Impacted

受影响
  • 文章类型: Journal Article
    下颌第三磨牙容易发生嵌塞,导致其无法爆发进入口腔。需要进行X线检查以支持受累牙齿的牙齿切除术。随着人工智能(AI)技术的进步,基于深度学习的计算机辅助诊断在医学和牙科领域正在兴起。这篇综述描述了深度学习在检测中的性能和前景,分类,并在全景X光片上评估第三磨牙-下颌管关系。
    这项工作是使用三个数据库进行的:PubMed,谷歌学者,科学直接。在文献选择之后,回顾了49篇文章,本文讨论了12篇主要文章。
    目前,在有或没有其他技术组合的情况下,深度学习的几种模型用于第三磨牙嵌塞的分割和分类。深度学习在全景射线照片上识别下颌阻生第三磨牙(ITM)方面表现出显著的诊断性能,精度范围为78.91%至90.23%。同时,深度学习在确定ITM与下颌管(MC)之间关系的准确性范围为72.32%至99%。
    基于深度学习的AI,具有高性能的检测,分类,在过去的十年中,使用全景射线照片对ITM与MC的关系进行了评估。然而,深度学习必须使用大型数据集进行改进,深度学习模型的诊断性能评估应与医学诊断测试协议保持一致。未来的研究涉及口腔放射科医师之间的合作,临床医生,计算机科学家需要确定正确的人工智能开发模型,高效,并适用于临床服务。
    UNASSIGNED: Mandibular third molar is prone to impaction, resulting in its inability to erupt into the oral cavity. The radiographic examination is required to support the odontectomy of impacted teeth. The use of computer-aided diagnosis based on deep learning is emerging in the field of medical and dentistry with the advancement of artificial intelligence (AI) technology. This review describes the performance and prospects of deep learning for the detection, classification, and evaluation of third molar-mandibular canal relationships on panoramic radiographs.
    UNASSIGNED: This work was conducted using three databases: PubMed, Google Scholar, and Science Direct. Following the literature selection, 49 articles were reviewed, with the 12 main articles discussed in this review.
    UNASSIGNED: Several models of deep learning are currently used for segmentation and classification of third molar impaction with or without the combination of other techniques. Deep learning has demonstrated significant diagnostic performance in identifying mandibular impacted third molars (ITM) on panoramic radiographs, with an accuracy range of 78.91% to 90.23%. Meanwhile, the accuracy of deep learning in determining the relationship between ITM and the mandibular canal (MC) ranges from 72.32% to 99%.
    UNASSIGNED: Deep learning-based AI with high performance for the detection, classification, and evaluation of the relationship of ITM to the MC using panoramic radiographs has been developed over the past decade. However, deep learning must be improved using large datasets, and the evaluation of diagnostic performance for deep learning models should be aligned with medical diagnostic test protocols. Future studies involving collaboration among oral radiologists, clinicians, and computer scientists are required to identify appropriate AI development models that are accurate, efficient, and applicable to clinical services.
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  • 文章类型: Journal Article
    在下颌阻生第三磨牙(MM3)手术中使用地塞米松(DXM)局部途径的支持者声称优于传统的全身途径。本系统评价和荟萃分析旨在确定围手术期DXM给药途径是否会影响MM3手术的炎症结局。
    对DXM在MM3手术中的随机试验进行了25年的电子数据库搜索。使用固定或随机效应模型提取并汇集平均差异或标准化平均差异。
    在选定的16项试验中,其中4项被考虑进行荟萃分析.DXM的局部和全身途径之间的炎症结果没有统计学上的显着差异。
    声称的DXM本地路线的优势似乎在科学上不成立。需要DXM血浆测量支持的临床试验来确认当局部施用DXM时不存在全身效应。
    UNASSIGNED: The proponents of local route of Dexamethasone (DXM) administration for impacted mandibular 3rd molar (MM3) surgeries claim advantages over the traditional systemic routes. This systematic review and meta-analysis were aimed to determine whether the route of perioperative administration of DXM influences the inflammatory outcomes of MM3 surgeries.
    UNASSIGNED: An electronic database search over a 25 year period of randomised trials of DXM in MM3 surgeries was conducted. The mean differences or standardised mean differences were extracted and pooled using the fixed or random-effects model.
    UNASSIGNED: Of the sixteen selected trials, four were considered for a meta-analysis. There were no statistically significant differences in the inflammatory outcomes between the local and systemic routes of DXM.
    UNASSIGNED: The claimed advantages of the local route of DXM do not appear to be scientifically valid. Clinical trials supported with DXM plasma measurements are needed to confirm the absence of a systemic effect when DXM is administered locally.
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  • 文章类型: Case Reports
    多余牙齿是牙齿异常,其特征是相对于正常牙列存在过多的牙齿。其中,多余的前磨牙的患病率为0.29%至0.64%,这是一个非常罕见的发现。另一方面,双生是牙齿形状的发育障碍,其中单个牙胚的部分分裂导致形成单个牙根和单个牙髓腔,但形成两个部分或完全分离的牙冠。尽管这些异常作为个体实体在临床实践中相当普遍,单颗牙齿中两种异常的发生极为罕见。在此,我们报告了一名45岁女性患者中罕见的节制多生前磨牙。对文献的彻底搜索显示,文献中只报道了四个列出这种异常的案例,因此值得一提。除了案例介绍,作者还回顾了有关这一异常的现有文献。
    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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  • 文章类型: Journal Article
    异位恒磨牙是恒牙偏离其正常萌出路径的一种情况。这种喷发异常的病因是多因素的,既有一般因素,也有地方因素。主要结果表明,不可逆后果的有效指标是第一恒磨牙的撞击程度。自我纠正在7至8岁之间最常见,之后可能需要帮助。因此,早期治疗可以帮助预防可能干扰维持平衡闭塞的后续潜在挑战.几个变量,包括中间倾斜的程度,根吸收的水平,和第二伯磨牙的状况,选择最有效的治疗方法可能至关重要。邻间楔入和远端倾斜是异位恒磨牙的两种基本治疗策略。此外,也可能需要使用固定或可移动的器具。不建议将治疗推迟到后期,因为早期诊断和治疗对于最佳管理至关重要。这篇综述旨在提供异位恒磨牙的全面概述,包括他们的患病率,病因因素,自校正率,对相邻牙齿的临床意义,和各种治疗技术,这强调了早期发现和干预在成功治疗异位恒磨牙中的重要性。此外,它强调了未来研究不可逆异位磨牙结局的贡献变量的重要性.
    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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  • 文章类型: Journal Article
    背景:乳牙下牙合是发生在原牙列和混合牙列期间的临床障碍,具有一些正畸意义。下咬合的牙齿被认为是咬合不正的潜在部位,有倾斜相邻牙齿和失去空间的风险。本系统综述旨在分析原发性磨牙下颌的治疗方法,并提供最新指南。
    方法:使用PubMed进行了文献检索,Scopus,和WebofScience数据库从2017年1月1日至2022年11月28日。纳入标准是:仅对人类受试者进行研究,开放获取研究,病例报告,随机试验,回顾性,观察性研究,和英语。
    结果:从数据库中确定了总共372篇出版物,最后9项研究纳入了该综述以进行定性分析。
    结论:患者的治疗取决于严重程度,诊断时的年龄,和存在成功的前磨牙。早期诊断闭塞的主要元素是基本的,不能推迟。如果没有或中度的原发性磨牙下咬合,则保留原发性磨牙可能是具有长期稳定性的有效选择。根吸收不到根的一半,没有腐烂或恢复。
    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.
    CONCLUSIONS: 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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  • 文章类型: Journal Article
    背景与目的:了解上颌中切牙阻生的形态学可能会导致更有效的治疗。因此,这项系统评价旨在评估上颌中切牙的形态,并将其与对侧牙齿进行比较。材料和方法:本系统综述遵循PRISMA声明。使用PubMed(Medline数据库)进行文献检索,科克伦图书馆,ProQuest,WebofScienceandScienceDirect电子数据库,截至2021年7月没有发布日期限制。提取用CBCT评估的单侧上颌中切牙(ICI)的形态评估数据,并对研究的质量进行了评估。表冠长度,根长,并将上颌中切牙的牙根撕裂与对侧未受影响的牙齿进行比较。结果:最初的数据库搜索确定了总共287项研究。应用选择标准后,选择了21篇文章进行全文分析,系统评价中纳入了4项涉及205例患者的回顾性研究.根据纽卡斯尔-渥太华量表(NOS),其中两篇文章被评为“好”,其余两篇被评为“一般”质量。结果显示,阻生牙齿和对侧牙冠之间没有差异,或ICI冠长略有减少(从0.15到0.56毫米)。上颌中切牙的根长明显短于对侧切牙(从2.13到3.22mm),随着牙齿年龄的增加,根生长减少,根撕裂的发生率更高。结论:上颌中切牙的根长与对侧切牙相比要短得多。牙根撕裂的频率和严重程度随着牙齿年龄的增加而增加。
    Background and Objectives: The knowledge of the morphology of impacted maxillary central incisors may lead to more effective treatment. Therefore, this systematic review aimed to evaluate the morphology of impacted maxillary central incisors and compare them with contralateral teeth. Material and methods: This systematic review adhered to the PRISMA statement. The literature search was carried out using PubMed (Medline database), Cochrane Library, ProQuest, Web of Science and Science Direct electronic databases with no publication date restrictions up to July 2021. Data assessing the morphology of unilaterally impacted maxillary central incisors (ICI) evaluated with CBCT were extracted, and the quality of the studies was evaluated. Crown length, root length, and root dilaceration of impacted maxillary central incisors were compared with contralateral unimpacted teeth. Results: The initial database search identified a total number of 287 studies. After applying the selection criteria, 21 articles were selected for a full-text analysis, and four retrospective studies involving 205 patients were included in the systematic review. According to the Newcastle-Ottawa Scale (NOS), two of included articles were graded as \"Good\" and the remaining two as \"Fair\" quality. The results showed no difference between impacted teeth and their contralateral crowns, or a minor decrease in ICI crown length (from 0.15 to 0.56 mm). The root lengths of impacted maxillary central incisors were considerably shorter than contralateral incisors (from 2.13 to 3.22 mm) and, as dental age increased, root growth decreased and the incidence of root dilaceration was more frequent. Conclusions: The root lengths of impacted maxillary central incisors were considerably shorter compared to the contralateral incisors. Root dilacerations frequency and severity increased as dental age increased.
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  • 文章类型: Journal Article
    背景和目的:本系统综述的目的是总结已发表的文章的现有数据,这些文章研究了通过手术-正畸方法治疗的上颌中切牙阻生(ICI)的治疗后状况。材料与方法:MEDLINE,Scopus,科克伦口腔健康小组的试验登记册,和ScienceDirect电子数据库进行了系统搜索,直到2021年1月没有发布日期限制。提取了评估手术-正畸联合治疗和强制萌出持续时间后ICI状态的数据,并对研究的质量进行了评估。结果:总的来说,确定了7074项研究,其中42篇文章通过全文评估获得资格评估。七项纳入研究(五项回顾性研究,一项随机临床试验,和一项前瞻性临床试验)符合纳入标准,代表211例单侧上颌切牙阻生的患者。偏倚的风险从中等到高不等。结果表明,在治疗后,未成熟ICIs的根长显着增加,但仍比同形牙齿短。经治疗的ICIs的牙周参数在临床上可接受的范围内。牙槽骨的测量显示骨厚度和支撑减少。平均强迫喷发持续时间为8.0±4.5至14.41±4.03个月。结论:根据现有证据,可以合理地得出结论,手术-正畸治疗影响了ICI的治疗后状态;然而,目前的文献不足以得出具体的结论。需要进一步进行大量样本的多中心随机研究来证实这一说法。
    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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  • 文章类型: Case Reports
    儿童的木制异物(WFB)损伤很常见。他们可能以急性表现报告或被延迟为保留的异物引起并发症。这些异物和急性表现的浅表皮肤渗透的病例可能便于诊断和切除。然而,本地化深受影响和长期保留的WFB是具有挑战性的,因为它们通常不是不透射线的,并且随着时间的推移,它们倾向于更深地移动到周围的软组织中。长时间滞留的异物可能会出现蜂窝织炎,深部组织感染,鼻窦,关节运动的限制,坏死性筋膜炎,骨髓炎或肿瘤样肿块。我们介绍了一个8岁的男孩,他在右髂窝和右大腿上内侧有鼻窦,由于受影响的WFB为3个月。及时的放射成像和手术切除帮助他完全康复。
    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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  • 文章类型: Journal Article
    牙齿撞击是每个临床医生经常遇到的现象。嵌入牙齿的人工萌出是将受影响的牙齿引导到正常咬合的过程。这一程序目前正引起人们的注意,目的是根据每种情况找到使用的最佳技术。本文介绍了有关阻生门牙的关键信息,犬科动物,和前磨牙。此外,我们描述了用于人工喷发的最常见技术,开放和封闭的技术。我们回顾了有关这些技术的文献,并概述了临床医生如何管理每种类型的患牙。
    Impacted teeth are a frequent phenomenon encountered by every clinician. The artificial eruption of embedded teeth is the process of directing an impacted tooth into normal occlusion. This procedure is currently attracting attention, with the aim of finding the best technique to use according to each case. This article presents key information regarding impacted incisors, canines, and premolars. In addition, we describe the most common techniques to use for artificial eruption, the open and closed techniques. We review the literature concerning these techniques and outline how clinicians can manage every type of impacted tooth.
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  • 文章类型: Case Reports
    Inversion has been defined as the malposition of a tooth in which the tooth is reversed and positioned upside down. Very few cases of inverted and impacted third molars have been reported in the literature. The most common location of such a third molar in the mandible is in the ascending ramus. In the maxilla, the teeth may be displaced as far as the floor of the orbit. Two cases of inverted and impacted third molars are described. They were conservatively managed without surgery. The two cases are reported because impaction with inversion of a molar tooth is not common.
    ملخص البحث : يعرف الوضع غير الطبيعي للأسنان بأنه الوضع العكسي الذي تكون فيه السن مقلوبة رأسا على عقب وهو من الأمور النادرة الحدوث. يعرض الباحثان حالتين للأسنان في الوضع العكسي وانحسار السن المولى الثالث (Third Molar). وقد تم علاجهما من غير تدخل جراحي.
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