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[Stress distribution analysis of a loaded fixed bridge by finite element method].

The fixed bridge is a common prosthesis widely used in clinical dentistry. In order to design an ideal fixed bridge which can provide the best protection of the abutments, we must study the stress distribution of alveolar bone, when the fixed bridge is under the loading. In this article, we report the application of the finite element method to examine the stress distribution of the alveolar bone of fixed bridge abutments. We have made seven vertical loading models and two oblique loading models. A quantitative analysis result has been obtained and the stress distribution result drawn up by a computer. The results of this analysis are as follows: 1. Under the seven vertical loadings, the bearing compress stress on the mesial apex of the second bicuspid is large. In this area the compress stress is largest, when the vertical loading is applied on the two-abutment tooth and pontic, the sigma 2 is -120.0 but the stress of alveolar bone of the molar is uniform. 2. Under the oblique loading, by the mesial apex of bicuspid are borne the tensile stress and compress stress, the latter is larger than the former, and the sigma 2 is -75.0. 3. The molar is an ideal abutment tooth for the fixed bridge.

Alveolar Process↗

Evaluation of a combined surgical repair and guided tissue regeneration technique to treat recent root canal perforations.

This study evaluated a technique that included retrofill to repair molar root canal perforations and guided tissue regeneration to restore the periodontium that was removed from the furcation area for access to the sites. Six dogs had root canal therapy on mandibular fourth premolars and first molars. The distal root of each tooth was perforated on the furcation aspect halfway between the furcation and the apex. Replaced flap surgery was performed for access to prepare and fill the perforation site with intermediate Restorative Material. A bone xenograft was placed in the access ostectomy site and covered with GoreTex Augmentation Material (GTAM). Controls included unfilled perforations and not using bone grafts and/or GTAM. Dogs were killed at 6, 12, and 24 wk postsurgery. Complications were more common when root perforations were left unfilled. Histomorphometry revealed a statistically significant decrease in inflammation and more bone fill when root perforations were filled and GTAM was used, respectively.

Analysis of Variance↗

[Complications of dental infections].

Infectious dental complications are quite frequent given the high incidence of tooth decay. Other pathologies not related to dental decay can cause mouth infectious such as periodontal infections, alveolitis, peri-coronitis of impacted wisdom tooth and secondary infection of dental fragments. Dental infection can be localised to apex (top of the root) or progress to soft and bony tissues surrounding the teeth. The most frequent germs involved in these infections are generally the same as saprophyte buccal flora but are often associated to other anaerobic germs. The following complications will be described in what concerns their etiology, pathology and treatment: abcess, fistula, phlegmon and cellulitis, odontogenic cysts, actinomycosis, craniofacial thrombophlebitis, osteitis and osteomyelitis, maxillary sinusitis, septicemia and local odontogenic infections. The consequences of these infections can vary according to immunologic resistance of the patient as well as the resistance of some germs to the most common antibiotics. Several factors should be taken in consideration in the treatment; patient history factors, germ virulence, maintaining or suppression of etiologic factors and drainage possibilities.

Abscess↗

[Diurnal layer formation in the incisor dentin of rodents].

The growth of dentin of the constantly growing lower incisors in rodents was studied using tetracycline as a vital marker of the growing parts of bones and teeth. In the common vole in nature the incisors grow in length at a rate of 490 micrometers per day; a basal-apical gradient of growth of the tooth walls in thickness was found: the minimal daily increment at the tooth base and the maximal in the apical third, it decreases again at the very apex. In the peripulp part of dentin of the apical incisor half there are diurnal layers seen both on polished sections and stained slides the formation of which correlates with the diurnal rhythm of skeleton growth. The diurnal dentin layers form in the apical incisor half only. The odontoblasts appear to begin to function rhythmically from the middle of their life on only. A similar phenomenon was found in a natural population of large-toothed redbacked voles. The topography of dentin layers in the laboratory rats is similar to that in the voles but the layers are not distinct and the basal-apical gradient of dentin growth is observed in young animals, rather than in the old ones.

Animals↗

Dens invaginatus: complications and treatment of non-vital infected tooth.

A case of non-vital infected dens invaginatus of the maxillary right lateral incisor with open apex, which presented with pain and swelling is presented. Although root growth and apical closure was achieved using calcium hydroxide, the periapical infection persisted and resolution was only achieved after apical curettage and apicectomy.

Apicoectomy↗

[Impacted wisdom tooth 48].

To illustrate the great variety of wisdom teeth impactions, the authors report a case where a vertically impacted 48 projected with its apex over the mandibular border by almost 2 mm. Possible causes of impaction and their consideration in the surgical removal of such teeth are mentioned.

Female↗

Predicting pulpectomy success and its relationship to exfoliation and succedaneous dentition.

This study evaluated factors that affected pulpectomy (PE) success and its effect on the succedaneous tooth's eruption and enamel formation. Sixty-five of 250 patients with PEs met the selection criteria and yielded 81 zinc oxide-eugenol PEs (30 incisors, 51 molars) followed a mean time of 90.8 months. Overall PE success was 77.7% with no difference between molars and incisors (P = 0.53). Enamel defects were observed in 18.7% of succedaneous teeth and were related (P = 0.005) to the pre-existing infection causing excess root resorption (>1 mm preoperative root resorption = 44.4% defects) but were not related to overretention of ZOE filler (P = 1) or length of fill (P = 0.36). The PE procedure was not related to causing succedaneous tooth defects since teeth replacing PEs showed no significant increase in the incidence of defects compared with untreated contralateral controls (P = 0.99). There was a 20% incidence of succedaneous tooth anterior cross-bite or palatal eruption following incisor PEs and 21.6% ectopic eruption of premolars following primary molar PEs. Most PEs (95.9%) were lost at their normal exfoliation time or earlier, but 35.8% needed extraction due to overretention by soft tissue at the time of shedding. Pulpectomy success rates showed that the most important preoperative predictor was the amount of primary tooth root resorption. Greater than 1 mm of root resorption resulted in only a 23.1% success rate, which was significant (P = 0.001). Pulpectomies filled short or to the apex had a significantly greater success (P = 0.011) than long fills. Pulpectomies correctly done do not appear to contribute to adverse effects on succedaneous tooth formation but have a 20% chance of altering the path of permanent tooth eruption.

Amelogenesis↗

Postoperative fractures of the lingual plate after bilateral sagittal split osteotomies.

We encountered the unusual complication of postoperative fracture of the lingual plate in four patients after bilateral sagittal split osteotomy. We then did a retrospective review to identify possible risk factors. Over a 1-year period we did 52 bilateral split osteotomies. The patients' casenotes were examined and a number of variables were recorded, including surgical technique, and the patient's sex, age, presence or absence of third molars, and the height of the mandible in the region of the osteotomy. Significant risk factors were a vertical mandibular height of 2 cm or less distal to the last molar tooth (p=0.02), and a depth of 0.6 cm or less from the apex of last molar root or impacted third molar to the lower border (p=0.005).

Adolescent↗

Autotransplantation of teeth (I). Indications for transplantation with a follow-up of 51 cases.

The indications for autotransplantation of teeth in 45 patients have been analysed together with a follow-up of the success rate of surgery. Most of the transplants were mature teeth, 37 out of 51, with closed apex. The majority of transplantations were carried out in order to replace single tooth losses (40) but in 11 cases, the teeth were used as an abutment in prosthetic rehabilitation. In 14 cases, an impacted tooth was transplanted to its normal position. The follow-up ranged from 3 months up to 10 years. No progressive root resorption has been observed so far; only 6 cases with slight surface resorption. Clinical signs of anchylosis were noticed in 4 teeth and shallow bone defects in 6 patients. Small- or medium-sized periapical destructions were observed in 4 cases. Mature transplanted teeth were always subjected to endodontic therapy within a month; the immobilisation varied between 2-4 weeks, while trying to keep it as short as possible with maintained stability. The experiences so far achieved do encourage a more comprehensive use of the method to solve problems associated with oral rehabilitation, from both prosthodontic and orthodontic points of view.

Adolescent↗

[Periodontal function and oral hygiene following an operation for apicoectomy].

The author analyzes the effect of the dental root apex resection on the function of marginal periodontal tissues of the operated on tooth and oral hygiene of 103 patients with chronic periapical foci of odontogenic infection, aged 12 to 53, on the basis of the data of monitoring the changes in the content of gingival fluid, depth of the gingival grooves or pouches, and the Schiller-Pisarev test and hygiene index. The operation in question was found to essentially disorder the biologic equilibrium in the marginal periodontal tissues and to deteriorate the hygienic status of the oral cavity. The developing shifts are reversible and disappear in two weeks after surgery. The author emphasizes that such patients should be timely trained to take care of the oral cavity in order to improve its hygienic status in the postoperative period.

Adolescent↗

[Ultratonotherapy in the combined treatment of chronic periodontitis].

The trial of apex-locator application for improvement of endodontic management of root canals of a tooth as well as of ultratonotherapy in 120 patients aged 20-40 years with chronic granulomatous and granulating periodontitis has proved that ultratonotherapy relieves inflammation and stimulates regeneration of bone tissue.

Adult↗

Maturogenesis of a cariously exposed immature permanent tooth using MTA for direct pulp capping: a case report.

Successful direct pulp capping of cariously exposed permanent teeth with reversible pulpitis and incomplete apex formation can prevent the need for root canal treatment. A case report is presented which demonstrates the use of mineral trioxide aggregate (MTA) as a direct pulp capping material for the purpose of continued maturogenesis of the root. Clinical and radiographic follow-up demonstrated a vital pulp and physiologic root development in comparison with the contralateral tooth. MTA can be considered as an effective material for vital pulp therapy, with the goal of maturogenesis.

Aluminum Compounds↗

Electrometric determination of the working length of root canals by means of Apex locator.

AIM: To evaluate an apex locator in determining the working length of root canals and detecting micro-communications with the pulp chamber. METHODS: The apparatus was tested on 21 patients, aged 18 - 70, who received endodontic treatment of 34 teeth with 45 root canals. The apparatus was used in compliance with the instructions of the manufacturer. The precision of the instrument was determined by a radiograph of the tooth with a file inserted in it at a depth equal to the length determined with the Apex locator. The obtained results were divided into three groups: canals determined as longer; canals in which the outline of the instrument was close to the roentgenologic apex; and canals determined as shorter. CONCLUSION: The average deviation from the roentgenologic apex was 1.17 mm, which is, in fact, the area of the physiological apex opening - the ideal limits for treatment and obturation. The apparatus can be successfully used to make differential diagnosis is useful of deep caries with pulpitis chronica ulcerosa. It is ergonomic and easy to use.

Adolescent↗