in premature loss. Treatment options include prosthetic implant replacement, autotransplantation, and orthodontic space closure with direct composite recontouring. This case report describes the treatment of an adolescent girl who presented with a crowded Class I malocclusion complicated by a history of trauma to the maxillary central incisors. The treatment plan consisted of orthodontic space closure following loss of both maxillary central incisors and mandibular premolars. This case highlights that orthodontic space closure can be a valuable treatment option in selected Class I crowded and Class II uncrowded malocclusions, producing predictable and efficient results.

The taper of cast post preparation measured using innovative image processing technique

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Al Hyiasat Ahmad S

2010-08-01

Full Text Available Abstract Background No documentation in the literature about taper of cast posts. This study was conducted to measure the degree of cast posts taper, and to evaluate its suitability based on the anatomy aspects of the common candidate teeth for post reconstruction. Methods Working casts for cast posts, prepared using Gates Glidden drills, were collected. Impressions of post spaces were made using polyvinyl siloxan putty/wash technique. Digital camera with a 10' high quality lens was used for capturing two digital images for each impression; one in the Facio-Lingual (FL and the other in the Mesio-Distal (MD directions. Automated image processing program was developed to measure the degree of canal taper. Data were analyzed using Statistical Package for Social Sciences software and One way Analysis of Variance. Results Eighty four dies for cast posts were collected: 16 for each maxillary anterior teeth subgroup, and 18 for each maxillary and mandibular premolar subgroup. Mean of total taper for all preparations was 10.7 degree. There were no statistical differences among the total taper of all groups (P = .256 or between the MD and FL taper for each subgroup. Mean FL taper for the maxillary first premolars was lower significantly (P = .003 than the maxillary FL taper of the second premolars. FL taper was higher than the MD taper in all teeth except the maxillary first premolars. Conclusions Taper produced did not reflect the differences among the anatomy of teeth. While this technique deemed satisfactory in the maxillary anterior teeth, the same could not be said for the maxillary first premolars. Careful attention to the root anatomy is mandatory.

Transmigration of mandibular second premolar in a patient with cleft lip and palate: case report

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Daniel Berretta Moreira Alves

2008-10-01

Full Text Available Disturbances involving abnormalities in tooth eruption are named ectopia. Transmigration is the name assigned to ectopia in the presence of teeth in areas distant from the alveolar process. Initial angulation of the tooth bud of the second premolar and premature loss of permanent mandibular 1st molars can influence the distal migration of the second premolar. Some studies have observed that ectopic teeth can be found in a variety of places around the oral cavity and also in other areas of the human body. There are records of teeth in the maxillary sinus, mandibular condyle, coronoid process, mandibular angle, orbit, palate, mentum and also the skin. The prevalence of tooth abnormalities is higher in children with cleft lip and palate compared to children without clefts. This paper presents a case report of migration of the mandibular left second premolar in a patient attending the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo (HRAC/USP, Brazil. Migration of the mandibular left 2nd premolar was confirmed by 8 panoramic and 1 periapical radiographs obtained during patient's treatment between 1978 and 2002, which were available in the files of the Department of Dental Radiology of HRAC/USP. It can be assumed that distal migration of the mandibular left 2nd premolar is not associated with presence of cleft lip and palate; observation of these two events in a same patient is rare, since no similar reported cases were found in the literature.

IRAK1 variant is protective for orthodontic-induced external apical root resorption.

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Pereira, S; Nogueira, L; Canova, F; Lopez, M; Silva, H C

2016-10-01

Interleukin-1 beta (IL1B) pathway is a key player in orthodontic-induced external apical root resorption (EARR). The aim of this work was to identify the genes related to the IL1 pathway as possible candidate genes for EARR, which might be included in an integrative predictive model of this complex phenotype. Using a stepwise multiple linear regression model, 195 patients who had undergone orthodontic treatment were assessed for clinical and genetic factors associated with %EARRmax (maximum %EARR value obtained for each patient). The four maxillary incisors and the two maxillary canines were assessed. Three functional single nucleotide polymorphisms (SNPs) were genotyped: rs1143634 in IL1B gene, rs315952 in IL1RN gene, and rs1059703 in X-linked IRAK1 gene. The model showed that four of the nine clinical variables and one SNP explained 30% of the %EARRmax variability. The most significant unique contributions to the model were gender (P = 0.001), treatment duration (P < 0.001), premolar extractions (P = 0.003), Hyrax appliance (P < 0.001), and homozygosity/hemizygosity for variant C from IRAK1 gene (P = 0.018), which proved to be a protective factor. IRAK1 polymorphism is proposed as a protective variant for EARR. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A comparison of apical root resorption after orthodontic treatment with surgical exposure and traction of maxillary impacted canines versus that without impactions.

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Lempesi, Evangelia; Pandis, Nikolaos; Fleming, Padhraig S; Mavragani, Maria

2014-12-01

Orthodontic management of maxillary canine impaction (MCI), including forced eruption, may result in significant root resorption; however, the association between MCI and orthodontically induced root resorption (OIRR) is not yet sufficiently established. The purpose of this retrospective cohort study was to comparatively evaluate the severity of OIRR of maxillary incisors in orthodontically treated patients with MCI. Additionally, impaction characteristics were associated with OIRR severity. The sample comprised 48 patients undergoing fixed-appliance treatment-24 with unilateral/bilateral MCI and 24 matched controls without impaction. OIRR was calculated using pre- and post-operative panoramic tomograms. The orientation of eruption path, height, sector location, and follicle/tooth ratio of the impacted canine were also recorded. Mann-Whitney U-test and univariate and multivariate linear mixed models were used to test for the associations of interest. Maxillary central left incisor underwent more OIRR in the impaction group (mean difference = 0.58mm, P = 0.04). Overall, the impaction group had 0.38mm more OIRR compared to the control (95% confidence interval, CI: 0.03, 0.74; P = 0.04). However, multivariate analysis demonstrated no difference in the amount of OIRR between impaction and non-impaction groups overall. A positive association between OIRR and initial root length was observed (95% CI: 0.08, 0.27; P Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Three-dimensional localization of impacted canines and root resorption assessment using cone beam computed tomography.

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Almuhtaseb, Eyad; Mao, Jing; Mahony, Derek; Bader, Rawan; Zhang, Zhi-xing

2014-06-01

The purpose of this study was to develop a new way to localize the impacted canines from three dimensions and to investigate the root resorption of the adjacent teeth by using cone beam computed tomography (CBCT). Forty-six patients undergoing orthodontic treatments and having impacted canines in Tongji Hospital were examined. The images of CBCT scans were obtained from KaVo 3D exam vision. Angular and linear measurements of the cusp tip and root apex according to the three planes (mid-sagittal, occlusal and frontal) have been taken using the cephalometric tool of the InVivo Dental Anatomage Version 5.1.10. The measurements of the angular and linear coordinates of the maxillary and mandibular canines were obtained. Using this technique the operators could envision the location of the impacted canine according to the three clinical planes. Adjacent teeth root resorption of 28.26 % was in the upper lateral incisors while 17.39% in upper central incisors, but no lower root resorption was found in our samples. Accurate and reliable localization of the impacted canines could be obtained from the novel analysis system, which offers a better surgical and orthodontic treatment for the patients with impacted canines.

Autotransplantation of Premolars With a 3-Dimensional Printed Titanium Replica of the Donor Tooth Functioning as a Surgical Guide: Proof of Concept.

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Verweij, Jop P; Moin, David Anssari; Mensink, Gertjan; Nijkamp, Peter; Wismeijer, Daniel; van Merkesteyn, J P Richard

2016-06-01

Autotransplantation of premolars is a good treatment option for young patients who have missing teeth. This study evaluated the use of a preoperatively 3-dimensional (3D)-printed replica of the donor tooth that functions as a surgical guide during autotransplantation. Five consecutive procedures were prospectively observed. Transplantations of maxillary premolars with optimal root development were included in this study. A 3D-printed replica of the donor tooth was used to prepare a precisely fitting new alveolus at the recipient site before extracting the donor tooth. Procedure time, extra-alveolar time, and number of attempts needed to achieve a good fit of the donor tooth in the new alveolus were recorded. For each transplantation procedure, the surgical time was shorter than 30 minutes. An immediate good fit of the donor tooth in the new alveolus was achieved with an extra-alveolar time shorter than 1 minute for all transplantations. These results show that the extra-alveolar time is very short when the surgical guide is used; therefore, the chance of iatrogenic damage to the donor tooth is minimized. The use of a replica of the donor tooth makes the autotransplantation procedure easier for the surgeon and facilitates optimal placement of the transplant. Copyright © 2016 The American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients

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Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

2015-01-01

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction. PMID:26668459

Use of anterior maxillary distraction osteogenesis in two cleft lip and palate patients.

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Srivastava, Dhirendra; Ghassemi, Alireza; Ghassemi, Mehrangiz; Showkatbakhsh, Rahman; Jamilian, Abdolreza

2015-01-01

Distraction osteogenesis (DO) has become a mainstream surgical technique for patients with jaw deformities. The aim of this study was to report the effect of DO done by a hyrax screw incorporated in an acrylic plate in the treatment of two maxillary deficient cases with cleft lip and palate. Two patients, a 24-year-old female and a 29-year-old male who suffered from maxillary deficiency and cleft lip and palate, were treated by DO. After making vertical cuts between the premolars on both sides and horizontal cuts similar to Le Fort 1, a hyrax screw was mounted on an acrylic plate for the slow anteroposterior expansion of maxillary arch. The expansion was achieved by turning the hyrax screw 0.8 mm per day after the latency period. Treatment was discontinued after achieving satisfactory over jet and occlusion. This study showed that anterior maxillary distraction is a reliable technique for correction of midfacial deformity arising out of cleft lip and palate. Incidences of complications are negligible compared to total maxillary distraction.

Interrupted orthodontic force results in less root resorption than continuous force in human premolars as measured by microcomputed tomography.

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Sawicka, Monika; Bedini, Rossella; Wierzbicki, Piotr M; Pameijer, Cornelis H

2014-01-01

Root resorption is an undesirable but very frequently occurring sequel of orthodontic treatment. The aim of this study was to compare root resorption caused by either continuous (CF) or interrupted (IF) orthodontic force. The study was performed on human subjects on 30 first upper and lower premolars scheduled for extraction for orthodontic reasons. During four weeks before extraction 12 teeth were subjected to either CF or IF. The force was generated by a segmental titanium-molybdenum alloy cantilever spring that was activated in buccal direction. Initially a force of 60 CentiNewton was used in both CF and IF groups, the force in the former, however, was reactivated every week for 4 weeks. There was no reactivation of force in the IF group after initial application. A morphometric analysis of root resorption was performed by microcomputed tomography and the extent of tooth movement was measured on stone casts. Furthermore, a Tartarate-Resistant Acidic Phosphatase activity (TRAP), the marker enzyme of osteoclasts and cementoclasts, was determined by histochemical method. The Mann-Whitney U test was used to compare the difference in measured parameters between treatment and control tooth groups. The number of resorption craters was significantly higher and their average volume almost twice as large in the CF compared to the IF group (p root structure as opposed to continuous force while the same tooth movement was achieved.

Fracture resistance of prepared premolars restored with bonded new lab composite and all-ceramic inlay/onlay restorations: Laboratory study.

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Wafaie, Ramy Ahmed; Ibrahim Ali, Ashraf; Mahmoud, Salah Hasab

2018-01-25

To assess the influence of new light curing lab composite, lithium-disilicate glass-ceramic and yttrium-stabilized zirconia-based ceramic on the fracture resistance of maxillary premolars with class II inlay and onlay preparations. Seventy sound maxillary premolars were divided randomly into seven main groups. The first group was left intact (control group). The remaining six groups were prepared with inlay and onlay cavities and restored with lab composite (SR Nexco), lithium-disilicate glass-ceramic (IPS e.max Press) and yttrium-stabilized zirconia-based ceramic (ICE Zirkon). The restorations were cemented with luting resin composite (Variolink N). All specimens were thermocycled 5000 cycles between 5°C ± 2°C and 55°C ± 2°C and were then cyclic loaded for 500 000 cycles. The specimens were subjected to a compressive load in a universal testing machine using a metal sphere until fracture occurred. The results were analyzed by 2-way ANOVA and Tukey HSD post hoc tests. The level of significance was set at P  .05). However, statistically significant differences were found among the means of control group and the groups restored with lab composite inlays, lab composite onlays, pressable glass ceramic inlays and pressable glass ceramic onlays (P lab composite is used. Conversely, when a ceramic material being used, the prepared teeth for inlay and onlay restorations showed a comparable strength to the intact teeth especially zirconia ceramic. Premolar teeth restored with zirconia ceramic inlays and onlays exhibited fracture resistance comparable to intact teeth. © 2018 Wiley Periodicals, Inc.

Regenerative endodontic treatment for necrotic immature permanent premolar: A report of case

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Sheetal B Ghivari

2017-01-01

Full Text Available Regenerative endodontic procedures provide new hope of converting nonvital tooth into vital once again. These potential regenerative approaches include root canal revascularization, postnatal stem-cell therapy, pulp implant, scaffold implant, three-dimensional cell printing, injectable scaffolds, and gene therapy. In this article, we describe successful revascularization treatment of necrotic permanent premolar tooth. Clinical and radiographic examination showed pulp involvement due to deep pit defect and periapical infection. Examination findings suggested revascularization treatment which was started with irrigation of canals using 1.25% of sodium hypochlorite and saline, followed by placement of 3-week dressing of triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline. After removal of triple antibiotic paste blood clot was induced and mineral trioxide aggregate was placed on the blood clot followed by sealing the canal with glass ionomer cement. During radiographic and clinical follow-ups, the patient was asymptomatic and periapical lesion was healed, roots continued to develop, and root apex maturogenesis was complete.

Cone-beam computed tomography evaluation of the association of cortical plate proximity and apical root resorption after orthodontic treatment.

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Nakada, Tomoo; Motoyoshi, Mitsuru; Horinuki, Eri; Shimizu, Noriyoshi

2016-01-01

We investigated the effects of proximity of the root apex to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate on apical root resorption. Cone-beam computed tomography was used to measure the amount of root resorption and root apex movement around maxillary right and left central incisors in 30 adults who underwent four-bicuspid extraction followed by treatment with multibracket appliances. The patients were divided into three groups on the basis of the direction of root apex movement, after which the correlation between the amount of root resorption and root apex movement was determined. Mean apical root resorption was 1.80 ± 0.82 mm (range, 0.18-3.96 mm). The amount of root apex movement was positively correlated with the amount of root resorption on the side of pressure. Root apex proximity to the maxillary labial cortical plate, palatal cortical plate, and incisive canal cortical plate was associated with apical root resorption. Orthodontic treatment plans should carefully consider root proximity to the maxillary cortical plate. (J Oral Sci 58, 231-236, 2016).

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.

Comparison of rate of maxillary canine movement with or without modified corticotomy facilitated orthodontic treatment: A prospective clinical trial

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Harshal N Suryavanshi

2015-01-01

Full Text Available Background and Objectives: The average orthodontic treatment time for extraction therapy is 31 months. One of the main disadvantages of orthodontic treatment is time. Alveolar corticotomies have been used in conjunction with orthodontics to reduce the treatment time by increasing the rate of tooth movement. Concerns about the possible risks of corticotomy procedure have led to the modification of this technique. Germeη et al. reported a case treated by their modified corticotomy technique and noted reduced treatment time without any adverse effects on the periodontium and the vitality of teeth with their new conservative corticotomy technique. This study was undertaken to clinically evaluate the efficacy of the aforesaid technique. Materials and Methods: A split-mouth study design was carried out to compare the rate of maxillary canine movement with and without modified corticotomy facilitated orthodontic treatment in 10 patients requiring maxillary first premolar extractions. The modified corticotomy procedure was performed on the maxillary arch unilaterally. The upper arch was immediately activated bilaterally after surgical procedure using equal orthodontic forces for retraction of the maxillary canines. The amount of tooth movement was recorded at an interval of every month till the completion of canine retraction. The rate of canine movement on experimental and control site was compared. The patients were followed for 6 months to check the occurrence of undesired effects such as root resorption, periodontal damage and loss of vitality of teeth on the experimental side. Results: Higher mean velocity was observed in canines with modified corticotomy facilitated retraction compared to conventionally retracted canines; with the difference in mean velocity between the two groups was found to be clinically significant as well as statistically significant (P < 0.001. Interpretation and Conclusion: The results suggested that modified corticotomy

Comparison of the changes of alveolar bone thickness in maxillary incisor area in extraction and non-extraction cases: computerized tomography evaluation

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Paulo Roberto Barroso Picanço

2013-10-01

Full Text Available OBJECTIVE: To compare, through computed tomography, alveolar bone thickness changes at the maxillary incisors area during orthodontic treatment with and without tooth extraction. METHODS: Twelve patients were evaluated. They were divided into 2 groups: G1 - 6 patients treated with extraction of right and left maxillary first premolars, with mean initial age of 15.83 years and mean treatment length of 2.53 years; G2 - 6 patients treated without extraction, with mean initial age of 18.26 years and mean treatment length of 2.39 years. Computed tomographies, lateral cephalograms and periapical radiographs were used at the beginning of the treatment (T1 and 18 months after the treatment had started (T2. Extraction space closure occurred in the extraction cases. Intragroup and intergroup comparisons were performed by dependent and independent t test, respectively. RESULTS: In G1, the central incisor was retracted and uprighted, while in G2 this tooth showed vestibularization. Additionally, G1 presented a higher increase of labial alveolar bone thickness at the cervical third in comparison with G2. The incidence of root resorption did not present significant differences between groups. CONCLUSION: There were no changes in alveolar bone thickness when extraction and nonextraction cases were compared, except for the labial alveolar bone thickness at the cervical third of maxillary incisors.

Ex vivo evaluation of three instrumentation techniques on E. faecalis biofilm within oval shaped root canals

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Vitor Cesar NAKAMURA

2015-01-01

Full Text Available The objective of the present study was to assess the effectiveness of reciprocating instrumentation in disinfecting oval-shaped root canals infected with Enterococcus faecalis. Forty-five human lower premolars were infected with a culture of E. faecalis (ATCC 29212 for 28 days. Five other teeth that were neither contaminated nor instrumented were used as controls. The 45 specimens were divided into three experimental groups (n = 15 based on the root canal preparation technique used: manual (K-type, Dentsply Maillefer, Ballaigues, Switzerland; rotary (MTwo, VDW GmbH, Munich, Germany; and reciprocating (Reciproc R50, VDW GmbH, Munich, Germany instruments. During chemomechanical preparation, 21 mL of 2.5% NaOCl was used as the irrigating solution. Microbiological sampling was performed before (S1 and immediately after (S2 the chemomechanical preparation using sterilized paper points. Specimens were then cleaved, and 0.02 g of dentine chips was collected from the root thirds to verify the presence of microorganisms in dentinal tubules. All three preparation techniques reduced the number of microorganisms in the root canal lumen and dentine chips from the root thirds, but no significant differences were observed between the three groups (p > 0.05. Reciprocating instrumentation with Reciproc R50 was effective in reducing the number of microorganisms within the root canal system. Although this technique involves the use of only one file to perform the root canal therapy, it is as effective as conventional rotary instrumentation in reducing theE. faecalis biofilm from the root canal system. However, further clinical investigations are warranted in order to ratify these results.

Three-dimensional prospective evaluation of tooth-borne and bone-borne surgically assisted rapid maxillary expansion

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Nada, R.M.; Fudalej, P.S.; Maal, T.J.J.; Berge, S.J.; Mostafa, Y.A.; Kuijpers-Jagtman, A.M.

2012-01-01

AIM: To three-dimensionally (3D) assess the long-term effects of tooth-borne and bone-borne surgically assisted rapid maxillary expansion (SARME). SUBJECTS AND METHODS: This prospective cohort study comprised 45 consecutive skeletally mature non-syndromic patients with transverse maxillary

Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular lingual groove by using spiral computed tomography as a diagnostic aid: a case report.

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Gandhi, A; Kathuria, A; Gandhi, T

2011-06-01

To present the successful endodontic and periodontal management of a two rooted maxillary lateral incisor tooth with a complex radicular lingual groove and severe periodontal destruction using spiral computed tomography as a diagnostic aid. A 30-year-old male patient presented with a chief complaint of mobility and discharge of pus in an upper front tooth. Clinical examination revealed a sinus tract on the labial gingival surface and a 10-mm-deep periodontal pocket associated with maxillary left lateral incisor tooth. On the lingual side, a groove emerging from cingulum, continuing mesioapically down the lingual aspect of tooth was found. Intraoral periapical radiographs demonstrated a lateral periodontal defect around the mesial aspect and a diffuse radiolucency at the apex of maxillary left lateral incisor tooth. The sinus tract was traced with gutta-percha to the maxillary left lateral incisor that showed an accessory root surrounded by a large radiolucent area. A spiral computed tomographic scan for better understanding of the complicated root canal morphology of the tooth was performed. Based on the clinical, radiographic and spiral computed tomographic findings, a diagnosis of an endo-perio lesion in tooth 22 was made. Management consisted of conventional root canal treatment, radiculoplasty, root resection of accessory root and surgical curettage of the periodontal defect. Follow-up with radiographic examination at 3 months and 1 year was performed. At 1-year recall, the patient was asymptomatic, there was no evidence of the sinus tract and a 3-mm nonbleeding pocket was present in relation to tooth 22. Progression of hard tissue healing was observed in the periapical radiograph taken 1 year postoperatively. The key to achieving favourable results in this particular type of developmental anomaly is accurate diagnosis and treatment planning. The health of the periapical osseous tissues appears to be the provital factor for tooth retention. A favourable outcome

Perawatan Satu\tKunjungan\tpada\tPremolar Pertama Atas Menggunakan Protaper Rotary dan Restorasi Resin Komposit

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Sherli Diana

2013-06-01

Full Text Available Preparasi kemomekanik pada saluran akar meliputi instrumentasi mekanis dan irigasi antibakteri yang secara prinsip dapat langsung mengeliminasi mikroorganisme pada sistem saluran akar. sejak diperkenalkan pada tahun 1988, instrumen rotary nikel-titanium (niti telah digunakan secara umum dalam perawatan endodontik karena kemampuannya membentuk saluran akar dengan prosedur komplikasi yang minimal. Tujuan dari laporan kasus ini adalah untuk memaparkan perawatan saluran akar satu kunjungan menggunakan protaper rotary dan restorasi resin komposit gigi premolar. Penderita pria 21 tahun datang ke RSGM Prof. Soedomo UGM Yogyakarta mengeluhkan gigi belakang atas kiri yang berlubang tapi tidak sakit dan pasien ingin  dirawat.Gigi  Premolar satu atas  kiri terdapat kavitas disto oklusal dengan pulpa terbuka. Pemeriksan objektif pada gigi 24 sondasi, perkusi, palpasi, dan tes termal menunjukkan hasil negatif.Pemeriksaan radiografis tidak terdapat lesi, lamina dura tidak terputus dan saluran akar jelas dan lurus. Pada kasus ini dilakukan perawatan saluran akar dengan menggunakan ProTaper rotary ( X-Smart, Dentsply. Pasca perawatan saluran akar, gigi premolar satu atas kiri dilakukan tumpatan resin komposit kelas II.Hasil evaluasi klinik saat kontrol tidak ada keluhan rasa sakit, pemeriksaan objektif juga tidak ada rasa sakit, warna gigi serasi dengan warna gigi tetangga.prognosis pada kasus ini baik dan tidak ada keluhan. Kesimpulan paska perawatan saluran akar satu kunjungan dengan instrumenrotary, tidak terdapat keluhan.Penggunaan Instrumen rotary Nikel-Titanium (NiTi sangat flexible dengan prosedur komplikasi yang minimal, dan hemat waktu. One Visit Treatment of Upper Premolar Tooth Using Rotary Protaper and Composite Resin Restoration. Chemomechanical preparation for root canal including mechanic instrumentation and anti-bacterial irrigation principally could eliminate microorganisms in root canal system. Many instruments and techniques have been

Association analysis of clinical aspects and vitamin D receptor gene polymorphism with external apical root resorption in orthodontic patients.

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Fontana, Maria Luiza S Simas Netta; de Souza, Cleber Machado; Bernardino, José Fabio; Hoette, Felix; Hoette, Maura Levi; Thum, Lotario; Ozawa, Terumi O; Capelozza Filho, Leopoldino; Olandoski, Marcia; Trevilatto, Paula Cristina

2012-09-01

Vitamin D is responsible for the regulation of certain genes at the transcription level, via interaction with the vitamin D receptor, and influences host immune responses and aspects of bone development, growth, and homeostasis. Our aim was to investigate the association of TaqI vitamin D receptor gene polymorphism with external apical root resorption during orthodontic treatment. Our subjects were 377 patients with Class II Division 1 malocclusion, divided into 3 groups: (1) 160 with external apical root resorption ≤1.43 mm, (2) 179 with external apical root resorption >1.43 mm), and (3) 38 untreated subjects. External apical root resorption of the maxillary incisors was evaluated on periapical radiographs taken before and after 6 months of treatment. After DNA collection and purification, vitamin D receptor TaqI polymorphism analysis was performed by polymerase chain reaction-restriction fragment length polymorphism. Univariate and multivariate analyses were performed to verify the association of clinical and genetic variables with external apical root resorption (P root resorption in orthodontically treated patients compared with the untreated subjects. In patients orthodontically treated, age higher than 14 years old, initial size of the maxillary incisor root superior to 30 mm, and premolar extraction were associated with increased external apical root resorption. Genotypes containing the C allele were weakly associated with protection against external apical root resorption (CC + CT × TT [odds ratio, 0.29; 95% confidence interval, 0.07-1.23; P = 0.091]) when treated orthodontic patients were compared to untreated individuals. Clinical factors and vitamin D receptor TaqI polymorphism were associated with external apical root resorption in orthodontic patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Efficacy of denture adhesives in maxillary dentures using gnathodynamometry: a comparative study.

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Polyzois, Gregory; Lagouvardos, Panagiotis; Frangou, Maria; Stefaniotis, Theodoros

2011-07-01

The purpose of this study was to investigate the effect of four commercially available denture adhesives on the incisal and premolar dislodgement forces of maxillary complete dentures by using an electronic and disposable gnathodynamometer and compare the measured incisal forces for differences. This study was conducted with 12 complete maxillary denture wearers. Four commercially available denture adhesives Super Corega(®), Corega Ultra(®), Super Corega Powder(®) and Fittydent Cationic(®) were investigated. Testing protocol and sequence included baseline measurements without adhesives (control) for previous and new dentures and then replications of measurements with the four adhesives. Maximum dislodgement forces were recorded in two sites between central incisors and the left 2nd premolars by using an electronic and disposable gnathodynamometer. To estimate the effect of the different adhesives on the dislodgement forces, data were analyzed by a 2- and 3-way ANOVA, while for estimating the agreement of the two devices a Bland-Altman and Mountain plots were used. ANOVAs indicated significant differences between adhesives (p adhesives increase the denture dislodgement forces, but with differences among them. The two devices do not highly agree with each other, but each one alone is useful in estimating dislodgement forces in clinical practice and research.

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

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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

Chronic Maxillary Sinusitis Associated with an Unusual Foreign Body: A Case Report

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Yunus Feyyat Şahin

2012-01-01

Full Text Available Foreign bodies in maxillary sinuses are unusual clinical conditions, and they can cause chronic sinusitis by mucosal irritation. Most cases of foreign bodies in maxillary sinus are related to iatrogenic dental manipulation and only a few cases with non-dental origin are reported. Oroantral fistulas secondary to dental procedures are the most common way of insertion. Treatment is surgical removal of the foreign body either endoscopically or with a combined approach, with Caldwell-Luc procedure if endoscopic approach is inadequate for visualisation. In this case, we present a 24-year-old male patient with unilateral chronic maxillary sinusitis due to a wooden toothpick in left maxillary sinus. The patient had a history of upper second premolar tooth extraction. CT scan revealed sinus opacification with presence of a foreign body in left maxillary sinus extending from the floor of the sinus to the orbital base. The foreign body, a wooden toothpick, was removed with Caldwell-Luc procedure since it was impossible to remove the toothpick endoscopically. There was no obvious oroantral fistula in the time of surgery, but the position of the toothpick made us to think that it was inserted through a previously healed fistula, willingly or accidentally.

Intraradicular Splinting with Endodontic Instrument of Horizontal Root Fracture

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Ersan Çiçek

2015-01-01

Full Text Available Introduction. Root fractures, defined as fractures involving dentine, cementum, and pulpal and supportive tissues, constitute only 0.5–7% of all dental injuries. Horizontal root fractures are commonly observed in the maxillary anterior region and 75% of these fractures occur in the maxillary central incisors. Methods. A 14-year-old female patient was referred to our clinic three days after a traffic accident. In radiographic examination, the right maxillary central incisor was fractured horizontally in apical thirds. Initially, following local infiltrative anesthetics, the coronal fragment was repositioned and this was radiographically confirmed. Then the stabilization splint was applied and remained for three months. After three weeks, according to the results of the vitality tests, the right and left central incisors were nonvital. For the right central incisor, both the coronal and apical fragments were involved in the endodontic preparation. Results. For the right central tooth, both the coronal and apical root fragments were endodontically treated and obturated at a single visit with white mineral trioxide aggregate whilst the fragments were stabilized internally by insertion of a size 40 Hedstrom stainless-steel endodontic file into the canal. Conclusion. Four-year follow-up examination revealed satisfactory clinical and radiographic findings with hard tissue repair of the fracture line.

Bilateral Second Premolars Agenesia Together with a Unilateral Canine Radiculomegaly.

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Kemoli, Arthur Musakulu; Junior, Thomas Munyao

2017-01-01

Congenitally missing teeth is a common feature for the third molars. However, missing teeth, macrodontia and radiculomegaly occurring in a single patient is very rare. This article describes a case of agenesis of mandibular second premolars, radiculomegaly with dilacerations of a canine tooth together with elongated roots of other canines. All these features had been discerned through diagnostic radiographs taken during a routine treatment planning.

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.

Long-term stability of soft tissue changes in anterior open bite adults treated with zygomatic miniplate-anchored maxillary posterior intrusion.

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Marzouk, Eiman S; Kassem, Hassan E

2018-03-01

To evaluate soft tissue changes and their long-term stability in skeletal anterior open bite adults treated by maxillary posterior teeth intrusion using zygomatic miniplates and premolar extractions. Lateral cephalograms of 26 patients were taken at pretreatment (T1), posttreatment (T2), 1 year posttreatment (T3), and 4 years posttreatment (T4). At the end of treatment, the soft tissue facial height and profile convexity were reduced. The lips increased in length and thickness, with backward movement of the upper lip and forward movement of the lower lip. The total relapse rate ranged from 20.2% to 31.1%. At 4 years posttreatment, 68.9% to 79.8% of the soft tissue treatment effects were stable. The changes in the first year posttreatment accounted for approximately 70% of the total relapse. Soft tissue changes following maxillary posterior teeth intrusion with zygomatic miniplates and premolar extractions appear to be stable 4 years after treatment.

Root canal treatment of a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement: a case report.

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Er, K; Bayram, M; Taşdemir, T

2011-12-01

To present the successful endodontic management of a maxillary lateral incisor tooth with a periradicular lesion caused by unintentional root damage after orthodontic miniscrew placement. A 22-year-old female was diagnosed with a skeletal Class II, Division 2 malocclusion with Class II molar and canine relationships on both sides. The treatment plan included distalization of the maxillary first molars bilaterally followed by full fixed appliance therapy. For the maxillary molar distalization, an appliance in conjunction with a miniscrew anchorage system was designed. Two months later, the patient came to the clinic with complaints of pain in the maxillary right lateral incisor region. On intraoral examination, intraoral sinus tracts were detected in the maxillary right buccal sulcus and palate. A large radiolucent lesion with a well-defined margin around the root of the maxillary right lateral incisor was seen. Root canal treatment was performed on the maxillary right lateral incisor tooth. The root canal was filled with gutta-percha and AH Plus sealer, using a lateral compaction technique. The final restoration of the tooth was completed using composite, and the tooth was reviewed after 10 months. The tooth was asymptomatic and radiographically showed repair of the lesion. Healing was achieved without any need for further endodontic or surgical intervention. Key learning points • This case illustrates the need to take care with miniscrews when performing orthodontic treatment, especially when the miniscrews are in close proximity to root apices. • The periradicular lesion as a result of miniscrew damage was successfully treated with root canal treatment. © 2011 International Endodontic Journal.

Prediction of width of un-erupted incisors, canines and premolars in a Ugandan population: A cross sectional study

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Buwembo William

2012-07-01

Full Text Available Abstract Background Accurate prediction of the space forms an important part of an orthodontic assessment in the mixed dentition. However the most commonly used methods of space analysis are based on data developed on Caucasian populations. In order to provide more accurate local data we set out to develop a formula for predicting the widths of un-erupted canines and premolars for a Ugandan population and to compare the predicted widths of the teeth from this formula with those obtained from Moyers’ tables, and Tanaka and Johnston’s equations. Methods Dental casts were prepared using mandibular and maxillary arch impressions of 220 children (85 boys/135 girls aged 12–17 years recruited from schools in Kampala, Uganda. The mesio-distal width of the mandibular incisors, mandibular and maxillary canines and premolars were measured with a pair of digital calipers. Based on regression analysis, predictive equations were derived and the findings were compared with those presented in Moyers’ probability tables, and Tanaka and Johnston’s equations. Results There were no statistically significant differences between the tooth widths predicted by our equations and those from Moyers’ probability tables at the 65th and 75th percentile probabilities for the girls and at 75th level in boys in the mandibular arch. While in the maxillary arch no statistically significant differences at the 75th and 95th levels were noted in girls. There were statistically significant differences between predicted tooth sizes using equations from the present study and those predicted from the Tanaka and Johnston regression equations. Conclusions In this Ugandan population, Moyers’ probability tables could be used to predict tooth widths at specific percentile probabilities, but generally, Tanaka and Johnston technique tends to overestimate the tooth widths.

Root canal morphology of Chalcolithic and early bronze age human populations of El Mirador Cave (Sierra de Atapuerca, Spain).

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Ceperuelo, Dolors; Lozano, Marina; Duran-Sindreu, Fernando; Mercadé, Montse

2014-12-01

This study provides a morphological characterization of the inner anatomy of the root canals of permanent first and second molars in Chalcolithic and early Bronze Age human fossils using cone-beam computed tomography. The general evolutionary trend in present-day human dentition is related to morphological simplification. As little is known about when this trend appeared in Homo sapiens populations, the aim of this work is to test the presence of modern radicular morphology 4,400 years ago. Fifty-four permanent first and second maxillary and mandibular molars of 17 individuals were included in the study. All maxillary first and second molars showed three separate roots. Almost all the lower molars analyzed (100% of first molars and 75% of second molars) had two separate roots. More differences in the canal system configuration were documented in the maxillary mesiobuccal roots than in the palatal or distobuccal roots. The most variable tooth in root and canal configuration is the maxillary second molar. It should be pointed out that 12.5% of the teeth analyzed showed a C-shaped root configuration. © 2014 Wiley Periodicals, Inc.

Treatment of traumatized maxillary central incisors

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Jun Kuo

2011-12-01

Full Text Available Traumatic injury to the upper anterior teeth is not uncommon in young children. Dental ankylosis frequently occurs when teeth are traumatically luxated or replanted after being avulsed. Orthodontic movement of a traumatized tooth is difficult, especially when treating an ankylosed tooth without surgical luxation and distraction osteogenesis. This report describes a case of a patient with class I crowded malocclusion and labially displaced and intruded traumatized maxillary incisors. The protruded traumatized incisors were successfully brought to an acceptable position with acceptable gingival esthetics through the use of simple orthodontic traction combined with first-premolar extraction. An acceptable overbite and overjet were achieved within 14 months after completion of orthodontic treatment.

Resistance to fracture of endodontically treated premolars restored with glass ionomer cement or acid etch composite resin: An in vitro study

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B Ranga

2010-01-01

Full Text Available Aim: Due to the weakness of endodontically treated posterior teeth requires more strengthened restoration to withstand occlusal forces. The purpose of the present study was to determine and compare the resistance to fracture of endodontically treated maxillary 1 st premolars restored with different materials in mesio-occluso-distal (MOD cavity preparations. Materials and Methods: MOD cavity preparations in 80 endodontically treated maxillary 1 st premolars were restored using four different methods. Fiber rings were filled with stone plaster and the teeth were placed into the plaster up to the level of cemento-enamel junction. The teeth were grouped according to restorative method, mounted in an Instrom T.T. machine, and the buccal walls subjected to a slowly increasing compressive force until fracture occurred. Result: The force of fracture of the walls of each tooth was recorded and the results in the various groups compared. All teeth fractured in a similar manner irrespective of the restorative method used. Conclusion: The resistance to the fracture of the teeth was the same when they were stored with glass ionomer cement as a base over which composite resin was placed. When the entire cavities were filled with glass ionomer cement, the resistance to fracture of the teeth decreased significantly compared with the acid etch resin technique.

Comparison of the dental anomalies found in maxillary canine-first premolar transposition cases with those in palatally displaced canine cases.

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Scerri, Erica Sultana; McDonald, Fraser; Camilleri, Simon

2016-02-01

To compare the developmental dental anomalies associated with maxillary canine-first premolar (MxCP1) transposition and those of palatally displaced canine (PDC) with each other and with the background prevalence in the Maltese population in order to elucidate whether the two conditions have similar or differing genetic backgrounds. Dental records of 477 subjects with PDC, 57 subjects with MxCP1, and a control group of 500 subjects with no history of a PDC or tooth transposition were compared for canine eruption anomalies and hypodontia. A high frequency of bilateral occurrence was present for both canine malpositions and when unilateral, a trend to right-sided occurrence was evident. The occurrence of transpositions in the PDC group and of PDC in the MxCP1 group was higher than expected. The prevalence of incisor hypodontia was significantly higher in subjects with PDC and MxCP1, as compared to the control group. The size of the MxCP1 group is relatively small. The study population is a small isolated Caucasian population and the results may not be applicable to other populations. There is no significant difference between the MxCP1 and PDC groups in the prevalence or distribution of hypodontia and each of these groups exhibits a higher prevalence of the other canine anomaly. These findings support the theory that PDC and MxCP1 form part of a group of interrelated dental anomalies that share a common genetic basis. © The Author 2015. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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.

Bilateral second premolars agenesia together with a unilateral canine radiculomegaly

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Arthur Musakulu Kemoli

2017-01-01

Full Text Available Congenitally missing teeth is a common feature for the third molars. However, missing teeth, macrodontia and radiculomegaly occurring in a single patient is very rare. This article describes a case of agenesis of mandibular second premolars, radiculomegaly with dilacerations of a canine tooth together with elongated roots of other canines. All these features had been discerned through diagnostic radiographs taken during a routine treatment planning.

Prediction of canine and premolar size using the widths of various permanent teeth combinations: A cross-sectional study

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Kalasandhya Vanjari

2015-01-01

Full Text Available Aims: To suggest the best predictor/s for determining the mesio-distal widths (MDWs of canines (C and premolars (Ps, and propose regression equation/s for hitherto unreported population. Methods: Impressions of maxillary and mandibular arches were made for 201 children (100 boys and 101 girls; age range: 11–15 years who met the inclusion criteria and poured with dental stone. The maximum MDWs of all the permanent teeth were measured using digital vernier caliper. Thirty-three possible combinations (patterns of permanent maxillary and mandibular first molars, central and lateral incisors were framed and correlated with MDWs of C and Ps using Pearson correlation test. Results: There were significant correlations between the considered patterns and MDWs of C and Ps, with difference noted between girls (range of r: 0.34–0.66 and boys (range of r: 0.28–0.77. Simple linear and multiple regression equations for boys, girls, and combined sample were determined to predict MDW of C and Ps in both the arches. Conclusions: The accuracy of prediction improved considerably with the inclusion of as many teeth as possible in the regression equations. The newly proposed equations based on the erupted teeth may be considered clinically useful for space analysis in the considered population.

Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

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Ma, Rong-Rong

1994-01-01

This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex. (author) 61 refs

Three dimensional analysis of CT image on naso-maxillary complex in cleft lip and palate patients

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Ma, Rong-Rong [Tokyo Medical and Dental Univ. (Japan). School of Dentistry

1994-12-01

This study was designed to clarify the three dimensional features of naso-maxillary complex in cleft lip and palate (CLP) by using computed tomography (CT) and to examine its change following an upper dental arch expansion. Sequential CT images with 2mm-thickness were obtained for 11 unilateral CLP boys (UCLP), 6 bilateral CLP boys (BCLP) and 4 boys without cleft (non-cleft). Additionally, two serial sets of upper dental cast before and after dental arch expansion coupled with CT images in UCLP were used to evaluate the effect of dental arch expansion on the naso-maxillary complex. UCLP demonstrated a remarkable naso-maxillary deformity characterized by a decreased volume of maxillary sinus in comparison with the non-cleft patients. Both the volume and shape of nasal cavity were significantly different between the cleft and non cleft side. Naso-maxillary morphology of BCLP, however, was similar to that of the non cleft except for the decreased volume of alveolar arch. Comparative study of UCLP and BCLP showed a significant difference in naso-maxillary morphology. There were some significant correlations between the dental arch expansion and change of each naso-maxillary component, suggesting the effect of expansion stress on the naso-maxillary complex in UCLP. However, deformation caused by expansion stress varied, depending on each component of the naso-maxillary complex. (author) 61 refs.

Comparison of panoramic radiograph with cone-beam computed tomography in assessment of maxillary sinus floor and nasal floor

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Vijay Kumar Bokkasam

2015-01-01

Full Text Available Introduction: Panoramic radiograph is frequently prescribed by dentists for implant planning and, hence, accurate assessment of anatomical structures in panoramic radiograph is of utmost importance. Aims: The aim of the present study is to know the accuracy of panoramic radiograph in assessment of relationship between maxillary sinus floor and posterior teeth roots, and the distance from alveolar crest to nasal floor by comparing it with that of cone-beam computed tomographic (CBCT image. Materials and Methods: Panoramic and CBCT images of 30 patients were analyzed. The topographic relationship of each root of posterior teeth to the maxillary sinus floor was evaluated and classified into three classes. The distance from the peak point on maxillary alveolar crest to nasal floor was measured in panoramic radiograph as well as in CBCT image. All the measurements were made by built-in measurement tools. Results: Class 1 roots in panoramic radiograph showed high agreement (86% with CBCT image, followed by class 0 (76%. There was a significant difference in the measurements of alveolar bone height (ABH in the nasal floor region with a P value of 0.018. Conclusion: Panoramic radiograph is reliable in assessment of nasal floor and maxillary sinus, provided position of the patient, distortion, and the inherent magnification factor are taken into consideration.

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.

Bilateral maxillary fused second and third molars: a rare occurrence.

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

2012-12-01

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 second molar. However, CBCT revealed that a third molar was fused to the second molar. Unexpectedly, the maxillary left third molar also was fused to the second molar, and the crown of an unerupted supernumerary fourth molar was possibly also fused to the apical root region of the second molar. Operative procedures should not be attempted without adequate radiographic investigation. CBCT allowed the precise location of the root canals of the right maxillary fused molar teeth to permit successful endodontic therapy, confirmed after 6 months.

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.

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.

Relationship between crown-root angulation (collum angle) of maxillary central incisors in Class II, division 2 malocclusion and lower lip line.

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Srinivasan, Bhadrinath; Kailasam, Vignesh; Chitharanjan, Arun; Ramalingam, Arthi

2013-01-01

The present study aimed to measure the magnitude of the collum angle (crown-root angulation) of maxillary central incisors present in Class II, division 2 malocclusion and to relate the changes in its magnitude with variations in the lower lip line. A set of 120 conventional lateral cephalograms were selected and divided into three groups of 40 each based on the type of malocclusion presented: Class II, division 2 (group 1); Class II, division 1 (group 2); and Class I (group 3). The collum angle of the maxillary central incisor was measured, and the lower lip line was recorded. Analysis of variance (ANOVA) revealed that the mean collum angle was statistically significantly different in the three groups. The mean collum angle was greatest in Class II, division 2 malocclusion (group 1). The mean collum angles were 3.24 ± 4.69 degrees, 0.95 ± 1.06 degrees, and 1.05 ± 1.50 degrees in groups 1, 2, and 3 respectively. In χ ² test comparison of the location of the lower lip line (incisal, middle, or apical third of the central incisor) among the three groups, the lower lip line was found to contact the middle third of the central incisor most frequently in Class II, division 2 malocclusion. ANOVA followed by Tukey honestly significant difference (HSD) test showed that the mean collum angle is significantly increased when the lower lip is in the middle third (P lower lip line suggest a probable etiologic role of the lower lip line in the development of the collum angle.

Morphological study of maxillary canine region based on CT

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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)

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.

Custom-made, root-analogue direct laser metal forming implant: a case report.

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Mangano, Francesco Guido; Cirotti, Bruno; Sammons, Rachel Lilian; Mangano, Carlo

2012-11-01

In the last few years, the application of digital technology in dentistry has become widespread with the introduction of cone beam computed tomography (CBCT) scan technology, and considerable progress has been made in the development of computer-aided design/ computer-aided manufacturing (CAD/CAM) techniques, including direct laser metal forming (DLMF). DLMF is a technology which allows solids with complex geometry to be produced by annealing metal powder microparticles in a focused laser beam, according to a computer-generated three-dimensional (3D) model. For dental implants, the fabrication process involves the laser-induced fusion of titanium microparticles, in order to build, layer by layer, the desired object. At present, the combined use of CBCT 3D data and CAD/CAM technology makes it possible to manufacture custom-made, root-analogue implants (RAI) with sufficient precision. This report demonstrates the successful clinical use of a custom-made, root-analogue DLMF implant. CBCT images of a non-restorable right maxillary first premolar were acquired and transformed into a 3D model. From this model, a custom-made, root-analogue DLMF implant was fabricated. Immediately after tooth extraction, the RAI with a pre-operatively designed abutment was placed in the extraction socket and restored with a single crown. At the 1-year follow-up examination, the RAI showed a good functional and aesthetic integration. The introduction of DLMF technology signals the start of a new revolutionary era for implant dentistry as its immense potential for producing highly complex macro- and microstructures is receiving vast interest in different medical fields.

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.

Root resorption diagnosed with cone beam computed tomography after 6 months and at the end of orthodontic treatment with fixed appliances.

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Makedonas, Dimitrios; Lund, Henrik; Hansen, Ken

2013-05-01

To investigate the prevalence of orthodontically induced root resorption after treatment and the correlation with resorption found after 6 months of treatment. One hundred fifty-six patients (11-18 years) treated with fixed appliances and extraction of four premolars were examined with cone beam computed tomography before treatment, after 6 months of treatment (n  =  97), and at the end of active treatment. The Malmgren Index was used to describe the degree of root resorption. Severe root resorption (>2 mm, score 3) was found in 25.6% of the patients at the end of treatment. Extreme root resorption was found in one patient. Root resorption was seen more frequently in the maxillary incisor region. There was no correlation between the severity of root resorption after 6 months and the amount observed at the end of treatment. Furthermore, no correlation was seen between treatment duration and the severity of root resorption. Clinically significant resorption was diagnosed in 25.6% of the patients, but no correlations, either with the resorption seen after 6 months or with the length of treatment, were found. Radiographic examination after 3 to 6 months of orthodontic treatment is too early and will not reduce the number of patients who will have teeth with severe root resorption.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis.

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Citak, Mehmet; Cakici, Elif Bahar; Benkli, Yasin Atakan; Cakici, Fatih; Bektas, Bircan; Buyuk, Suleyman Kutalmış

2016-01-01

The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

Influence of Palatal Coverage and Implant Distribution on Denture Strain in Maxillary Implant Overdentures.

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Takahashi, Toshihito; Gonda, Tomoya; Tomita, Akiko; Mizuno, Yoko; Maeda, Yoshinobu

2016-01-01

As maxillary implant overdentures are being increasingly used in clinical practice, prosthodontic complications related to these dentures are also reported more often. The purpose of this study was to examine the influence of palatal coverage and implant distribution on the shear strain of maxillary implant overdentures. A maxillary edentulous model with implants inserted in the anterior, premolar, and molar areas was fabricated. Two kinds of experimental overdentures, with and without palatal coverage, were also fabricated, and two strain gauges were attached at the 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 in each denture was compared by analysis of variance (P = .05). In all situations, the shear strain in palateless dentures was significantly higher than in dentures with palate on both sides (P overdentures exhibited much higher strain than overdentures with palate regardless of the implant distribution; this may cause more prosthodontic and implant complications. The most favorable configuration to prevent complications in maxillary implant overdentures was palatal coverage that was supported by more than four widely distributed implants.

Quantitative analysis of the relationship between maxillary incisors and the incisive canal by cone-beam computed tomography in an adult Japanese population

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Tomonari Matsumura

2017-08-01

Full Text Available Abstract Background In setting goals for orthodontic treatment, determining the morphologies of the alveolar bone and maxillary incisor root is important for avoiding root resorption, dehiscence, and fenestration. This study aimed to analyze the configurational relationships among maxillary incisors, the alveolar border, and the incisive canal by cone-beam computed tomography (CBCT. Methods Cone-beam CT images of 93 orthodontic patients were evaluated for length of the incisive canal (L; angles between the palatal plane and the maxillary alveolar border (θ1, the incisive canal (θ2, and maxillary incisor (θ3; distance from the left maxillary incisor to the incisive canal (D; and cross-sectional areas of the incisive canal (CSAs at three vertical levels. Comparison of variables between male and female patients was performed with the two-sample t test. Correlations between parameters were examined by Pearson’s correlation analysis and Bonferroni correction for multiple comparisons. Results Male patients exhibited significantly greater values of L than female patients. There were significant positive correlations between θ1 and θ2, θ2 and θ3, and θ3 and θ1. While the value of D was the lowest at the oral opening, that of the cross-sectional area of the incisive canal (CSA was the greatest at the incisal root apex. Conclusions This study demonstrated that the incisive canal had large inter-individual variability, and the proximity between the incisive canal and the incisal root could not be precisely predicted by the conventional cephalograms. Therefore, pre-treatment CBCT examination should be recommended when a large amount of maxillary anterior retraction and/or intrusion is planned in orthodontic diagnosis.

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.

Rehabilitation of large maxillary defect with two-piece maxillary obturators

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Kanchan P Dholam

2015-01-01

Full Text Available The insertion and removal of an obturator in large maxillary defects with or without trismus is difficult. Fabrication of a two-piece obturator in such cases overcomes this problem. This article describes rehabilitation of large maxillary defects with two piece maxillary obturator of three types. All these obturators have a maxillary plate and a bulb component, which are approximated together by various techniques namely, silicone cover, embedded magnets, and press studs. Prosthetic rehabilitation of large maxillary defects with two-piece obturators offers the possibility of adequate oral rehabilitation by fabricating light weight prosthesis, which is easy to use. The bulb covers the undercut areas of the defect enhancing the facial contour and retention. It facilitates easy examination of underlying tissues, recreation of the anatomic barrier between the oral and nasal cavities and restoration of the function and esthetics. Thus, it adds to the quality of life.

Severe root resorption resulting from orthodontic treatment: prevalence and risk factors.

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Maués, Caroline Pelagio Raick; do Nascimento, Rizomar Ramos; Vilella, Oswaldo de Vasconcellos

2015-01-01

To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular), treatment with or without extractions, treatment duration, root apex stage (open or closed), root shape, as well as overjet and overbite at treatment onset. Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9%) presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset.

Tooth-Borne Anterior Maxillary Distraction for Cleft Maxillary Hypoplasia: Our Experience With 147 Patients.

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Richardson, Sunil; Selvaraj, Dhivakar; Khandeparker, Rakshit V; Seelan, Nikkie S; Richardson, Shweta

2016-12-01

 = 35) in velopharyngeal insufficiency, resonance, nasal air emission, articulation, and intelligibility, respectively, were observed, with worsening of all parameters in 1 patient (2%). An overall complication rate of 25.17% (n = 37) was noted, with bleeding being the most common intra- and postoperative complication noted in 15 patients (10.2%). No serious consequences related to any complication were noted. Anterior maxillary distraction can be considered a suitable treatment option for the management of mild to moderate cleft maxillary hypoplasia because the anteroposterior deficiency can be addressed at a young age, immediately after the eruption of the maxillary second premolars. Stable long-term results with negligible skeletal relapse are possible with this technique, with an added advantage of unhampered or even improved velopharyngeal function. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Prediction of the size of unerupted canines and premolars in an Iranian population

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Mashaallah Khanehmasjedi

2013-01-01

Full Text Available Background and Aim: One of the important aspects of diagnosis and treatment planning in the mixed dentition is estimation of the size of unerupted permanent canines and premolars. One of the most commonly used the prediction methods are Tanaka and Johnston, which are based on data from a sample of Northern European descent children. The accuracy of this method when applied to a different ethnic population is questionable. The aim of this study was to determine the modified equations from Tanaka and Johnston for Iranian population. Materials and Methods: This study was an analytic and cross-sectional investigation with the randomized cluster sampling in Ahwaz. Fifty four students of 14-18 years age (32 girls, 22 boys were selected between 320 students and plaster models of their maxillary and mandibular arches were prepared. Subjects had fully erupted teeth, class I canine and molar relationship and presented no proximal caries or fillings, morphological anomalies, missing teeth or occlusal abrasion, and bruxism. The mesiodistal crown diameters of the permanent teeth were measured with using the sharpened boley gauge (accuracy 0.01 mm. The data were analyzed by using the regression correlation analyses and t-test. Results: The size of permanent canines and premolars were larger in maxilla than mandible and males than females. These values in Iran were different from other countries. Conclusion: In this study to predict the space (in mm required for alignment of unerupted canine and premolars in Iranian children, halve the sum of mesiodistal dimension of the four mandibular incisors and add the respective constants 10.5 for upper jaw and 10 for lower jaw.

The Effect of Composite Thickness on the Stress Distribution Pattern of Restored Premolar Teeth with Cusp Reduction.

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Panahandeh, Narges; Torabzadeh, Hassan; Ziaee, Nargess; Mahdian, Mina; Tootiaee, Bahman; Ghasemi, Amir

2017-07-01

Different thicknesses of restorative material can alter the stress distribution pattern in remaining tooth structure. The assumption is that a thicker composite restoration will induce a higher fracture resistance. Therefore, the present study evaluated the effect of composite thickness on stress distribution in a restored premolar with cusp reduction. A 3D solid model of a maxillary second premolar was prepared and meshed. MOD cavities were designed with different cusp reduction thicknesses (0, 0.5, 1, 1.5, 2.5 mm). Cavities were restored with Valux Plus composite. They were loaded with 200 N force on the occlusal surface in the direction of the long axis. Von Mises stresses were evaluated with Abaqus software. Stress increased from occlusal to gingival and was maximum in the cervical region. The stressed area in the palatal cusp was more than that of the buccal cusp. Increasing the thickness of composite altered the shear stress to compressive stress in the occlusal area of the teeth. The model with 2.5 mm cusp reduction exhibited the most even stress distribution. © 2015 by the American College of Prosthodontists.

[Sequence orthodontic treatment of impacted dilacerated maxillary central incisors].

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Zheng, Yi; Pang, Xuannai; Nan, Lan; Mo, Shuixue

2012-06-01

To explore an effective orthodontic method for treating impacted dilacerated maxillary central incisors. 12 impacted teeth of 11 cases were chosen. The position of the impacted teeth and the relations with neighbour tissues were assessed by X-ray images, oral examination and plaster model, etc. The impacted teeth were induced to erupt with the closed-eruption technique and fixed orthodontic appliances, root canal therapy, apicoectomy and prosthetic treatment. 12 impacted teeth were moved into arches, and the occlusal relationship was normal. There were no root resorption or conglutination in those impacted teeth. The labial impacted teeth of nine cases had bigger labial crown torsion. The root apexes of four impacted teeth were palpable under mucosa of the labial sulcus and operated by root canal therapy and apicoectomy. One of them received prosthetic treatment. Others (five cases) hadn't accepted root canal therapy, and were observed temporarily. The effects of two palatal impacted teeth was stable. It was a good method to expand indication with sequence orthodontic treatment. The impacted dilacerated maxillary central incisors could be aligned with good esthetical and functional effect.

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.

A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study

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Vaishali Kalburge

2013-01-01

Full Text Available Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10. Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01 Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored

Repair of experimental plaque-induced periodontal disease in dogs.

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Shoukry, M; Ben Ali, L; Abdel Naby, M; Soliman, A

2007-09-01

Forty mongrel dogs were used in this study for induction of periodontal disease by placing subgingival silk ligatures affecting maxillary and mandibular premolar teeth during a 12-month period. Experimental premolar teeth received monthly clinical, radiographic, and histometric/pathologic assessments. The results demonstrated significant increases in scores and values of periodontal disease parameters associated with variable degrees of alveolar bone loss. The experimental maxillary premolar teeth exhibited more severe and rapid rates of periodontal disease compared with mandibular premolar teeth. Histometric analysis showed significant reduction in free and attached gingiva of the experimental teeth. Histopathological examination of buccolingual sections from experimental premolar teeth showed the presence of rete pegs within the sulcular epithelium with acanthosis and erosive changes, widening of the periodontal ligament, and alveolar bone resorption. Various methods for periodontal repair were studied in 194 experimental premolar teeth exhibiting different degrees of periodontal disease. The treatment plan comprised non-surgical (teeth scaling, root planing, and oral hygiene) and surgical methods (closed gingival curettage, modified Widman flap, and reconstructive surgery using autogenous bone marrow graft and canine amniotic membrane). The initial non-surgical treatment resulted in a periodontal recovery rate of 37.6% and was found effective for treatment of early periodontal disease based on resolution of gingivitis and reduction of periodontal probing depths. Surgical treatment by closed gingival curettage to eliminate the diseased pocket lining resulted in a recovery rate of 48.8% and proved effective in substantially reducing deep periodontal pockets. Open root planing following flap elevation resulted in a recovery rate of 85.4% and was effective for deep and refractory periodontal pockets. Autogenous bone graft implantation combined with canine amniotic

Dental root periapical resorption caused by orthodontic treatment

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Pinandi Sri Pudyani

2006-03-01

Full Text Available Dental root resorption especially in maxillary incisive region almost always happens simultaneously with orthodontic treatment, and it gained researchers attention, in particular after the use of periapical radiography. However, the fundamental etiology of dental root resorption is still dubious. Multifactoral causes are mentioned, among others are hormonal, nutritition, trauma, dental root form and dental root structure anomalies, genetic, while from treatment side are duration, types, strength scale and dental movement types. Based on these findings, orthodontic treatment was proven to cause dental root resorption in maxillary incisive teeth.

Effect of Different Liners on Fracture Resistance of Premolars Restored with Conventional and Short Fiber-Reinforced Composite Resins.

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Shafiei, Fereshteh; Doozandeh, Maryam; Ghaffaripour, Dordaneh

2018-01-11

To see whether applying four different liners under short fiber-reinforced composite (SFRC), everX Posterior, compared to conventional composite resin, Z250, affected their strengthening property in premolar MOD cavities. Mesio-occluso-distal (MOD) cavities were prepared in 120 sound maxillary premolars divided into 10 groups (n = 12) in terms of two composite resin types and 4 liners or no liner. For each composite resin, in 5 groups no liner, resin-modified glass ionomer (RMGI), conventional flowable composite (COFL), self-adhesive flowable composite resin (SAFL), and self-adhesive resin cement (SARC) were applied prior to restoring incrementally. After water storage and thermocycling, static fracture resistance was tested. Data (in Newtons) were analyzed using two-way ANOVA (α = 0.05). Fracture resistance was significantly affected by composite resin type (p = 0.02), but not by the liner (p > 0.05). The interaction of the two factors was not statistically significant (p > 0.05). SFRC exhibited higher fracture strength (1470 ± 200 N) compared to conventional composite resin (1350 ± 290), irrespective of the application of liners. Application of SARC and SAFL liners led to a higher number of restorable fractures for both composite resins. The four liners can be used without interfering with the higher efficacy of SFRC, compared to conventional composite resins, to improve the fracture strength of premolar MOD cavities. © 2018 by the American College of Prosthodontists.

A segmented appliance for space closure followed by Invisalign and fixed appliances.

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Uribe, Flavio; Cutrera, Alice; Nanda, Ravinda

2011-01-01

This case report describes the use of a segmented appliance for space closure prior to using Invisalign. The maxillary right canine was retracted into the extracted first premolar space with a sectional wire from the first molar to the canine with no visible brackets in the incisor region. The advantage of this technique is the ability to achieve better root and rotational control during space closure with a fixed appliance that also has limited visibility. A maxillary fixed appliance was used to refine the esthetics in the maxillary arch due to the limitations of the Invisalign appliance in achieving rotational and vertical movements.

Severe root resorption resulting from orthodontic treatment: Prevalence and risk factors

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Caroline Pelagio Raick Maués

2015-02-01

Full Text Available OBJECTIVE: To assess the prevalence of severe external root resorption and its potential risk factors resulting from orthodontic treatment. METHODS: A randomly selected sample was used. It comprised conventional periapical radiographs taken in the same radiology center for maxillary and mandibular incisors before and after active orthodontic treatment of 129 patients, males and females, treated by means of the Standard Edgewise technique. Two examiners measured and defined root resorption according to the index proposed by Levander et al. The degree of external apical root resorption was registered defining resorption in four degrees of severity. To assess intra and inter-rater reproducibility, kappa coefficient was used. Chi-square test was used to assess the relationship between the amount of root resorption and patient's sex, dental arch (maxillary or mandibular, treatment with or without extractions, treatment duration, root apex stage (open or closed, root shape, as well as overjet and overbite at treatment onset. RESULTS: Maxillary central incisors had the highest percentage of severe root resorption, followed by maxillary lateral incisors and mandibular lateral incisors. Out of 959 teeth, 28 (2.9% presented severe root resorption. The following risk factors were observed: anterior maxillary teeth, overjet greater than or equal to 5 mm at treatment onset, treatment with extractions, prolonged therapy, and degree of apex formation at treatment onset. CONCLUSION: This study showed that care must be taken in orthodontic treatment involving extractions, great retraction of maxillary incisors, prolonged therapy, and/or completely formed apex at orthodontic treatment onset.

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.

Apical root resorption due to orthodontic treatment detected by cone beam computed tomography.

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Castro, Iury O; Alencar, Ana H G; Valladares-Neto, José; Estrela, Carlos

2013-03-01

To determine the frequency of apical root resorption (ARR) due to orthodontic treatment using cone beam computed tomography (CBCT) in a sample of 1256 roots from 30 patients. All patients had Class I malocclusion with crowding. Of the 30 patients evaluated, 11 were boys and 19 were girls; their mean age was 13 years (11 to 16 years). Orthodontic treatment followed the nonextraction treatment. CBCT images were obtained before and after orthodontic treatment, and ARR was determined using Axial Guided Navigation of CBCT images. All patients had ARR. No statistically significant association was found between resorption frequency, gender, and age. ARR was detected using CBCT in 46% of all roots that underwent orthodontic treatment. CBCT was effective for detecting in vivo even minimal degrees of ARR due to orthodontic treatment and allowed three-dimensional evaluation of dental roots and visualization of palatine roots of maxillary molars. The highest frequencies and the most significant ARR occurred in incisors and distal roots of first maxillary and mandibular molars.

Effects of labial and lingual retraction and intrusion force on maxillary central incisor with varying collum angles: A three-dimensional finite elemental analysis

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Sandesh S Pai

2017-01-01

Full Text Available Aims: This study aims to analyze the effects of intrusive force, retraction force, and torque control on the maxillary central incisors with varying degrees of collum angle in labial and lingual orthodontic treatment procedures using finite element analysis. Subjects and Methods: Four pairs of three-dimensional finite element models (FEMs representative of maxillary central incisor with periodontal ligament (PDL and alveolar bone were constructed using ANSYS software (version 5.4, ANSYS Inc., Canonsburg, PA, USA. The models with 0°, 5°, 10°, and 15° were created based on crown root angulation. Four models for labial and four models for lingual orthodontic procedure were constructed. Each model was subjected to three forces, i.e., retraction force of 1 N, lingual root torque of −5 × 10−3 N and intrusive force of 0.64 N on crown with labially and lingually positioned brackets. Principal stress and strain, center of rotation and root apex displacement were monitored. Statistical Analysis Used: Not required (FEM study. Results: With the increase in collum angle, the stress-strain distribution in PDL was increased in both labial orthodontics (LaO and lingual orthodontics (LiO. Stress-strain distribution in the PDL with LiO was more in all the models as compared to LaO. There was more of tipping movement as collum angle increased from 0° to 15° in both LaO and LiO. The amount of intrusion reduced as the collum angle increased in both the systems. However, more of intrusion was seen in LaO. With increase in collum angle, the center of rotation moved cervically in both the systems. Conclusions: From the present study, we conclude that as the collum angle increased, the stress-strain distribution increased in LaO and LiO. The center of rotation shifted cervically, and the intrusion decreased when collum angle increased. The values were more marked in LiO.

Varicella Zoster Virus and Internal Root Resorption: A Case Report.

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Talebzadeh, Bita; Rahimi, Saeed; Abdollahi, Amir Ardalan; Nouroloyuni, Ahmad; Asghari, Vahide

2015-08-01

Herpes zoster is a viral infection caused by the reactivation of the varicella zoster virus. One of the less well-recognized maxillofacial complications is tooth root resorption. To our knowledge, this is the first case report about internal resorption associated with varicella zoster virus involving different dental quadrants. A 38-year-old woman presented with internal resorption of maxillary canine and first premolar tooth roots on the right quadrant and generalized internal resorption of second molars of both mandibular quadrants. The patient's medical history showed mild oral lichen planus and infection with varicella zoster virus (chickenpox) with severe clinical manifestations 5 years previously. The patient developed diabetes mellitus type I and hypothyroidism a short time after varicella zoster virus infection, and by the time of infection with this virus, oral lichen planus had progressed from the reticular pattern to the generalized severe erosive form. Viral etiology could also be considered in these diseases. The root canals of the affected teeth were debrided, irrigated, and dried, and calcium hydroxide paste was placed in the root canals for a week during the first treatment session. The root canals were obturated during the second session. Six-month follow-up showed improvement of oral lichen planus and resolution of widening of periodontal ligament of the affected teeth, with follow-up radiographs revealing no periapical problems. It appears some cases of internal root resorption classified as idiopathic might have viral etiology. Therefore, it is recommended that patients be questioned about a history of chickenpox and herpes zoster. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Clinical and radiographic evaluation of maxillary central incisors exposure in patients undergoing maxillary advancement

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Guilherme dos Santos Trento

2015-12-01

Full Text Available Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%. Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002. Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

Revascularization of an impacted, immature dilacerated permanent maxillary central incisor associated with odontoma and a supernumerary tooth

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Priya Subramaniam

2013-01-01

Full Text Available To intentionally replant an impacted immature permanent maxillary central incisor in the mixed dentition period followed by revascularization in order to achieve apical root closure. A 9-year-old boy presented with retained maxillary left primary incisors. Radiographic evaluation revealed the presence of a supernumerary tooth and an odontoma associated with an impacted permanent maxillary left central incisor, having root dilaceration. Treatment included surgical removal of mesiodens and odontoma. The impacted dilacerated permanent central incisor was removed and intentionally replanted, followed by revascularization of pulp. During the follow-up, root end closure with narrowing of canal space was observed, patient has been asymptomatic and the tooth remains vital. Revascularization of the immature reimplanted tooth showed continued root development and thickening of the lateral dentinal walls through deposition of new hard tissue and narrowing of the canal space.

Root resorption during orthodontic treatment with Invisalign®: a radiometric study

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Giulia Gay

2017-05-01

Full Text Available Abstract Background Root resorption (RR is described as a permanent loss of tooth structure from the root apex. Many reports in the literature indicate that orthodontically treated patients are more likely to have severe apical root shortening, interesting mostly maxillary, followed by mandibular incisors. The aim of the study was to investigate the incidence and severity of RR in adult patients treated with aligners. The study group consisted of 71 class I adult healthy patients (mean age 32.8 ± 12.7 treated with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA. All incisors, canines, upper first premolars, and first molars were assessed. Root and crown lengths of 1083 teeth were measured in panoramic radiographs at the beginning (T0 and at the end (T1 of clear aligner therapy. Individual root-crown ratio (RCR of each tooth and therefore the relative changes of RCR (rRCR were determined. A decrease of rRCR was assessed as a reduction of the root length during treatment. Results All patients had a minimum of one teeth affected with a reduction of root length, on average 6.38 ± 2.28 teeth per patient. Forty one, 81% of the 1083, measured teeth presented a reduction of the pre-treatment root length. A reduction in percentage of >0% up to 10% was found in 25.94% (n = 281, a distinct reduction of >10% up to 20% in 12.18% (n = 132 of the sample. 3.69% (n = 40 of the teeth were affected with a considerable reduction (>20%. Conclusions Orthodontic treatment with Invisalign® aligners could lead to RR. However, its incidence resulted to be very similar to that described for orthodontic light forces, with an average percentage of RR < 10% of the original root length.

Root resorption during orthodontic treatment with Invisalign®: a radiometric study.

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Gay, Giulia; Ravera, Serena; Castroflorio, Tommaso; Garino, Francesco; Rossini, Gabriele; Parrini, Simone; Cugliari, Giovanni; Deregibus, Andrea

2017-12-01

Root resorption (RR) is described as a permanent loss of tooth structure from the root apex. Many reports in the literature indicate that orthodontically treated patients are more likely to have severe apical root shortening, interesting mostly maxillary, followed by mandibular incisors. The aim of the study was to investigate the incidence and severity of RR in adult patients treated with aligners. The study group consisted of 71 class I adult healthy patients (mean age 32.8 ± 12.7) treated with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). All incisors, canines, upper first premolars, and first molars were assessed. Root and crown lengths of 1083 teeth were measured in panoramic radiographs at the beginning (T0) and at the end (T1) of clear aligner therapy. Individual root-crown ratio (RCR) of each tooth and therefore the relative changes of RCR (rRCR) were determined. A decrease of rRCR was assessed as a reduction of the root length during treatment. All patients had a minimum of one teeth affected with a reduction of root length, on average 6.38 ± 2.28 teeth per patient. Forty one, 81% of the 1083, measured teeth presented a reduction of the pre-treatment root length. A reduction in percentage of >0% up to 10% was found in 25.94% (n = 281), a distinct reduction of >10% up to 20% in 12.18% (n = 132) of the sample. 3.69% (n = 40) of the teeth were affected with a considerable reduction (>20%). Orthodontic treatment with Invisalign® aligners could lead to RR. However, its incidence resulted to be very similar to that described for orthodontic light forces, with an average percentage of RR root length.

Severe maxillary osteomyelitis in a Gray Wolf (Canis lupus)

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Barber-Meyer, Shannon

2012-01-01

Dental injuries to or abnormalities in functionally important teeth and associated bones in predators may significantly reduce the ability to kill and consume prey (Lazar et al. 2009). This impairment is likely exacerbated in coursing predators, such as Gray Wolves, that bite and hold onto fleeing and kicking prey with their teeth. Damage to carnassials (upper fourth premolar, P4, and lower first molar, M1) and associated bones in Gray Wolves may especially inhibit the consumption of prey because these teeth slice meat and crush bone. Here I report maxillary osteomyelitis involving the carnassials in a wild Gray Wolf from northeastern Minnesota of such severity that I hypothesize it ultimately caused the Gray Wolf to starve to death.

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.

Maxillary distraction osteogenesis in the adolescent cleft patient: three-dimensional computed tomography analysis of linear and volumetric changes over five years.

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Chen, Philip Kuo-Ting; Por, Yong-Chen; Liou, Eric Jein-Wein; Chang, Frank Chun-Shin

2011-07-01

To assess the results of maxillary distraction osteogenesis with the Rigid External Distraction System using three-dimensional computed tomography scan volume-rendered images with respect to stability and facial growth at three time frames: preoperative (T0), 1-year postoperative (T1), and 5-years postoperative (T2). Retrospective analysis. Tertiary. A total of 12 patients with severe cleft maxillary hypoplasia were treated between June 30, 1997, and July 15, 1998. The mean age at surgery was 11 years 1 month. Le Fort I maxillary distraction osteogenesis. Distraction was started 2 to 5 days postsurgery at a rate of 1 mm per day. The consolidation period was 3 months. No face mask was used. A paired t test was used for statistical analysis. Overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. From T0 to T1, there were statistically significant increments of overjet, ANB, and SNA and maxillary, pterygoid, and mandibular volumes. The T1 to T2 period demonstrated a reduction of overjet (30.07%) and ANB (54.42%). The maxilla showed a stable SNA and a small but statistically significant advancement of the ANS point. There was a significant increase in the mandibular volume. However, there was no significant change in the maxillary and pterygoid volumes. Maxillary distraction osteogenesis demonstrated linear and volumetric maxillary growth during the distraction phase without clinically significant continued growth thereafter. Overcorrection is required to take into account recurrence of midface retrusion over the long term.

Health of periodontal tissues and resorption status after orthodontic treatment of impacted maxillary canines.

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Oz, A Z; Ciger, S

2018-03-01

The aim of the present study was to evaluate the changes of incisor root resorption associated with impacted maxillary canines and health of periodontal tissues around maxillary canines erupted with orthodontic treatment. Twenty patients with a unilateral palatally impacted maxillary canine were included in the study. Cone-beam computed tomography images taken before and after orthodontic treatment were compared with the contralateral canines serving as control teeth. Root resorption was present in 10% of central and 40% of lateral incisors before treatment. After treatment, the incidence of resorption decreased. The thickness of the buccal bone surrounding the impacted canines was similar to that surrounding the contralateral canines, except in the apical area. Periodontal pocket depth and alveolar bone loss were greater for the impacted canine teeth than for the contralateral canines. Incisor root resorption associated with impacted canine teeth showed signs of repair after orthodontic treatment. Slight differences related to periodontal health were found between the previously impacted teeth and contralateral canine teeth.

Assessment of periodontal status following the alignment of impacted permanent maxillary canine teeth.

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Szarmach, I J; Szarmach, J; Waszkiel, D; Paniczko, A

2006-01-01

The aim of the study was to assess the effect of orthodontic movement of the impacted canines after surgical exposure and alignment on the periodontal status of the transpositioned and adjacent teeth as well as to compare certain parameters with those of spontaneously erupted teeth. Twenty-four patients (mean age 18.4 +/- 3.66) with unilaterally impacted 24 canines were enrolled in the study. The following parameters were assessed: pocket depth (PD), clinical attachment level (CAL), platelet index (PI) of Silness and Löe, and modified sulcus bleeding index (SBI). Optic density of the alveolar bone along the root surface of the aligned canine was analysed based on digital radiological images made with the right angle technique. Control group consisted of spontaneously erupted teeth. In comparison to the control group, in the orthodonticaly treated group PD was found to increase on the mesial buccal and palatal surfaces of the first premolar (p aligned canine (p aligned tooth were statistically significant (p alignment zone and the control, and there was no link between the method of treatment and periodontal status, either. The alignment of the impacted permanent maxillary canines poses a risk of periodontal deterioration. Patients subjected to surgical-orthodontic treatment require periodic periodontal follow-ups.

Rapid maxillary expansion effects: An alternative assessment method by means of cone-beam tomography

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Camilo Aquino Melgaço

2014-10-01

Full Text Available INTRODUCTION: This study aims to develop a method to assess the changes in palatal and lingual cross-sectional areas in patients submitted to rapid maxillary expansion (RME. METHODS: The sample comprised 31 Class I malocclusion individuals submitted to RME and divided into two groups treated with Haas (17 patients and Hyrax (14 patients expanders. Cone-beam computed tomography scans were acquired at T0 (before expansion and T1 (six months after screw stabilization. Maxillary and mandibular cross-sectional areas were assessed at first permanent molars and first premolars regions and compared at T0 and T1. Mandibular occlusal area was also analyzed. RESULTS: Maxillary cross-sectional areas increased in 56.18 mm2 and 44.32 mm2 for the posterior and anterior regions. These values were smaller for the mandible, representing augmentation of 40.32 mm2 and 39.91 mm2 for posterior and anterior sections. No differences were found when comparing both expanders. Mandibular occlusal area increased 43.99mm2 and mandibular incisors proclined. Increments of 1.74 mm and 1.7 mm occurred in mandibular intermolar and interpremolar distances. These same distances presented increments of 5.5 mm and 5.57 mm for the maxillary arch. CONCLUSION: Occlusal and cross-sectional areas increased significantly after RME. The method described seems to be reliable and precise to assess intraoral area changes.

Three-dimensional analysis of maxillary stability after Le Fort I osteotomy using hydroxyapatite/poly-L-lactide plate.

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Park, Jung-Hyun; Kim, Minkyu; Kim, Sang Yoon; Jung, Hwi-Dong; Jung, Young-Soo

2016-04-01

To evaluate three-dimensional change in maxillary position using biodegradable plates. A total of 53 patients who underwent orthognathic surgery using biodegradable plates were analyzed retrospectively. The position of maxilla was measured three-dimensionally using cone beam computed tomography data at preoperative (T0), 1-month postoperative (T1), and 1-year postoperative (T2) time points. Changes in the maxilla 1 year after the operation (T2-T1) were analyzed to demonstrate postoperative stability. The correlation between postoperative relapse (T2-T1) and surgical movement (T1-T0) of the maxilla was investigated. At 1-year postoperatively, no significant changes in maxillary position were noted in the antero-posterior and transverse dimensions. The anterior maxillary position in the vertical dimension also showed no significant changes, but the posterior maxillary position (posterior nasal spine, greater palatine foramen) showed a 0- to 2.98-mm relapse at 1-year postoperatively. The posterior maxilla tended to relapse inferiorly when the amount of surgical upward movement was greater than 3-3.5 mm and to relapse superiorly when the amount of surgical upward movement was less than 3-3.5 mm. For all patients, no postoperative complications in the osteofixated maxilla were observed during the follow-up period. Maxilla fixed with biodegradable plates was stable in the antero-posterior and transverse and the vertical (anterior maxilla) dimensions. Posterior maxillary vertical relapse was clinically acceptable, but relapse patterns that relate to the amount of surgical upward movement should be considered for surgical treatment planning. Copyright © 2016. Published by Elsevier Ltd.

Evaluation of 4% Sodium Hypochlorite in eliminating Enterococcus faecalis from the Root Canal when Used with Three Irrigation Methods: An in vitro Study.

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Priyank, Harsh; Pandey, Vinisha; Bagul, Abhishek; Majety, Kishore Kumar; Verma, Parul; Choudhury, Basanta Kumar

2017-03-01

Endodontic treatment removes all pathogens, such as Enterococcus faecalis from pulp and root canals. The aim of this study is to assess the usefulness of sodium hypo-chlorite (NaOCl) in removing E. faecalis from the root canal used with three different irrigation methods. This study was conducted on freshly extracted maxillary incisors. After biomechanical preparation, root canals were injected with E. faecalis. Three groups were made which contained 30 teeth in each group; 2 mL of NaOCl solution was used for irrigation followed by agitation with K-files in group I; 2 mL of NaOCl solution was used for irrigation and ultrasonic agitation was done in group II. In group III, an alternate irrigation with NaOCl and 3% hydrogen peroxide was done. The fourth group (control) was irrigated with sterile saline solution. E. fae-calis bacteria were sampled to the root canals with paper points and were transferred to tubes that contained 5 mL of brain heart infusion broth. Tubes were incubated and the presence of broth turbidity was suggestive of bacteria remaining in the root canal. All three groups showed no statistically significant difference. However, difference existed between experimental groups and control groups. The author concluded that all three methods of application of NaOCl were effective in disinfecting the root canal than the saline solution. No single irrigant has 100% efficiency. Thus by this study, a best irrigating solution with maximum properties can be established.

Maxillary canine impactions related to impacted central incisors: two case reports.

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Bayram, Mehmet; Ozer, Mete; Sener, Ismail

2007-09-01

The purpose of this case report is to describe the combined surgical and orthodontic treatment of two cases with an impacted maxillary central incisor and canine in the same quadrant and to discuss the causal relationship between them. The most common causes of canine impactions are usually the result of one or more factors such as a long path of eruption, tooth size-arch length discrepancies, abnormal position of the tooth bud, prolonged retention or early loss of the deciduous canine, trauma, the presence of an alveolar cleft, ankylosis, cystic or neoplastic formation, dilaceration of the root, supernumerary teeth, and odontomas. Although impaction of the maxillary central incisor is almost as prevalent as impacted canines its etiology is different. The principal factors involved in causing the anomaly are supernumerary teeth, odontomas, and trauma. Case #1: A 10.5-year-old girl in the early mixed dentition stage presented with a chief complaint of the appearance of her anterior teeth. She had a Class I skeletal pattern and a history of trauma to the maxillary central incisors at age five with premature exfoliation. Radiographs revealed an impacted upper right central incisor in the region of the nasal floor, delayed eruption of the maxillary permanent central incisor, and the adjacent lateral incisor was inclined toward the edentulous space. Treatment was done in two stages consisting of surgical exposure and traction of the impacted central incisor and fixed orthodontic treatment. Case #2: An 11.5-year-old girl presented for orthodontic treatment with the chief complaint of an unerupted tooth and the appearance of her upper anterior teeth. She was in the late mixed dentition period with a Class III skeletal pattern along with an anterior cross-bite with some maxillary transverse deficiency. The maxillary right canine and central incisor were absent, but the maxillary right deciduous canine was still present. Treatment included arch expansion followed by

Unpredictable Root Canal Morphology: Expect the Unexpected

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Sohez J Makani

2015-01-01

Full Text Available Background: A maxillary first molar with more than four canals is an interesting example of anatomic variations, especially when two of these canals are detected, with separate apical foramen in the distal root. The inability to locate the unexpected canals of various anatomical configuration and subsequently treat them , may lead to therapeutic failures. Endodontic retreatment is usually the modality of choice in such cases. This report describes a case of a maxillary first molar with five canals (two mesial canals in mesial root, two distal canals in two distal roots and a palatal canal in palatal root. Additionally it shows a rare anatomic configuration and emphasizes the importance of identifying additional canals.

Root perforations treatment using mineral trioxide aggregate and Portland cements.

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Silva Neto, José Dias da; Brito, Rafael Horácio de; Schnaider, Taylor Brandão; Gragnani, Alfredo; Engelman, Mírian; Ferreira, Lydia Masako

2010-12-01

Clinical, radiological and histological evaluation of root perforations treated with mineral trioxide aggregate (MTA) or Portland cements, and calcium sulfate barrier. One molar and 11 premolar teeth of a male mongrel dog received endodontic treatment and furcations were perforated with a high-speed round bur and treated with a calcium sulfate barrier. MTA, Portland cement type II (PCII) and type V (PCV), and white Portland cement (WPC) were used as obturation materials. The teeth were restored with composite resin and periapical radiographs were taken. The animal was euthanized 120 days post-surgery for treatment evaluation. Right lower first premolar (MTA), right lower third premolar (PCV), left lower second premolar (MTA), and right lower second premolar (WPC): clinically normal, slightly radio-transparent area on the furcation, little inflammatory infiltrate, and new-bone formation. Left lower third premolar (PCII), right upper first premolar (WPC), right upper third premolar (PCII), and left upper first molar (PCV): clinically normal, radiopaque area on the furcation, and new-bone formation. Right upper second premolar (MTA), left upper second premolar (WPC), left upper third premolar (PCII): presence of furcation lesion, large radiolucent area, and intense inflammatory infiltrate. All obturation materials used in this study induced new-bone formation.

Radiographic prevalence of root canal ramifications in a sample of root canal treatments in a Brazilian Dental School Prevalência radiográfica de ramificações do canal radicular em uma amostra de tratamentos endodônticos em uma Faculdade de Odontologia Brasileira

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Iadasa de Quadros

2007-06-01

Full Text Available The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP, SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13, followed by mandibular premolars (n = 10 and maxillary incisors (n = 10. Apical deltas were mostly found in mandibular molars (n = 14, followed by maxillary incisors (n = 9. Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.O objetivo deste estudo foi investigar radiograficamente a presença de ramificações do canal radicular encontrada depois do tratamento endodôntico, e determinar qualquer relação entre a presença destas e do tipo de substância química auxiliar usada. O estudo avaliou 1.470 tratamentos endodônticos executados pelos estudantes do último ano da Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP, SP, Brasil, no período de 1998 a

[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

[Radiologic picture of maxillary sinus aspergilloma].

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Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

2010-06-01

Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to

[Root resorption and orthodontic treatment].

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Sebbar, M; Bourzgui, F

2011-09-01

The aim of our study was to investigate the prevalence of root resorption during and at the end of orthodontic treatment and to assess its relationship with age, sex and treatment with or without extractions. Our study included 82 patients (51 women and 31 men) aged between 6 and 38 years, who received orthodontic treatment. Evaluation of root resorption was performed on panoramics at the beginning and at the end of orthodontic treatment. All the teeth were observed. The degree of root resorption was increased respectively by the standards in four ordinal levels (4). Data analysis was performed by Epi Info 6.0. Root resorption was present in all the teeth and maxillary incisors are the most affected. The correlation between age and root resorption was significant (p = 0.008). Women were more affected by resorption (P = 0.002). Patients treated with extraction showed more root resorption (p = 0.12). Our results suggest that orthodontic treatment is involved in the development of root resorption. The most often teeth resorbed are maxillary incisors. Age, sex and orthodontic extractions can be considered as risk factors for root resorption.

Radiodense concretions in maxillary sinus aspergillosis: pathogenesis and the role of CT densitometry

International Nuclear Information System (INIS)

Lenglinger, F.X.; Krennmair, G.; Mueller-Schelken, H.; Artmann, W.

1996-01-01

The purpose of this study was to investigate by CT the origin of radiodense maxillary sinus concretions and whether CT densitometry is effective in the prediction of maxillary sinus aspergillosis and in the differentiation of the origin of these concretions. In a prospective study in 21 patients with radiodense maxillary sinus concretions detected by radiography, a preoperative CT study of the paranasal sinuses and the concretions was undertaken. Additional scans of the upper alveolar ridge were also performed. Radiological findings were compared with clinical symptoms and with CT findings, especially CT densitometry of the sinus concretions and dental root-filling material. All patients underwent a functional Caldwell-Luc operation; histological and microbiological examinations were performed. Fifteen of the 21 patients (71.4%) with radiodense concretions had a histological and microbiological diagnosis of sinus aspergillosis. The sinus concretions had CT densities higher than 2000 HU (Housfield units) in 15 patients and lower than 2000 HU in 6. Fourteen of 15 patients (93.3%) with concretions ahving CT densities higher than 2000 HU had a postoperative diagnosis of maxillary sinus aspergillosis. The mean CT density of the sinus concretions in patients with maxillary sinus aspergillosis was 2868 HU (range 1870-3070 HU), and in patients without aspergiollosis was 778 HU (range 228-2644 HU). The mean CT density of the dental root-filling material was 2866 HU (range 2156-3070 HU). Paranasal sinus CT with CT densitometry of a sinus concretion has a higher accuracy than standard radiogrpahy and clinical findings in the prediction of maxillary sinus aspergillosis (93.3% vs 71.4%). CT densitometry helps to confirm the dental origin of maxillary sinus concretions and to explain a possible dental pathogenesis of maxillary sinus aspergillosis. (orig.)

Accuracy of CBCT as modality to identify the presence of secondary mesiobuccal root canal in the maxillary first molar

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Haikal Halil

2017-11-01

Full Text Available Introduction: A successful endodontic treatment requires the clinician to be able to locate, disinfect, and obturate all canals presence in the root canal system to remove the infection and prevent re-infection. However, there are canals that often missed upon examination and the treatment, for example, the secondary mesiobuccal (MB root canal. The success of locating these canals is determined by the methods used, for example, a periapical radiograph and Cone Beam Computed Tomography (CBCT. The purpose of this study was to examine the sensitivity and accuracy of the periapical radiograph (PA and CBCT on determining the presence of the secondary MB root canal. Methods: As much as 40 intact crown and intact radicular of the maxillary first molars, without root caries, root restoration, and endodontic treated, were taken as the samples. The presence of a secondary MB root canal was evaluated by a PA radiograph, CBCT and clinical sectioning. All of the samples were undergone each test and sectioned after being completed the radiographic evaluation steps. The results from each test were then documented and analyzed by using SPSS® version 16. Results: CBCT radiograph was successfully identifying 62.5% secondary MB root canal presence, whilst the PA radiograph has detected only 20% of the samples. The sensitivity of CBCT and PA radiograph was compared with the gold standard method, resulting 86.2% and 27.6% respectively. The statistical analysis showed that there was no significant difference between CBCT test and the gold standard (p=0.00. Conclusion: CBCT was proven to be a reliable method to detect the presence of secondary MB root canals due to its sensitivity and accuracy as high as the clinical sectioning compared to the PA radiograph.

Influence of Palatal Coverage and Implant Distribution on Implant Strain in Maxillary Implant Overdentures.

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Takahashi, Toshihito; Gonda, Tomoya; Mizuno, Yoko; Fujinami, Yozo; Maeda, Yoshinobu

2016-01-01

Maxillary implant overdentures are often used in clinical practice. However, there is no agreement or established guidelines regarding prosthetic design or optimal implant placement configuration. The purpose of this study was to examine the influence of palatal coverage and implant number and distribution in relation to impact strain under maxillary implant overdentures. A maxillary edentulous model with implants and experimental overdentures with and without palatal coverage was fabricated. Four strain gauges were attached to each implant, and they were positioned in the anterior, premolar, and molar areas. A vertical occlusal load of 98 N was applied through a mandibular complete denture, and the implant strains were compared using one-way analysis of variance (P = .05). The palatolabial strain was much higher on anterior implants than on other implants in both denture types. Although there was no significant difference between the strain under dentures with and without palatal coverage, palateless dentures tended to result in higher implant strain than dentures with palatal coverage. Dentures supported by only two implants registered higher strain than those supported by four or six implants. Implants under palateless dentures registered higher strain than those under dentures with palatal coverage. Anterior implants exhibited higher palatolabial strain than other implants regardless of palatal coverage and implant configuration; it is therefore recommended that maxillary implant overdentures should be supported by six implants with support extending to the distal end of the arch.

The Effect of Diode Laser Treatment for Root Canal Disinfection on Fracture Resistance and Micro-hardness of the Tooth

International Nuclear Information System (INIS)

Elmiligy, H.H; Diab, A.H.; Sabet, N.E.; Saafan, A.M.

2014-01-01

This study evaluated the effect of diode laser treatment for root canal disinfection on fracture resistance and micro-hardness of the tooth. Sixty freshly extracted mandibular and maxillary premolars were accessed under coolant then root canals were flared up to apical preparation size 40 MFA coupled with 5.25% NaOCl as an irrigant. Teeth were divided into two groups, control group (group I) and lased group (group II) that was lased by diode laser with average power 2 w through fibrooptic into the canal 2 mm shorter than the apex. Each tooth was embedded in acrylic block, and then subjected to the fracture resistance test. Each root was then sectioned transversely and polished to record dentin Vickers hardness. Data was analysed with student t-test then with linear regression test. The Lased samples presented a significantly higher resistance to fracture than unlased samples. There was no statistically significant differences found between Vickers hardness (HV) of lased and unlased samples and there was no relation between fracture resistance and microhardness. Diode laser (980 nm) treatment had no adverse effect on dentin microhardness, also it increased the fracture resistance of dentin. Diode laser (980 nm) treatment could attain better function ability and maintenance of tooth after endodontic treatment.

Successful Ultra-Conservative Management of a Mandibular Premolar with Dens Invaginatus.

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Abazarpour, Ramin; Parirokh, Masoud; Farhadi, Aida; Jalali, Zahra; Kheirabadi, Nasir

2017-01-01

Dens invaginatus is one of the most common anomalies of tooth structure. It is caused by the invagination of the crown surface during odontogenesis that enters the pulp chamber of the affected tooth. Depending on the complexity of invagination, the tooth might present with pulp necrosis, open apex and a complicated root canal system. This case report presents an Oehlers' type 2 dens-invaginatus in a mandibular premolar with chronic apical abscess. In most cases, dens invaginatus is removed during treatment. However, in this case report, based on cone-beam computed tomography (CBCT) evaluation, non-surgical treatment and maintenance of the invaginated segment was chosen in order to prevent compromising the tooth structure and its susceptibility to future root fracture. This is a new treatment approach and has not been performed in previous reports. Calcium-enriched mixture (CEM) cement was used as an apical plug followed by gutta-percha in warm vertical compaction for root canal obturation. The case was followed up for 36 months after treatment. This report highlights the importance of selecting the appropriate treatment approach based on CBCT evaluation.

Fracture resistance of premolar teeth restored with silorane-based or dimethacrylate-based composite resins.

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Akbarian, Golsa; Ameri, Hamideh; Chasteen, Joseph E; Ghavamnasiri, Marjaneh

2014-01-01

To restore posterior teeth using low-shrinkage composite to minimize microleakage. To compare the fracture resistance of mesio-occlusal-distal (MOD) cavity preparations restored with either low-shrinkage composite or with dimethacrylate-based composite in conjunction with cavity liners and without them. The null hypothesis of the study is that there are no differences in either fracture resistance or fracture mode between the silorane group and dimethacrylate groups with and without the use of cavity liners. Sixty maxillary premolars were divided into six groups of 10. MOD cavities were prepared in four groups: F: posterior composite (Filtek P60); GF: 0.5-mm Glass Ionomer (Fuji LC) + posterior composite; FF: 0.5-mm flowable composite (Filtek Supreme XT) + posterior composite; and S: low-shrinkage composite (Filtek P90). Negative (N) and positive (P) control groups consisted of unrestored and sound teeth, respectively. The specimens were thermocycled and loaded. Data were analyzed using analysis of variance, Tukey, and chi-square tests (α = 0.05). Groups FF (1643.09 ± 187/80 N) and GF (1596.80 ± 163/93 N) (p = 0.06 > 0.05) were statistically identical, although less than group P (1742/33 ± 110/08 N), but still demonstrated greater fracture resistance than the other groups. The fracture resistance of group S (1434/69 ± 107/62 N) was identical to GF and FF (p = 0.06 > 0.05). The fracture resistance of F (1353/19 ± 233/90 N) was less than GF and FF, and statistically identical to S (p = 0.87 > 0.05). Silorane-based composite showed a resistance to fracture similar to methacrylate-based composite restorations regardless of whether cavity liners were used. The findings of this study support the selection of silorane-based composite for the restoration of maxillary premolars with standardized Class II cavity preparations in order to strengthen the resistance to fracture to the same extent as do dimethacrylate

Comparação entre os resultados oclusais e os tempos de tratamento da má oclusão de Classe II por meio da utilização do aparelho Pendulum e das extrações de dois pré-molares superiores Comparison of the occlusal outcomes and the treatment time of Class II malocclusion with the Pendulum appliance and with extraction of two maxillary premolars

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Célia Regina Maio Pinzan-Vercelino

2010-02-01

Full Text Available OBJETIVO: comparar os resultados oclusais e os tempos de tratamento da má oclusão de Classe II realizado com o aparelho Pendulum e com extrações de dois pré-molares superiores. MÉTODOS: a amostra constituiu-se dos modelos de gesso e das telerradiografias de 48 pacientes com má oclusão de Classe II, divididos em dois grupos de acordo com o protocolo de tratamento. O grupo 1 foi composto por 22 pacientes tratados com o aparelho Pendulum, com idade inicial média de 14,44 anos. O grupo 2 constituiu-se por 26 pacientes tratados com extrações de dois pré-molares superiores, com idade inicial média de 13,66 anos. Os resultados oclusais obtidos pelos dois protocolos de tratamento utilizados foram avaliados em modelos de gesso por meio do índice oclusal PAR, enquanto o tempo de tratamento foi calculado a partir das anotações clínicas presentes nos prontuários. As avaliações foram realizadas por meio do teste t independente. RESULTADOS E CONCLUSÕES: os resultados oclusais obtidos não demonstraram diferenças entre os grupos, porém o grupo 2 apresentou um tempo de tratamento significativamente menor.AIM: The purpose of this study was to compare the occlusal outcomes and the treatment time of Class II malocclusion with the Pendulum appliance and with extraction of two maxillary premolars. METHODS: 48 Class II malocclusion patients were selected and divided into two groups according to the treatment protocol - group 1 consisted of dental study casts and initial cephalograms of 22 patients treated with the Pendulum appliance, with an initial mean age of 14.44 years, and group 2 consisted of dental study casts and initial cephalograms of 26 patients treated with two maxillary premolar extractions and a initial mean age of 13.66 years. The occlusal outcomes were evaluated on dental casts with the PAR occlusal index and the treatment time of each group was calculated by the clinical records. The variables were compared by the t tests

Maxillary unicystic ameloblastoma: a case report.

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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

Morphology of the cemento-enamel junction in premolar teeth.

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Arambawatta, Kapila; Peiris, Roshan; Nanayakkara, Deepthi

2009-12-01

The present study attempted to describe the distribution of the mineralized tissues that compose the cemento-enamel junction, with respect to both the different types of permanent premolars of males and females and the various surfaces of individual teeth. The cervical region of ground sections of 67 premolars that had been extracted for orthodontic reasons were analyzed using transmitted light microscopy to identify which of the following tissue interrelationships was present at the cemento-enamel junction: cementum overlapping enamel; enamel overlapping cementum; edge-to-edge relationship between cementum and enamel; or the presence of gaps between the enamel and cementum with exposed dentin. An edge-to-edge interrelation between root cementum and enamel was predominant (55.1%). In approximately one-third of the sample, gaps between cementum and enamel with exposed dentin were observed. Cementum overlapping enamel was less prevalent than previously reported, and enamel overlapping cementum was seen in a very small proportion of the sample. In any one tooth, the distribution of mineralized tissues at the cemento-enamel junction was irregular and unpredictable. The frequency of gaps between enamel and cementum with exposure of dentin was higher than previously reported, which suggests that this region is fragile and strongly predisposed to pathological changes. Hence, this region should be protected and carefully managed during routine clinical procedures such as dental bleaching, orthodontic treatment, and placement of restorative materials.

Influence of X-ray beam angulations on the detection of horizontal root fractures

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Josue Martos

2015-01-01

Full Text Available Aims: The aim of this study was to evaluate the variation of vertical angle for detection of fractures. Materials and Methods: Twenty-five (25 single-rooted premolar teeth were divided into two groups, fractured teeth (n = 15 and non-fractured teeth (n = 10. Artificially fractured teeth were classified according to location, number of fragments, and direction of fracture line: Horizontal, oblique, or complex. The tooth fragments were juxtaposed with cyanoacrylate, and the specimens (fractured and non-fractured were placed individually in the dental alveolus of a human jaw with the aid of silicone rubber impression material and submitted to eight periapical radiographs in a digital sensor with a vertical range of 10 degrees (−40, −30, −20, −10, 0, +10, +20, +30. Three examiners evaluated the characteristics of the fractures and their correlation with the radiographic diagnosis (perceived or not by varying the vertical angle. Statistical Analysis: Descriptive analysis was performed through the analytical comparison and Kappa test inter-examiner. Results: Among the three examiners, inter-examiner Kappa value was 0.536. The radiographic identification of root fracture in the 15 prepared samples was 60% (nine at angle 0, and at the angles of +10, −10, and −20, it was less than 50%. Conclusions: Multiple radiographs with variations of vertical angle are fundamental to facilitate the diagnosis of horizontal root fractures in premolars.

Effect of gingival fibroblasts and ultrasound on dogs' root resorption during orthodontic treatment.

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Crossman, Jacqueline; Hassan, Ali H; Saleem, Ali; Felemban, Nayef; Aldaghreer, Saleh; Fawzi, Elham; Farid, Mamdouh; Abdel-Ghaffar, Khaled; Gargoum, Ausama; El-Bialy, Tarek

2017-01-01

To investigate the effect of using osteogenic induced gingival fibroblasts (OIGFs) and low intensity pulsed ultrasound (LIPUS) on root resorption lacunae volume and cementum thickness in beagle dogs that received orthodontic tooth movement. Seven beagle dogs were used, from which gingival cells (GCs) were obtained and were induced osteogenically to produce OIGFs. Each third and fourth premolar was randomly assigned to one of the five groups, namely, LIPUS, OIGFs, bone morphogenetic protein-2 (BMP-2), OIGFs + LIPUS, and control. All groups received 4 weeks of bodily tooth movement, then LIPUS-treated groups received LIPUS for 20 min/day for 4 weeks, and OIGFs groups received an injection of OIGFs near the root apex. Microcomputed tomography analysis was used to calculate root resorption lacunae volume and histomorphometric analysis was performed to measure the cementum thickness of each root at 3 root levels on compression and tension sides. There was no significant difference in resorption volume between the treatment groups. OIGFs + LIPUS increased cementum thickness ( P > 0.05) in third premolars near the apex, and LIPUS increased cementum thickness ( P > 0.05) in fourth premolars near the apex. Furthermore, BMP2 increased cementum thickness at the coronal third at the compression side. OIGFs, LIPUS, and BMP-2 can be potential treatments for orthodontically induced root resorption, however, improvements in experimental design and treatment parameters are required to further investigate these repair modalities.

Esthetic periodontal surgery for impacted dilacerated maxillary central incisors.

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Wei, Yu-Ju; Lin, Yi-Chun; Kaung, Shou-Shin; Yang, Shue-Fen; Lee, Shyh-Yuan; Lai, Yu-Lin

2012-10-01

Clinicians do not frequently see impacted dilacerated maxillary incisors in their patients. When they do, there are several diagnostic and management challenges for correcting root dilacerations. An unfavorable esthetic outcome might occur as a result of soft-tissue complications during surgical eruption procedures. We present 2 patients with an impacted and dilacerated maxillary central incisor. Computed tomography scans with 3-dimensional reformation were used to accurately assess the positions of the dilacerated teeth, the degree of dilaceration, and the stage of root formation. The therapy primarily involved 2-stage crown exposure surgery combined with orthodontic traction. An apicoectomy was performed on 1 dilacerated tooth; the other exhibited pulp vitality. This article highlights the periodontal surgical strategies for the esthetic management of inverted crowns. Through periodontal plastic surgery and interdisciplinary cooperation, the impacted dilacerated central incisors were properly aligned, and successful esthetic results were achieved. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

[Autotransplantation of a maxillary incisor and orthodontic care: a case study].

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Charpentier, Valentine; Makaremi, Masrour; Brondeau, François de

2017-12-01

Severely impacted teeth with atypical root anatomy do not respond well to orthodontic traction after surgical exposure. Consequently, they are often removed, but replacing them with dental prostheses can prove difficult in patients who are still growing. Thus, autotransplantation seems to be the only way to preserve a natural tooth and the alveolar bone. An upper central incisor impacted in the region of the nasal cavities with an open apex was diagnosed in an 8.5-year-old female patient. The tooth displayed a curved root pressed against the maxillary cortical bone preventing orthodontic traction treatment. Through this clinical case involving autotransplantation of a maxillary incisor report and a review of the literature, this article explores the indications and exposes the different stages of this orthodontic-surgical protocol. In this case, autotransplantation enabled restoration of maxillary arch continuity. After two years of orthodontic treatment, the bone reconstruction of the extraction site was very satisfactory. The benefits of this technique and the precautions to be taken are discussed as well as the various protocols. The increasing success rate of this surgical procedure makes it possible to consider it as a protocol for the future. © EDP Sciences, SFODF, 2017.

Efficacy of enamel matrix protein applied to spontaneous periodontal disease in two dogs.

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Watanabe, Kazuhiro; Kikuchi, Masahiro; Okumura, Masahiro; Kadosawa, Tsuyoshi; Fujinaga, Toru

2003-09-01

Enamel matrix protein (EMP) was applied for regeneration of periodontal tissue in 2 dogs with spontaneous periodontal disease. Case 1 had bony resorption around the root and root apex of the maxillary fourth premolars. Case 2 had vertical resorption of bone between the mandibular first and second molars. A flap was formed in the buccal gingiva, and EMP was applied onto the surface of the exposed root. One or 4 months postoperatively, increased bone level and clinical attachment were recognized. EMP was therefore suggested to be effective to induce regeneration of periodontal tissues in the cases with periodontal disease.

Conservative management of displaced horizontal root fracture

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Sanjeev Kunhappan

2011-01-01

Full Text Available Traumatic injuries of teeth are the main cause of emergency treatment in dental practice. Radicular fractures in permanent teeth are uncommon, being only 0.5-7% of the cases. Horizontal root fractures are more frequently observed in the maxillary anterior region of young male patients and vary in severity from enamel fractures to avulsions. Fracture occurs often in the middle-third of the root followed by apical and coronal third. The present case report describes a clinical case of a horizontal root fracture located at the middle third of a maxillary left-central incisor treated endodontically after approximating fracture segment with the help of orthodontic appliance. After 6 months follow-up, the tooth was asymptomatic with normal periodontal health.

Predisposing factors to severe external root resorption associated to orthodontic treatment.

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Picanço, Gracemia Vasconcelos; de Freitas, Karina Maria Salvatore; Cançado, Rodrigo Hermont; Valarelli, Fabricio Pinelli; Picanço, Paulo Roberto Barroso; Feijão, Camila Pontes

2013-01-01

The aim of this study was to evaluate predisposing factors among patients who developed moderate or severe external root resorption (Malmgren's grades 3 and 4), on the maxillary incisors, during fixed orthodontic treatment in the permanent dentition. Ninety-nine patients who underwent orthodontic treatment with fixed edgewise appliances were selected. Patients were divided into two groups: G1 - 50 patients with no root resorption or presenting only apical irregularities (Malmgren's grades 0 and 1) at the end of the treatment, with mean initial age of 16.79 years and mean treatment time of 3.21 years; G2 - 49 patients presenting moderate or severe root resorption (Malmgren's grades 3 and 4) at the end of treatment on the maxillary incisors, with mean initial age of 19.92 years and mean treatment time of 3.98 years. Periapical radiographs and lateral cephalograms were evaluated. Factors that could influence the occurrence of severe root resorption were also recorded. Statistical analysis included chi-square tests, Fisher's exact test and independent t tests. The results demonstrated significant difference between the groups for the variables: Extractions, initial degree of root resorption, root length and crown/root ratio at the beginning, and cortical thickness of the alveolar bone. It can be concluded that: Presence of root resorption before the beginning of treatment, extractions, reduced root length, decreased crown/root ratio and thin alveolar bone represent risk factors for severe root resorption in maxillary incisors during orthodontic treatment.

Assessment of root surfaces of apicected teeth: A scanning electron ...

African Journals Online (AJOL)

Objectives: The aim of this study was to determine the apical surface characteristics and presence of dental cracks in single‑rooted premolars, resected 3.0 mm from the root apex, using the Er: YAG laser, tungsten carbide bur, and diamond‑coated tip, by scanning electron microscopy (SEM). Experimental design: Thirty ...

The Effect of Using Self-ligating Brackets on Maxillary Canine Retraction: A Split-mouth Design Randomized Controlled Trial.

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Hassan, Siba E; Hajeer, Mohammad Y; Alali, Osama H; Kaddah, Ayham S

2016-06-01

The results of previous studies about the efficacy of using self-ligating brackets (SLBs) in controlling canine movement during retraction are not in harmony. Therefore, the current study aimed to compare the effects of using new passive SLBs on maxillary canine retraction with sliding mechanics vs conventional ligating brackets (CLBs) tied with metal ligatures. The sample comprised 15 adult patients (4 males, 11 females; 18-24 years) requiring bilateral extraction of maxillary first premolars. Units of randomization are the left or right maxillary canines within the same patient. The two maxillary canines in each patient were randomly assigned to one of the two groups in a simple split-mouth design. The canines in the SLBs group (n = 15) were bracketed with SLBs (Damon Q™), while the canines in the CLBs group (n = 15) were bracketed with conventional brackets (Mini Master Series). Transpalatal bars were used for anchorage. After leveling and alignment, 0.019 × 0.025" stainless steel working archwires were placed. Canines were retracted using a nickel-titanium close-coil springs with a 150 gm force. The amount and rate of maxillary canine retraction, canine rotation, and loss of anchorage were measured on study models collected at the beginning of canine retraction (T0) and 12 weeks later (T1). Differences were analyzed using paired-samples t-tests. The effect differences were statistically significant (p brackets gave better results compared to the CLBs in terms of rate of movement, amount of canine rotation following extraction, and anchorage loss.

Comparison of the effect of labiolingual inclination and anteroposterior position of maxillary incisors on esthetic profile in three different facial patterns

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Chirivella, Praveen; Singaraju, Gowri Sankar; Mandava, Prasad; Reddy, V Karunakar; Neravati, Jeevan Kumar; George, Suja Ani

2017-01-01

Objective: To test the null hypothesis that there is no effect of esthetic perception of smiling profile in three different facial types by a change in the maxillary incisor inclination and position. Materials and Methods: A smiling profile photograph with Class I skeletal and dental pattern, normal profile were taken in each of the three facial types dolichofacial, mesofacial, and brachyfacial. Based on the original digital image, 15 smiling profiles in each of the facial types were created using the FACAD software by altering the labiolingual inclination and anteroposterior position of the maxillary incisors. These photographs were rated on a visual analog scale by three panels of examiners consisting of orthodontists, dentists, and nonprofessionals with twenty members in each group. The responses were assessed by analysis of variance (ANOVA) test followed by post hoc Scheffe. Results: Significant differences (P esthetics. The result of the ANOVA showed differences among the three groups for certain facial profiles. Conclusion: The hypothesis was rejected. The esthetic perception of labiolingual inclination and anteroposterior of maxillary incisors differ in different facial types, and this may effect in formulating treatment plans for different facial types. PMID:28197396

Management of persistent periapical infection on maxillary lateral incisorby apex resection of: A case report

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Yusri Yusri

2016-06-01

Full Text Available Endodontic failure can be caused by different etiology, one of them is a persistent periapical infection in the root canal system. If the endodontic convensional retreatment is difficult to be done, surgical endodontic will be recomended. Endodontic surgical can eliminate the causative agent of periradicular disease and to restore the biological condition of periodontium and functional. A 22 years old male patient came to the Dental Hospital Hasanuddin University at Tamalanrea with the chief complaint is discomfort of the left maxillary lateral incisor. Radiograph examinations showed radiolucency 4 mm of tooth 22. The diagnosis is chronic apical periodontitis.Three month after endodontic conventional, the patients complaint is settled. Extended care plan will be treated is apex resection. The purpose of this case report is to present the treatment protocol of apex resection on  the maxillary left lateral incisor.

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.

New hominin fossils from Kanapoi, Kenya, and the mosaic evolution of canine teeth in early hominins

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J. Michael Plavcan

2012-03-01

Full Text Available Whilst reduced size, altered shape and diminished sexual dimorphism of the canine–premolar complex are diagnostic features of the hominin clade, little is known about the rate and timing of changes in canine size and shape in early hominins. The earliest Australopithecus, Australopithecus anamensis, had canine crowns similar in size to those of its descendant Australopithecus afarensis, but a single large root alveolus has suggested that this species may have had larger and more dimorphic canines than previously recognised. Here we present three new associated dentitions attributed to A. anamensis, recently recovered from the type site of Kanapoi, Kenya, that provide evidence of canine evolution in early Australopithecus. These fossils include the largest mandibular canine root in the hominin fossil record. We demonstrate that, although canine crown height did not differ between these species, A. anamensis had larger and more dimorphic roots, more like those of extant great apes and Ardipithecus ramidus, than those of A. afarensis. The canine and premolar occlusal shapes of A. anamensis also resemble those of Ar. ramidus, and are intermediary between extant great apes and A. afarensis. A. afarensis achieved Homo-like maxillary crown basal proportions without a reduction in crown height. Thus, canine crown size and dimorphism remained stable during the early evolution of Australopithecus, but mandibular root dimensions changed only later within the A. anamensis–afarensis lineage, coincident with morphological changes in the canine–premolar complex. These observations suggest that selection on canine tooth crown height, shape and root dimensions was not coupled in early hominin evolution, and was not part of an integrated adaptive package.

THREE-DIMENSIONAL ASSESSMENT OF THE PHARYNGEAL AIRWAY AND MAXILLARY SINUS VOLUMES IN INDIVIDUALS WITH NON-SYNDROMIC CLEFT LIP AND PALATE

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Ana NEMȚOI

2015-09-01

Full Text Available Introduction: Children with cleft lip and palate (CLP are known to have airway problems. Introduction of ConeBeam CT (CBCT and imaging software has facilitated generation of 3D images for assessing the volume of maxillary sinuses and pharyngeal airway. Consequently, the present study aimed at evaluating and comparing the maxillary sinus and pharyngeal airway volume of patients with cleft lip and palate in healthy patients, using cone beam computed tomography (CBCT images. Materials and method: The sample group included 27 individuals (15 with cleft lip and palate subjects and 12 healthy subjects. The pharyngeal airway and each maxillary sinus were three-dimensionally assessed, segmented and their volume was calculated. A comparison between the right and left sinus was performed by Student t-test, and the differences between the control and cleft groups were calculated using ANOVA. Results: No statistically significant differences were found when the maxillary sinuses volumes from each side were compared (p >0.05. The unilateral CLP patients presented the lowest sinus volume. Individuals with CLP did not exhibit a total airway volume smaller than the nonCLP controls. Conclusions: 3D imaging using CBCT and Romexis software is reliable for assessing maxillary sinus and pharyngeal airway volume. The present study showed that the pharyngeal airway is not compromised in CLP individuals. The unilateral CLP individuals present maxillary sinuses with smaller volumes, no differences being recorded between the cleft and non-cleft side.

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.

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

Science.gov (United States)

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.

Orthodontic treatment of a complete transposed impacted maxillary canine

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Pi-Huei Liu

2015-03-01

Full Text Available Tooth transposition is a positional interchange of two adjacent teeth. Transposition most often occurs at maxillary canine. Moving transposed teeth to their normal positions is challenging because this requires bodily movement and translation of one tooth to pass another. This procedure may cause damage to the teeth or supporting structures. We report a case of complete transposition of maxillary canine and lateral incisor. Transposed teeth were successfully moved orthodontically to their normal positions. Multiple mechanics were meticulously applied to achieve complete correction of the tooth positions and to minimize root resorption and/or periodontal defects of canine and lateral incisors. Factors concerning treatment planning for transposed teeth are discussed.

Ceramic inlays : effect of mechanical cycling and ceramic type on restoration-dentin bond strength

NARCIS (Netherlands)

Trindade, F.Z.; Kleverlaan, C.J.; da Silva, L.H.; Feilzer, A.J.; Cesar, P.F.; Bottino, M.A.; Valandro, L.F.

2016-01-01

This study aimed to evaluate the bond strength between dentin and five different ceramic inlays in permanent maxillary premolars, with and without mechanical cycling. One hundred permanent maxillary premolars were prepared and divided into 10 groups (n=10) according to the ceramic system (IPS e.Max

Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up

OpenAIRE

Kallel, Ines; Moussaoui, Eya; Chtioui, Fadwa; Douki, Nabiha

2018-01-01

According to the American Association of Endodontists, “a ‘true’ vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually.” Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical ...

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Özok, A.R.; van der Sluis, L.W.M.; Wu, M.K.; Wesselink, P.R.

2008-01-01

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

Sealing ability of a new polydimethylsiloxane-based root canal filling material

NARCIS (Netherlands)

Ozok, Ahmet R.; van der Sluis, Lucas W. M.; Wu, Min-Kai; Wesselink, Paul R.

We tested the null hypothesis that there is no difference in the sealing ability of GuttaFlow, RoekoSeal, and AH26 in root canals. Sixty extracted mandibular premolars were filled with AH26 (lateral compaction), RoekoSeal, or GuttaFlow (modified single-cone). The sealing ability of the root canal

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.

Nonsurgical endodontic retreatment of fused teeth with transposition: a case report

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Miguel Agostinho Beco Pinto Cardoso

2016-05-01

Full Text Available Tooth transposition is a disorder in which a permanent tooth develops and erupts in the normal position of another permanent tooth. Fusion and gemination are developmental disturbances presenting as the union of teeth. This article reports the nonsurgical retreatment of a very rare case of fused teeth with transposition. A patient was referred for endodontic treatment of her maxillary left first molar in the position of the first premolar, which was adjacent to it on the distobuccal side. Orthopantomography and periapical radiography showed two crowns sharing the same root, with a root canal treatment and an associated periapical lesion. Tooth fusion with transposition of a maxillary molar and a premolar was diagnosed. Nonsurgical endodontic retreatment was performed. At four yr follow-up, the tooth was asymptomatic and the radiolucency around the apical region had decreased, showing the success of our intervention. The diagnosis and treatment of fused teeth require special attention. The canal system should be carefully explored to obtain a full understanding of the anatomy, allowing it to be fully cleaned and obturated. Thermoplastic techniques were useful in obtaining hermetic obturation. A correct anatomical evaluation improves the set of treatment options under consideration, leading to a higher likelihood of esthetically and functionally successful treatment.

A comparative histologic study on furcal perforation repair with Root MTA and Pro Root MTA in fully developed teeth in dog

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Rahimi S.

2005-07-01

Full Text Available Background and Aim: The goal of endodontics is to seal the root canal system from the orifice to apical constriction completely and tridimensionally.Hence perforations during root canal therapy, because of caries or resorptions must be sealed and obturated with ideal materials. The aim of this study was to histologically compare two kinds of mineral trioxide aggregate Root MTA and Pro Root MTA for furcal perforation repair in developed teeth in dog. Materials and Methods: In this experimental study, thirty teeth consisting of second, third and fourth mandibular premolars of five German shepherd dogs were selected. Twenty-four teeth were randomly divided into four experimental groups (6 teeth each. One pair of Root MTA and Pro Root MTA groups studied in one month and the other in three months intervals. Positive and negative control groups was each contained three teeth. In positive control group, perforations were not treated and negative control group contained intact teeth. In experimental groups perforations repaired after one week exposure to oral cavity with Root MTA or Pro Root MTA. After time intervals animals were subjected to vital perfusion and 6 m histologic sections were prepared. Inflammation and hard tissue formation were ranked by Cox criteria. Data were analysed using Mann-Whitney and Chi-Square statistical tests with P0.05. Conclusion: Mineral Trioxide Aggregate is an adequate material for furcal perforation repair in dog’s teeth. Root MTA could be a good substitute for Pro Root MTA considering the lower cost and similar characteristics.

A comparative evaluation of root canal area increase using three different nickel-titanium rotary systems: An ex vivo cone-beam computed tomographic analysis

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Adrija Deka

2015-01-01

Full Text Available Background and Objectives: The present study was undertaken to compare and evaluate the area increase of root canals with ProTaper, iRaCe and Revo-S systems using cone beam computed tomography for analysis. Materials and Methodology: Forty five extracted human mandibular premolars having single canal and straight root were collected. Teeth were randomly assigned to three groups (n=15. Samples were decoronized by maintaining root length at 14 mm. Pre-instrumentation cone beam computed tomography scan was done after stabilizing the samples on wax blocks. The working length was determined at 1 mm short from the apical foramen by using a ISO 15 K-file tip protruding at apical foramen. Preparation was carried out according to the manufacturer′s instructions. Finally, canals were instrumented upto 30/.06 apically for each group. After each instrumentation, root canals were irrigated with 2ml of 3% sodium hypochlorite solution followed by 2 ml of 17% EDTA solution. Final irrigation was done with 5ml of saline. Post instrumentation cone beam computed tomography scans of all samples in the 3 groups were acquired. Results: Mean percentage of area increase in different thirds of the canal was highest for ProTaper followed by i-RaCe and Revo-s system which was statistically significant. Interpretation and Conclusion: Root canal area increase was highest for ProTaper followed by i-Race and Revo-S systems.

Orthodontic management of a dilacerated central incisor and partially impacted canine with unilateral extraction - A case report.

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Felicita, A Sumathi

2017-10-01

To align a dilacerated maxillary central incisor and partially impacted canine with unilateral extraction in a young patient with skeletal deep bite. A 14 year old male patient reported to the hospital with skeletal deep bite (basal plane angle-17°), severe horizontal pattern of growth (Go-Gn to Sn -22°), upright maxillary incisors (U1 to NA -26°) and retroclined lower incisors (L1 to NB -11°). The maxillary left central incisor was dilacerated, and the maxillary left canine was partially impacted. Unilateral extraction of the left maxillary premolar and left mandibular central incisor was done. A canine disimpaction spring was used to align the impacted canine. An anterior bite plane was given to open the bite. Superimposition of lateral cephalogram (T1, T2) revealed bite opening, normal overjet and overbite. There was backward rotation of the mandible and increase in lower anterior facial height. There was no evidence of root resorption or loss of vitality in the dilacerated tooth. Clinically the canine was well aligned in the arch. Orthodontic management of a dilacerated incisor can be done without root resorption or loss of vitality. The partially impacted canine was well aligned in the arch. Unilateral extraction can produce good treatment results.

Congenitally missing mandibular second premolars: clinical options.

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Kokich, Vincent G; Kokich, Vincent O

2006-10-01

Congenital absence of mandibular second premolars affects many orthodontic patients. The orthodontist must make the proper decision at the appropriate time regarding management of the edentulous space. These spaces can be closed or left open. If the space will be left open for an eventual restoration, the keys during orthodontic treatment are to create the correct amount of space and to leave the alveolar ridge in an ideal condition for a future restoration. If the space will be closed, the clinician must avoid any detrimental alterations to the occlusion and the facial profile. Some early decisions that the orthodontist makes for a patient whose mandibular second premolars are congenitally missing will affect his or her dental health for a lifetime. Therefore, the correct decision must be made at the appropriate time. In this article, we present and discuss various treatment alternatives for managing orthodontic patients with at least 1 congenitally missing mandibular second premolar.

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

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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.

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.

A geometric morphometric analysis of hominin upper premolars. Shape variation and morphological integration.

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Gómez-Robles, Aida; Martinón-Torres, María; Bermúdez de Castro, José María; Prado-Simón, Leyre; Arsuaga, Juan Luis

2011-12-01

This paper continues the series of articles initiated in 2006 that analyse hominin dental crown morphology by means of geometric morphometric techniques. The detailed study of both upper premolar occlusal morphologies in a comprehensive sample of hominin fossils, including those coming from the Gran Dolina-TD6 and Sima de los Huesos sites from Atapuerca, Spain, complement previous works on lower first and second premolars and upper first molars. A morphological gradient consisting of the change from asymmetric to symmetric upper premolars and a marked reduction of the lingual cusp in recent Homo species has been observed in both premolars. Although percentages of correct classification based on upper premolar morphologies are not very high, significant morphological differences between Neanderthals (and European middle Pleistocene fossils) and modern humans have been identified, especially in upper second premolars. The study of morphological integration between premolar morphologies reveals significant correlations that are weaker between upper premolars than between lower ones and significant correlations between antagonists. These results have important implications for understanding the genetic and functional factors underlying dental phenotypic variation and covariation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cuspal Deflection of Premolars Restored with Bulk-Fill Composite Resins.

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Behery, Haytham; El-Mowafy, Omar; El-Badrawy, Wafa; Saleh, Belal; Nabih, Sameh

2016-01-01

This in vitro study compared cuspal deflection of premolars restored with three bulk-fill composite resins to that of incrementally-restored ones with a low-shrinkage silorane-based restorative material. Forty freshly-extracted intact human upper premolars were used. Reference points at buccal and palatal cusp tips were acid-etched and composite rods were horizontally bonded to them (TPH-Spectra-HV, Dentsply). Two acrylic resin guiding paths were made for each premolar to guide beaks of a digital micrometer used for cuspal deflection measurements. Standardized MOD cavities, 3 mm wide bucco-lingually and 3.5 mm deep, were prepared on each premolar. Prepared teeth were then equally divided into four groups (n = 10) and each group was assigned to one of four composite resin (QuiXX, Dentsply; X-tra fil, Voco; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; low-shrinkage Filtek LS, 3M/ESPE). Adper Single Bond-Plus, 3M/ESPE was used with all bulk-fill restoratives. LS-System Adhesive, 3M/ESPE was used with Filtek LS. For each prepared premolar, cuspal deflection was measured in microns as the difference between two readings between reference points before and after restoration completion. Means and SDs were calculated and data statistically-analyzed using One-way ANOVA and Tukey's test. Filtek LS showed the lowest mean cuspal deflection value 6.4(0.84)μm followed by Tetric EvoCeram Bulk Fill 10.1(1.2) μm and X-tra fil 12.4(1.35)μm, while QuiXX showed the highest mean 13(1.05)μm. ANOVA indicated significant difference among mean values of groups (p composite resins tested. Filtek LS had the lowest significant mean cuspal deflection in comparison to all tested bulk-fill restoratives. The use of Tetric EvoCeram Bulk fill composite resin restorative for class II MOD cavities resulted in reduced cuspal deflection in comparison to the two other bulk-fill composite resins tested. The silorane-based Filtek LS restorative resulted in the least cuspal deflection in

Coupling image processing and stress analysis for damage identification in a human premolar tooth.

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Andreaus, U; Colloca, M; Iacoviello, D

2011-08-01

Non-carious cervical lesions are characterized by the loss of dental hard tissue at the cement-enamel junction (CEJ). Exceeding stresses are therefore generated in the cervical region of the tooth that cause disruption of the bonds between the hydroxyapatite crystals, leading to crack formation and eventual loss of enamel and the underlying dentine. Damage identification was performed by image analysis techniques and allowed to quantitatively assess changes in teeth. A computerized two-step procedure was generated and applied to the first left maxillary human premolar. In the first step, dental images were digitally processed by a segmentation method in order to identify the damage. The considered morphological properties were the enamel thickness and total area, the number of fragments in which the enamel is chipped. The information retrieved by the data processing of the section images allowed to orient the stress investigation toward selected portions of the tooth. In the second step, a three-dimensional finite element model based on CT images of both the tooth and the periodontal ligament was employed to compare the changes occurring in the stress distributions in normal occlusion and malocclusion. The stress states were analyzed exclusively in the critical zones designated in the first step. The risk of failure at the CEJ and of crack initiation at the dentin-enamel junction through the quantification of first and third principal stresses, von Mises stress, and normal and tangential stresses, were also estimated. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Evaluation of maxillary arch morphology in children with unilaterally impacted incisors via three-dimensional analysis of digital dental casts: a controlled study.

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Pavoni, Chiara; Franchi, Lorenzo; Buongiorno, Marco; Cozza, Paola

2016-01-01

The purpose of this work was to analyze variations in maxillary arch dimensions in subjects presenting unilaterally impacted maxillary permanent central incisors compared with a control group of subjects without eruption anomalies. A group of 23 Caucasian children [8 females and 15 males, mean age 9.7 years, standard deviation (SD) 1.6 years] displaying unilaterally impacted maxillary permanent central incisors (impacted incisor group: IIG) were compared with a control group (CG) of 23 subjects (9 females; 14 males, mean age 8.8 years, SD 1.9 years) presenting no eruption disorders. Pretreatment dental casts were taken from each subject and the upper arch was scanned using a three-dimensional scanner. Linear measurements were taken on each digital model to analyze maxillary arch dimensions. Significant between-group differences were tested with the Student's t test (p < 0.05). The transverse and sagittal upper-arch measurements were significantly smaller in the IIG than in the CG. In particular, the anterior arch was 1.35 mm shorter in the IIG, while intercanine width was decreased by 2.51 mm on the impacted side. Children revealing unilaterally impacted maxillary central incisors demonstrated a significantly constricted maxillary transverse width and shorter arch on the impacted side compared with subjects with no eruption disorders.

C-SHAPED CONFIGURATION OF THE ROOT CANAL SYSTEM – PROBLEMS AND SOLUTIONS.

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Janet Kirilova

2014-06-01

Full Text Available Introduction: The patients with C-shaped configuration of the root canal system are definitely a problem in the everyday dental practice. The C-shaped configuration of the root canal can be seen in the mandibular and maxillary molars. The treatment of these teeth is very difficult. Purpose: To trace the treatment of clinical cases with C-shaped configuration of the root canal system. Material and methods: There are some different cases that are described with a C-shaped configuration of the root canal system with one, two, three and four separate root canals. Careful exploration of the floor of the pulp chamber, inspection with magnification, use of ultrasonic irrigation and a modified filling technique are of particular use. Results and Discussion: Clinical cases of a C-shaped pulp chamber and root canal system shows that this root canal aberration occurs in a wide variety and variability with a single root canal up to two, three and four separate root canals. The diameter of the root canal themselves also varies from very wide to such with a small diameter. Conclusions: Knowledge of the different anatomical variations will improve the endododntic practice of the general dental practitioners.

Taurodontism: A case report of successful treatment of root and crown

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Abdolsamadi HR.

2006-08-01

Full Text Available Taurodontism is a rare dental anomaly in which the involved tooth has enlarged and elongated body and pulp chamber with apical displacement of the pulpal floor. Endodontic treatment of these teeth is challenging because it requires identifying the number of root canals. A case of bilateral involvement of maxillary first molar teeth is presented. Endodontic treatment of the right maxillary first molar with taurodontism was indicated due to irreversible pulpitis. In this article, we described the procedure of root canal therapy for this case.

Prevalence of delayed emergence of permanent teeth as a result of local factors.

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Johnsen, D C

1977-01-01

Delayed emergence of permanent teeth as a result of local etiologic factors was found in 45 of 1,032(4.3%) persons ages 8 through 18 in a dentally indigent population. In 36 persons (3.4%) delayed emergence resulted from causes other than those associated with premature primary molar extraction. This statistic probably approximates the potential for this problem in a treated population group. Teeth most commonly involved were mandibular second premolars, maxillary canines, and maxillary central incisors. The most common causes, respectively, were space loss, palatal position, and mesiodens. Supernumerary, malformed, and congenitally missing teeth were more frequent in persons with delayed emergence than in the rest of the population sampled. The difference was statistically significant. No correlation was found between delayed emergence and sex of the patient. In this study, teeth delayed in emergence behaved as other teeth in that they exhibited normal root development and did not contribute to resorption of adjacent roots. Except for maxillary canines, enlarged follicular spaces did not develop after eruption

Damage to root dentin during retreatment procedures

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Shemesh, H.; Roeleveld, A.C.; Wesselink, P.R.; Wu, M.K.

2011-01-01

Introduction: The aim of this study was to explore the influence of retreatment procedures on the appearance of defects on the root canal walls. Methods: Two hundred mandibular premolars were divided into 4 groups. One group was left unprepared. The rest of the teeth were prepared with ProTaper

Anterior and middle superior alveolar nerve block for anesthesia of maxillary teeth using conventional syringe

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Ignacio Velasco

2012-01-01

Full Text Available Background: Dental procedures in the maxilla typically require multiple injections and may inadvertently anesthetize facial structures and affect the smile line. To minimize these inconveniences and reduce the number of total injections, a relatively new injection technique has been proposed for maxillary procedures, the anterior and middle superior alveolar (AMSA nerve block, which achieves pulpal anesthesia from the central incisor to second premolar through palatal approach with a single injection. The purpose of this article is to provide background information on the anterior and middle superior alveolar nerve block and demonstrate its success rates of pulpal anesthesia using the conventional syringe. Materials and Methods: Thirty Caucasian patients (16 men and 14 women with an average age of 22 years-old, belonging to the School of Dentistry of Los Andes University, were selected. All the patients received an AMSA nerve block on one side of the maxilla using the conventional syringe, 1 ml of lidocaine 2% with epinephrine 1:100.000 was injected to all the patients. Results: The AMSA nerve block obtained a 66% anesthetic success in the second premolar, 40% in the first premolar, 60% in the canine, 23.3% in the lateral incisor, and 16.7% in the central incisor. Conclusions: Because of the unpredictable anesthetic success of the experimental teeth and variable anesthesia duration, the technique is disadvantageous for clinical application as the first choice, counting with other techniques that have greater efficacy in the maxilla. Although, anesthetizing the teeth without numbing the facial muscles may be useful in restorative dentistry.

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.

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.

Marsupialization of a large dentigerous cyst in the mandible with orthodontic extrusion of three impacted teeth. A case report.

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Abu-Mostafa, Nedal; Abbasi, Arshad

2017-09-01

The dentigerous cyst (DC) is the most common type of developmental odontogenic cyst. It is usually asymptomatic and associated with the crown of an unerupted or impacted tooth. However, after a long duration, it is likely to cause significant bone resorption, cortical expansion, and tooth displacement. This report presents a large infected DC in the mandible of a 12-year-old female patient. The DC was located inferior to badly decayed primary molars and surrounded three impacted permanent teeth: canine, first premolar, which had a dilacerated root, and second premolar. The DC was treated successfully by marsupialization and extrusion of the impacted teeth. In conclusion, the combination of marsupialization with orthodontic extrusion is a conservative, efficient protocol that stimulates bone healing and promotes the eruption of cyst-associated teeth even if they are deeply impacted, crowded, or have a dilacerated root. Key words: Dentigerous cyst, marsupialization, impacted teeth, orthodontic extrusion, dilacerated root.

Integrated three-dimensional digital assessment of accuracy of anterior tooth movement using clear aligners.

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Zhang, Xiao-Juan; He, Li; Guo, Hong-Ming; Tian, Jie; Bai, Yu-Xing; Li, Song

2015-11-01

To assess the accuracy of anterior tooth movement using clear aligners in integrated three-dimensional digital models. Cone-beam computed tomography was performed before and after treatment with clear aligners in 32 patients. Plaster casts were laser-scanned for virtual setup and aligner fabrication. Differences in predicted and achieved root and crown positions of anterior teeth were compared on superimposed maxillofacial digital images and virtual models and analyzed by Student's t-test. The mean discrepancies in maxillary and mandibular crown positions were 0.376 ± 0.041 mm and 0.398 ± 0.037 mm, respectively. Maxillary and mandibular root positions differed by 2.062 ± 0.128 mm and 1.941 ± 0.154 mm, respectively. Crowns but not roots of anterior teeth can be moved to designated positions using clear aligners, because these appliances cause tooth movement by tilting motion.

A central incisor with 4 independent root canals: a case report

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Aznar Portoles, C.; Moinzadeh, A.T.; Shemesh, H.

2015-01-01

The maxillary central incisor is the tooth with the least anatomic variations. Despite the fact that several studies have reported a prevalence of 100% for the presence of a single canal, root canal aberrations of maxillary central incisors with up to 3 canals have also been reported. Such cases

Skeletal response to maxillary protraction with and without maxillary expansion: a finite element study.

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Gautam, Pawan; Valiathan, Ashima; Adhikari, Raviraj

2009-06-01

The purpose of this finite element study was to evaluate biomechanically 2 treatment modalities-maxillary protraction alone and in combination with maxillary expansion-by comparing the displacement of various craniofacial structures. Two 3-dimensional analytical models were developed from sequential computed tomography scan images taken at 2.5-mm intervals of a dry young skull. AutoCAD software (2004 version, Autodesk, San Rafael, Calif) and ANSYS software (version 10, Belcan Engineering Group, Cincinnati, Ohio) were used. The model consisted of 108,799 solid 10 node 92 elements, 193,633 nodes, and 580,899 degrees of freedom. In the first model, maxillary protraction forces were simulated by applying 1 kg of anterior force 30 degrees downward to the palatal plane. In the second model, a 4-mm midpalatal suture opening and maxillary protraction were simulated. Forward displacement of the nasomaxillary complex with upward and forward rotation was observed with maxillary protraction alone. No rotational tendency was noted when protraction was carried out with 4 mm of transverse expansion. A tendency for anterior maxillary constriction after maxillary protraction was evident. The amounts of displacement in the frontal, vertical, and lateral directions with midpalatal suture opening were greater compared with no opening of the midpalatal suture. The forward and downward displacements of the nasomaxillary complex with maxillary protraction and maxillary expansion more closely approximated the natural growth direction of the maxilla. Displacements of craniofacial structures were more favorable for the treatment of skeletal Class III maxillary retrognathia when maxillary protraction was used with maxillary expansion. Hence, biomechanically, maxillary protraction combined with maxillary expansion appears to be a superior treatment modality for the treatment of maxillary retrognathia than maxillary protraction alone.

Computed tomographic features of apical infection of equine maxillary cheek teeth: a retrospective study of 49 horses.

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Bühler, M; Fürst, A; Lewis, F I; Kummer, M; Ohlerth, S

2014-07-01

Computed tomographic (CT) studies evaluating the relevance of individual CT features of apical infection in maxillary cheek teeth are lacking. To study the prevalence and relationship of single CT features in horses with and without clinical evidence of apical infection in maxillary cheek teeth. Retrospective case-control study. Multislice CT scans of the head of 49 horses were evaluated retrospectively. Changes of the infundibulum, pulp, root, lamina dura, periodontal space and alveolar bone in maxillary cheek teeth were recorded. Single CT changes were much more prevalent in the 28 horses with clinical signs. However, infundibular changes and a nondetectable lamina dura were also common in the 21 horses without clinical evidence of apical infection. Computed tomographic abnormalities of the pulp, root, periapical bone and periodontal space and the presence of a tooth fracture were significantly related. Infundibular changes were not associated with other CT signs of apical infection. Although nondetectable lamina dura was the most frequent CT change in all teeth in both studied groups, it was most commonly a solitary feature in otherwise normal teeth. Apical infections, defined as ≥3 CT changes, occurred mainly in the 108/208, 109/209 and 110/210 (Triadan numbers) and were found only in horses with clinical evidence of apical infection, except in one horse without clinical signs that had one affected root. Combined CT changes of the pulp, root, lamina dura, periapical bone and periodontal space and the presence of a tooth fracture appear to be reliable features to diagnose apical infection in maxillary cheek teeth. As a solitary feature, a nondetectable lamina dura should be interpreted cautiously and may even be considered normal due to its minor thickness and/or too low resolution of the imaging modality. © 2013 EVJ Ltd.

EVALUATION OF MAXILLARY BONE DIMENSIONS IN SPECIFIC AREAS FOR REMOVABLE DENTURES

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Dobromira Shopova

2017-05-01

Full Text Available Background: The removable prosthetics is a big part of Prosthetic Dentistry. The prosthetic field is very important for successful treatment with partial or complete dentures. Maxillary bone is covered with soft tissues, but its anatomy is essential for retention, chewing stability and comfort of the patients. Purpose: The study’s aim was to evaluate the dimensions of maxillary bone in specific zones for removable dentures. Methods: Sixteen craniums were measured in 10 different zones. It was used an Electronic Digital Caliper 0-150 mm. Results: Consistently were applied F-test and Welch t-test for equality of variance and group’s comparison mean, respectively. The spread of the data was described by calculating range and standard deviation. The estimated value of range was highest in the FI-A1P, followed by FI-AC and FI-A2P. The smallest amplitude was established in the TM-PP and SNA. The estimated value of standard deviation was 2,57/2,51 in FI-AC zone, 2,46/2,59 in FI-A1P zone and a few smaller 2,08/2,13 in FI-A2P zone. The lowest values were in TM-PP and SNA areas. Conclusion: Tuber maxillae and Spina nasalis anterior have stable dimensions. The areas of canine and premolars are varied, because the zone is tasked by chewing function.

Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up

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Ines Kallel

2018-01-01

Full Text Available According to the American Association of Endodontists, “a ‘true’ vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually.” Vertical root fracture (VRF usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

Diagnosis and Managment of Maxillary Incisor with Vertical Root Fracture: A Clinical Report with Three-Year Follow-Up.

Science.gov (United States)

Kallel, Ines; Moussaoui, Eya; Chtioui, Fadwa; Douki, Nabiha

2018-01-01

According to the American Association of Endodontists, "a 'true' vertical root fracture is defined as a complete or incomplete fracture initiated from the root at any level, usually directed buccolingually." Vertical root fracture (VRF) usually starts from an internal dentinal crack and develops over time, due to masticatory forces and occlusal loads. When they occur in teeth, those types of fractures can present difficulties in diagnosis, and there are however many clinic and radiographical signs which can guide clinicians to the existence of the fracture. Prognosis, most often, is hopeless, and differential diagnosis from other etiologies may be difficult sometimes. In this paper, we present a case of VRF diagnosed after surgical exploration; the enlarged fracture line was filled with a fluid resin. A 36-month clinical and radiological follow-up showed an asymptomatic tooth, reduction of the periodontal probing depth from 7 mm prior to treatment to 4 mm with no signs of ankylosis. In this work, the diagnosis and treatment alternatives of vertical root fracture were discussed through the presented clinical case.

Floating retained root lesion mimicking apical periodontitis.

Science.gov (United States)