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1.
Rev. Odontol. Araçatuba (Impr.) ; 44(3): 35-40, set.-dez. 2023. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1553121

ABSTRACT

As perfurações endodônticas podem ocorrer patologicamente por lesão cariosa profunda, bem como durante o acesso ou na instrumentação dos canais radiculares, que em sua grande maioria estão relacionadas com a negligência ou desconhecimento das variações anatômicas internas do dente. O presente trabalho descreve um caso clínico de perfuração de furca, onde o tratamento inicial foi baseado na descontaminação e selamento da comunicação com uma técnica de inserção modificada do MTA. Após a anestesia, foi realizado o isolamento absoluto e remoção de tecido infectado presente na câmara pulpar. Feita a limpeza da perfuração utilizando soro fisiológico e modelagem do canal com o instrumento reciprocante, a obturação foi concebida com cone de guta percha e cimento biocerâmico. Em seguida, o MTA foi manipulado, de acordo com recomendações do fabricante usando água destilada na proporção 1:1 e inserido na canaleta de uma régua endodôntica com a espátula de inserção nº1. O material foi removido da canaleta e inserido na perfuração, finalizando o vedamento da mesma. Portanto, concluiu-se que o selamento da perfuração apresentou um resultado satisfatório, tanto clínico como radiográfico, destacado pela proservação de 5 meses, evidenciando discreta formação de trabeculado ósseo na região de furca(AU)


Endodontic perforations can occur pathologically due to a deep carious lesion, as well as during access or instrumentation of root canals, which are mostly related to negligence or ignorance of the internal anatomical variations of the tooth. The present work describes a clinical case of furcation perforation, where the initial treatment was based on decontamination and sealing of the communication with a modified MTA insertion technique. After anesthesia, absolute isolation and removal of infected tissue present in the pulp chamber was performed. After cleaning the perforation using saline solution and modeling the canal with the reciprocating instrument, the filling was designed with a gutta-percha cone and bioceramic cement. Then, the MTA was manipulated, according to the manufacturer's recommendations, using distilled water in a 1:1 ratio and inserted into the groove of an endodontic ruler with the #1 insertion spatula. The material was removed from the channel and inserted into the perforation, finishing its sealing. Therefore, it was concluded that the sealing of the perforation presented a satisfactory result, both clinical and radiographic, highlighted by the 5-month followup, evidencing a slight formation of bone trabeculate in the furcation region(AU)


Subject(s)
Humans , Male , Adult , Root Canal Obturation , Biocompatible Materials , Furcation Defects , Dental Cements , Root Canal Therapy , Dental Pulp , Gutta-Percha
2.
J. oral res. (Impresa) ; 12(1): 152-167, abr. 4, 2023. tab, ilus
Article in English | LILACS | ID: biblio-1516525

ABSTRACT

Objective: The objective of the present systematic review and meta-analysis was to compare treatment with membrane associated with bone grafting and treatment exclusively with membrane in the approach of Class II furcation defects in mandibular molars. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were conducted in five databases (PubMed, Web of Science, Scopus, Ovid, and Lilacs), in Septem-ber 2021, without restriction regarding publication year or language. Studies comparing membranes associated with bone grafting and membranes exclusively in the treatment of Class II furcation lesions were included. Cross-sectional, case-control studies, and reviews were excluded. Study selection, data extraction, and risk of bias assessment (MINORS) were performed by two review authors. The certainty of the evidence (GRADE) was evaluated and meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. Results: Four hundred eighty-six references were iden-tified and four studies were included. Greater reduction in probing depth [MD = 0.32 (CI = 0.09, 0.56)] and greater clinical attachment level gain [MD = 0.41 (CI = 0.24, 0.57)] were observed when membrane and bone grafting were used. The risk of bias of included studies was low. Conclusions: This present systematic review and meta-analysis demonstrated that treatment of Class II furcation defects in mandibular molars using membrane and bone grafing is significantly more efficacious than treatment with the exclusive use of membrane.


Objetivo: El objetivo de la presente revisión sistemática y metanálisis fue comparar el tratamiento con membrana asociado a injerto óseo y el tratamiento exclusivamente con membrana en el abordaje de lesiones de furca grado II en molares mandibulares. Materiales y Métodos: Se siguió la declaración de elementos de informe preferidos para revisiones sistemáticas y metanálisis (PRISMA). Las búsquedas se realizaron en cinco bases de datos (PubMed, Web of Science, Scopus, Ovid y Lilacs), en septiembre de 2021, sin restricción de año de publicación o idioma. Se incluyeron estudios que compararon membranas asociadas con injertos óseos y membranas exclusivamente en el tratamiento de lesiones de furca de grado II. Se excluyeron los estudios transversales, de casos y controles y las revisiones. Dos revisores realizaron la selección de estudios, la extracción de datos y la evaluación del riesgo de sesgo (MINORS). Se evaluó la certeza de la evidencia (GRADE) y se realizó un metanálisis. Se proporcionaron la diferencia de medias (DM) y el intervalo de confianza (IC) del 95%. Resultados: Se identificaron 486 referencias y se incluyeron cuatro estudios. Se observó una mayor reducción en la profundidad de sondaje [DM = 0,32 (IC = 0,09, 0,56)] y una mayor ganancia en el nivel de inserción clínica [DM = 0,41 (IC= 0,24, 0,57)] cuando se utilizaron injertos de membrana y hueso. El riesgo de sesgo de los estudios incluidos fue bajo. Conclusión: La presente revisión sistemática y metanálisis demostró que el tratamiento de los defectos de furca de grado II en molares mandibulares utilizando membrana e injertos de hueso es significativamente más eficaz que el tratamiento con el uso exclusivo de membrana.


Subject(s)
Humans , Bone Transplantation/methods , Furcation Defects/therapy , Periodontitis , Guided Tissue Regeneration , Membranes, Artificial
3.
Pesqui. bras. odontopediatria clín. integr ; 23: e210126, 2023. tab, graf
Article in English | LILACS, BBO | ID: biblio-1521284

ABSTRACT

ABSTRACT Objective: To assess the effectiveness of platelet-rich fibrin (PRF) with decalcified freeze-dried bone allograft (DFDBA) compared to DFDBA alone in mandibular grade-II furcation defects. Material and Methods: A quasi-experimental study was conducted on nine patients with chronic periodontitis, each having two almost identical mandibular grade II furcation defects. Test sites (left mandibular first molars) were treated with open flap debridement (OFD), DFDBA, and PRF, whereas control sites (right mandibular first molars) received OFD and DFDBA alone. Clinical parameters (plaque index (PI), gingival index (GI), vertical clinical attachment level (VCAL) and horizontal clinical attachment level (HCAL) into the furcation defect) and radiographic measurements (mean alveolar bone defect) were done at baseline and after six months postoperatively. Results: The gain in relative horizontal clinical attachment level (RHCAL) in the test sites was 2.94±0.52 mm compared to 1.33±0.35 mm in control sites (p=0.01). Improvement in mean alveolar bone defect (MABD) (was 1.21±0.5 mm2 at test sites compared to 1.15±0.7 mm2 at control sites) probing pocket depth (PPD), recession, relative vertical attachment level (RVCAL), and percentage of bone fill was found in the test sites compared to control, which statistically insignificant. Conclusion: The test sites had better outcomes than control sites, which was significant for the parameter RHCAL. Therefore, combining the biological benefits of autologous PRF with DFDBA is an efficient and economical treatment modality for the management of mandibular grade II furcation defects.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Platelet-Derived Growth Factor , Furcation Defects/pathology , Chronic Periodontitis/pathology , Allografts , Statistics, Nonparametric , Non-Randomized Controlled Trials as Topic
4.
Arq. odontol ; 59: 123-131, 2023. tab
Article in English | LILACS, BBO | ID: biblio-1518972

ABSTRACT

Aim: This study compared alveolar bone loss, teeth with furcation, and mandibular cortical modification between individuals with type 1 diabetes mellitus (T1DM) and nondiabetic individuals. Methods: Radiographs of 50 T1DM individuals and 100 nondiabetic individuals were examined to evaluate the presence of teeth with furcation, alveolar bone loss, and mandibular cortical modifications. The Mann-Whitney, Chi-square, and Student's t tests were used to analyze personal characteristics and bone status. Linear and logistic regression was performed to explore associations. Results: A significant difference was observed in the average number of teeth with furcation and in the median of alveolar bone loss between T1DM and the nondiabetic participants. T1DM individuals are more likely to have alveolar bone loss (OR = 3 2.250), teeth with furcation (OR = 8.903), and mandibular cortical modification (OR = 15.667) than are nondiabetic individuals. Among T1DM individuals, the glycemic control has a high influence in mandibular cortical modifications (p < 0.05). Conclusions: A high association between uncontrolled blood glucose and mandibular cortical modifications was observed among T1DM individuals. Alveolar bone loss of T1DM individuals was associated with age, time of diagnosis, glycemic control, and the existence of chronic complications.


Objetivo:Comparar a perda óssea alveolar, a presença de dentes com lesão de furca e a alteração da cortical óssea entre indivíduos com DMT1 e indivíduos não-diabéticos. Métodos: Foram examinadas radiografias de 50 indivíduos diabéticos e de 100 não-diabéticos para avaliar a presença de dentes com lesão de furca, perda óssea alveolar e alteração cortical mandibular. Para analisar as características individuais e as condições ósseas foram usados os testes de Mann-Whitney,Qui-quadrado e t de Student. Regressões linear e logística foram realizadas para identificar associações. Resultados: Foi encontrada diferença significativa na média de dentes com lesão de furca e na mediana da perda óssea alveolar entre diabéticos e não-diabéticos. Indivíduos com DMT1 possuem mais chance de apresentar perda óssea alveolar (OR = 32,250), lesão de furca (OR=8,903) e alteração da cortical mandibular (OR = 15,667) em comparação aos indivíduos não-diabéticos. Entre os diabéticos, o controle da glicemia possui grande influência nas alterações da cortical mandibular (p < 0,05). Conclusões: Existe uma alta associação entre os níveis de glicemia descontrolada e alterações na cortical mandibular entre os indivíduos com DMT1. A perda óssea alveolar de indivíduos com DMT1 foi associada aos fatores idade, tempo de diagnóstico, controle da glicemia e a presença de complicações crônicas.


Subject(s)
Alveolar Bone Loss , Furcation Defects , Diabetes Mellitus, Type 1 , Glycemic Control
5.
Chinese Journal of Stomatology ; (12): 609-614, 2023.
Article in Chinese | WPRIM | ID: wpr-986118

ABSTRACT

Furcation involvement (FI) is the lesion and destruction of periodontium that spread to the root furcation of multi-root teeth, where periodontal pockets, loss of periodontal attachment and resorption of alveolar bone are formed. Furcation involvement is a common concomitant lesion of periodontitis. The severity of furcation involvement can directly affect the prognosis of periodontitis. However, the specificity of the anatomical structure of the root furcation greatly increases the difficulty of treatment. Therefore, early detection and treatment of furcation involvement is crucial for the prevention and control of periodontitis. This paper briefly describes the pathogenesis of furcation involvement and discusses the diagnosis, classification and treatment of this disease, which is helpful to improve the clinical diagnosis and treatment of furcation involvement.


Subject(s)
Humans , Molar , Furcation Defects/therapy , Periodontitis/complications , Periodontal Pocket , Prognosis
6.
West China Journal of Stomatology ; (6): 582-591, 2023.
Article in English | WPRIM | ID: wpr-1007942

ABSTRACT

Conventional periodontal regenerative surgery has limited effect on tooth with severe periodontitis-related alveolar bone defects. This article reported a case of regenerative treatment in severe distal-bone defect of mandibular first molar. The treatment involved applying 3D printing, advanced/injectable platelet-rich fibrin, and guided tissue-regeneration technology. After the operation, the periodontal clinical index significantly improved and the alveolar bone was well reconstructed.


Subject(s)
Humans , Platelet-Rich Fibrin , Follow-Up Studies , Digital Technology , Furcation Defects/drug therapy , Periodontitis , Guided Tissue Regeneration, Periodontal
7.
J. oral res. (Impresa) ; 10(2): 1-7, abr. 30, 2021. ilus
Article in English | LILACS | ID: biblio-1381603

ABSTRACT

Introduction: Clinicians tend to encounter unfavorable situations in the treatment of teeth with severe attachment loss. Periodontal regeneration has been a successful therapeutic approach in treatments that require a long-term prognosis improvement. This case shows the benefits of combined regenerative periodontal therapy in a patient with a molar severely compromised by furcation, intrabony defects and attachment loss to the apex. Case Report: The clinical case included an endo-periodontal, class III furcation and intrabony defects in a generalized periodontitis, Stage III Grade C patient. After non-surgical periodontal treatment and re-evaluation, a full-thickness flap and surgical debridement were performed. Dental root surface was treated with EDTA and enamel matrix derivatives and the defects were filled with allograft and platelet-rich fibrin, additionally a collagen membrane was applied over the graft. After a 12-month follow-up there was a resolution of the intrabony defects and periodontal regeneration. Clinical and radiographic evaluation also showed the partial resolution of the class III furcation defect. Conclusion: Combined periodontal regeneration can be a therapeutic approach to improve the prognosis and prevent the extraction of molars severely compromised by furcation, intrabony defects and attachment loss to the apex.


Introducción: Los clínicos tienden a encontrar situaciones desfavorables en el tratamiento de dientes por pérdida de inserción severa. La regeneración periodontal ha sido un enfoque terapéutico exitoso en tratamientos que requieren una mejora del pronóstico a largo plazo. Este caso demuestra los beneficios de la terapia periodontal regenerativa combinada en un paciente con un molar gravemente comprometido por furcación, defectos intraóseos y por pérdida de inserción hasta el ápice. Reporte de caso: El caso clínico incluyó un defecto endoperiodontal, furcación clase III y defectos intraóseos en una Periodontitis estadio III generalizada grado C. Tras el tratamiento periodontal no quirúrgico y la reevaluación, se realizó un colgajo de espesor total y un desbridamiento quirúrgico. La superficie de la raíz dental se trató con EDTA y derivados de la matriz de esmalte y los defectos se rellenaron con aloinjerto y fibrina rica en plaquetas, adicionalmente se aplicó una membrana de colágeno sobre el injerto. Después de un seguimiento de 12 meses hubo resolución de los defectos intraóseos y regeneración periodontal. La evaluación clínica y radiográfica también mostró la resolución parcial del defecto de furcación de clase III. Conclusión: La regeneración periodontal combinada puede ser un abordaje terapéutico para mejorar el pronóstico y prevenir la extracción de molares severamente comprometidos por furcación, por defectos y hasta el ápice.


Subject(s)
Humans , Female , Adult , Guided Tissue Regeneration, Periodontal , Furcation Defects/therapy , Periodontitis , Regeneration , Periodontal Attachment Loss , Platelet-Rich Fibrin
8.
West China Journal of Stomatology ; (6): 347-354, 2021.
Article in English | WPRIM | ID: wpr-878454

ABSTRACT

Due to the complicated anatomical structures in the furcation area of multirooted mandibular first molars, dental hygiene is greatly compromised once the furcation is involved in the periodontitis, leading to the unfavorable prognosis of teeth with furcation involvement. A patient came to a dental office with the chief complaint of "mobile mandibular posterior tooth" 27 years ago. The periapical film showed alveolar bone resorption at the root furcation of the right mandibular first molar. Flap surgery and fine supportive therapy were conducted. The patient was diagnosed with "furcation involvement Class Ⅲ" during a revisit three years ago. Satisfactory and healthy periodontal statuses were observed 2, 9, 24, and 33 months after the periodontal flap surgery plus tunneling procedures. A follow-up of 27 years in the present case demonstrated that a favorable prognosis of furcation involvement can be achieved after adequate periodontal treatment.


Subject(s)
Humans , Follow-Up Studies , Furcation Defects/surgery , Mandible , Molar , Periodontitis
9.
Rev. cient. odontol ; 8(1): e011, ene.-abr. 2020. ilus.
Article in Spanish | LILACS, LIPECS | ID: biblio-1095510

ABSTRACT

Durante el tratamiento del conducto se pueden producir complicaciones como las perforaciones a diferentes niveles, y la más común es la de furca, asociada con la apertura cameral. No obstante, en la actualidad, los cementos bio cerámicos permiten obtener un mejor pronóstico. Se presenta el caso de un primer molar inferior derecho con perforación de furca, el cual fue sellado con Biodentine®. (AU)


During the root canal treatment procedure, complications such as perforations at different levels may occur, the most common being furcal perforation associated with the cameral opening. However, the bioceramic cements currently available can provide better outcomes. We present a case of a right lower first molar with furcation, which was sealed with Biodentine®. (AU)


Subject(s)
Humans , Male , Middle Aged , Furcation Defects , Dental Pulp Cavity , Endodontics , Follow-Up Studies
10.
Article in English | LILACS, BBO | ID: biblio-1056875

ABSTRACT

Abstract Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects. Material and Methods: Thirty patients with furcation defects were selected, oral hygiene instructions, scaling, and root planing with ultrasonic devices and hand instruments and occlusal adjustments were performed. Pre-surgical clinical measurements were carried out at the buccal aspect of the selected mandibular molars. The horizontal furcation measurements were measured with a Nabers Probe starting at the furcation entrance to the greatest horizontal depth. The degree of furcation involvement was graded from 0 to III. Bone loss in the horizontal and vertical direction and the width of the furcation entrance were measured on CBCT and after reflecting the full-thickness flap and debridement of the defects. The data were analyzed using t-test and Pearson's correlation coefficient. Results: The width of furcation entrance in clinical method was 3.27 ± 0.77, while in CBCT method was 3.35 ± 0.71, clinically the vertical bone loss was 3.61±1.09, while in CBCT was 3.57 ± 1.15, horizontal bone loss in clinical method was 5.08 ± 2.21, while in CBCT was 5.11 ± 2.23. No significant difference between the two methods was noted, and a high correlation between the two methods was observed. With regards to the agreement between the two methods of assessment, the width of furcation entrance revealed a difference between the two methods by 0.08 ± 0.21, while vertical bone loss showed difference between the two methods by -0.04 ± 0.19, the horizontal bone loss showed a mean difference between the two methods by 0.03 ± 0.21. Conclusion: CBCT provided high accuracy for the furcation involvement detection and anatomy of surrounding periodontal tissues.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Furcation Defects , Cone-Beam Computed Tomography/instrumentation , Molar , Odontometry/methods , Data Interpretation, Statistical , Root Planing , Occlusal Adjustment , Malaysia
11.
Braz. dent. sci ; 23(3): 1-8, 2020. tab, ilus
Article in English | BBO, LILACS | ID: biblio-1103699

ABSTRACT

The advent of CBCT has contributed significantly to dental imaging. In the field of periodontics, CBCT provides a multi-planar view to assess the alveolar bone in three dimensions. This helps the dentist to make measurements at any location that could significantly improve periodontal diagnosis. Objective: The aim of this systematic review is to evaluate the accuracy of using CBCT in the assessment of alveolar bone level and furcation involvement in periodontal diseases. Material and Methods: PubMed, LILACS and Google Scholar databases were searched for literature related to the application of CBCT in periodontal diseases. Keywords used for the search were CBCT, furcation involvement, measurement and their synonyms. Results: Fifteen full-text English language research papers were eligible for the systematic review using the PRISMA guidelines. Conclusion: From the results of the systematic review it can be concluded that conebeam computed tomography imaging technique offers significantly reliable images of the furcation involvement and height of the alveolar bone. (AU)


O advento da Tomografia computadorizada de feixe cônico (TCFC) contribuiu significativamente para a imageologia. No campo da periodontia, a TCFC fornece uma visão multiplano para avaliar o osso alveolar em três dimensões. Isso ajuda o dentista a fazer medições em qualquer local que possa melhorar significativamente o diagnóstico periodontal. Objetivo: O objetivo desta revisão sistemática foi avaliar a precisão do uso da TCFC na avaliação do nível ósseo alveolar e do envolvimento da furca em doenças periodontais. Material e Métodos: As bases de dados PubMed, LILACS e Google Scholar foram pesquisadas na literatura relacionada à aplicação da TCFC em doenças periodontais. As palavras-chave utilizadas para a pesquisa foram TCFC, envolvimento da furca, mensuração e seus sinônimos. Resultados: Quinze trabalhos de pesquisa em inglês com texto completo foram elegíveis para a revisão sistemática usando as diretrizes do PRISMA. Conclusão: A partir dos resultados da revisão sistemática, pode-se concluir que a técnica de imagem por tomografia computadorizada de feixe cônico oferece imagens significativamente confiáveis do envolvimento da furca e da altura do osso alveolar.(AU)


Subject(s)
Diagnostic Imaging , Alveolar Bone Loss , Furcation Defects , Cone-Beam Computed Tomography
12.
Braz. dent. sci ; 23(1): 1-8, 2020. tab
Article in English | LILACS, BBO | ID: biblio-1049727

ABSTRACT

Objective: Periodontal diseases are very common dental disease. Many risk factors may play significant role in the periodontal disease initiation and progression. This study was performed to evaluate the effects of khat chewing, smoking, age and gender on periodontal status among Yemeni adults. Material and Methods: This cross-sectional study was performed on 1231 patients attending the outpatient dental polyclinics of University of Science and Technology during the academic years 2017/2018. All completed sheets were collected throughout the year by the supervisors. Data cleaning, descriptive statistics, and inferential statistics were then performed. Results: Khat chewers were more frequent than non-chewers counterparts (60.7% vs. 39.3%). The prevalence of smoking was 25.5% (297 patients). Study results indicated that periodontitis is more associated with female gender and participants aged more than 35 years old. Results also showed that female and age older participants aged more than 35 years were significantly associated with gingival recession. Mean number of the teeth with gingival recession in male patients were higher than in females. Male gender and patients aged more than 35 years old were significantly associated with furcation involvement. Conclusion: The present study has shown females gender and age older than 35 seem to be risk factors of periodontal diseases. Males has more teeth affected by gingival recession and more furcation involvement (AU)


Objetivo: As doenças periodontais são patologias dentárias com alta prevalência. Diversos fatores de risco podem desempenhar papel significativo no início e progressão das doenças periodontais. Este estudo foi realizado para avaliar os efeitos da mastigação de khat, tabagismo, idade e gênero na condição periodontal de adultos iemenitas. Material e Métodos: Este estudo transversal foi realizado em 1231 pacientes atendidos nas policlínicas odontológicas ambulatoriais da Universidade de Ciência e Tecnologia durante os anos acadêmicos de 2017/2018 através de um questionário para coleta de dados préestabelecido. Todas os questionários preenchidos foram coletados ao longo do ano pelos supervisores. A apuração dos dados, estatística descritiva e estatística inferencial foram realizadas. Resultados: os mastigadores de Khat foram mais frequentes do que as não-mastigadores (60,7% vs. 39,3%). A prevalência de tabagismo foi de 25,5% (297 pacientes). Os resultados do estudo indicaram que a periodontite está mais associada ao gênero feminino e aos participantes com mais de 35 anos de idade. Os resultados também mostraram que participantes do gênero feminino e acima de 35 anos foram significativamente associadas à recessão gengival. O número médio de dentes com recessão gengival em pacientes do gênero masculino foi maior que no feminino. O gênero masculino e os pacientes com mais de 35 anos de idade foram significativamente associados ao envolvimento da furca. Conclusão: O presente estudo mostrou que o gênero feminino e a idade acima de 35 anos parecem ser fatores de risco para doenças periodontais. Pacientes do gênero masculino têm mais dentes afetados pela recessão gengival e mais envolvimento de furca.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Periodontal Diseases/epidemiology , Tobacco Use Disorder/epidemiology , Catha , Mastication , Periodontal Diseases/etiology , Periodontitis/etiology , Periodontitis/epidemiology , Tobacco Use Disorder/complications , Yemen/epidemiology , Cross-Sectional Studies , Risk Factors , Sex Distribution , Furcation Defects/etiology , Furcation Defects/epidemiology , Age Distribution , Catha/adverse effects , Gingival Recession/etiology , Gingival Recession/epidemiology
13.
West China Journal of Stomatology ; (6): 270-273, 2020.
Article in Chinese | WPRIM | ID: wpr-827547

ABSTRACT

OBJECTIVE@#This study aimed to assess the accuracy of cone beam computed tomography (CBCT) in detecting furcation involvement (FI) in maxillary molars.@*METHODS@#Thirty-one maxillary molars of 15 patients with generalized chronic periodontitis considered for furcation surgery were assessed. Clinical examination and CBCT were performed, and the FI degree was evaluated. Clinical and CBCT-based FI assessments were compared with intrasurgical data.@*RESULTS@#The agreement between clinical and intrasurgical assessments was weak in all sites, with a kappa of less than 0.4; the complete, overestimated, and underestimated agreement percentages were 42.0%, 24.7%, and 33.3%, respectively. The agreement between the CBCT and intrasurgical assessments was strong, with a ka ppa of 0.831; the complete, overestimated, and underestimated agreement percentages were 88.2%, 3.2%, and 8.6%, respectively. The agreement between both assessments was the highest in the buccal furcation entrance (κ=0.896), followed by that in the distopalatal (κ=0.822) and mesiopalatal (κ=0.767) furcation entrances.@*CONCLUSIONS@#CBCT images demonstrated high accuracy in assessing the horizontal bone loss of FI in maxillary molars.


Subject(s)
Humans , Chronic Periodontitis , Cone-Beam Computed Tomography , Furcation Defects , Molar
14.
Journal of Peking University(Health Sciences) ; (6): 346-352, 2020.
Article in Chinese | WPRIM | ID: wpr-942010

ABSTRACT

OBJECTIVE@#Tissues loss due to periodontal disease is typically treated by a variety of regenerative treatment modalities, including bone grafts, guided tissue regeneration (GTR) and growth factors, to reform the supporting tissues of teeth. Concentrated growth factors (CGF) are produced by centrifuging blood samples at alternating and controlled speeds using a special centrifuge. The purpose of this study was to evaluate whether GTR could improve the effect of CGF combined with bone graft in the treatment of classII furcations of mandibular molars.@*METHODS@#In the present study, thirty-five classII furcation involvements were included and randomly divided into two groups. The experimental group (n=17) accepted GTR combined with CGF and bone graft therapy, and the controlled group (n=18) accepted CGF combined with bone graft therapy. The clinical examinations and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery. Comparisons of clinical and CBCT data before and after operation between the experimental group and the control group were made.@*RESULTS@#The clinical and CBCT data of both groups were not statistically different at baseline (P>0.05). At the end of 1 year post-surgery, the clinical parameters of both groups were significantly improved (P<0.001). The probing depths of the experimental group were (4.81±1.95) mm and (3.56±1.94) mm, respectively, significantly higher than the changes of the control group (P<0.001). The vertical and horizontal attachment gains of the experimental group were (4.11±1.98) mm and (3.84±1.68) mm, respectively, significantly higher than the changes of the control group (P<0.001). At the end of 1 year post-surgery, the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with those of the control group: (3.84±1.68) and (3.88±2.12) mm, respectively (P<0.001).@*CONCLUSION@#Within the limitation of the present study, GTR showed positive role in the effect of CGF combined with bone graft in the treatment of classII furcation involvements of mandibular molars.


Subject(s)
Humans , Bone Transplantation , Cone-Beam Computed Tomography , Furcation Defects , Guided Tissue Regeneration, Periodontal , Molar , Periodontal Attachment Loss
15.
J. oral res. (Impresa) ; 8(6): 527-539, dic. 28, 2019. ilus, tab, graf
Article in English | LILACS | ID: biblio-1224625

ABSTRACT

Objective: This study aims to assess the accuracy of the linear measurements of intrabony and/or furcation defect quantified by cone beam computed tomography (CBCT). Material and Methods: A systematic search of the literature was conducted by two authors independently from the PubMed, Scopus, and EBSCO for full articles published in journals between January 2003 and March 2017. Eligible studies were assessed for quality and heterogeneity using the QUADAS-2 tool. A meta-analysis was performed to identify the accuracy of CBCT in the measurement of intrabony defects. The effect size was estimated and reported as the standardised mean difference (SMD). Results: A total of 105 titles and abstracts were screened. Of those, 11 articles met the inclusion criteria for the systematic review while only four were selected for meta-analysis. The overall effects of standardized mean difference and 95% CI was -0.03 [95% CI -0.67 to 0.60] with a x2 statistic of 0.49 with 3 degrees of freedom (p>0.05), I2= 0.01%. Conclusion: CBCT is highly accurate and reproducible regarding linear measurements for assessing intrabony defects with a weighted standardized mean difference of 0.03 mm. More randomised controlled trials are required to assess the accuracy of CBCT in assessing patients with periodontal defects.


Objetivo: Este estudio tiene como objetivo evaluar la precisión de las mediciones lineales de defectos intraóseos y/o de furcación cuantificados por tomografía computarizada de haz cónico (CBCT). Material y Métodos: Dos autores, independientemente realizaron una búsqueda sistemática de la literatura en PubMed, Scopus y EBSCO, para obtener artículos completos publicados en revistas entre Enero de 2003 y Marzo de 2017. Los estudios elegibles se evaluaron para determinar la calidad y la heterogeneidad utilizando la herramienta QUADAS-2. Se realizó un metanálisis para identificar la precisión de CBCT en la medición de defectos intraóseos. El tamaño del efecto se estimó y se informó como la diferencia de medias estandarizada (DME). Resultados: Se seleccionaron un total de 105 títulos y resúmenes. De ellos, 11 artículos cumplieron con los criterios de inclusión para la revisión sistemática, mientras que solo cuatro fueron seleccionados para el metanálisis. Los efectos generales de la diferencia de medias estandarizada y el IC del 95% fueron -0.03 [IC del 95%: -0.67 a 0.60] con una estadística X2 de 0.49 con 3 grados de libertad (p>0.05), I2= 0.01%. Conclusión: CBCT es altamente preciso y reproducible con respecto a mediciones lineales para evaluar defectos intraóseos con una diferencia de medias estandarizada ponderada de 0.03 mm. Se requieren más ensayos controlados aleatorios para evaluar la precisión de CBCT en la evaluación de pacientes con defectos periodontales.


Subject(s)
Humans , Periodontal Diseases/diagnostic imaging , Periodontitis/diagnostic imaging , Cone-Beam Computed Tomography , Databases, Bibliographic , Furcation Defects
17.
Journal of Peking University(Health Sciences) ; (6): 913-918, 2019.
Article in Chinese | WPRIM | ID: wpr-941908

ABSTRACT

OBJECTIVE@#To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss.@*METHODS@#A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed.@*RESULTS@#(1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%.@*CONCLUSION@#The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.


Subject(s)
Humans , Chronic Periodontitis , Furcation Defects , Molar , Retrospective Studies , Tooth Loss
18.
Odontoestomatol ; 20(31): 27-33, junio de 2018.
Article in English, Spanish | LILACS | ID: biblio-905018

ABSTRACT

Objetivo. Describir las características morfométricas de los dientes multirradiculares a nivel de la zona de furcación. Método. 54 dientes multirradiculares (maxilares y mandibulares); fueron evaluados a través de un calibrador de precisión: longitud del tronco radicular, separación radicular, ángulo de divergencia radicular, longitud radicular así como la extensión de las proyecciones cervicales del esmalte y presencia de perlas del esmalte. Resultados. El ángulo de divergencia de la furca distal (50°) maxilar fue mayor que a nivel bucal (22°) y mesial (37°), a nivel mandibular bucal fue de 25° y lingual de 22°. No se encontró perlas del esmalte y las proyecciones cervicales del esmalte más comunes fueron de clase I a nivel bucal (60% para maxilares y 31% para mandibulares). La longitud del tronco radicular lingual fue de 2,8mm y a nivel bucal de 2,2mm. Conclusión. El tronco radicular de los molares mandibulares es mayor a nivel lingual que bucal, al igual que la zona palatina de molares maxilares. En los molares maxilares el mayor ángulo de divergencia se presentó en la entrada de la furca distal, siendo esta la recomendable para iniciar la instrumentación mecánica.


Objective. The aim of this study is to describe the morphometric characteristics of multirooted teeth at the furcation area. Method. Fifty-four multirooted teeth (maxillary and mandibular teeth) were evaluated using a precision calibrator: root trunk length, root separation, root divergence angle, root length, length of cervical enamel projections and presence of enamel pearls. Results. The divergence angle of the maxillary distal furcation (50°) was greater than on the buccal (22°) and mesial (37°) aspects. On the mandible it was 25° on the buccal aspect and 22° lingually. No enamel pearls were found. The cervical enamel projections most commonly found were class I on the oral aspect (60% for maxillary teeth and 31% for mandibular teeth). The length of the lingual root trunk was 2.8 mm, and on the buccal aspect it was 2.2 mm. Conclusion. The root trunk of mandibular molars is larger lingually than on the buccal aspect, as is the palatal area of maxillary molars. In maxillary molars the greater divergence angle appeared at the entrance of the distal furcation, which is the one recommended to start using mechanical instruments.


Subject(s)
Tooth/anatomy & histology , Furcation Defects , Odontometry
19.
Braz. oral res. (Online) ; 32: e103, 2018. tab, graf
Article in English | LILACS | ID: biblio-974462

ABSTRACT

Abstract The aim of this study is to evaluate the expression of cytokines in response to mineral trioxide aggregate (MTA) plus selenium in germ-free mice with experimental furcal perforation. The first left maxillary molar was opened, and the furcal area was perforated and treated with post-MTA-Se (experimental group). The same surgical intervention was performed for the maxillary right first molar, which was treated with MTA (control group). Fifteen mice were sacrificed 7, 14, and 21 days after furcal perforation, and periapical tissue samples were collected. The mRNA expression levels of the cytokines TGF-β, TNF-α, IFN-γ, HPRT, IL-10, IL-4, RANK, RANKL, IL-1, and IL-17 were assessed by using real-time polymerase chain reaction. In the experimental group, at 21-days post-MTA-Se sealing, the mRNA levels of TNF-α and IL-10 were upregulated compared with those in the control group (p < 0.05). Futher assessment revealed basal mRNA expression levels of IL-1α, IFN-γ, RANK, RANKL, IL-17A, IL-4, and TGF-β, over long experimental times, in both the experimental and control groups (p > 0.05). In conclusion, MTA+Se sealing favoured increased expression of IL-10 and TNF-α at later time points (day 21).


Subject(s)
Animals , Male , Female , Oxides/pharmacology , Root Canal Filling Materials/pharmacology , Selenium/pharmacology , Cytokines/analysis , Silicates/pharmacology , Furcation Defects/drug therapy , Calcium Compounds/pharmacology , Aluminum Compounds/pharmacology , Dental Pulp Cavity/injuries , Root Canal Therapy/methods , Time Factors , Reproducibility of Results , Treatment Outcome , Furcation Defects/immunology , Dental Pulp Cavity/drug effects , Dental Pulp Cavity/immunology , Drug Combinations , Real-Time Polymerase Chain Reaction , Molar/drug effects , Molar/injuries
20.
Imaging Science in Dentistry ; : 79-86, 2018.
Article in English | WPRIM | ID: wpr-740376

ABSTRACT

PURPOSE: This study aimed to carry out a systematic review of studies in the literature comparing conventional imaging techniques with cone-beam computed tomography in terms of the role of these techniques for assessing any of the following periodontal conditions and parameters: infrabony defects, furcation involvement, height of the alveolar bone crest, and the periodontal ligament space. MATERIALS AND METHODS: Interventional and observational studies comparing conventional imaging techniques with cone-beam computed tomography were considered eligible for inclusion. The MEDLINE and Embase databases were searched for articles published through 2017. The PRISMA statement was followed during data assessment and extraction. RESULTS: The search strategy yielded 351 publications. An initial screening of the publications was performed using abstracts and key words, and after the application of exclusion criteria, 13 studies were finally identified as eligible for review. CONCLUSION: These studies revealed cone-beam computed tomography to be the best imaging technique to assess infrabony defects, furcation lesions, the height of the alveolar bone crest, and the periodontal ligament space.


Subject(s)
Cone-Beam Computed Tomography , Diagnosis, Oral , Furcation Defects , Mass Screening , Periodontal Ligament , Periodontics
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