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Hurry KJ, Bolooki H, Davies J, Chang C, Jauhar P. A retrospective analysis of the patient journey for children with an unerupted maxillary central incisor. Int J Paediatr Dent 2024; 34:277-284. [PMID: 37985600 DOI: 10.1111/ipd.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/19/2023] [Accepted: 10/26/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Maxillary central incisors (MCI) are the third most impacted teeth. Timely multidisciplinary management is indicated as unerupted incisors can cause functional- and appearance-related distress. AIM To assess the patient journey for children with unerupted MCI, including referral, clinical assessment, surgical management and follow-up treatment, and highlight areas for improvement, as well as identify factors impacting orthodontic treatment burden (OTB). DESIGN A retrospective service evaluation of children aged 6-16 years who had surgical management of unerupted MCI under general anaesthetic (GA) between 2018 and 2021. RESULTS Fifty-two children with 62 unerupted MCI were identified. Mean age at referral was 8.8 years. Most children (82.7%) had supernumerary teeth in the anterior maxilla. Mean time between listing for GA and surgery increased from 4.3 to 15.2 months following the COVID-19 lockdown. Mean age at surgery was 10.4 years. Supernumerary removal and incisor exposure and bond was the most common treatment (56.6%). Most patients required hospital orthodontic treatment post-surgery (65.4%). CONCLUSION Most children referred were below 9 years (60.1%); these children had reduced OTB compared to those who had been referred at an older age. Stage of root development was also a significant predictor in OTB. An unexpected finding was that conical supernumeraries were found to prevent MCI eruption.
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Affiliation(s)
- K Julia Hurry
- Paediatric Dental Department, Institute of Dentistry, Faculty of Medicine and Dentistry, Barts Health NHS Trust, London, UK
| | - Honieh Bolooki
- Orthodontic Department, Royal London Dental Hospital, Barts Health NHS Trust, London, UK
| | - Janet Davies
- Paediatric Dental Department, Institute of Dentistry, Faculty of Medicine and Dentistry, Barts Health NHS Trust, London, UK
| | - Cherry Chang
- Paediatric Dental Department, Institute of Dentistry, Faculty of Medicine and Dentistry, Barts Health NHS Trust, London, UK
| | - Preeti Jauhar
- Orthodontic Department, Royal London Dental Hospital, Barts Health NHS Trust, London, UK
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2
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Bajjad AA, Ahemad MS, Gupta S, Mehjabeen F, Guin S, Mehra S, Rajesh R. Assessment of clinical validity of KPG index for 3D classification of impacted maxillary canines by cone beam computed tomography in patients. Orthod Craniofac Res 2024. [PMID: 38577813 DOI: 10.1111/ocr.12788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVES The primary objective of this study was to assess the validity of the KPG index in predicting the difficulty of treatment involving impacted maxillary canines. The secondary objective was to assess the reliability and reproducibility of the index. MATERIALS AND METHODS A retrospective study was conducted on 96 maxillary impacted canines (MIC) in 60 patients aged 13-35 years. Cone-beam computed tomography (CBCT) scans were used to predict the treatment difficulty of MIC using the KPG index. Patient case files were assessed for the actual difficulty encountered in treating MIC. Cohen's kappa correlation coefficient was used for intra-observer reliability and Kendell's W test was used for inter-observer reliability. Spearman's correlation coefficient test was used to assess the correlation between predicted and actual treatment. RESULTS Easy and moderately difficult cases exhibited a moderate correlation between actual and predicted treatment outcomes, whereas difficult cases displayed a weak correlation. The perfect correlation was observed exclusively in extremely difficult cases. The intra-observer reliability for assessing CBCT scans using the KPG guide was found to be 0.88, and the inter-rater reliability was 0.94. CONCLUSION The KPG index displayed 87%, 71%, 50% and 100% validity in easy, moderately difficult, difficult, and extremely difficult cases, respectively. This index showed good reliability and reproducibility. However, it is imperative to consider a multitude of other factors, including the patient's age, presence of associated root resorption in adjacent teeth, and duration of treatment, to make an informed decision between surgical exposure and extraction.
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Affiliation(s)
- A A Bajjad
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - M S Ahemad
- Department of Orthodontics, Saraswati Dhanwantari Dental College and PG Institute, Parbhani, Maharashtra, India
| | - S Gupta
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - F Mehjabeen
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - S Guin
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - S Mehra
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
| | - R Rajesh
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar-Pradesh, India
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Dias R, Kanungo H, Gupta M, Mishra K, Soni A, Jaiswal A. Comparison of 3D Easy Box cone-beam computed tomography analysis with 2D Modified Easy Box on OPG as a prognostic tool for impacted maxillary canines: A pilot study. J Orthod 2024:14653125241242138. [PMID: 38561938 DOI: 10.1177/14653125241242138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess and compare the validity of 2D modified Easy Box and measurement of the Beta angle on standard conventional orthopantomogram (OPG) versus 3D cone-beam computed tomography (CBCT) OPG-constructed view. DESIGN A retrospective agreement study. METHODS The aim of this study was to construct an Easy Box on a standard conventional OPG and to validate this novel method by comparing it with the Easy Box method on 3D CBCT. After approval from the Ethics Committee, OPG and CBCT radiographs were obtained for the study from departmental records and five private practices in the same location (Indore, India). The radiographs were selected based on record availability and with written consent from the participants before the commencement of the study. The records were analysed to enable a comparison and to assess the accuracy of Easy Box construction on both 3D CBCT and standard conventional OPG radiographs. The location of the impacted canine within the Easy Box boundaries and the measurement of the Beta angle were determined on both views. RESULTS A perfect agreement was obtained for the comparison of 3D Easy Box CBCT analysis with 2D modified Easy Box on OPG for impacted maxillary canines (Kappa = 1.0). A Bland-Altman (LoA) analysis showed no proportional bias in the comparison of the Beta angle on 3D and 2D OPG radiographs. CONCLUSION Beta angle and 2D modified Easy Box on a conventional OPG yield similar results when compared to Easy Box on 3D CBCT OPG-constructed view. The standard OPG was valuable and cost-effective, particularly in the early stages of diagnosis and treatment planning, either as a substitute or when CBCT was unavailable.
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Affiliation(s)
- Rochelle Dias
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Himanshu Kanungo
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Mukesh Gupta
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Kratika Mishra
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Akanksha Soni
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
| | - Aayush Jaiswal
- Department of Orthodontics, Index Institute of Dental Sciences, Indore, Madhya Pradesh, India
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Ilo AM, Waltimo-Sirén J, Pakbaznejad Esmaeili E, Ekholm M, Kortesniemi M. The effect of optimum, indication-specific imaging fields on the radiation exposure from CBCT examinations of impacted maxillary canines and mandibular third molars. Acta Odontol Scand 2024; 82:66-73. [PMID: 38058132 DOI: 10.1080/00016357.2023.2258981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/11/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Indication-specific optimum field-of-views (FOVs) have been assessed for CBCT scans of impacted maxillary canines and mandibular third molars, as 40∅ × 35 mm and 35∅ × 35 mm, respectively. The objective was to investigate possible changes in absorbed organs and effective doses, for these two imaging indications, performing CBCT examinations with optimum FOV sizes instead of commonly used FOVs. Additionally, radiation exposure-induced cancer risk was calculated for both imaging indications with optimum FOVs. METHODS An adult female head phantom (ATOM 702-D, CIRS, Norfolk, VA, USA) was scanned using Planmeca Viso G7 CBCT-device (Planmeca, Helsinki, Finland). Scanning factors, different FOV sizes, dose-area product (DAP) values and anatomical FOV locations were used for Monte Carlo PCXMC-simulation and ImpactMC software. In the PCXMC- simulation, 10-year-old child and 30-year-old adult phantoms were used to estimating effective and absorbed organ doses. RESULTS The effective dose varied from 58 µSv to 284 µSv for impacted maxillary canines, and from 38 µSv to 122 µSv for mandibular third molars, the lowest dose value for each corresponding to optimum FOV. Effective dose reduction between the optimum FOV and the smallest common FOV of 50∅ × 50 mm, maintaining other scanning factors constant, was 33% for impacted maxillary canines, and 45% for mandibular third molars. At all examinations, the highest absorbed organ doses were in salivary glands or in oral mucosa. CONCLUSIONS Optimum FOVs, 40∅ × 35 mm for impacted maxillary canine and 35∅ × 35 mm for mandibular third molar, could decrease effective doses received by young patients, and improve radiation safety in these common CBCT imaging procedures.
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Affiliation(s)
- Anne-Mari Ilo
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, University of Turku, Turku, Finland
| | - Janna Waltimo-Sirén
- Department of Pediatric Dentistry and Orthodontics, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of South-West Finland, Finland
| | | | - Marja Ekholm
- Department of Oral Pathology and Oral Radiology, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of South-West Finland, Finland
- Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Mika Kortesniemi
- HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Shinde M, Daigavane P, Kamble R, Agarwal N, Suchak D, Chaudhari US. An Oral Odyssey: Navigating the Complexity of Impacted Parapremolars and Paramolars in the Oral Landscape! Cureus 2024; 16:e53056. [PMID: 38410302 PMCID: PMC10896245 DOI: 10.7759/cureus.53056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
Supernumerary molars are an uncommon anomaly that can occur in the maxillofacial complex, referring to the presence of additional teeth in the dental arch. This condition is often associated with several rare disorders such as Gardner's syndrome, Cleidocranial dysplasia, Ehler-Danlos syndrome, and Down syndrome However, it is seldom observed in non-syndromic associations. They occur more frequently in the maxilla than in the mandible. This research represents a unique case study that explores unerupted paramolar and parapremolar follicles coexisting in both the maxillary and mandibular arches of a 17-year-old male patient. The discovery of these follicles was fortuitous, as the patient exhibited no symptoms during the initial orthopantomogram scan. Despite the absence of noticeable symptoms, vigilant monitoring and observation were employed over time. Subsequently, a substantial shift in the approach to management occurred with the integration of surgical and orthodontic methodologies, guided eruption strategies, and a collaborative, multidisciplinary effort.
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Affiliation(s)
- Mrudula Shinde
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pallavi Daigavane
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Ranjit Kamble
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nishu Agarwal
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dhwani Suchak
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Utkarsha S Chaudhari
- Orthodontics and Dentofacial Orthopaedics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Skitioui M, Jaoui D, Haj Khalaf L, Touré B. Mandibular Second Molars and Their Pathologies Related to the Position of the Mandibular Third Molar: A Radiographic Study. Clin Cosmet Investig Dent 2023; 15:215-223. [PMID: 37869067 PMCID: PMC10588752 DOI: 10.2147/ccide.s420765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Objective The aim of this study was to determine the prevalence of mandibular third molar malposition and its impact in relation to the lower second molar using panoramic radiography. Methods and Materials This was a cross-sectional descriptive study of 353 panoramic images of patients who visited the Dental Clinic of the International University of Rabat. Panoramic images were analyzed in order to determine the number of second molar pathologies associated with the positions of third molars. The following radiographic lesions on the second molar were recorded: caries, root resorption and distal alveolysis. The Chi-square test was used to assess the association between different variables. Results Of these 353 radiographies, 169 were males, ie, 48%, and 184 were females, ie, 52%. The age range was from 18 to 63 years. The prevalence of the impacted position of the lower third molar was noted in 60%. Distal caries on the second mandibular molar was present in 47.5% of instances having an impacted third molar. Caries was present in 65.5% of wisdom teeth in a normal position and was also present in 79.6% of the impacted teeth. This difference was statistically significant with p = 0.01. The angulation of the third molar is a factor of caries of the second molar: 58.56% of them were carious. Of all the teeth in association with an angulation, 72.03% showed distal alveolysis in the second molar. In addition, root resorption was found in 20.4% of second molars linked to a wisdom tooth in all angulation occurrences. Conclusion It has been noted that among the pathologies seen on the mandibular second molar, distal alveolysis accounts for the majority of cases (58%), followed by caries (47.5%) and root resorption (13.3%). This study illustrated the importance of performing Orthopantomogram X-rays at each new consultation in patients over the age of 18.
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Affiliation(s)
- Mohamed Skitioui
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Dounia Jaoui
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Lauzan Haj Khalaf
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Babacar Touré
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
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Trybek G, Jaroń A, Gabrysz-Trybek E, Rutkowska M, Markowska A, Chmielowiec K, Chmielowiec J, Grzywacz A. Genetic Factors of Teeth Impaction: Polymorphic and Haplotype Variants of PAX9, MSX1, AXIN2, and IRF6 Genes. Int J Mol Sci 2023; 24:13889. [PMID: 37762190 PMCID: PMC10530430 DOI: 10.3390/ijms241813889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/03/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
In recent research, there has been a growing awareness of the role of genetic factors in the positioning and eruption of teeth in the maxilla and mandible. This study aimed to evaluate the potential of specific polymorphic markers of single nucleotide polymorphisms (SNPs) located within the PAX9, MSX1, AXIN2, and IRF6 genes to determine the predisposition to tooth impaction. The study participants were divided into two groups: the first group consisted of individuals with at least one impacted secondary tooth. In contrast, the second group (control group) had no impacted teeth in their jaws. To analyze the genes, real-time PCR (polymerase chain reaction) and TaqMan probes were utilized to detect the selected polymorphisms. The findings suggest that disruptions in the structure and function of the mentioned genetic factors such as polymorphic and haplotype variants of PAX9, MSX1, AXIN2, and IRF6 genes, which play a direct role in tooth and periodontal tissue development, might be significant factors in tooth impaction in individuals with genetic variations. Therefore, it is reasonable to hypothesize that tooth impaction may be influenced, at least in part, by the presence of specific genetic markers, including different allelic variants of the PAX9, AXIN2, and IRF6 genes, and especially MSX1.
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Affiliation(s)
- Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72/18, 70-111 Szczecin, Poland
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland; (A.J.); (A.M.)
| | - Aleksandra Jaroń
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland; (A.J.); (A.M.)
| | - Ewa Gabrysz-Trybek
- Individual Specialist Medical Practice Ewa Gabrysz-Trybek, 70-111 Szczecin, Poland;
| | - Monika Rutkowska
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland; (A.J.); (A.M.)
| | - Aleksandra Markowska
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland; (A.J.); (A.M.)
| | - Krzysztof Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-046 Zielona Góra, Poland; (K.C.); (J.C.)
| | - Jolanta Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-046 Zielona Góra, Poland; (K.C.); (J.C.)
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland;
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Desai SK, Shetye OA, Kamat RD, Mandrekar PN, Sinai Khandeparker RV, Dhupar V. Geminated Supernumerary Premolar Impacted in the Palate: A Report of a Rare Case and Review of the Literature. Cureus 2023; 15:e46244. [PMID: 37908926 PMCID: PMC10613930 DOI: 10.7759/cureus.46244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
Supernumerary teeth are dental anomalies characterized by the presence of an excessive number of teeth in relation to normal dentition. Among these, the supernumerary premolars have a prevalence of 0.29% to 0.64%, making it a very rare finding. On the other hand, gemination is a developmental disturbance in the shape of the teeth where a partial cleavage of a single tooth germ results in the formation of a singular root and a singular pulp chamber but two partially or totally separated crowns. Although these anomalies as individual entities are fairly common in clinical practice, the occurrence of both anomalies in a single tooth is an extremely rare occurrence. We hereby report a rare case of impacted geminated supernumerary premolar in a 45-year-old female patient. A thorough search of the literature revealed that only four cases listing this anomaly have been reported in the literature thus deserving a mention. In addition to the case presentation, the authors have also reviewed the existing literature on this anomaly.
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Affiliation(s)
- Sayali K Desai
- Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
| | - Omkar A Shetye
- Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
| | - Rahul D Kamat
- Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
| | - Pooja N Mandrekar
- Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
| | | | - Vikas Dhupar
- Oral and Maxillofacial Surgery, Goa Dental College and Hospital, Bambolim, IND
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Alfuriji S, Alamro H, Kentab J, Alosail L, Alali L, Altuwaijri N, Alalwan R. Ectopic Permanent Molars: A Review. Dent J (Basel) 2023; 11:206. [PMID: 37754326 PMCID: PMC10529219 DOI: 10.3390/dj11090206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/28/2023] Open
Abstract
Ectopic permanent molar is a condition in which the permanent tooth deviates from its normal path of eruption. The etiology of this eruption anomaly is multifactorial, with both general and local factors. The principal results suggest that a valid indicator of irreversible consequences is the degree of impaction of the first permanent molar. Self-correction is most common between the ages of 7 and 8, after which help may be required. Accordingly, early management can assist in preventing subsequent potential challenges that could interfere with maintaining a balanced occlusion. Several variables, including the degree of mesial tilting, the level of root resorption, and the condition of the second primary molar, may be crucial in choosing the most effective method of treatment. Interproximal wedging and distal tipping are the two basic therapeutic strategies for ectopic permanent molars. Additionally, the use of fixed or removable appliances might also be required. Delaying treatment until a later stage is not recommended because early diagnosis and treatment are essential for optimal management. This review aims to provide a comprehensive overview of ectopic permanent molars, including their prevalence, etiologic factors, self-correction rates, clinical implications for adjacent teeth, and various treatment techniques, that emphasizes the importance of early detection and intervention in the successful management of ectopic permanent molars. In addition, it highlights the importance of future research into the contributing variables of irreversible ectopic molar outcomes.
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Affiliation(s)
- Samah Alfuriji
- Department of Preventive Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia;
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, P.O. Box 3660, Riyadh 11481, Saudi Arabia
| | - Haifa Alamro
- Department of Preventive Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia;
- King Abdullah International Medical Research Center, Ministry of National Guard-Health Affairs, P.O. Box 3660, Riyadh 11481, Saudi Arabia
| | - Jomanah Kentab
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia; (J.K.); (L.A.); (N.A.); (R.A.)
| | - Lama Alosail
- Department of Periodontics, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, P.O. Box 22490, Riyadh 11426, Saudi Arabia;
| | - Linah Alali
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia; (J.K.); (L.A.); (N.A.); (R.A.)
| | - Nada Altuwaijri
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia; (J.K.); (L.A.); (N.A.); (R.A.)
| | - Rahaf Alalwan
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 3660, Riyadh 11481, Saudi Arabia; (J.K.); (L.A.); (N.A.); (R.A.)
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10
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Bin Rubaia’an MA, Neyaz A, Talic F, Alkhamis A, Alghabban A, Assari A. The Association Between Skeletal Facial Types and Third Molars Impaction in a Saudi Arabian Subpopulation: A CBCT Study. Clin Cosmet Investig Dent 2023; 15:143-156. [PMID: 37601239 PMCID: PMC10439799 DOI: 10.2147/ccide.s419325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/04/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To assess the state of mandibular and maxillary third molars in relation to different facial types in a Saudi population using cone-beam computed tomography (CBCT) records. Patients and Methods A retrospective study was performed on CBCTs. Statistical analysis determined the relationship between impacted maxillary and mandibular third molars and different skeletal facial types. The degree of third molar impaction was evaluated. Results A total of 198 CBCTs from subjects were evaluated, with a mean age of 34.2 years. Archer II classification was found to be significantly associated with all skeletal profiles. The incidence of mesioangular impactions in lower third molar showed a notable increase in the brachyfacial group, which was statistically significant. Conclusion In conclusion, this study demonstrates that different facial types are associated with the angulation of third molar impactions.
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Affiliation(s)
| | - Aymen Neyaz
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Talic
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | - Ali Alkhamis
- College of Dentistry, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
| | | | - Ahmad Assari
- Oral and Maxillofacial Surgery and Diagnostic Sciences Department, Riyadh Elm University, Riyadh, Kingdom of Saudi Arabia
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11
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Park S, Lee H, Lee E, Jeong T, Lee H, Shin J. Guided Autotransplantation of Impacted Canines Using a CAD/CAM Surgical Template. Children (Basel) 2023; 10:children10040708. [PMID: 37189956 DOI: 10.3390/children10040708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 05/17/2023]
Abstract
Autotransplantation is a potential treatment alternative when orthodontic traction of an impacted tooth is difficult. In this article, we describe two cases of guided autotransplantation of an impacted canine using a computer-aided designed and manufactured surgical template. The impacted canine was segmented on preoperative cone-beam computed tomography images to ensure a sufficient periodontal ligament space and placement of the donor tooth with the least pressure on it. The canine was virtually transposed using a simulation program considering the adjacent teeth. The surgical template, which was connected to the occlusal stop on adjacent teeth, was designed and 3D-printed with polymer resin. The recipient site was prepared using the surgical template, followed by immediate transplantation of the surgically extracted canine into the socket. The transplanted donor tooth was positioned in planned infra-occlusion to prevent occlusal interference. It was then splinted with the adjacent teeth for initial stabilization. During follow-up, one transplanted tooth showed pulp canal obliteration and the other had suspected pulp necrosis; endodontic treatment was performed. One year after the procedure, the periradicular condition of both teeth was favorable.
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Affiliation(s)
- Soyoung Park
- Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea
| | - Haena Lee
- Department of Pediatric Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Eungyung Lee
- Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea
- Department of Pediatric Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Taesung Jeong
- Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea
- Department of Pediatric Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea
| | - Jonghyun Shin
- Department of Pediatric Dentistry, Dental Research Institute, Pusan National University Dental Hospital, Yangsan 50612, Republic of Korea
- Department of Pediatric Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan 50612, Republic of Korea
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Patano A, Inchingolo AM, Laudadio C, Azzollini D, Marinelli G, Ceci S, Latini G, Rapone B, Inchingolo AD, Mancini A, Inchingolo F, Di Venere D, Tartaglia GM, Dipalma G, Malcangi G. Therapeutic Strategies of Primary Molar Infraocclusion: A Systematic Review. Children (Basel) 2023; 10:children10030582. [PMID: 36980140 PMCID: PMC10047580 DOI: 10.3390/children10030582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/08/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Infraocclusion of deciduous molars is a clinical disturbance that occurs during primary and mixed dentition and has some orthodontic implications. Infraoccluded teeth are believed to be potential sites of malocclusion, with a risk of tipping neighbouring teeth and losing space. This systematic review aims to analyse the management of primary molars infraocclusion and to provide updated guidelines. METHODS A literature search was performed using PubMed, Scopus, and Web of Science databases from 1 January 2017 to 28 November 2022. The inclusion criteria were: studies only on human subjects, open access studies, case reports, randomised trials, retrospective, observational studies, and English language. RESULTS A total of 372 publications were identified from the databases and a final number of nine studies were included in the review for qualitative analysis. CONCLUSION Management of patients suffering from infraocclusion depends on the severity, age at diagnosis, and presence of succeeded premolars. Early diagnosis of infraoccluded primary elements is fundamental and cannot be postponed. Preservation of the primary molars may be a valid option with long-term stability if there is no or moderate primary molar infraocclusion, root resorption of less than half of the root, and no decay or restoration.
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Affiliation(s)
- Assunta Patano
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Claudia Laudadio
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Azzollini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Grazia Marinelli
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Sabino Ceci
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giulia Latini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | | | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Milan, Italy
- UOC Maxillo-Facial Surgery and Dentistry, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20100 Milan, Italy
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy
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Altaweel AA, El-Hamid Gaber A, Alnaffar MZ, Almowallad AS, Almech MH, Almuwallad AS, Alharbi RK, Arab WA. A novel therapeutic approach for reducing postoperative inflammatory complications after impacted mandibular third molar removal. Medicine (Baltimore) 2022; 101:e30436. [PMID: 36123843 PMCID: PMC9478325 DOI: 10.1097/md.0000000000030436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND This study was designed to compare effect of combined use of dexamethasone and honey versus each agent alone in controlling complications associated with removal of impacted mandibular third molar. METHODS This randomized clinical study included patients suffering from impacted mandibular wisdom teeth. Patients were divided randomly into 4 groups. Group I, control, group II, received dexamethasone injection preoperatively, group III, received honey locally in the wound after extraction, and group IV, received dexamethasone injection preoperatively and topical honey application. All patients were evaluated preoperatively and postoperatively to assess facial edema, interincisal distance, pain, and total analgesic dose used. RESULTS Significant edema developed in group I than other groups and improved significantly in group II and III on seventh postoperative day, and tenth postoperative day in group I. Insignificant edema developed in group IV. Significant decrease in interincisal distance occurred in all groups on third postoperative day that improved significantly on seventh postoperative days in all groups except group I, it improved on tenth postoperative day. Pain was significantly minimum in group IV than other groups and its maximum degree was in group I. CONCLUSION Both dexamethasone and honey are an effective way of minimizing swelling, pain, and trismus after removal of impacted lower third molars. Both agents either alone or in combination provide simple, safe, painless, and cost-effective method to eliminate postoperative discomfort. However, dexamethasone or honey can decrease complications related to surgical extraction of mandibular third molar, the simultaneous application of both agents is more effective method in this regard.
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Affiliation(s)
- Alaa Abdelqader Altaweel
- Oral & Maxillofacial Surgery, Faculty of Dental Medicine for Boys, Al-Azhar University, Cairo, Egypt
- Consultant of Oral & Maxillofacial Surgery, Nahdicare Clinics, Jeddah, Saudi Arabia
- *Correspondence: Alaa Abdelqader Altaweel, Faculty of Dental Medicine for Boys, Al-Azhar University, AL Mokhaym AL Daem St., Nasr City, Cairo 11751, Egypt (e-mail: )
| | - Abd El-Hamid Gaber
- Clinical Pharmacology, Department of Clinical Pharmacology, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Mahmoud Z. Alnaffar
- Periodontology and Preventive Dentistry, Vision Colleges, Jeddah, Saudi Arabia
| | | | | | | | | | - Wasan A. Arab
- Dental Intern at Vision Colleges, Jeddah, Saudi Arabia
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Díaz-Reissner C, Pistilli E, Caje R, Maldonado C, Jolay E, Ferreira-Gaona M. [Prognosis of impacted canines according to their position in the upper maxillary using different radiographic analyzes]. Rev Cient Odontol (Lima) 2022; 10:e096. [PMID: 38389911 PMCID: PMC10880707 DOI: 10.21142/2523-2754-1001-2022-096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/14/2022] [Indexed: 02/24/2024] Open
Abstract
Introduction Canine impaction is an anomaly in which the tooth is prevented from erupting. It occurs when eruption has been delayed and there is radiographic evidence. Objective To determine the prognosis of impacted canines according to their position in the maxilla by means of different analyses: Ericson & Kurol, Warford and Power & Short; in patients attending private clinics in the city of Asuncion from 2015 to 2020. Methodology The design is observational descriptive, cross-sectional, using panoramic radiograph measurements. Results: The sample consisted of 37 patients and the 48 canines. It was found that the presence of impacted canines was more frequent in women (69.44%), with unilateral location (70.27%) and palatal position (68.75%). In more than half of the cases the prognosis was unfavorable, however, the concordance was only 75%. There was greater concordance in Warford's prognosis with that of Power & Short (95.91%), while the concordance was lower with that of Ericson & Kurol (81.25%). Conclusion The frequency of impacted canines in a Paraguayan sample was higher in females, unilaterally located and positioned by palatine. Being unfavorable in more than half of the cases. It is suggested to combine the analyses for projection.
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Affiliation(s)
- Clarisse Díaz-Reissner
- Direccion de Investigacion. Facultad de Odontologia. Universidad Nacional de Asuncion, Paraguay. , Universidad Nacional de Asunción Direccion de Investigacion Facultad de Odontologia Universidad Nacional de Asuncion Paraguay
| | - Elke Pistilli
- Instituto Latinoamericano de Estudios Superiores. Asuncion, Paraguay. , , , Instituto Latinoamericano de Estudios Superiores Asuncion Paraguay
| | - Rodrigo Caje
- Instituto Latinoamericano de Estudios Superiores. Asuncion, Paraguay. , , , Instituto Latinoamericano de Estudios Superiores Asuncion Paraguay
| | - Clara Maldonado
- Instituto Latinoamericano de Estudios Superiores. Asuncion, Paraguay. , , , Instituto Latinoamericano de Estudios Superiores Asuncion Paraguay
| | - Elena Jolay
- Instituto Latinoamericano de Estudios Superiores. Asuncion, Paraguay. , , , Instituto Latinoamericano de Estudios Superiores Asuncion Paraguay
| | - Marta Ferreira-Gaona
- Direccion de Investigacion. Facultad de Odontologia. Universidad Nacional de Concepcion, Paraguay. Universidad Nacional de Concepción Direccion de Investigacion Facultad de Odontologia Universidad Nacional de Concepcion Paraguay
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Andresen AK, Jonsson MV, Sulo G, Thelen DS, Shi XQ. Radiographic features in 2D imaging as predictors for justified CBCT examinations of canine-induced root resorption. Dentomaxillofac Radiol 2022; 51:20210165. [PMID: 34324382 PMCID: PMC8693324 DOI: 10.1259/dmfr.20210165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES This retrospective observational study aimed to evaluate the diagnostic accuracy of two-dimensional radiographs on canine-induced root resorption (CIRR) in lateral incisors and identify predictors of CIRR in patients with impacted maxillary canines (IMC). METHODS Ninety-nine patients aged 9-17 years, with 156 IMCs, were included in the study. All had CBCT-volumes and two-dimensional radiographs consisting of at least one panoramic radiograph. Two radiologists jointly viewed all cases twice. First, radiographic features related to the IMC and possible CIRR were recorded from two-dimensional radiographs. Then, CIRR was determined from CBCT and according to position and extension classified as mild, moderate and severe. RESULTS CIRRs was detected in 80% of lateral incisors (mild: 45%; moderate: 44%; severe: 11%). The sensitivity was generally low at mild and moderate cut-offs (29 and 29%), and somewhat higher for severe (50%). Corresponding specificities were 48%, 63% and 68%. Canine cusp-tip superimposing the lateral incisor's middle third and root/crown ratio >1 was positively associated with mild CIRR, with an odds ratio (OR) of 3.8 and 6.7, respectively. In addition, the root development stage was positively associated with moderate/severe CIRR when the canine root was nearly or fully developed (OR = 3.1). CONCLUSIONS The diagnostic accuracy of two-dimensional radiographs was inadequate for detecting CIRR amongst patients referred for CBCT examinations. Based on our results, none of the suggested two-dimensional radiographic features could predict moderate/severe CIRR except for root development stage. IMC in a later stage of root development seems to be associated with a higher risk of moderate/severe CIRR.
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Affiliation(s)
- Amanda K.H. Andresen
- Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Norway, United Kingdom
| | | | | | - Dorina S. Thelen
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway, United Kingdom
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Kumari CBN, Ramakrishnan T, Devadoss P, Vijayalakshmi R, Alzahrani KJ, Almasri MA, Al-Ahmari MM, Al Dira HS, Suhluli M, Bhati AK, Ahmad ZH, Raj AT, Bhandi S, Patil S. Use of Collagen Membrane in the Treatment of Periodontal Defects Distal to Mandibular Second Molars Following Surgical Removal of Impacted Mandibular Third Molars: A Comparative Clinical Study. Biology (Basel) 2021; 10:biology10121348. [PMID: 34943263 PMCID: PMC8698821 DOI: 10.3390/biology10121348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/12/2021] [Accepted: 12/16/2021] [Indexed: 06/01/2023]
Abstract
The study aims to assess the efficacy of using collagen membrane in the treatment of distal periodontal defects of mandibular second molars following the removal of mesioangularly or horizontally impacted mandibular third molars surgically. Forty sites in twenty patients with bilaterally impacted mandibular third molars (mesioangular or horizontal) were considered for the study. In 20 test sites (Group A), after surgical removal of the mandibular third molar, a resorbable collagen membrane barrier was placed on the distal aspect of the mandibular second molar to cover the post-surgical bone defect. In the other control 20 sites (Group B), the same surgical procedure was repeated without placing any membrane barrier. The clinical parameters recorded were Oral Hygiene Index Simplified (OHI-S), Probing pocket depth (PPD), Clinical attachment level (CAL), and radiographic assessment of alveolar bone level (ABL). OHI-S score of most of the patients was observed to be satisfactory. Group A was observed to achieve a statistically significant reduction in PPD, CAL, and ABL gain compared to Group B. The improvements indicated that the use of collagen membrane facilitates early wound stabilization and promotes primary closure of the defect. This recovery is achieved through its unique property to assist fibrinogenesis over osteoconduction. Further longitudinal studies are needed to confirm the present findings.
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Affiliation(s)
- C. Burnice Nalina Kumari
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Thiagarajan Ramakrishnan
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Pradeep Devadoss
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India;
| | - Rajaram Vijayalakshmi
- Department of Periodontology and Implantology, Faculty of Dentistry, Meenakshi Academy of Higher Education and Research, Chennai 600095, India; (T.R.); (R.V.)
| | - Khalid J. Alzahrani
- Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 11099, Saudi Arabia;
| | - Mazen A. Almasri
- Department of Oral Maxillofacial Surgery, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Manea Musa. Al-Ahmari
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Hajar Saeed Al Dira
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.S.A.D.); (M.S.)
| | - Malath Suhluli
- College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia; (H.S.A.D.); (M.S.)
| | - Ashok Kumar Bhati
- Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Zeeshan Heera Ahmad
- Dental College Hospital, King Saud University Medical City, Riyadh 11362, Saudi Arabia;
| | - A. Thirumal Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai 600130, India;
| | - Shilpa Bhandi
- Department of Restorative Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Shankargouda Patil
- Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Stabryła J, Plakwicz P, Kukuła K, Zadurska M, Czochrowska EM. Comparisons of different treatment methods and their outcomes for impacted maxillary and mandibular canines: A retrospective study. J Am Dent Assoc 2021; 152:919-926. [PMID: 34489068 DOI: 10.1016/j.adaj.2021.05.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/26/2021] [Accepted: 05/18/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Impacted canines may pose a functional and an esthetic problem for patients and can affect neighboring incisors. The aim of the study was to compare different treatment methods and their outcomes for impacted maxillary and mandibular canines. METHODS The authors included 102 patients with 118 impacted canines (82 maxillary and 36 mandibular canines). Impacted canine were confirmed during clinical and radiologic examinations. Eighty-five patients (83%) with 97 impacted canines started the treatment. The authors analyzed treatment types and outcomes. Two maxillary and 4 mandibular canines were scheduled for extraction. RESULTS Orthodontic extrusion was used most frequently to treat impacted maxillary canines (89%), whereas orthodontic extrusion and transalveolar transplantation were performed most frequently in impacted mandibular canines (33% and 37.5%, respectively). The treatment was successful in 96% of the maxillary and 95% of the impacted mandibular canines. CONCLUSIONS Different methods were used for impacted maxillary and mandibular canines, but their overall success rate was high. PRACTICAL IMPLICATIONS Successful outcome is determined via a well-planned and carefully executed orthodontic and surgical treatment. Early diagnosis is pivotal in facilitating spontaneous canine eruption and implementing transalveolar transplantation in a timely way.
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Žarovienė A, Grinkevičienė D, Trakinienė G, Smailienė D. Post-Treatment Status of Impacted Maxillary Central Incisors following Surgical-Orthodontic Treatment: A Systematic Review. Medicina (Kaunas) 2021; 57:783. [PMID: 34440987 DOI: 10.3390/medicina57080783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022]
Abstract
Background and Objectives: The aim of this systematic review was to summarize currently available data of published articles that have investigated the post-treatment status of impacted maxillary central incisors (ICI) treated by the surgical-orthodontic approach. Materials and Methods: MEDLINE, Scopus, Cochrane Oral Health Group’s Trials Register, and ScienceDirect electronic databases were systematically searched with no publication date restrictions up to January 2021. Data assessing the status of ICI after combined surgical-orthodontic treatment and forced eruption duration were extracted, and the quality of the studies was evaluated. Results: In total, 7074 studies were identified, of which 42 articles were assessed for eligibility through full-text evaluation. Seven included studies (five retrospective studies, one randomized clinical trial, and one prospective clinical trial) met the inclusion criteria, representing 211 patients with unilaterally impacted maxillary incisors. The risk of bias ranged from moderate to high. The results show that the root length of immature ICIs increased significantly but remained shorter than that of homonym teeth at post-treatment. Periodontal parameters of treated ICIs were in a clinically acceptable range. Measurements of the alveolar bone showed a reduction of bone thickness and support. The average forced eruption duration ranged from 8.0 ± 4.5 to 14.41 ± 4.03 months. Conclusions: Based on existing evidence, it is reasonable to conclude that the surgical-orthodontic treatment affected the post-treatment status of ICI; however, the current literature is insufficient to draw concrete conclusions. Further well-conducted multi-center randomized studies with a large sample are needed to confirm this statement.
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Crincoli V, Cazzolla AP, Di Comite M, Lo Muzio L, Ciavarella D, Dioguardi M, Bizzoca ME, Palmieri G, Fontana A, Giustino A, Di Cosola M, Vincenzo B, Lovero R, Di Serio F. Evaluation of Vitamin D (25OHD), Bone Alkaline Phosphatase (BALP), Serum Calcium, Serum Phosphorus, Ionized Calcium in Patients with Mandibular Third Molar Impaction. An Observational Study. Nutrients 2021; 13:1938. [PMID: 34200107 DOI: 10.3390/nu13061938] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to evaluate the levels of vitamin D (25OHD) and other bone biomarkers in patients with third molar impaction (TMI). Thirty males and 30 females with unilateral or bilateral impacted mandibular third molar, and 15 males and 15 females as a control group (CG) were recruited. Rx-OPT was used to evaluate dental position and Pederson index to measure the difficulty of the intervention. Bone biomarkers were measured through blood venous sample in TMI group and CG. Mann-Whitney test, Pearson’s correlation coefficient, linear regression model were used to compare the different parameters in the two groups. 25OHD showed lower values in TMI group than in CG (p < 0.05) with values significantly lower in bilateral impaction (p < 0.05). Pearson’s coefficient for 25OHD presented a negative correlation with the Pederson index (ρ = −0.75). Bone alkaline phosphatase (BALP) showed significantly lower dosage in TMI group than CG (p = 0.02), Pearson’s coefficient for BALP presented a negative correlation with the Pederson index. Serum calcium, serum phosphorus, ionized calcium levels in TMI and CG groups were similar and Mann-Whitney test did not significantly differ between TMI and CG. TMI could be a sign of vitamin D deficiency and of low BALP levels that should be investigated.
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Rohani K, Eslamian L, Nahvi G. Correlation between maxillary cuspid impaction with available space and anomalies of maxillary lateral incisors. Dent Res J (Isfahan) 2021; 18:27. [PMID: 34249253 PMCID: PMC8248261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 06/18/2020] [Accepted: 09/09/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Association of cuspid impaction with adjacent lateral incisor anomalies is under controversy. The aim of this study was to investigate the correlation between maxillary cuspid impaction with dental anomalies. MATERIAL AND METHODS In this in vitro experimental study, the material consisted of pretreatment dental records of 102 patients with at least one palatally or buccally displaced impacted permanent cuspid (palatal and buccal impaction groups). They were matched with a comparison control group of 102 patients having normally erupted maxillary cuspids. Available space, mesiodistal dimensions of teeth, and morphologic parameters of lateral incisors were measured using the digital caliper. Comparison of mean values of lateral incisors anomalies and severity of crowding between different groups were performed using the one-way ANOVA test, and the analysis of associations between position of the impaction and anomaly of the lateral incisors and severity of crowding was performed using the Chi-square test. P < 0.05 was considered statistically significant. RESULTS There was no statistically significant difference in the arch length-tooth size discrepancy between the cuspid impaction groups and control group. The impaction group (buccal or palatal) presented statistically significant differences in terms of anomalies of maxillary lateral incisor compared to the control group. Peg-shaped lateral incisor was related to buccal cuspid impaction and microdontia had relationship with palatal cuspid impaction. CONCLUSION There is the relationship between cuspid impaction and adjacent lateral incisor abnormality, but no difference was observed between buccal and palatal cuspid impactions. Crowding revealed no relationship with cuspid impaction (buccal or palatal) in this study.
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Affiliation(s)
- Kimia Rohani
- MSc Student, Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada
| | - Ladan Eslamian
- Professor of Orthodontics, Dentofacial Deformities Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Golnaz Nahvi
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Golnaz Nahvi, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail:
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Abstract
We encountered a 73-year-old patient who presented with right upper abdominal pain and jaundice. On evaluation, he was found to have cholelithiasis with choledocholithiasis. Endoscopic retrograde cholangiography was attempted, but during the procedure, the wire snapped and the dormia basket got retained in the common bile duct (CBD). Laparoscopic CBD exploration was performed and the basket with calculus was found impacted in the lower CBD. The basket was disengaged by holding its tip through another dormia introduced through choledochoscope and basket with all calculi retrieved. Clearance of CBD was ascertained with choledochoscopy and CBD was closed primarily. He did well in the post-operative period and was discharged on the 5th post-operative day. At 1-year follow-up, the patient was doing well. Laparoscopic CBD exploration is a feasible and safe option for the retained dormia basket. We utilised the 'dormia with dormia technique' to retrieve the impacted basket which has not been reported before.
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Affiliation(s)
- Vaibhav Kumar Varshney
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - K S Sreesanth
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Manish Gupta
- Department of Gastroenterology, Goyal Hospital, Jodhpur, Rajasthan, India
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Elgebaly O, Abdeldayem H, Idris F, Elrifai A, Fahmy A. Antegrade mini-percutaneous flexible ureteroscopy versus retrograde ureteroscopy for treating impacted proximal ureteric stones of 1-2 cm: A prospective randomised study. Arab J Urol 2020; 18:176-180. [PMID: 33029428 PMCID: PMC7473252 DOI: 10.1080/2090598x.2020.1769385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Objectives To prospectively assess the safety and effectiveness of antegrade mini-percutaneous (miniperc) ureteroscopy (URS) and compare it with the conventional retrograde URS (RURS) approach in treating impacted proximal ureteric stones of 1–2 cm. Patients and methods The study included 60 patients admitted to the Department of Urology, Alexandria Main University Hospital, presenting with impacted proximal ureteric stones of 1–2 cm. Patients were randomly divided into two groups: Group A, were treated with RURS using a semi-rigid or flexible ureteroscope to access the stone; and Group B, were treated by antegrade miniperc URS, were a 14-F renal tract was obtained to pass a ureteric access sheath, then a flexible ureteroscope was used going downwards to the stone. Holmium laser was used for stone fragmentation. A JJ stent was inserted in all cases. Follow-up with non-contrast computed tomography was performed after 2 weeks. Results Both groups were comparable in terms of patient demographics and stone criteria. The stone-free rate was significantly higher in Group B (83.3%) compared to Group A (60%). The mean (SD) operative time was significantly shorter in Group A vs Group B, at 64.7 (±17.7) vs 112.0 (±15.3) min; while the mean lithotripsy time was comparable between the groups. The mean radiation exposure time was significantly less in Group A (11 s) compared to Group B (200 s). Both groups where comparable concerning minor complications, with no major complications. Conclusion Antegrade miniperc flexible URS is safe and more effective than RURS for treating large impacted proximal ureteric stones. Abbreviations ESWL: extracorporeal shockwave lithotripsy; KUB: plain abdominal radiograph of the kidneys, ureters and bladder; miniperc: mini-percutaneous; PCNL: percutaneous nephrolithotomy; PCS: pelvi-calyceal system; SFR: stone-free rate; (R)URS: (retrograde) ureteroscopy
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Affiliation(s)
- Omar Elgebaly
- Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hussein Abdeldayem
- Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Faisal Idris
- Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Alaa Elrifai
- Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Fahmy
- Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Yhoshu E, Chaudhary G, Gupta MK. Retained wooden foreign body in groin in a child: A case report and review of literature. Afr J Paediatr Surg 2020; 17:127-130. [PMID: 33342850 PMCID: PMC8051621 DOI: 10.4103/ajps.ajps_22_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/19/2020] [Accepted: 10/08/2020] [Indexed: 11/04/2022] Open
Abstract
Wooden foreign body (WFB) injuries in children are common. They may report with acute presentation or be delayed as retained foreign body giving rise to complications. Cases with superficial skin penetration by these foreign bodies and acute presentation may be convenient to diagnose and remove. However, localising deeply impacted and chronically retained WFB is challenging, as they are usually not radiopaque and have a tendency to move deeper into the surrounding soft tissues with time. Foreign body retained for prolonged duration may present with either cellulitis, deep tissue infections, sinus, restriction of joint movements, necrotising fasciitis, osteomyelitis or tumour-like mass. We present an 8-year-old boy with discharging sinuses in the right iliac fossa and medial aspect of the right upper thigh, due to an impacted WFB for 3 months. Prompt radiological imaging and surgical removal helped him recover completely.
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Affiliation(s)
- Enono Yhoshu
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Gyanendra Chaudhary
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manish Kumar Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Chandhoke R, Bamberger JN, Gallante B, Atallah W, Gupta M. Peri-Calculus Ureteral Thickness on Computed Tomography Predicts Stone Impaction at Time of Surgery: A Prospective Study. J Endourol 2019; 34:107-111. [PMID: 31650853 DOI: 10.1089/end.2019.0449] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction and Objectives: Ureteroscopic management of impacted ureteral stones poses multiple challenges. We examined whether ureteral thickness measured on preoperative noncontrast computed tomography (CT) is predictive of stone impaction at the time of ureteroscopy (URS). Methods: Thirty-eight patients with preoperative CT scan and undergoing URS for ureteral stones were prospectively studied. Ureteral thickness directly above, around (peri-calculus ureteral thickness [P-CUT]), and below the calculus were determined on CT scan. The cross-sectional surface area around the stone (P-CUT) was also calculated. Stones were considered impacted at surgery if contrast had difficulty passing, a guidewire could not pass, and the stone was visually impacted >5 on a Likert scale. The surgeon determining intraoperative impaction and the individual measuring the ureteral thickness on CT were blinded. Results: Fourteen of the 38 patients were found to have an impacted ureteral stone at the time of surgery. Patients with an intraoperative finding of an impacted stone had significantly higher ureteral thickness above, around (P-CUT), below the calculus, and P-CUT surface area with all four p-values <0.001. P-CUT surface area was independently predictive of impaction at the time of surgery on multivariate analysis. A mean P-CUT of 6.1 and 1.6 mm and P-CUT surface area of 92.6 and 15.4 mm2 were noted for the impacted and nonimpacted stones, respectively. Conclusion: Ureteral thicknesses above, around (P-CUT), and below the calculus are readily measurable on CT scan. P-CUT surface area can also be calculated for a stronger representation of ureteral thickness. These four parameters are predictive of ureteral stone impaction and useful for surgical planning and patient counseling.
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Affiliation(s)
- Ryan Chandhoke
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Jacob N Bamberger
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Blair Gallante
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - William Atallah
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mantu Gupta
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York
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Shoshani-Dror D, Shilo D, Ginini JG, Emodi O, Rachmiel A. Controversy regarding the need for prophylactic removal of impacted third molars: An overview. Quintessence Int 2019; 49:653-662. [PMID: 30109309 DOI: 10.3290/j.qi.a40784] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Removal of third molars (3Ms) is one of the most common surgical procedures performed by dental surgeons. 3Ms that are associated with pathologic changes such as infection, nonrestorable caries lesions, cysts, tumors, and destruction of adjacent teeth and bone are under consensus for their removal. However, debate exists regarding the prophylactic removal of asymptomatic impacted 3Ms. This review attempts to establish indications for prophylactic extraction of 3Ms. METHOD AND MATERIALS Clinical experience and a summary of the literature are presented concerning the effects of retained 3Ms in relation to caries and periodontal disease, dental arch changes and anterior crowding, cysts and other etiologies, mandibular fractures, temporomandibular pain, and aging of bone. RESULTS Nearly half of impacted 3Ms are associated with some form of pathology, most frequently caries (20%) and periodontal disease (17%). They increase the probability of fractures and their presence results in difficult fracture reduction and a higher rate of complication. The number of 3Ms decreases rapidly with age, with only 31% remaining at 38 years of age. CONCLUSION Preventive removal of 3Ms at a young age is justified because retained 3Ms are at high risk of developing various pathologies. In addition, at older ages extraction of 3Ms becomes more complex, with an increased rate of complication due to deteriorated systemic physiologic conditions and changes in bone physiology.
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Punnoose SE, Victor J, Hazarika P, Ss M. C-MAC® video-laryngoscope assisted removal of pediatric upper airway foreign body via apneic technique: Two case reports. SAGE Open Med Case Rep 2019; 7:2050313X18823088. [PMID: 30719297 PMCID: PMC6349973 DOI: 10.1177/2050313x18823088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 12/13/2018] [Indexed: 11/16/2022] Open
Abstract
C-MAC® video-laryngoscope is often used by anesthetists in difficult intubation
scenarios primarily in adults. Using this C-MAC® device in two of our pediatric
cases, we successfully removed the laryngeal foreign body, while the anesthetist
provided the apneic technique. A systematic review of PubMed and Google Scholar
for similar cases was conducted. We found only one such case report of pediatric
airway foreign body removal via video-laryngoscope in the English literature.
The use of this high-quality, magnified video-laryngoscope in children in an
emergency scenario is often not adequately applied. This procedure provides
continuous real-time visualization to both the operating surgeon as well as the
anesthetist in respect to the airway and thereby reduces the chance of any
untoward complications. Here, we present two interesting case reports of C-MAC®
video-laryngoscope assisted removal of laryngeal foreign body via apneic
technique with spontaneous ventilation performed on two different children in
our facility. Both these children had clinical symptoms of upper airway
obstruction with fluctuating stridor simulating croup or asthma.
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Affiliation(s)
| | - John Victor
- Department of ENT, NMC Specialty Hospital, Abu Dhabi, UAE
| | | | - Marla Ss
- Department of Anesthesia, NMC Specialty Hospital, Abu Dhabi, UAE
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Grisar K, Vanpoecke J, Raes M, Albdour EA, Willems G, Politis C, Jacobs R. Development and validation of the autotransplanted maxillary canine radiological index. Clin Exp Dent Res 2018; 4:167-173. [PMID: 30386638 PMCID: PMC6203832 DOI: 10.1002/cre2.125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 11/11/2022] Open
Abstract
The purpose of this study was to propose and validate an index evaluating 2D and 3D radiographic variables of autotransplanted maxillary canines. Setting and sample population are from the Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Eight oral-maxillofacial surgeons rated 12 autotransplanted maxillary canines and adjacent bone using 11 rating variables. A new autotransplanted maxillary canine radiological index (AMCRI) was proposed. It consisted of 11 variables. These variables were based on 2D (intraoral) and 3D Cone Beam Computed Tomography (CBCT) radiographs. Intraclass correlation coefficient (ICC) and Fleiss's kappa statistics were performed to analyze intrarater and interrater agreement. Considering cumulative assessment of the AMCRI, the mean ICC value for the interrater agreement of the eight examiners was 0.94, representing an excellent agreement. Intrarater agreement was 0.91. The AMCRI is an objective tool in rating radiological outcome of autotransplanted canines and adjacent bone, when compared with the contralateral canine.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Jasper Vanpoecke
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Margot Raes
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Emad Ali Albdour
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Guy Willems
- Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
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Grisar K, Claeys G, Raes M, Albdour EA, Willems G, Politis C, Jacobs R. Development and validation of the Maxillary Canine Aesthetic Index. Clin Exp Dent Res 2018; 4:216-223. [PMID: 30386643 PMCID: PMC6203826 DOI: 10.1002/cre2.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 08/28/2018] [Accepted: 08/30/2018] [Indexed: 11/30/2022] Open
Abstract
Aesthetic appraisal is rarely included in the objective assessment of outcome studies of impacted maxillary canines treatment. The present study aimed to validate a new index for assessing the aesthetic appearance of maxillary canines and adjacent soft tissues. The Department of Oral and Maxillofacial Surgery at University Hospitals Leuven. Four oral-maxillofacial surgeons, two orthodontists, two prosthodontists, and two lay persons rated 11 maxillary canines and adjacent soft tissues according to the new index. Each of the examiners repeated the examination three times with a 2-week interval. Twelve relevant aesthetic variables were selected on the basis of the anatomic form, color, and surface characteristics of the canine crown and on the basis of the anatomic form, color, and surface characteristics of the adjacent soft tissues. Intraclass correlation (ICC) coefficient and Fleiss' kappa statistics were performed to analyze the intrarater and interrater agreement. The index proofed to be a reliable assessment tool. Considering the cumulative assessment of the Maxillary Canine Aesthetic Index (MCAI), the mean ICC value for the interrater agreement of the 10 examiners was 0.71, representing a good agreement. Intrarater agreement ranged from 0.10 to 0.91. Interrater agreement (Fleiss' kappa statistics) calculated for each variable ranged from 0.08 to 0.98. The MCAI is a tool in rating aesthetic outcome of impacted canine treatment and adjacent soft tissues. The MCAI can be used to evaluate the aesthetic outcome after surgical exposure or transalveolar transplantation of maxillary canines.
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Affiliation(s)
- Koenraad Grisar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Gilles Claeys
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Margot Raes
- Orthodontics, Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Emad Ali Albdour
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Guy Willems
- Orthodontics, Department of Oral Health SciencesUniversity of Leuven, University Hospitals LeuvenBelgium
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of MedicineUniversity LeuvenBelgium
- Department of Dental MedicineKarolinska InstitutetSweden
- Department of Oral and Maxillofacial SurgeryUniversity Hospitals LeuvenBelgium
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Abstract
The purpose of this paper is to describe the case of surgical management of massive compound odontoma with 36 denticles in a 9-year-boy who presented with a complaint of pain and swelling in mandibular left posterior region and retained 74. The denticles were removed after the removal of retained 74 completely and wound healing was observed. Odontomas are considered as hamartomatous dental malformation rather than true neoplasm of odontogenic origin. They are the most commonly occurring abnormally formed dental tissues that interfere with eruption of associated teeth. The eruption disturbances seen due to odontomas are delayed eruption or deflection of associated teeth. These malformations are usually asymptomatic and discovered during routine radiographic investigations. Correct diagnosis followed by proper treatment plan results in a favorable prognosis.
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Affiliation(s)
- Yogesh J Kale
- Department of Pedodontics and Preventive Dentistry, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Prasanna T Dahake
- Department of Pedodontics and Preventive Dentistry, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Prasannakumari S Patil
- Department of Pedodontics and Preventive Dentistry, MIDSR Dental College and Hospital, Latur, Maharashtra, India
| | - Mahesh V Dadpe
- Department of Pedodontics and Preventive Dentistry, MIDSR Dental College and Hospital, Latur, Maharashtra, India
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Abstract
Foreign body (FB) impaction in the oesophagus is fairly common in paediatric Gastroenterology practice. This study aims to describe a case of an unusually impacted button lithium battery, in the mid-oesophagus of a 7-year-old child that was confirmed, and removed during oesophagogastroduodenoscopy. A 7-year-old male child, presented at the Emergency Paediatric Unit of our hospital with a history of ingestion of a button-like metallic object. A plain soft tissue X-ray of the neck and chest, however, revealed a dense round object located at the sternal angle of Louis. The object was dislodged and identified as a flat lithium battery after an oesophagogastroduodenoscopy, carried out under general anaesthesia using a flexible forward-viewing video gastroscope. The button battery was subsequently passed in faeces. Endoscopic removal of impacted oesophageal FBs under general anaesthesia is an effective and safe procedure in children in experienced hands.
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Affiliation(s)
- Olusegun A Obateru
- Department of Medicine, Gastroenterology Unit, Federal Medical Centre, Lokoja, Nigeria
| | | | - Abdulfatai B Olokoba
- Department of Medicine, Gastrointestinal Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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Koszowski R, Pisulska-Otremba A, Wójcik S, Śmieszek-Wilczewska J. Canine transmigration accompanying mandibular retrognathism secondary to osteitis. Open Med (Wars) 2015; 10:566-571. [PMID: 28352756 PMCID: PMC5368884 DOI: 10.1515/med-2015-0096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/27/2015] [Indexed: 11/30/2022] Open
Abstract
Transmigration is a tooth pathology in which the migrating tooth bud passes the median plane. Methods: This study is a presentation of the diagnostic and therapeutic outcomes in the cases of 4 stomach teeth transmigrations diagnosed in 3 patients with mandibular retrognathia which was a complication after osteitis in the postnatal period and infancy. Results: Extending imaging diagnostics to include CT, most preferably CBCT, makes it possible to precisely evaluate a transmigrated canine’s position and to plan a course of treatment. Conclusions: Planning of the treatment of teeth in transmigration in patients with temporomandibular ankylosis should be done by a team consisting of an orthodontist and a surgeon.
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Affiliation(s)
- Rafał Koszowski
- Department of Oral Surgery, School of Medicine with the Division of Dentistry in Zabrze, Pl. Akademicki 17, 41-902 Bytom
| | - Agnieszka Pisulska-Otremba
- Department of Orthodontics, School of Medicine with the Division of Dentistry in Zabrze, Pl. Akademicki 17, 41-902 Bytom
| | - Sylwia Wójcik
- Department of Oral Surgery, School of Medicine with the Division of Dentistry in Zabrze, Pl. Akademicki 17, 41-902 Bytom
| | - Joanna Śmieszek-Wilczewska
- Department of Oral Surgery, School of Medicine with the Division of Dentistry in Zabrze, Pl. Akademicki 17, 41-902 Bytom
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Abstract
OBJECTIVES The aim of this study was to establish prediction criteria for maxillary canine impaction in young patients, based on angular and linear measurements on panoramic radiographs. METHODS From 828 records having at least 2 panoramic radiographs, both taken between the ages of 7 and 14 years, with a minimum 1-year and maximum 3-year interval (T1 and T2), a training data set consisting of 30 subjects with unilateral canine impaction (12 males and 18 females) was selected. The patients' mean age was 10.1 years [standard deviation (SD) 1.3 years] at T1 and 11.9 years (SD 1.1 years) at T2. The training data set also consisted of 30 maxillary canines from the contralateral sides and an additional 60 normal erupted canines from 30 subjects. Those 30 subjects of a test data set were selected based on displaying bilateral maxillary canine eruption at T2 and being matched for gender and age with the subjects of the training data set [12 males and 18 females; mean age at T1, 10.1 years (SD 1.3 years) and at T2, 11.1 years (SD 1.2 years)]. Angular and linear measurements were performed separately by two observers on the total study sample at T1. Linear measurements were expressed as a multiplication of the maxillary central incisor width at the non-impacted side. RESULTS Significant differences for linear and angular measurements and radiographic factors were found between the maxillary impacted canine and erupted maxillary canine. The three best-discriminating parameters were canine to first premolar angle, canine cusp to midline distance and canine cusp to maxillary plane distance. These three parameters were combined in a multiple logistic regression model to calculate the probability of impaction, yielding a high area under the curve (AUC) equal to 0.97 (95% confidence interval: 0.94-0.99), with 90% sensitivity and 94% specificity. CONCLUSIONS Prediction of maxillary canine impaction from a combination of parameters relating to angles and distances measured in panoramic radiographs is weak. However, the final prediction model, based on canine-first premolar angle, canine cusp tip to midline distance and canine cusp tip to maxillary occlusal plane distance, might be useful to discriminate canine impaction for early intervention or regular follow-up.
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Affiliation(s)
- Ali Alqerban
- 1 Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia.,2 Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Ann-Sophie Storms
- 2 Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Martine Voet
- 2 Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Steffen Fieuws
- 3 I-BioStat Department of Public Health, KU Leuven and Universiteit Hasselt, Belgium
| | - Guy Willems
- 2 Department of Oral Health Sciences - Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Leuven, Belgium
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Abstract
Supernumerary teeth occur frequently in human dentition, but presence of multiple supernumerary teeth in patients without any associated syndrome or systemic disorder is a rare phenomenon. Presence of supernumerary teeth in itself is not a problem and may not require removal in all cases but in certain conditions, they may be associated with several clinical complications and require removal. Here, we present a 14 year old female who complained of non emergence of permanent teeth. Orthopantomogram initially showed presence of fifteen impacted supernumerary teeth distributed in all quadrants, but later, cone-beam computed tomography further revealed four additional teeth, totaling to nineteen supernumerary teeth. Consultation with concerned specialists ruled out any syndromes or systemic disorders which led us to the diagnosis of "non-syndromic multiple supernumerary teeth" and this probably is the highest number of supernumerary teeth reported in a single non-syndromic patient till date.
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Affiliation(s)
- Lei Yan
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Stomatology, Jiamusi University, Heilongjiang, China
| | - Long Wang Yu
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Stomatology, Jiamusi University, Heilongjiang, China
| | - Kishor Bhandari
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Stomatology, Jiamusi University, Heilongjiang, China
| | - Chang Li Shan
- Department of Oral and Maxillofacial Surgery, 2nd Affiliated Hospital of Stomatology, Jiamusi University, Heilongjiang, China
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Alqerban A, Jacobs R, van Keirsbilck PJ, Aly M, Swinnen S, Fieuws S, Willems G. The effect of using CBCT in the diagnosis of canine impaction and its impact on the orthodontic treatment outcome. J Orthod Sci 2014; 3:34-40. [PMID: 24987661 PMCID: PMC4077106 DOI: 10.4103/2278-0203.132911] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim: To investigate the added-value of using CBCT in the orthodontic treatment method of maxillary impacted canines and treatment outcome. Materials and Methods: The sample consisted of 118 treated patients. The CBCT group (n = 58) (39 females/19 males with the mean age of 14.3 years) included those with conventional treatment records consisting of panoramic and cephalometric radiographs, intra-and extra-oral photographs, and dental casts and complemented with a CBCT scan for additional diagnostic information. The conventional group (n = 60) (31 females/29 males with mean age 13.1 years) included those with similar conventional treatment records but without CBCT imaging. Results: There were significant differences in the canine-related variables between both groups. The CBCT group had the higher level of difficulty and more severely displaced canines when compared with the conventional group. However, no significant difference was found between groups either in the number of treatment methods used or in the use of interceptive methods combined with other treatment modalities or choice of extraction versus non-extraction. In terms of treatment success and interval duration, no significant differences were found. However, treatment duration was significantly (4 months) shorter in the CBCT group compared with the conventional group (P = 0.023). Conclusion: CBCT has been used in cases with more severe symptoms of maxillary canine impaction. The use of CBCT improved the diagnostic capabilities and improved the chances of success in the more difficult cases to a level similar to that of simpler cases treated on the basis of 2D information.
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Affiliation(s)
- Ali Alqerban
- Department of Oral Health Sciences, KU Leuven, Orthodontics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Reinhilde Jacobs
- Department of Imaging and Pathology, OMFS-IMPATH Research Group, Faculty of Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Pieter-Jan van Keirsbilck
- Department of Oral Health Sciences, KU Leuven, Orthodontics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Medhat Aly
- Department of Oral Health Sciences, KU Leuven, Orthodontics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Steven Swinnen
- Department of Oral Health Sciences, KU Leuven, Orthodontics, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Steffen Fieuws
- Department of Public Health, KU Leuven and Universiteit Hasselt, 3000 Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven, Orthodontics, University Hospitals Leuven, 3000 Leuven, Belgium
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Montevecchi M, Incerti Parenti S, Checchi V, Palumbo B, Checchi L, Alessandri Bonetti G. Periodontal healing after 'orthodontic extraction' of mandibular third molars: a retrospective cohort study. Int J Oral Maxillofac Surg 2014; 43:1137-41. [PMID: 24774723 DOI: 10.1016/j.ijom.2014.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 03/24/2014] [Accepted: 03/25/2014] [Indexed: 11/16/2022]
Abstract
In this study we investigated periodontal healing of mandibular second molars following 'orthodontic extraction' of adjacent impacted third molars, under the null hypothesis that there would be no difference in probing pocket depths (PPD) and clinical attachment levels (CAL) at the distal aspect of second molars before and after treatment. A retrospective survey was conducted of 64 patients who consecutively underwent 'orthodontic extraction' of mandibular third molars in close anatomical relationship with the mandibular canal from January 1997 to January 2011. Age, smoking habit, and PPD and CAL at the distal aspect of second molars before and after treatment were recorded. A statistically significant difference was found in PPD and CAL before and after treatment for the overall sample and for the sample classified by age (>25 or ≤25 years), smoking habit (smoker or non-smoker), and type of third molar impaction (horizontal, mesioangular, or vertical). Median PPD and CAL reductions amounted to 6mm and 5mm, respectively. The null hypothesis was rejected and orthodontic extraction proved to be indicated for those impacted mandibular third molars at high risk of a postoperative periodontal defect at the distal aspect of the adjacent second molar.
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Affiliation(s)
- M Montevecchi
- Department of Periodontology, University of Bologna, Bologna, Italy
| | | | - V Checchi
- Department of Periodontology, University of Bologna, Bologna, Italy
| | - B Palumbo
- Department of Periodontology, University of Bologna, Bologna, Italy
| | - L Checchi
- Department of Periodontology, University of Bologna, Bologna, Italy
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Ephraim R, Dilna NC, Sreedevi S, Shubha M. A labially positioned mesiodens and its repositioning as a missing central incisor. J Int Oral Health 2014; 6:114-7. [PMID: 25395807 PMCID: PMC4229818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 06/09/2014] [Indexed: 11/04/2022] Open
Abstract
Hyperdontia is an increased number of teeth within the dental arches. This is of particular interest to pediatric dentists who commonly make the initial diagnosis. Most often a large portion of these teeth is completely embedded or impacted within the jaws and can be viewed only radiographically. Hyperdontia can occur on virtually every tooth-bearing surface. However, the most frequent is the mesiodens, in the anterior maxillary region. Anterior maxillary teeth are one of the most important features contributing to aesthetics of an individual. Missing anterior teeth can cause undue psychological stress in children, during their growing years. Most of the literature available show that the mesiodens are situated on the palatal aspect of the permanent incisors. Their treatment frequently involves an early recognition, extraction through a traditional palatal technique and guiding the associated permanent tooth to its original position. The purpose of this article is to enlighten the clinician of the need of deviating from the traditional approach of early extraction in particular situations and to conserve the mesiodens if favorable as an alternative treatment to a malformed permanent tooth, which may fail to erupt. This report describes a successful multidisciplinary approach to treatment of a unerrupted, labially placed mesiodens in conjunction with a dilacerated and impacted permanent tooth, in a child with a missing left central incisor. Treatment consisted of localizing and confirming the placement of the mesiodens to be labial, surgically exposing the crown of the mesiodens through a labial surgical approach, orthodontically guiding it to the position of the missing central incisor, extracting the malformed permanent incisor, and restoring the mesiodens to the required anatomy with composites, to establish aesthetics and function of the affected region.
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Affiliation(s)
- Rena Ephraim
- Professor and Head, Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences, Mahe, UT of Puducherry, India,Correspondence: Dr. Ephraim R. Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences, Mahe - 673 310, UT of Puducherry, India.
| | - N C Dilna
- Reader, Department of Pedodontics and Preventive Dentistry, Pariyaram Dental College, Kannur, Kerala, India
| | - S Sreedevi
- Professor, Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences, Mahe, UT of Puducherry, India
| | - M Shubha
- Reader, Department of Pedodontics and Preventive Dentistry, Mahe Institute of Dental Sciences, Mahe, UT of Puducherry, India
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Alqerban A, Hedesiu M, Baciut M, Nackaerts O, Jacobs R, Fieuws S, Willems G. Pre-surgical treatment planning of maxillary canine impactions using panoramic vs cone beam CT imaging. Dentomaxillofac Radiol 2013; 42:20130157. [PMID: 23906975 DOI: 10.1259/dmfr.20130157] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this prospective study was to compare the impact of using two-dimensional (2D) panoramic radiographs and three-dimensional (3D) cone beam CT for the surgical treatment planning of impacted maxillary canines. METHODS This study consisted of 32 subjects (19 females, 13 males) with a mean age of 25 years, referred for surgical intervention of 39 maxillary impacted canines. Initial 2D panoramic radiography was available, and 3D cone beam CT imaging was obtained upon clinical indication. Both 2D and 3D pre-operative radiographic diagnostic sets were subsequently analysed by six observers. Perioperative evaluations were conducted by the treating surgeon. McNemar tests, hierarchical logistic regression and linear mixed models were used to explore the differences in evaluations between imaging modalities. RESULTS Significantly higher confidence levels were observed for 3D image-based treatment plans than for 2D image-based plans (p < 0.001). The evaluations of canine crown position, contact relationship and lateral incisor root resorption were significantly different between the 2D and 3D images. By contrast, pre- and perioperative evaluations were not significantly different between the two image modalities. CONCLUSIONS Surgical treatment planning of impacted maxillary canines was not significantly different between panoramic and cone beam CT images.
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Affiliation(s)
- A Alqerban
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Abstract
Pre-eruptive migration of a tooth across the midline is termed as transmigration. It is believed that transmigration is rare and unique to the mandibular permanent canines, and even more rarely reported for others. Transmigration is a phenomenon of yet unknown etiology. It follows the direction of its long axis, with the crown leading the migration. The tendency of a canine to cross the barrier of mandibular midline suture is a more important consideration than the distance of migration after crossing the midline. Here we present one new case of aberrantly positioned right mandibular canine which has undergone migration and was accidently found on radiological examination before orthodontic treatment. Once diagnosed an aberrantly positioned impacted canine requires surgical removal.
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Affiliation(s)
- Rashi Bahl
- Department of Oral and Maxillofacial Surgery, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Jeetinder Singla
- Deparment of Orthodontics and Dentofacial Orthopaedics, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Mohita Gupta
- Graduate, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
| | - Ankit Malhotra
- Graduate, Genesis Institute of Dental Sciences and Research, Ferozepur, Punjab, India
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Abstract
There are many reports on the endoscopic management of ingested foreign bodies in the upper gastrointestinal tract, however, little is known about the management of a specific subset of esophageal foreign bodies - impacted esophageal foreign bodies (IEFBs), especially perforating esophageal foreign bodies (PEFBs). The aim of this retrospective study on 78 cases was to report experience and outcome in the endoscopic management of the IEFBs in Chinese patients. From January 2006 to July 2011, a total of 750 patients with suspected upper gastrointestinal foreign bodies were admitted to the endoscopy center. Among these 750 patients, 78 cases that met the defined criteria of IEFBs were retrospectively enrolled in the present study, including 12 cases (12/78, 15.4%) with PEFBs. The major types of IEFBs were poultry bones (35.9%) and fish bones (17.9%). Most of the IEFBs (80.8%) were located in the upper esophagus, as were two thirds (66.7%) of the PEFBs. Foreign-body retrieval forceps were the most frequently used accessory devices. Extraction of IEFBs failed in eight patients (10.3%) during the endoscopic procedure. The difficult points in endoscopic management were PEFBs, IEFBs with sharp points, and those with impaction for more than 24 hours. IEFBs should be treated as early as possible, and their endoscopic management is safe and effective. Endoscopic management is the first choice for PEFBs when the duration of impaction is less than 24 hours and there are no abscesses outside of the esophageal tract as determined by a computed tomography scan.
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Affiliation(s)
- T Chen
- Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai, China
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Abstract
Adenomatoid odontogenic tumor (AOT) is a slow-growing, benign tumor that appears in the anterior portion of the jaws and more frequently, the anterior maxilla usually in association with the crowns of unerupted teeth. Most of the tumors are diagnosed in second decade of life. A rare case report of AOT associated with an impacted right mandibular first premolar in a 24-year-old female is reported.
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Affiliation(s)
- Raman Preet Kaur Bhullar
- Departments of Oral and Maxillofacial Pathology, Genesis Institute of Dental Sciences and Research, Ferozepur, India
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Abstract
Odontomas are benign tumors containing various component tissues of teeth. They usually remain asymptomatic and are diagnosed on routine radiographs. Clinically, they are often associated with delayed eruption or impaction of permanent teeth and retained primary teeth. A case of compound odontoma in association with an unerupted, rotated and dilacerated maxillary permanent right central incisor in a 12-year-old boy is reported. Such combination is rare, making it an interesting case for reporting. We have also discussed the clinical features, diagnosis and treatment of such a condition.
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Affiliation(s)
- Vinaya Kumar Kulkarni
- Department of Pedodontics and Preventive Dentistry, People's College of Dental Sciences and Research Centre, Bhopal, Madhya Pradesh, India
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Nandra RS, Uppal H, Matharu G, Brooks S, Srinivasan K. Innovative use of computer-assisted tomography in the management of an irreducible anterior shoulder dislocation. Int J Shoulder Surg 2011; 5:77-80. [PMID: 22058641 PMCID: PMC3205527 DOI: 10.4103/0973-6042.86245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Anterior dislocation of the shoulder is a common injury which is often reduced in the emergency department, without specialist orthopedic input. We report a case of an irreducible locked anterior glenohumeral dislocation with impaction of the humeral head onto the antero-inferior glenoid rim and subsequent generation of a Hill–Sachs lesion. To our knowledge, we describe the first reported case of using computer-assisted tomography to generate a sequence of movements to safely disimpact the locked dislocation without causing further iatrogenic injury or a fracture through the humeral articular surface. This novel image-assisted closed reduction technique spared the patient from the morbidity associated with performing open reduction surgery. At 6-month follow-up, the patient reported no re-dislocations, returned to work and had excellent range of motion.
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Affiliation(s)
- Rajpal S Nandra
- Orthopaedic Trainee, Heart of England Foundation Trust, Birmingham Heartlands Hospital, Bordesley Green East, Bordesley Green, Birmingham, United Kingdom
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