Factores determinantes de extracción de dientes permanentes en pacientes que asisten a hospitales y/o servicios odontológicos / determinant factors in the permanent teeth extractions in patients attending dental hospitals of dental services

Este artículo tiene como objetivo identificar y analizar los factores determinantes que conducen a la extracción de dientes permanentes en pacientes que asisten a hospitales y/o servicios odontológicos. A través de una revisión exhaustiva de la literatura científica y datos epidemiológicos, se exploran las principales causas de pérdida dental, incluyendo caries, enfermedad periodontal, trauma y factores socioeconómicos. Se discuten las implicaciones clínicas y de salud pública de estos hallazgos, así como estrategias preventivas y terapéuticas para reducir la incidencia de extracciones dentales (AU)

This article aims to identify and analyze the determining factors leading to the extraction of permanent teeth in patients attending hospitals and/or dental services. Through a comprehensive review of scientific literature and epidemiological data, the main causes of tooth loss are explored, including caries, periodontal disease, trauma, and socioeconomic factors. The clinical and public health implications of these findings are discussed, as well as preventive and therapeutic strategies to reduce the incidence of dental extractions (AU)

Association between hyperglycemia and post-exodontia complications in patients with type ii diabetes mellitus: a scoping review / Asociación entre hiperglucemia y complicaciones post-exodoncia en pacientes con diabetes mellitus tipo ii: scoping review

Introduction: Diabetes mellitus (DM) is a prevalent chronic metabolic disorder worldwide, with Type II DM (T2DM) emerging as the most widespread variant. In Chile, approximately 11% of adults aged 20 to 79 suffer from this condition. Given its high prevalence, dental surgeons should be trained to evaluate risk factors, particularly the potential complications linked to tooth extraction in individuals with T2DM. Objetive: To describe the available scientific evidence on post-exodontia complications associated with hyperglycemia in patients with Type II diabetes mellitus. Materials and Methods: An exploratory systematic review was conducted following the PRISMA-ScR extension protocols using the databases PubMed, EBSCO, Scopus and the Cochrane Library. The search employed the following algorithms: (("Diabetic patient complications" AND "Dental extractions")), (("Diabetes" AND "tooth extraction")), (("Glycemia" AND "Tooth extraction complications"), (("Blood glucose" AND "Tooth extractions"), (("Dental extraction sockets" AND "Diabetics"). Results: Out of a total of 973 articles, 25 were included for this review. Six relevance criteria were considered, revealing safety parameters for conducting extractions in patients with T2DM, with capillary blood glucose levels not exceeding 200 mg/dL for elective extractions and 240 mg/dL for emergency extractions. Conclusions: There is limited evidence correlating threshold values of hyperglycemia with post-extraction complications in patients with T2DM. Most authors agree that the primary concern is not T2DM itself, but hyperglycemia. Furthermore, there is minimal consistency in the recommended care protocols for these patients.

Introducción: La diabetes mellitus (DM) es un trastorno metabólico crónico. A nivel mundial, la DM tipo II (DM2) resulta ser la más frecuente. En Chile, un 11% de la población adulta entre los 20 y 79 años la padece. Su alta prevalencia, requiere de un cirujano dentista preparado para valorar los factores de riesgo, como las posibles complicaciones asociadas a la extracción dental en estos pacientes. Objetivo: Describir la evidencia científica disponible sobre complicaciones post-exodoncia asociadas a hiperglicemia en pacientes con diabetes mellitus tipo II. Materiales y Métodos: Se realizó una revisión sistemática exploratoria bajo los protocolos de extensión PRISMA-ScR utilizando las bases de datos, PubMed, EBSCO, Scopus y Cochrane Library con los algoritmos de búsqueda (("Diabetic patient complications" AND "Dental extractions")), (("Diabetes"AND "Tooth extraction")), (("Glycemia" AND "tooth extraction complications")), (("Blood glucose" AND "Tooth extractions")), (("Dental extraction sockets"AND "Diabetics")). Resultado: De un total de 973 artículos se incluyeron 25 artículos para esta revisión. Se consideraron 6 criterios de pertinencia, los cuales mostraron parámetros de seguridad para realizar exodoncias, en pacientes con DM2, con la glucemia capilar no mayor a 200mg/dl en caso de ser electiva y 240 mg/dl en exodoncia de urgencias. Conclusión: Existe poca evidencia que correlacione valores absolutos de hiperglucemia y complicaciones post exodoncia en pacientes con DM2. La mayoría de los autores concuerda en que el problema no es la DM2, sino la hiperglucemia. Existe poca uniformidad en los protocolos de atención recomendados para estos pacientes.

La desaferentación dental como factor etiológico de disfunciones gustativas en ratas Wistar machos / Dental deafferentation as an etiologic factor of taste dysfunction in male Wistar rats / A surdeferentação dentária como fator etiológico das disfunções gustativas em ratos Wistar machos

RESUMEN Objetivo : Evaluar la influencia de la desaferentación dental (DD) en el sentido del gusto de ratas Wistar machos mediante el test de reactividad gustativa (TRG). Materiales y métodos : Estudio experimental, siguiendo las directrices de ARRIVE 2.0, realizado en diez ratas Wistar. Se las aleatorizó y asignó en un grupo control o en un grupo experimental, y se implantaron cánulas para el TRG en ambos grupos. En el grupo experimental se realizó exodoncias de los tres molares superiores del lado derecho. Al tercer día se inició el TRG (día 1) mediante la infusión de 1 M de una sustancia dulce (ingestiva) y 3 mM de una sustancia amarga (aversiva), a razón de 1 mL en 1 minuto. Este TRG se repitió los días 7, 14 y 21. Se puntuó las respuestas ingestivas y aversivas durante 1 minuto. Los datos fueron procesados en el paquete estadístico SPSS v. 26. Se usó la prueba U de Mann-Withney para identificar las diferencias; y la magnitud de la diferencia se calculó mediante la r de Rosenthal. Resultados : Se obtuvo respuestas ingestivas a sacarosa el día 1 (p > 0,05); en los otros días se obtuvo respuestas diferentes: día 7 (p = 0,05), día 14 (p = 0,009) y día 21 (p = 0,009). Asimismo, se obtuvo respuestas aversivas a benzoato de denatonio (BD) los días 1, 7 y 21 (p > 0,05); esto fue diferente el día 14 (p = 0,05). Conclusiones : Se encontró una diferencia en las medianas de las respuestas ingestivas a sacarosa y aversivas a BD en ratas Wistar machos a consecuencia de la DD.

ABSTRACT Objective : To evaluate the influence of dental deafferentation (DD) on the sense of taste in male Wistar rats using the taste reactivity test (TRG). Materials and methods : An experimental study was conducted on ten Wistar rats, following ARRIVE 2.0 guidelines. They were randomized and assigned to a control or experimental group, and both groups' cannulae for the TRG were implanted. In the experimental group, exodontia of the three upper molars on the right side was performed. On the third day, GRT was started (day 1) by infusing 1 M of a sweet substance (ingestive) and 3 mM of a bitter substance (aversive) at a rate of 1 mL in 1 minute. This TRG was repeated on days 7, 14, and 21. Ingestive and aversive responses were scored for 1 minute. The data were processed in the SPSS v. 26 statistical package. The Mann-Whitney U test was used to identify differences, and the magnitude of the difference was calculated using Rosenthal's r. Results : Ingestive responses to sucrose were obtained on day 1 (p > 0.05); different responses were obtained on the other days: day 7 (p = 0.05), day 14 (p = 0.009), and day 21 (p = 0.009). Likewise, aversive responses to denatonium benzoate (BD) were obtained on days 1, 7, and 21 (p > 0.05); this was different on day 14 (p = 0.05). Conclusions : We found a difference in median ingestive responses to sucrose and aversive responses to BD in male Wistar rats due to DD.

RESUMO Objetivo : Avaliar a influência da surdeferentação dentária (DD) no sentido do paladar de ratos Wistar machos através do teste de reatividade gustativa (TRG). Materiais e métodos : Estudo experimental, seguindo as diretrizes ARRIVE 2.0, realizado em dez ratos Wistar. Estes foram aleatorizados e atribuídos a um grupo de controlo ou a um grupo experimental, tendo sido implantadas cânulas para TRG em ambos os grupos. No grupo experimental, foi efetuada a exodontia dos três molares superiores do lado direito. No terceiro dia, iniciou-se a TRG (dia 1) com a infusão de 1 M de uma substância doce (ingestiva) e 3 mM de uma substância amarga (aversiva), na velocidade de 1 mL em 1 minuto. Esse TRG foi repetido nos dias 7, 14 e 21. As respostas ingestivas e aversivas foram avaliadas durante 1 minuto. Os dados foram processados no pacote estatístico SPSS v. 26. O teste U de Mann-Withney foi usado para identificar diferenças; e a magnitude da diferença foi calculada usando o r de Rosenthal. Resultados : As respostas ingestivas à sacarose foram obtidas no dia 1 (p > 0,05); foram obtidas respostas diferentes no dia 7 (p = 0,05), no dia 14 (p = 0,009) e no dia 21 (p = 0,009). Também se obtiveram respostas aversivas ao benzoato de denatónio (BD) nos dias 1, 7 e 21 (p > 0,05); estas foram diferentes no dia 14 (p = 0,05). Conclusões : Foi encontrada uma diferença nas respostas ingestivas medianas à sacarose e nas respostas aversivas ao BD em ratos Wistar machos como resultado da DD.

Clinical research of approach selection of extraction of maxillary embedded mesiodens / 安徽医科大学学报

Objective @#To explore the related factors for the unilateral flap and bilateral flap by changing the original operation plan in the extraction of maxillary impacted mesiodens. @*Methods @#81 patients with impacted mesiodens in the middle of the maxillary were retrospectively analyzed. The primary outcome variables were planned surgery (unilateral flap)and unplanned surgery (bilateral flap) . The secondary outcome variables consisted of operation time and postoperative swelling. The predictive variables were as follows:the differential value of the shortest distance from the supernumerary tooth to the labial and palatal bone plates , which was divided into≥1. 5 mm group and < 1. 5 mm group ; the ratio of the distance from the adjacent tooth apex to the nasal floor, compared to the length of the supernumerary teeth , was recorded as≥1 and < 1 . A statistical software SPSS 20 was used to complete the statistical analysis. @*Results @#When the differential value was less than 1. 5 mm , the possibility of unplanned surgery increased , and the probability of planned surgery was 0. 085 times than that of unplanned surgery. With age growing each 1 ⁃year, the probability of planned surgery gradually decreased , HR = 0. 745. The postoperative swelling of the palatal approach was only 0. 374 times than that of the labial approach. With age increasing , the operation time increased gradually , B = 1. 213. The ratio of the distance from the adjacent tooth apex to the nasal floor to the length of the supernumerary teeth did not affect the change of the surgical plan during the operation. @*Conclusion @#The shortest distance difference between the supernumerary teeth and the labial and palatal bone plates can be used as a reference for the selection of surgical approach for the extraction of maxillary impacted mesiodens.

Evaluation of the treatment effect on sinus elevation and implant restoration in cases with odontogenic maxillary sinusitis after tooth extraction / 口腔疾病防治

Objective@#To investigate the clinical effects of sinus elevation surgery and implant restorationdue to insufficient bone massafter tooth extraction in patients with odontogenic maxillary sinusitis (OMS) and to provide a reference for use in clinical practice.@*Methods@#This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. Forty-five teeth were extracted from patients with OMS in the maxillary posterior area (the study group). Sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction in the study group. Forty-eight teeth were extracted from patients without "OMS" in the maxillary posterior area (the control group), and sinus elevation and implantation were performed due to insufficient bone height in the implant area 6-8 months after tooth extraction inthe control group. In the study group, 13 cases of discontinuous maxillary sinus floor bone and residual alveolar bone height of the maxillary sinus floor less than 4 mm were addressed with lateral wall sinus elevation, and the other 32 cases were addressed with crest-approach sinus elevation. In the control group, 8 cases of residual alveolar bone height less than 4 mm in the maxillary sinus floor were addressed with lateral wall sinus,and the other 40 cases were addressed with crest approach sinus elevation. Restorations were placed 6 to 8 months after surgery. The patients were followed up 21 days, 3 months, and 8 months after implantation and every 6 months after the placement of the restorations. The sinus bone gain (SBG), apical bone height (ABL) and marginal bone loss (MBL) were statistically analyzed 24 months after the restoration.@*Results@#The average preoperative mucosal thickness in the 45 patients in the study group was (1.556 ± 0.693) mm, which was significantly larger than that in the control group (1.229 ± 0.425) mm (P<0.001). There were no perforations in either group. Twenty-four months after restoration, there was no significant difference in the SBG, ABH or MBL between the two groups (P>0.05).@*Conclusion@#After the extraction of teeth from patients with OMS, the inflammation of the maxillary sinus decreased, and the bone height and density in the edentulous area were restored to a certain degree. The effects of sinus floor lifting surgery and implant restoration do not differ between patients with and without OMS.

The effects of sodium alendronate on socket healing after tooth extraction: a systematic review of animal studies

Abstract The aim of this systematic review was to answer the following question: "Does alendronate, a nitrogen-containing bisphosphonate, improve or impair alveolar socket healing after tooth extraction in animal models"? To this end, a systematic review of the literature was carried out in PubMed, Scopus, LILACS, Web of Science, as well as in the gray literature up to May 2023. Preclinical studies that evaluated alveolar healing after tooth extraction and the intake of sodium alendronate compared with placebo were included. Two investigators were responsible for screening the articles independently, extracting the data, and assessing their quality through the SYRCLE's RoB tool for randomized trials in animal studies. The study selection process, study characteristics, risk of bias in studies, impact of alendronate on bone healing, and certainty of evidence were described in text and table formats. Methodological differences among the studies were restricted to the synthesis methods. The synthesis of qualitative results followed the Synthesis Without Meta-analysis (SWiM) reporting guideline. From the 19 included studies, five were considered to have low risk, three were of unclear risk, and eleven presented a high risk of bias. The studies were considered heterogeneous regarding alendronate posology, including its dosage and route of administration. Furthermore, a variety of animal species, different age ranges, diverse teeth extracted, and exposure or not to ovariectomy contributed to the lack of parity of the selected studies. Our results indicated that alendronate monotherapy negatively affects the early phase of wound healing after tooth extraction in preclinical studies, suggesting that the bone resorption process after tooth extraction in animals treated with alendronate might impair the bone healing process of the extraction socket. In conclusion, alendronate administration restrains bone resorption, thereby delaying alveolar socket healing . Future studies should be conducted to validate these findings and to better understand the effects of alendronate therapy on oral tissues.

Effect of music therapy on pain and anxiety during third molar surgery

Music therapy has been used with promising results to reduce pain and anxiety in surgical specialties. It is suggested to reduce anxiety and pain perception during dental surgeries and thereby improving clinical outcomes. Aim: The aim of this study is to determine whether listening to music during trans-alveolar mandibular third molar extraction reduces pain perception and anxiety. Methods: One hundred and forty-six adult participants were randomized into music and non-music groups, with each group comprising seventy-three participants. Each participant had trans-alveolar third molar extraction with or without music intervention depending on the group randomly assigned. Pain scores of participants were measured at one minute after consent, during and after administration of local anaesthetic, during osteotomy, after tooth delivery, and one minute after flap closure. Postoperative pain scores were recorded at one-hour, 3-hour, 6-hour, 24-hour and 48-hour after the last stitch. Pre- and post-operative anxiety scores were also recorded. Descriptive statistics was used to describe sociodemographic data. Student t-test was used to compare the mean of quantitative variables between the groups while chi-square test was used to compare proportions and to investigate association between categorical variables. The statistical significance was defined at p<0.05. Results: The study showed similar sociodemographic characteristics, baseline clinical features and duration of surgery between groups. Pain score peaked during local anaesthetic administration (p = 0.254) and at 3 hours after surgery (p = 0.170) but no statistically significant difference was observed in the mean pain score. The mean anxiety scores also revealed no statistically significant differences. Conclusion: Music was found to add no significant anxiolytic and adjunctive analgesic benefit to participants who underwent third molar surgeries in this study

Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction

ABSTRACT Introduction: Extraction vs. non-extraction is a crucial decision in orthodontic therapy. Objective: The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. Material and Methods: This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. Results: The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). Conclusion: Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

RESUMO Introdução: Extrair ou não extrair dentes é uma decisão crucial no tratamento ortodôntico. Objetivo: O objetivo do presente estudo foi investigar as alterações na largura da arcada dentária e no corredor bucal após o tratamento ortodôntico com extração e o tratamento sem extração com o sistema autoligável Damon. Material e Métodos: Esse estudo retrospectivo consistiu de 35 pacientes (20 do sexo feminino e 15 do sexo masculino, com idade média de 12,5 anos), tratados com extração de 4 ou 2 pré-molares; e 37 pacientes (16 do sexo feminino e 21 do sexo masculino, com idade média de 12,8 anos), tratados sem extração de pré-molares. Ambos os grupos foram tratados com o sistema autoligável Damon. Os modelos de gesso antes (T0) e depois (T1) do tratamento foram medidos, e os valores de largura da arcada foram determinados ao nível dos primeiros molares, segundos pré-molares, caninos e rugas palatinas. A largura do corredor bucal foi medida usando as imagens extrabucais em T0 e T1. O teste t pareado foi usado para a análise dos dados com distribuição normal, e o teste U de Wilcoxon Mann-Whitney foi usado para os dados com distribuição não normal. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados: A distância intercaninos superiores aumentou significativamente em ambos os grupos (p<0,01). No grupo sem extração, a largura da arcada aumentou significativamente na região dos segundos pré-molares e primeiros molares superiores (p<0,01), bem como na região dos caninos (p=0,04), segundos pré-molares (p=0,01) e primeiros molares (p<0,01) inferiores. O corredor bucal diminuiu significativamente no grupo sem extração (p<0,01). Conclusão: A extração de pré-molares em combinação com o sistema autoligável Damon não levou à redução na largura da arcada dentária superior, nem aumentou o tamanho dos corredores bucais.

Preservação óssea alveolar pós exodontia: objetivos, opções técnicas, vantagens e desvantagens / Alveolar bone preservation after tooth extraction: objectives, technical options, advantages and disadvantages

A extração do elemento dentário promove uma série de eventos biológicos que resultam no colapso da estrutura alveolar, ocasionando a perda óssea volumétrica na região de extração. Preservar esse alvéolo dentário é imprescindível para uma boa reabilitação dentária do paciente. Objetivo: Realizar uma revisão de literatura abordando os objetivos, opções técnicas, vantagens e desvantagens da preservação óssea alveolar pós extração. Materiais e métodos: Foi feita uma revisão de literatura utilizando as bases de dados Biblioteca Virtual em Saúde (BVS), PubMed e Google acadêmico, usando os descritores "extração dentária", "perda do osso alveolar", "regeneração óssea". Foram incluídos 34 artigos. Resultados: A preservação alveolar pós extração começa desde a realização de uma técnica cirúrgica menos invasiva até a colocação de enxertos do tipo autógenos, alógenos, xenógenos, aloplásticos e biomateriais promotores de cicatrização e reparação tecidual. Conclusão: Existe na literatura atual uma vasta gama de textos científicos que abordam técnicas de preservação alveolar pós exodontia, com distintas respostas teciduais. Todavia, nenhum biomaterial listado nesta revisão contém todas as características que proporcionam regeneração completa do osso alveolar após exodontia(AU)

The extraction of the dental element promotes a series of biological events that results in the collapse of the alveolar structure, causing volumetric bone loss in the region of extraction. Preserving this dental alveolus is essential for a good dental rehabilitation of the patient. Objective: To conduct a literature review addressing the objectives, technical options, advantages and disadvantages of post-extraction alveolar bone preservation. Materials and methods: A literature review was carried out using the Virtual Health Library (VHL), PubMed and academic Google databases, using the descriptors "tooth extraction", "alveolar bone loss", "bone regeneration". 34 articles were included. Results: Post-extraction alveolar preservation starts from the performance of a less invasive surgical technique to the placement of autogenous, allogeneic, xenogeneic, alloplastic and biomaterials that promote healing and tissue repair. Conclusion: There´s is a wide range of scientific texts in the current literature that address post-extraction alveolar preservation techniques with different tissue responses. However, none of the biomaterials listed in this review contain all the characteristics that provide complete regeneration of alveolar bone after extraction(AU)

Sonal Appliance an innovative space maintainer in the management of early loss of first permanent Molar: A Rare Case Report

Introduction:In preventative and interventional dentistry, keeping deciduous teeth until their natural exfoliation is critical. An early tooth or group of teeth loss might have a variety of effects. The first molar is the largest tooth in the mouth, it carries the most occlusal stress, and it affects the vertical distance between the mandible and the maxilla.Adolescent patients who have lost a permanent first molar (PFM) require early space maintenance.Case report:In this case report a successful use of a modified distal shoe appliance was made in a patient whose 1st permanent molar was lost before the eruption of 2nd permanent molar.In circumstances when the permanent first molar is lost before the emergence of the permanent mandibular second molar, a unique device is described in this publication.The distal extension of a normal distal shoe appliance was extended distally along with a fixed bilateral appliance, a modified band and loop, and other components in this design. Conclusion:For individuals with bilateral molar loss, a modified distal shoe appliance is a promising option.

Effects of early unilateral mandibular first molar extraction on condylar and ramal asymmetry / Efectos de la extracción temprana del primer molar mandibular unilateral sobre la asimetría condilar y ramal

SUMMARY: Craniofacial symmetry is an important factor in creating a harmonious facial appearance. Genetic and external factors may cause the formation of mandibular asymmetry. The aim of this study was to evaluate vertical mandibular asymmetries in adolescents who had unilateral mandibular first permanent molar (FPM) teeth extracted at an early age. The study group consisted of 60 subjects (30 females, 30 males with a mean age of 16.18±1.04 years) who had their mandibular permanent first molar tooth extracted before the age of 12, and the control group consisted of 60 healthy subjects (30 females, 30 males with a mean age of 16.23±0.92 years). Condylar asymmetry index (CAI), ramal asymmetry index (RAI), and condylar-ramal asymmetry index (CRAI) were calculated using panoramic radiographs of the subjects. Independent samples t-test was used to evaluate the differences between groups. CAI, RAI, and CRAI values were similar between male and female subjects in both control and study groups, and no statistically significant difference was found (p>0.05). No statistically significant difference was observed between the group who had their mandibular first permanent molar teeth extracted at an early age and the control group (p>0.05). CAI values were relatively higher in both groups, but there was no significant difference between the CAI, RAI, and CRAI values between the groups.

La simetría craneofacial es un factor importante para crear una apariencia facial armoniosa. Factores genéticos y externos pueden causar la formación de asimetría mandibular. El objetivo de este estudio fue evaluar las asimetrías mandibulares verticales en adolescentes a quienes se les extrajo el primer molar permanente (FPM) mandibular unilateral a una edad temprana. El grupo de estudio consistió en 60 sujetos (30 mujeres, 30 hombres con una edad media de 16,18±1,04 años) a quienes se les extrajo el primer molar mandibular permanente antes de los 12 años, y el grupo control consistió en 60 sujetos sanos (30 mujeres, 30 hombres con una edad media de 16,23±0,92 años). El índice de asimetría condilar (CAI), el índice de asimetría ramal (RAI) y el índice de asimetría condilar-ramal (CRAI) se calcularon utilizando radiografías panorámicas de los sujetos. Se utilizó la prueba t de muestras independientes para evaluar las diferencias entre los grupos. Los valores de CAI, RAI y CRAI fueron similares entre los hombres y las mujeres tanto en el grupo control como en el de estudio, y no se encontraron diferencias estadísticamente significativas (p>0.05). No se observaron diferencias estadísticamente significativas entre el grupo al que se le extrajo el primer molar permanente mandibular a una edad temprana y el grupo control (p>0,05). Los valores de CAI fueron relativamente más altos en ambos grupos, pero no hubo diferencias significativas entre los valores de CAI, RAI y CRAI entre los grupos.

Lesões reabsortivas múltiplas em cão: relato de caso / Multiple resorptive lesions in dogs: case report

A lesão de reabsorção dentária consiste em um processo patológico que acomete elementos dentários permanentes, principalmente de animais adultos e idosos, e sua expressão na espécie canina vem aumentando. Etiologias diversas e não esclarecidas, associada ao subdiagnóstico por falta da realização de exames radiográficos na rotina e profissionais não especializados na área odontológica, tem permitido que injúrias na estrutura externa e interna do dente sofram processo reabsortivo por células clásticas. Frequentemente se confunde com a doença periodontal ou a ela está associada. O diagnóstico baseia-se nos achados clínicos e na radiografia intraoral. O tratamento depende do estágio da doença, sendo a exodontia a opção que devolve a qualidade de vida natural ao animal no longo prazo. O presente relato tem como objetivo descrever o caso de um cão da raça Dachshund, com seis anos de idade, inteiro, com queixa de halitose, disfagia, ptialismo, anorexia, desidratação, perda de peso, letargia, meneios de cabeça e espirros, e ao exame de imagem apresentava diversas lesões de reabsortivas, cujo tratamento periodontal promoveu remissão de todos os sinais clínicos e bem-estar ao paciente.

Tooth resorption injury consists of a pathological process that affects permanent dental elements, especially in adult and elderly animals, and its expression in the canine species has been increasing. Several and unclear etiologies, associated with underdiagnosis due to lack of routine radiographic examinations and professionals not specialized in the dental area, have allowed injuries to the external and internal structure of the tooth to undergo a resorptive process by cells clastic. It is often confused with or associated with periodontal disease. Diagnosis is based on clinical findings and intraoral radiography. The treatment depends on the stage of the disease, and tooth extraction is the option that returns the natural quality of life to the animal in the long term. The present report aims to describe the case of a six-year-old Dachshund dog, whole, complaining of halitosis, dysphagia, ptyalism, anorexia, dehydration, weight loss, lethargy, head sneezing and sneezing, and the imaging exam presented several resorptive lesions, whose periodontal treatment promoted remission of all clinical signs and well-being to the patient.

Effect of extraction timing of mesiodens on orthodontic treatment duration for abnormal eruption of permanent teeth in children / 口腔疾病防治

Objective@# To discuss the correlation between the extraction timing of mesiodens and the orthodontic treatment duration of its eruption-related complications in children to provide a reference for the clinic.@*Methods @#The mesiodentes of 187 children were classified as eruption type (typeⅠ), dental crown impacted type (type Ⅱ), interdental impacted type (type Ⅲ), and dental root impacted type (type Ⅳ). According to the timing of extraction, mesiodentes in typeⅠ, type Ⅲ, and type Ⅳ were divided into Groups A: before the eruption of the adjacent central incisor and B: after the eruption of the adjacent central incisor. Mesiodentes in type Ⅱ were divided into Group A: before the eruption of the contralateral central incisor and B: after the eruption of the contralateral central incisor. Eruption-related complications and orthodontic treatment durations caused by mesiodens were statistically analyzed. @*Results @# There were 106 cases of displacement, 28 cases of failed eruption, 27 cases of tooth rotation, and 26 cases of individual cross-bite among the eruption-related complications caused by mesiodens. The mean orthodontic treatment cycle in Group A of type Ⅰ (7.07 ± 2.45 month), Group A of type Ⅱ (6.57 ± 1.12 month), and Group A of type Ⅲ (6.95 ± 2.52 month) were lower than that in Group B of type Ⅰ (9.67 ± 3.04 month), Group B of type Ⅱ (10.25 ± 1.29 month), and Group B of type Ⅲ (9.33 ± 3.26 month), and the differences were statistically significant (P<0.01). Meanwhile, there was no significant difference in the mean orthodontic treatment duration between Groups A (6.00 ± 0.94 month) and B (6.33 ± 0.80 month) of type Ⅳ (P>0.05).@*Conclusion@# In most cases, the mesiodens are removed before the eruption of the adjacent central incisor, which can reduce the duration of orthodontic treatment for eruption-related complications in children.

Clinical application of a digital positioning guide template during the extraction of maxillary wholly impacted supernumerary teeth / 口腔疾病防治

Objective@#To evaluate the clinical efficacy of positioning guide templates for maxillary wholly impacted supernumerary teeth to provide technological solutions for clinical applications. @*Methods @#After approval by the hospital ethics committee and informed consent given by the patients. Data from 136 patients with maxillary wholly impacted supernumerary teeth from January 2016 to April 2022 were analyzed retrospectively. The patients were divided into two groups according to the usage of the positioning guide template. The experimental group included patients using the positioning guide template (71 cases), and the control group did not use the positioning guide template (65 cases). The operation time and complications were statistically analyzed to evaluate the clinical efficacy after surgery. @*Results @# All operations were successfully completed. The average operation time in the experimental group was (21.5 ± 3.4) min, significantly shorter than that in the control group (27.2 ± 4.9) min. There were statistically significant differences between the experimental and control groups (t = 7.599, P<0.001). One week after the operation, there were no complications in the experimental group, and there were 2 cases of adjacent tooth injury and 3 cases of gingival numbness in the control group.@* Conclusion @# A digital positioning guide template can effectively shorten the time of maxillary wholly impacted supernumerary teeth extraction and is an effective means to assist clinical maxillary wholly impacted supernumerary teeth extraction.

Application progress of alveolar ridge preservation in patients with tooth extracted due to periodontitis / 口腔医学

@#Alveolar ridge preservation (ARP) has developed rapidly as a method for preserving the alveolar socket's bone volume after tooth extraction. ARP can create conditions for implant restoration, and reduce operation difficulties by decreasing alveolar ridge absorption. There are certain difficulties of ARP applicationin patients with tooth extracted due to periodontitis. This paper mainly introduces the characteristics of ARP, compares the similarities and differences among ARP, guided tissue regeneration, guided bone regeneration and immediate implant, and then summarizes their advantages and disadvantages. The paper focuses on the specificity of ARP and the progress of ARP application in patients with tooth extracted due to periodontitis, in order to offer direction for clinical application and future research on ARP.

Study of tooth drifts after orthodontic extractions in cases of interruption / 口腔疾病防治

Objective @# To compare the tooth drift differences between different types of patients after orthodontic extraction for 1.5 months (45 days) without return to the clinic on time for some reasons.@*Methods@#This study has been reviewed and approved by the Ethics Committee, and informed consent has been obtained from patients. A total of 84 patients had bilateral premolars extracted but were not bonded the bracket for some reasons. The upper and lower jaw dental models were cast, scanned, and reconstructed in 3D. Patients were divided into 12 groups based on extraction positions (first premolar or second premolar), jaw types (maxilla or mandible) and vertical facial types (average angle, high angle, or low angle). Multivariate analysis of variance was used to analyze the changes in the following five indicators in different types of patients who were interrupted for 1.5 months after extraction: anterior tooth crowding, width between canines, width between first molars, tooth extraction space, and overbite of anterior teeth. @*Results @#The tooth extraction position, jaw type and vertical facial type had an effect on the reduction in tooth extraction space and anterior tooth crowding before and after the sudden emergent state (1.5 months after tooth extraction) (P<0.001), and the tooth extraction position and vertical facial type had an effect on the increase in anterior tooth overbite (P<0.001). The drift of bilateral adjacent teeth was greater in patients with first premolars extracted than in those with second premolars extracted (P<0.001), and the drift of bilateral adjacent teeth in the maxilla was larger than that of the mandible (P<0.001). The drift of bilateral adjacent teeth in patients with high angles was more obvious than that of patients with average angles and low angles (P<0.001). @* Conclusion@# For orthodontic patients who have maxillary tooth extraction, first premolar extraction, and even high angles in the vertical facial type, the bilateral adjacent teeth are easier to drift, orthodontic treatment should be carried out soon after extraction, and attention should be given to anchorage control.

Assessing Inter-rater Reliability of the Dental Practicality Index and the American Association of Endodontists Endodontic Case Difficulty Assessment Form among Undergraduates

@#Dental Practicality Index (DPI) and American Association of Endodontists Endodontic Case Difficulty Assessment (AAECDA) form potentially can guide clinicians in making clinical decisions and triaging in large practices and academic settings. Nonetheless, the reliability and validity should be evaluated before institution-wide implementation. This study aimed to evaluate the inter-rater reliability of the DPI and AAECDA forms. Ten randomly selected, trained students rated 25 cases with both forms. The itemby- item inter-rater and overall reliability were estimated with Gwet’s agreement coefficient (AC2) and intraclass correlation coefficient (ICC), respectively. The association between clinical decisions and the scores was analysed with the Generalised Estimating Equation. The inter-rater reliability of DPI was generally very good (AC2 = 0.81–1.00), except context (good; AC2 = 0.718; 95% confidence interval [CI] = 0.575–0.861). The inter-rater reliability of AAECDA was generally very good (AC2 = 0.81–1.00) and good (AC2 = 0.61–0.80), except the radiographic appearance of the canal(s) (fair; AC2 = 0.424, 95% CI = 0.263–0.585). Moderate overall inter-rater reliability of AAECDA (ICC = 0.53, 95% CI = 0.38–0.70) and DPI (ICC = 0.62, 95% CI = 0.48–0.77) was observed. Referral to an endodontist was positively associated with AAECDA score (odds ratio [OR] = 1.323, 95% CI = 1.145–1.52, p < 0.001). The decision of tooth extraction was positively associated with the DPI score (OR = 1.983, 95% CI = 1.539–2.555; p < 0.001). In conclusion, DPI and AAECDA are methods with moderate inter-rater reliability when used among dental students.

Nitrous oxide or midazolam to tooth extraction? a systematic review / Óxido nitroso ou midazolam para extracção dentária? uma revisão sistemática / ¿Óxido nitroso o midazolam para la extracción dental? una revisión sistemática

Aim: This systematic review aimed to evaluate the use of midazolam and nitrous oxide in conscious sedation for dental extraction procedures. Methods: A search was conducted in electronic searches Medline/PubMed, Embase, Cochrane Library, Web of Science, grey literature, and the main scientific journals in the area, following PRISMA. Booleans operators were used for the combinations of terms and the search strategy was adapted to each of the databases, ("tooth extraction" OR "molar, third" OR "tooth, impacted" OR "surgery, oral" OR "exodontics" OR "wisdom tooth" AND "nitrous oxide" OR "anesthetics, inhalation" OR "conscious sedation" OR "laughing gas" OR "moderate sedation" AND "midazolam" OR "benzodiazepines" OR "hypnotics and sedatives" OR "sedative effect"). Study Selection and Data Extraction: The inclusion criteria were parallel and crossover RCTs involving patients of any age submitted to tooth extraction at a dental office under local anesthesia. No language restrictions have been imposed until 2023. The exclusion criteria were studies involving patients submitted to extraction in the hospital setting, studies that did not measure anxiety or sedation and studies for which the full text was not available. Results: Where within the eight articles that met the eligibility criteria, no significant differences were found between the methods, in relation to sedation or anxiety. Conclusion: In conclusion, nitrous oxide and midazolam safely ensure good levels of sedation and anxiety control, being pharmacological approaches possible to be used in dental care, even in those more invasive such as, tooth extraction.

Objetivo: Esta revisão sistemática visava avaliar a utilização de midazolam e óxido nitroso na sedação consciente para procedimentos de extração dentária. Métodos: Foi realizada uma pesquisa nas pesquisas electrónicas Medline/PubMed, Embase, Cochrane Library, Web of Science, literatura cinzenta, e nas principais revistas científicas da área, seguindo o PRISMA. Foram utilizados operadores booleanos para as combinações de termos e a estratégia de pesquisa foi adaptada a cada uma das bases de dados, ("extração dentária" OU "molar, terceiro" OU "dente, impactado" OU "cirurgia, oral" OU "exodontia" OU "dente do siso" OU "óxido nitroso" OU "anestésico, inalação" OU "sedação consciente" OU "gás do riso" OU "sedação moderada" OU "midazolam" OU "benzodiazepinas" OU "hipnóticos e sedativos" OU "efeito sedativo"). Seleção do estudo e extração de dados: Os critérios de inclusão foram RCTs paralelos e cruzados envolvendo pacientes de qualquer idade submetidos a extração dentária num consultório dentário sob anestesia local. Não foram impostas restrições linguísticas até 2023. Os critérios de exclusão eram estudos que envolviam pacientes submetidos a extração no ambiente hospitalar, estudos que não mediam ansiedade ou sedação e estudos para os quais o texto completo não estava disponível. Resultados: Nos oito artigos que preenchiam os critérios de elegibilidade, não foram encontradas diferenças significativas entre os métodos, em relação à sedação ou ansiedade. Conclusão: Em conclusão, o óxido nitroso e o midazolam garantem, com segurança, bons níveis de sedação e controle de ansiedade, sendo abordagens farmacológicas possíveis de serem usadas nos cuidados odontológicos, mesmo naqueles mais invasivos como, a extração dentária.

Objetivo: Esta revisión sistemática pretendía evaluar el uso de midazolam y óxido nitroso en la sedación consciente para procedimientos de extracción dental. Métodos: Se realizó una búsqueda en las bases de datos electrónicas Medline/PubMed, Embase, Cochrane Library, Web of Science, literatura gris y en las principales revistas científicas del área, siguiendo PRISMA. Se utilizaron operadores booleanos para las combinaciones de términos y se adaptó la estrategia de búsqueda a cada una de las bases de datos, ("tooth extraction" OR "molar, third" OR "tooth, impacted" OR "surgery, oral" OR "exodontia" OR "wisdom tooth" OR "nitrous oxide" OR "anaesthetic, inhalation" OR "conscious sedation" OR "laughing gas" OR "moderate sedation" OR "midazolam" OR "benzodiazepines" OR "hypnotics and sedatives" OR "sedative effect"). Selección de estudios y extracción de datos: Los criterios de inclusión fueron ECA paralelos y cruzados que incluyeran pacientes de cualquier edad sometidos a extracción dental en un consultorio dental bajo anestesia local. No se impusieron restricciones de idioma hasta 2023. Los criterios de exclusión fueron estudios que incluyeran pacientes sometidos a extracción en el ámbito hospitalario, estudios que no midieran la ansiedad o la sedación y estudios para los que no estuviera disponible el texto completo. Resultados: En los ocho artículos que cumplían los criterios de elegibilidad, no se encontraron diferencias significativas entre los métodos con respecto a la sedación o la ansiedad. Conclusión: En conclusión, el óxido nitroso y el midazolam garantizan con seguridad buenos niveles de sedación y control de la ansiedad, siendo abordajes farmacológicos posibles de ser utilizados en la atención odontológica, incluso en aquellas más invasivas como, la extracción dentaria.

Success and survival rates of immediate anatomic zirconia implants: a prospective clinical and radiographic evaluation

Modern immediate titanium implants have two major drawbacks which are the black metal appearance that might be seen through the mucosa and the gap between implant and extraction socket. Immediate anatomical zirconia implants were introduced to match the shape of the extracted root and fill the socket without gaps while still providing better metal-free appearance. Aim: This study aims to investigate success and survival rates of immediate anatomical zirconia implants. Methods: This prospective interventional study was held between 2017 and 2020 in the faculty of dental medicine, Damascus University, Syria. The sample consisted of 27 immediate anatomical zirconia implants in 21 patients from both genders. Implants were designed and manufactured starting from CBCT image and prior to extraction. Specialized software applications were used to modify implant design. Implants went through different processing procedures to make them ready for insertion immediately after tooth extraction. Restorations were made after a minimum period of 3 months, clinical and radiographic follow ups were performed after 10 - 13.5 months from restoring the implants in order to evaluate their success/ survival. Repeated measures ANOVA was used to assess marginal bone loss, t test for probing depth assessment. Results: Immediate anatomical zirconia implants showed success in (n=17) 63% of total cases, satisfactory survival (n=3) 11.1%, compromised survival (n=2) 7.4% and they failed in (n=5) 18.5%. Conclusions: Immediate anatomical zirconia implants had low success/survival rates when compared to conventional immediate implants. Therefore, they cannot be considered as a predictable alternative in their current form

Soft tissue and incisor position changes in class I bimaxillary subjects after retraction using friction and frictionless mechanics

Aim: Bimaxillary protrusion is a common condition observed irrespective of race and ethnicity and is a chief concern for patients who seek orthodontic treatment. The aim of this study was to compare and evaluate changes in soft tissue structures and incisor positions in class I bimaxillary protrusion subjects undergoing orthodontic therapy when friction and frictionless mechanics were used. Methods: Two groups with a total of 40 patients aged 18­30 years diagnosed with class I bimaxillary protrusion treated by extracting first premolars were considered for this study. Patients treated with friction mechanics were included in Group 1 and those treated with frictionless mechanics in Group 2. The digital lateral cephalograms were calibrated and analyzed using Nemoceph software. Selected landmarks were marked on pre- and post-treatment cephalograms and assessed for intra- and inter-group soft tissue and incisor position changes. Student's t-test was used to analyze the collected data using SPSS 20 software. Result: Intragroup comparison revealed significant changes in both groups. Inter-group comparison of the selected parameters between groups 1 and 2 showed differences but without any statistical significance, except for the inter-incisal angle. Conclusion: Pre- and post-treatment comparison analysis revealed significant soft tissue changes in both groups. However, the comparison between friction and frictionless mechanics showed no statistically significant changes