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At least 145 records · Page 8Linked to original sources

PubMed2001

Development of an orthodontic simulator for measurement of orthodontic forces.

In this research we developed an orthodontic simulator for analysis of orthodontic forces distribution in the case of the continuous arch technique. In order to take into account vertical force, besides horizontal force and occlusogingival moment on instrumented artificial tooth, tooth root was designed as a ring load cell. Fixing each artificial tooth onto combined mechanical stages enabled variation of tooth anteroposterior position and inclination related to occlusal plane. Calibration of forces and moment of each instrumented artificial tooth showed linearity of outputs and provided the generalized inverse matrix for evaluation of forces and moments from measured strain data. A simulation to retract the anterior teeth was accomplished, and distribution of forces and moment acting at the bracket of each tooth were determined. The average accuracy was 82% and 97% in the horizontal and vertical direction, respectively, by comparing the applied forces and the evaluated ones.

Algorithms↗

PubMed2002

Surgical repositioning of an impacted dilacerated incisor in mixed dentition.

BACKGROUND: Treatment options for a dilacerated incisor are either extraction or surgery and orthodontic traction. Because patients with such incisors usually are young, and because of the root angulation of the impacted incisor, treatment usually is lengthy and complicated. Surgical repositioning provides another option for treatment of this unique problem. CASE DESCRIPTION: The author presents the case of a 9-year-old girl with an impacted dilacerated maxillary central incisor to demonstrate the timing, technique and results of the surgical repositioning treatment approach. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root's adapting to the new position. CLINICAL IMPLICATIONS: Surgical repositioning is a simplified treatment for dilacerated incisors. It is especially valuable in cases of difficult-to-treat impaction. Timing of surgical repositioning depends on the incisor's root development and the space available for the transplant.

Child↗

PubMed2006

Clinical modification in root correction phase in segmented arch technique.

The segmented arch technique uses the differential moment/force ratio in the anterior and posterior segments so that the extraction space in cases of critical anchorage can be closed with minimal or no anchorage loss. The objective of this article is to discuss the root correction phase, the force system involved, and the clinical problem of the tendency of space reopening during this phase. It also presents the use of a closed NiTi spring as a clinical alternative for this phase, concluding that this device can be used to avoid space reopening.

Biomechanical Phenomena↗

PubMed2006

Use of a synthetic bone substitute to retard molariform tooth drift after maxillary tooth loss in ponies.

OBJECTIVE: To evaluate the effect of alveolar bone substitute on post-extraction drift of maxillary cheek teeth in ponies. STUDY DESIGN: In vivo longitudinal experimental study. ANIMALS: Five ponies (5-7 years) with a healthy dentition. METHODS: Both maxillary 4th premolar teeth (Triadan 08) were surgically removed. One alveolus was filled with a biocompatible non-resorbable bone substitute (Bioplant 24), whereas the other healed by second intention. A polyvinylsiloxane plug and spring wire isolated the bone substitute from the oral environment. Pathologic changes to dentition and adjacent soft tissue were recorded. Tooth drift was calculated after 1 and 2 years. RESULTS: At 1 month, bone substitute material was incorporated into healthy tissue. Tooth drift was observed but differed significantly between control and treated sides at 2 years (P<.01). For both techniques, tooth drift differed significantly between years 1 and 2 (P<.001). Total drift in control arcades for year 1 was 10.69+/-2.12 mm and for year 2 was 9.08+/-0.87 mm, whereas for bone substitute arcades it was 9.90+/-1.60 mm for year 1 and 5.60+/-1.78 mm for year 2. CONCLUSIONS: Partial tooth replacement therapy after maxillary P4 extraction provided good healing in the immediate post-surgical phase. Alveolar filling with bone substitute material significantly slowed post-extraction tooth drift but did not stop it completely. Clinical Relevance- Important changes occur in equine dentition after maxillary cheek teeth removal. Further longer term observations are needed to fully validate study findings.

Animals↗

PubMed1999

Surgical extrusion of crown-root-fractured teeth: a clinical review.

AIM: In this clinical study combined surgical and endodontic treatment was performed in 20 cases of crown-root fracture and the outcomes reviewed. METHODOLOGY: Surgical treatment involved a conventional extraction and stabilization technique. Root canal treatment using calcium hydroxide was performed. Before root canal obturation, a calcium hydroxide dressing was maintained for 3 months. RESULTS: Follow-up examinations, which varied between 6 and 36 (mean 14.5) months, showed that there were no radiographic and clinical signs of progressive root resorption, marginal bone loss or periapical disease in all except one case. CONCLUSIONS: The favourable results of this study demonstrate that surgical extrusion in teeth with crown-root fractures may be an alternative treatment to orthodontic extrusion.

Adolescent↗

PubMedDate not supplied

Rescue surgery (surgical repositioning) of impacted lower second molars.

The impaction of lower second molars, given that its incidence is 0.03 to 0.21%, is a rare complication in tooth eruption. It has been detected more often in unilateral form than bilateral and is more common in the mandible than in the maxillary. It has a slight predilection for males, and mesial inclination is more usual. A wide variety of therapeutic approaches have been published, basically referring to surgical techniques, independent or complemented by means of orthodontic technical aids, with the aim of placing the tooth in the correct position, and which are encompassed under the concept of surgical rescue. In cases resolved with repositioning of an impacted tooth, prophylactic root extraction has been proposed as obligatory. We present a case of a 12 and a half year old patient referred to the University of Seville due to non-eruption of the left lower second molar. The patient was referred by her orthodontist, who detected the impaction before starting orthodontic treatment. The orthodontist requested that, if it was possible, we did not extract the root of the third molar, because its eruption would be feasible in the future (there would be sufficient space in the arch). The spaces available were measured and we decided to attempt the repositioning of the impacted tooth without extracting the root of the wisdom tooth, which was carried out successfully.

Child↗

PubMed2000

Mucogingival interceptive surgery of buccally-erupted premolars in patients scheduled for orthodontic treatment. I. A 7-year longitudinal study.

BACKGROUND: Mucogingival interceptive therapy in patients with buccally erupting teeth is performed to prevent the ectopic permanent tooth from developing periodontal lesions. The keratinized tissue entrapped between the erupting tooth and the deciduous tooth is retained to maintain a satisfactory width of the gingiva for the permanent tooth. The aim of the present study on buccally-erupted premolars scheduled for orthodontics was to evaluate the keratinized tissue width 3 months, 2 years, and 7 years subsequent to mucogingival interceptive therapy and orthodontic treatment. METHODS: Twenty-nine patients participated. Three different surgical techniques were used according to specific indications. Eight patients were treated with double pedicle flaps (DPF), 10 patients with apically positioned flaps (APF), and 11 with free gingival grafts (FGG). RESULTS: The amount of keratinized tissue on the treated (test) sites was not significantly less than on the control (untreated) sites showing normally erupting premolars at all observation periods. All 3 surgical procedures appeared to be effective in saving the keratinized tissue for the permanent tooth. Preoperative periodontal parameters such as gingival width, probing depth, and bleeding on probing significantly influenced the outcome 3 months after surgery (P <0.01). CONCLUSIONS: Mucogingival interceptive surgery is an effective approach to conserve the keratinized buccal gingiva of ectopically erupting premolars.

Adolescent↗

PubMed1979

Traction--a surgical/orthodontic procedure.

Maxillary crowding may cause failure of eruption of the canine. The teeth so displaced are directed buccally or palatally. In both cases, surgical intervention is indicated after space has been made in the arch. Palatally displaced canines are treated by surgical excision of palatal mucosa to promote eruption. Wide excision is indicated to prevent the healing process from covering the exposed tooth crown. Because of the anatomy of the buccal mucosa, however, surgical excision of the crowns of buccally displaced canine frequently results in periodontal problems. An alternative technique is therefore presented; this involves the surgical exposure of the crowns of buccally displaced teeth to allow the attachment of a wire traction hook. The crown is then recovered. The traction hook provides a point of attachment, so that orthodontic forces may be applied to the unerupted tooth to guide its eruption. The preservation of the mucosal flap ensures a normal epithelial attachment develops on the buccal surface of the tooth, and the normal gingival anatomy of the buccal mucosa is maintained. The procedure may also be used in cases where upper incisors have been prevented from erupting because of the presence of supernumerary teeth. Even after surgical removal of the supernumerary teeth, the permanent incisors often fail to erupt. In such cases, the placement of traction hooks will enable the orthodontist to bring the unerupted teeth into their correct positions in the arch.

Adolescent↗

PubMed2006

Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging.

OBJECTIVE: This study correlated the topographic relationship of the maxillary sinus floor to the roots of posterior teeth imaged by panoramic radiography and cross-sectional computed tomography (CT). STUDY DESIGN: Paired panoramic radiographs and CT images of maxillae from 80 subjects were analyzed. A total of 422 maxillary roots were classified according to their topographic relationship to the maxillary sinus and measured according to their projection lengths on the sinus cavity for both imaging modalities. Correlations between the 2 radiographic techniques were examined statistically. RESULTS: Teeth roots that did not contact the sinus floor or contacted it but did not project on the sinus cavity (classifications 0 and 1) showed a high agreement of 86% to 96% when using the 2 imaging techniques. Only 39% of the teeth roots that projected on the sinus cavity in panoramic radiographs (classification 3) showed protrusion into the sinus with CT. The panoramic radiographs showed a statistically significant 2.1 times longer root projection on the sinus cavity in comparison to the root protrusion length into the sinus measured by using CT images (P < .001). CONCLUSION: For the majority of the roots projecting on the sinus cavity in panoramic radiographs, no vertical protrusion into the sinus was observed in CT images. Roots that did protrude into the sinus in the CT showed a protrusion length that was much shorter than the projection length appearance using panoramic radiography.

Bicuspid↗

PubMed2000

Periodontal health of orthodontically extruded impacted teeth. A split-mouth, long-term clinical evaluation.

BACKGROUND: Impaction of front teeth (often upper canines) can result in esthetic, functional, and phonetic problems, in addition to root resorption and chronic or acute infections. Most impacted front teeth can be extruded orthodontically after minor periodontal surgery. The purpose of this retrospective study was to examine the periodontal outcome of surgically exposed and orthodontically extruded impacted teeth compared with the spontaneously erupted contralateral teeth. METHODS: A total of 38 patients, who had been treated by a combined surgical and orthodontic approach (closed eruption technique by same periodontist and 2 associated orthodontists), underwent a periodontal re-examination after 4 to 10 years. Periodontal parameters (plaque and gingivitis indices, probing depth, bleeding on probing, gingival recession and width, bone level, and root resorption) of the orthodontically extruded teeth (test) were scored and compared with those of the contralateral naturally erupted teeth (control) in a masked set-up. RESULTS: No significant differences could be detected between test and control teeth, except for the gingival width, which was 1 mm larger for the spontaneously erupted teeth. CONCLUSIONS: The data indicate that orthodontic extrusion of impacted front teeth does not jeopardize their periodontal health. This procedure appears to be a satisfactory alternative to extraction and/or transplantation.

Adolescent↗

PubMed1995

Orthodontic eruption of furca-involved molars.

Guided tissue regeneration techniques, which are used in the treatment of certain advanced Class II and Class II furca-involved teeth, have progressed from promising to predictable. However, furca-modification techniques remain important aspects of treatment. Tooth eruption, combined with standard furca-modification techniques, improves the prognosis for both the treated and the adjacent teeth. Continued eruption of periodontally involved molars improves the crown-to-root ratio and maintains the periodontium of the adjacent dentition. These same concepts can be used to treat restoratively compromised molars, many of which were considered hopeless and subsequently extracted. Passive eruption can be useful in treating cases that need less than 3 mm of tooth eruption; orthodontic-active eruption with fixed appliances is advised if more than 3 mm of eruption is desired. Slower eruption rates (2 mm per month) allow the periodontal ligament to repair and the alveolar bone to remodel between orthodontic adjustments (3 to 4 weeks between adjustments). Periodic periodontal maintenance is accomplished during orthodontic treatment. After a retention period (8 weeks), periodontal++ surgery should be performed to reestablish the tooth's biologic width. After surgical wound healing (6 to 8 weeks), the tooth should be restored.

Adolescent↗

PubMed1990

[Changes with time in incomplete root and periodontal tissues of young dog teeth with torque loading applied].

We investigated, using labeling techniques (tetracycline, calcein) and routine histopathological methods (H. E. and Azan stainings), the histological changes with passage of time in incomplete root and the periodontium of young dog teeth with torque loading applied. The maxillary left first, second and third incisor teeth were used as anchorage teeth, and the maxillary right second incisor was loaded with either 3 degrees or 9 degrees torque. The orthodontic forces of these are 20-30 g and 80-90 g, respectively. Some temporal disturbances (such as mild, moderate, or severe bendings of labial and palatal apexes) were observed in certain regions of the apex of the incomplete root. However, with subsequent development of the root, the disturbances were repaired and pulp of the teeth was normally formed. Furthermore, although periodontium was also temporarily disturbed, it developed normally with the passage of time.

Alveolar Bone Loss↗

PubMed2000

A radiographic comparison of apical root resorption after orthodontic treatment with a standard edgewise and a straight-wire edgewise technique.

The purpose of this study was to compare the severity of apical root resorption occurring in patients treated with a standard edgewise and a straight-wire edgewise technique, and to assess the influence of known risk factors on root resorption incident to orthodontic treatment. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars. Variables recorded for each patient included gender, age, ANB angle, overjet, overbite, trauma, habits, invagination, agenesis, tooth shedding, treatment duration, use of Class II elastics, body-build, general factors, impacted canines, and root form deviation. Forty patients were treated with a standard edgewise and 40 with a straight-wire edgewise technique, both with 0.018-inch slot brackets. Crown and root lengths of the maxillary incisors were measured on pre- and post-treatment periapical radiographs corrected for image distortion. Percentage of root shortening and root length loss in millimetres were then calculated. There was significantly more apical root resorption (P < 0.05) of both central incisors in the standard than in the straight-wire edgewise group. No significant difference was found for the lateral incisors. Root shortening of the lateral incisors was significantly associated with age, agenesis, duration of contraction period (distalization of incisors), and invagination, while root shortening of the central incisors was related to treatment group and trauma.

Adolescent↗

PubMed2006

Application of a vibration measuring technique to evaluate the dynamic stiffness of porcine periodontal ligament.

The performance of a tooth replacement by using a dental implant relies on the mechanical and biological capability of the anatomical substitute to restore lost physiological functions. The design of an implant device able to properly replace the physiological tooth requires the study of the load transfer mechanism at the implant-bone interface and the understanding of the relevance of the periodontal ligament (PDL) in this mechanism. The PDL is a connective soft tissue that provides the fixation of the tooth in its bone-socket and the attenuation of occlusal loads. It also provides the ground cells that are involved in the remodelling process, induced by a change in the stress-strain pattern of the alveolar bone and also in the cementum of the tooth root. The purpose of this study was to determine the PDL effects on the dynamic load transfer mechanism, from the tooth to the alveolar bone, evaluating the equivalent dynamic stiffness of the ligament structure. A porcine fresh mandible with a tooth was used within the study, applying an experimental procedure to identify the dynamic transmissibility of the entire system. The transmissibility function provided information about the stiffness and damping of the PDL, information that can assist the design of an improved dental implant system.

Alveolar Process↗

PubMed2005

Intraoral piezosurgery: preliminary results of a new technique.

The piezosurgery instrument, developed in 1988, uses a modulated ultrasonic frequency that permits highly precise and safe cutting of hard tissue. Nerves, vessels, and soft tissue are not injured by the microvibrations (60 to 200 mm/sec), which are optimally adjusted to target only mineralized tissue. The selective and thermally harmless nature of the piezosurgery instrument results in a low bleeding tendency. In addition, the instrument can be used in operations requiring either local or general anesthesia. The precise nature of the instrument allows exact, clean, and smooth cut geometries during surgery. The difference in time requirement for surgical procedures using the piezosurgery instrument in comparison with the conventional drill is negligible. Postoperatively, excellent wound healing, with no nerve and soft tissue injuries, is observed. It is apparent that the range of application of piezosurgery is not limited to minor operations. Because of its highly selective and accurate nature, with its cutting effect exclusively targeting hard tissue, its use may be extended to more complex oral surgery cases, as well as to other interdisciplinary problems.

Adolescent↗

PubMed1995

Pulp and periodontal healing, root development and root resorption subsequent to transplantation and orthodontic rotation: a long-term study of autotransplanted premolars.

One hundred and eighteen premolars transplanted at a stage with 3/4 to 4/4 root development with a wide open apical foramen were followed with standardized clinical and radiographic techniques for signs of pulpal and periodontal ligament healing and root development. Pulp healing, evaluated first by radiographic presence of pulp canal obliteration, appeared to be an earlier sign of pulp healing than the detection of pulp vitality with an electrometric test. Continued root growth of premolars was seen in some cases. Complete arrest of root development was usually followed by development of the missing root structure at the donor site, indicating a separation of the Hertwig's epithelial root sheath. Orthodontic rotation performed on 11 premolars induced slight surface resorption and a significant shortening of tooth length (mean 1.2 mm), compared with nontreated but transplanted control teeth. However, the extent of the apical root resorption is of minor clinical importance, and is equivalent to what has been found in previous investigations of orthodontic treatment of nontransplanted premolars. Late pulp necrosis occurred in 2 of the 11 treated cases 6 years after transplantation and 5 years after orthodontic rotation. To prevent late pulp necrosis, orthodontic rotation is recommended after periodontal healing and before total pulp canal obliteration has taken place, i.e., 3 to 9 months after transplantation.

Bicuspid↗

PubMed2006

A retrospective evaluation of the eruption of impacted permanent incisors after extraction of supernumerary teeth.

AIMS: Delayed eruption of teeth may be caused by the presence of one or more supernumerary teeth. The purpose of this study was to evaluate findings, predisposing factors and differentiate different techniques used that affect the outcome following removal of supernumerary teeth. A comprehensive literature review was also undertaken. METHODS: A longitudinal retrospective study was carried out at the Royal Liverpool Children's Hospital. A total of 120 patients were identified from the general anesthesia records that had supernumeraries extracted. Only 43 cases had delayed eruption of teeth caused by supernumeraries. The pre and post extraction record data collected were the gender, radiographic assessment, position of the supernumerary, age at time of referral and extraction of the supernumerary, age at time of eruption of the impacted tooth and the orthodontic and surgical management. RESULTS: The mean age of referral was 9.1 years with a male to female ratio of 4.4:1. There was a greater predilection for supernumeraries to be on the left side and be positioned palatally. Tuberculate type supernumeraries were the most frequent followed by the conical type. Spontaneous eruption of the impacted tooth occurred in 49% of cases. Eruption of the impacted tooth within eighteen months following removal of the supernumerary was observed in 91% of cases. The chronological age and space availability were the two factors that were critical in determining if eruption was spontaneous following removal of the supernumerary. CONCLUSIONS: The findings of this study reiterates the fact that given early referral, sufficient space and time, the majority of teeth prevented from erupting by a supernumerary tooth would erupt spontaneously following removal of the supernumerary alone. Randomized multi-centre prospective studies are suggested.

Adolescent↗

PubMed1999

The physical characteristics of neodymium iron boron magnets for tooth extrusion.

Impaction and non-eruption of teeth is a common problem encountered in orthodontics and many techniques have been proposed for the management of this condition. It has been advocated that a system utilizing magnets would supply a continuous, directionally sensitive, extrusive force, through closed mucosa and thus provide not only a physiological sound basis for successful treatment, but also reduce the need for patient compliance and appliance adjustment. This ex vivo investigation examined in detail the physical characteristics of neodymium iron boron magnets employed in attraction in order to assess their usefulness in the clinical situation. Attractive force and magnetic flux density measurements were recorded for nine sets of magnet pairs with differing morphologies. The effect of spatial relationship on force was assessed by varying vertical, transverse and horizontal positions of the magnets relative to each other, and by altering the pole face angles. The data obtained suggest that magnets with larger pole face areas and longer magnetic axes provide the best performance with respect to clinical usefulness. It was possible to formulate a specific relationship between force and flux density for each magnet pair. This relationship can be used in the clinical management of unerupted teeth to predict the force between the magnets by measuring the magnetic flux density present at mucosal level. The results indicate that magnetic systems may, indeed, have a place in the treatment of unerupted teeth.

Biomechanical Phenomena↗