Molar, Third

Molar,Third
  • DOI:
    文章类型: Journal Article
    Distalization of mandibular molars comes with significant challenges, especially in adult and young adult patients. In selected cases, third molar extraction procedures offer the opportunity to place miniplates for anchorage to distalize mandibular molars, providing additional solutions to the traditional extraction of premolars or a single incisor. This approach can be of special interest to adult patients, who may have life commitments and time restraints that limit traditional orthodontic and surgical treatment options, and it can improve the efficiency of dental care. This case series describes 3 clinical scenarios in which miniplates were placed with minimal invasiveness during the removal of impacted third molars, offering the patients nontraditional orthodontic treatment options. Awareness of these options is essential for general dentists so that they can explain all treatment possibilities and provide appropriate referrals to patients with impacted third molars.
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  • 文章类型: Journal Article
    这项建议的目的是(1)回顾目前的文献,(2)阐明制定普遍接受的指导方针的重要性,(3)在下颌第三磨牙(M3Ms)摘除的决策过程中提供帮助和指导,(4)降低由于M3M的不适当去除或保留而使患者遭受不必要伤害和并发症的风险。很明显,M3M的提取适应症将继续是一个有争议和激烈争论的领域。支持或反对预防性提取的证据是矛盾的;在某些特定情况下,有证据表明接受或拒绝反对预防性提取的立场,并且有发表的文章支持两种相反的观点。现有的第三磨牙拔除指南数量有限,并且大多是根据特定的设置或国家/地区量身定制的。没有可用的准则可以广泛用于帮助国际社会的决策过程。我们希望这项建议将是朝着建立普遍接受的指导迈出的重要的第一步。
    The aim of this proposal is to (1) review the current literature, (2) shed light on the importance of creating universally accepted guidelines, (3) provide help and guidance in the decision-making process with regard to the removal of mandibular third molars (M3Ms), and (4) reduce the risk of exposing the patient to unnecessary harm and complications due to the inappropriate removal or retention of M3Ms.It is obvious that the indications for the extraction of M3Ms will continue to be an area of controversy and strong debate. The evidence for or against prophylactic extraction is ambivalent; there is evidence to accept or reject the stance against prophylactic extraction in some specific cases, and there are published articles to support both opposing views. The available guidelines on the extraction of third molars are limited in number, and are mostly tailored to fit specific settings or countries. There are no available guidelines that might be widely used to help in the decision-making process for the international community. We hope this proposal will constitute an important first step toward creating universally accepted guidance.
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  • 文章类型: Journal Article
    目的:本研究的目的是比较白细胞和富血小板纤维蛋白(L-PRF)和光生物调节(PBM)的应用,一再被报道优于对照组,在疼痛方面,拔牙槽中的软组织和骨愈合。
    方法:这种双盲,随机临床研究完成了34例患者,他们有拔除双侧受累牙齿的指征。将患者的左右牙齿随机分为L-PRF组和PBM组。L-PRF组用血液制品以2700rpm离心12分钟,PBM组在不同的点用二极管激光治疗60s,波长为940nm,重复疗程。术后疼痛采用视觉模拟评分法(VAS)评估,软组织愈合与兰德里指数(LI),下颌第二磨牙远端区域的组织愈合通过探测深度测量,使用ImageJ程序通过全景X射线进行骨骼愈合。
    结果:两组之间的任何变量相比均无统计学意义的差异。
    结论:L-PRF和PBM应用在拔牙槽的愈合方面提供了类似的支持。然而,两种方法的优缺点决定了它们的使用领域。
    结论:虽然L-PRF在拔牙槽的早期愈合方面是有利的,就长期骨小梁形成而言,PBM可能是首选。
    OBJECTIVE: The aim of this study was to compare leukocyte and platelet-rich fibrin (L-PRF) and photobiomodulation (PBM) applications, which have been repeatedly reported to be superior to control groups, in terms of pain, soft tissue and bone healing in tooth extraction sockets.
    METHODS: This double-blind, randomized clinical study was completed with 34 patients, who had an indication for extraction of their bilaterally impacted teeth. The right and left teeth of the patients were randomly divided into L-PRF and PBM groups. L-PRF group was treated with the blood product centrifuged for 12 min at 2700 rpm, and the PBM group was treated with a diode laser at different points for 60 s with a wavelength of 940 nm in repeated sessions. Postoperative pain was evaluated using Visual Analogue Scale (VAS), soft tissue healing with Landry Index (LI), tissue healing in the distal region of mandibular second molar by probing depth measurement, and bone healing via panoramic x-ray using the Image J program.
    RESULTS: No statistically significant difference was found for any variable compared between the groups.
    CONCLUSIONS: L-PRF and PBM applications provide similar support in the healing of extraction sockets. Nevertheless, the advantages and disadvantages of both methods determine their usage areas.
    CONCLUSIONS: While L-PRF is advantageous in the early healing of extraction sockets, PBM may be preferred in terms of bone trabeculation in the long term.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    目的:这项研究的第一个目的是确定通过粘合剂自固化或在减少的光照下双重固化聚合的触摸固化水泥的转化程度(DC)是否存在差异。第二个目的是比较使用触摸固化水泥自固化或通过减少光照双重固化的氧化锆修复体的界面适应性。
    方法:使用傅立叶变换红外光谱法连续测量带有粘合剂的触摸固化树脂粘固剂的DC。实验组根据触摸固化水泥而有所不同。每组有三个亚组的聚合方法。对于第1子组,通过自固化测量DC。对于亚组2和3,通过双重固化测量DC,减少光穿透3毫米和1毫米氧化锆块,分别。对于界面适应性评估,在提取的第三磨牙上制备I类腔,并制作了氧化锆修复体。修复体使用相同的水泥进行胶结。用于界面适应的组和子组与DC测量的相同。热循环后,使用扫频源光学相干断层扫描成像评估牙齿-修复界面的界面适应性。
    结果:接触固化水泥的DC因测量时间而异,树脂水泥,和聚合方法(p<0.05)。界面适应性因树脂水泥和聚合方法而异(p<0.05)。
    结论:对于接触固化水泥,与低辐照度或自固化的光固化相比,高辐照度的光固化具有更高的DC和更好的界面适应性。
    结论:尽管一些粘合剂加速了触摸固化水泥的自固化,接触固化水泥的光固化是氧化锆胶结所必需的。
    OBJECTIVE: The first aim of this study was to determine whether there is a difference in degree of conversion (DC) of touch-cure cements polymerized by self-curing with adhesive or dual-curing under reduced light. The second aim was to compare interfacial adaptation of zirconia restoration cemented using touch-cure cements self-cured or dual-cured by reduced light.
    METHODS: The DC of touch-cure resin cements with adhesive was measured continuously using Fourier transform infrared spectrometry. Experimental groups differed depending on touch-cure cement. Each group had three subgroups of polymerization method. For subgroup 1, the DC was measured by self-curing. For subgroups 2 and 3, the DCs were measured by dual-curing with reduced light penetrating 3 mm and 1 mm zirconia blocks, respectively. For interfacial adaptation evaluation, Class I cavity was prepared on an extracted third molar, and zirconia restoration was fabricated. The restoration was cemented using the same cement. Groups and subgroups for interfacial adaptation were the same as those of the DC measurement. After thermo-cycling, interfacial adaptation at the tooth-restoration interface was evaluated using swept-source optical coherence tomography imaging.
    RESULTS: The DC of touch-cure cement differed depending on the measurement time, resin cement, and polymerization method (p < 0.05). Interfacial adaptation was different depending on the resin cement and polymerization method (p < 0.05).
    CONCLUSIONS: For touch-cure cement, light-curing with higher irradiance presented a higher DC and superior interfacial adaptation than light-curing with lower irradiance or self-curing.
    CONCLUSIONS: Although some adhesives accelerate the self-curing of touch-cure cement, light-curing for touch-cure cement is necessary for zirconia cementation.
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  • 文章类型: Journal Article
    目的:这项回顾性研究的目的是确定特立尼达人中受影响的第三磨牙的患病率和模式。
    方法:在牙科学院总共拍摄了1500张正像图(OPG),西印度群岛大学,从2008年至2019年,对15至67岁的患者进行了评估。从收集的数据来看,第三磨牙撞击的患病率,性别的参数,成角,影响程度,和相关的病理进行了评估。还记录了其他类型的受影响牙齿。
    结果:在查看的1500个OPG中,408(27.2%)的研究样品呈现有至少一个受影响的第三磨牙。男性161人(39.5%),女性247人(60.5%),男女比例为1:1.5。下颌第三磨牙的发生率高于上颌第三磨牙,频率为77.9%和22.1%,分别。最常见的嵌塞类型(冬季分类)是下颌骨的水平和上颌骨的立体。下颌骨中最常见的嵌塞水平(Pell和Gregory分类)是1A级。受影响的牙齿总数为775,其中,75(9.7%)显示出除第三磨牙外的其他受累牙齿。犬齿和第二前磨牙最普遍,分别为7.6%和1.5%,分别。第二磨牙(49.3%)和第三磨牙(40%)上的龋齿是最常见的相关病理。
    结论:本研究中阻生智齿的患病率为27%。这些结果提高了人们的认识,并为特立尼达的牙科专业人员提供了有关受影响的第三磨牙患病率的见解,他们的模式,以及常见的相关病理,以及在人群中进行筛查的必要性。
    OBJECTIVE: The aim of this retrospective study was to determine the prevalence and patterns of impacted third molars in a Trinidadian population.
    METHODS: A total of 1500 orthopantomograms (OPG) taken at the School of Dentistry, University of the West Indies, from 2008 to 2019 in patients between 15 and 67 years old were evaluated. From the data collected, the prevalence of third molar impaction, the parameters of gender, angulation, level of impaction, and associated pathologies were evaluated. Other types of impacted teeth were also recorded.
    RESULTS: Of the 1500 OPG viewed, 408 (27.2%) of the study sample presented with at least one impacted third molar. 161 (39.5%) were males and 247 (60.5%) were females, with a male-to-female ratio of 1:1.5. There was a greater incidence of mandibular third molars versus maxillary third molars, which had a frequency of 77.9% and 22.1%, respectively. The most common type of impaction (Winter\'s classification) was horizontal in the mandible and distoangular in the maxilla. The most common level of impaction in the mandible (Pell and Gregory classification) was level 1A. The total number of impacted teeth was 775, and of these, 75 (9.7%) showed other impacted teeth besides the third molars. Canines and second premolars were the most prevalent with 7.6% and 1.5%, respectively. Caries on the second molar (49.3%) and third molars (40%) were the most frequently associated pathologies identified.
    CONCLUSIONS: The prevalence of impacted wisdom teeth in this study was 27%. These results raise awareness and provide insight among dental professionals in Trinidad as to the prevalence of impacted third molars, their patterns, as well as commonly associated pathologies, and the need for screening within the population.
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  • 文章类型: Case Reports
    抗磷脂综合征(APS)是一种全身性自身免疫性疾病,其特征是复发性静脉或动脉血栓形成和妊娠并发症。持续性抗磷脂自身抗体。APS通常与其他自身免疫性疾病一起发现,如系统性红斑狼疮(SLE)。与SLE相关的APS患者可能需要牙科手术,例如拔牙。由于这种自身免疫性疾病的复杂性,围手术期管理需要各种医学专家参与的综合方法.这些患者经常服用抗凝剂等药物,抗血小板药物,改善疾病的药物和免疫抑制剂。这种药物治疗方案会增加他们术后并发症的风险,包括出血,血栓形成,延迟愈合和术后感染。目前,目前尚无针对SLE相关APS患者进行拔牙的既定指南.我们报告了一例SLE相关的APS伴冠周炎,需要手术摘除。本报告的目的是为牙科手术的围手术期管理和在这种情况下使用的药物的改变提供实用建议。
    Antiphospholipid syndrome (APS) is a systemic autoimmune condition characterised by recurrent venous or arterial thrombosis and pregnancy complications, with persistent antiphospholipid autoantibodies. APS is often found in conjunction with other autoimmune diseases, such as systemic lupus erythematosus (SLE). SLE-associated APS patients may require dental procedures like tooth extractions. Due to the complex nature of this autoimmune disorder, perioperative management requires a comprehensive approach involving various medical specialists.These patients are frequently taking medications like anticoagulants, antiplatelet drugs, disease-modifying drugs and immunosuppressants. This medication regimen can increase their risk of postoperative complications, including bleeding, thrombosis, delayed healing and postoperative infections. Currently, there are no established guidelines for performing tooth extractions in individuals with SLE-associated APS.We report a case of SLE-associated APS with pericoronitis requiring surgical extraction. The purpose of this report is to offer practical recommendations for the perioperative management of dental procedures and alteration in medications used in such cases.
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  • 文章类型: Case Reports
    背景:化脓性脊柱盘炎是一种感染性脊柱疾病,可引起严重的运动障碍。由于其快速发作和非特异性症状,其诊断可能具有挑战性。
    方法:一名79岁的日本男子,有2型糖尿病和风湿性多肌痛病史,出现舌痛。在全身麻醉下进行部分舌状切除术和智齿拔除后,术后10天(POD),患者出现右侧腹痛和行走困难。在12POD上,该患者因呼吸窘迫和截瘫而被送往市立医院。
    方法:患者被诊断为化脓性脊柱盘炎和脓胸。血液检查显示C反应蛋白水平升高(36.5),白细胞计数(19,570),和中性粒细胞计数(17,867)。
    方法:患者接受3g/2天的美罗培南水合物作为急性感染的经验性抗生素治疗。16POD入住急诊科后,肺脓肿被引流,进行了半椎板切除术。
    结果:血培养,痰检,手术期间引流的胸脓肿和脊柱脓肿的培养物显示甲氧西林敏感的金黄色葡萄球菌。成功控制了感染,呼吸障碍和炎症反应得到改善。然而,患者身体的下半部分仍然瘫痪。随后,患者在45POD时被转移到康复机构.病人继续接受功能恢复训练,逐渐恢复功能,并最终实现了以抓步态行走的能力。
    结论:这是首例金黄色葡萄球菌由于口腔手术后伤口的血流感染引起化脓性脊柱盘炎和脓胸的病例报告。继发血源性感染引起的化脓性脊柱盘炎难以诊断,并可导致严重的功能障碍。根据详细的患者访谈进行及时和适当的诊断和治疗,额外的血液测试,计算机断层扫描是必不可少的。
    BACKGROUND: Pyogenic spondylodiscitis is an infectious spinal disease that causes significant motor dysfunctions. Its diagnosis can be challenging owing to its rapid onset and nonspecific symptoms.
    METHODS: A 79-year-old Japanese man with a history of type 2 diabetes mellitus and polymyalgia rheumatica presented to our department with tongue pain. Following partial glossectomy and wisdom tooth extraction under general anesthesia, on 10 postoperative day (POD) the patient developed right-sided abdominal pain and difficulty in walking. On 12 POD, the patient was admitted to a municipal hospital due to respiratory distress and paraplegia.
    METHODS: The patient was diagnosed with pyogenic spondylodiscitis and empyema. Blood tests revealed elevated C-reactive protein levels (36.5), white blood cell count (19,570), and neutrophil count (17,867).
    METHODS: The patient received meropenem hydrate 3 g/2 days as empiric antibiotic treatment for acute infection. Upon admission to the emergency department on 16 POD, the lung abscess was drained, hemilaminectomy was performed.
    RESULTS: Blood cultures, sputum tests, and cultures from the thoracic and spinal abscesses drained during surgery revealed methicillin-sensitive Staphylococcus aureus. The infection was successfully managed, and the respiratory disturbance and inflammatory response improved. However, the lower half of the patient body remained paralyzed. Subsequently, the patient was transferred to a rehabilitation facility on 45 POD. The patient continued to undergo functional restoration training, gradually regained function, and eventually achieved the ability to walk with grasping gait.
    CONCLUSIONS: This is the first case report of S aureus causing pyogenic spondylodiscitis and empyema due to blood stream infection from a post-oral surgical wound. Pyogenic spondylodiscitis arising from a secondary hematogenous infection is difficult to diagnose and can lead to severe functional impairment. Prompt and appropriate diagnosis and treatment based on detailed patient interviews, additional blood tests, and computed tomography are essential.
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  • 文章类型: Case Reports
    背景技术牙源性角化囊肿(OKC)是一种常见的牙源性囊肿,它更频繁地发生在下颌骨中,牙弓的后部区域,角度,或者ramus是最常见的受影响的部位。上颌窦内发生的牙源性角化囊肿极为罕见,仅占病例的1%左右。病例报告一名没有任何临床症状的20岁女性患者接受了口腔检查,在此期间,上颌窦内发现了致密的牙齿阴影,周围是低密度的阴影。体格检查显示没有左上颌第三磨牙,粘膜完整。患者报告无拔牙史。X射线和锥形束计算机断层扫描显示了左侧上颌窦内的高密度图像,像牙齿,被软组织阴影包围,与常规牙源性囊肿相比,其密度更高。最初的诊断是上颌窦中的牙源性角化囊肿,并带有异位的上颌第三磨牙。采用Caldwell-Luc方法进行囊肿的手术摘除和患牙的拔除。组织病理学分析证实了OKC的存在。随访6个月无明显复发。结论上颌窦牙源性角化囊肿伴第三磨牙异位少见,早期可能没有任何症状。可以使用Caroler-Luke方法进行手术,以获得理想的治疗效果。鉴于OKC的高复发率,术后应进行密切随访.
    BACKGROUND Odontogenic keratocyst (OKC) is a common odontogenic cyst, and it occurs more frequently in the mandible, with the posterior region of the dental arch, the angle, or the ramus being the most commonly affected sites. Odontogenic keratocyst occurring within the maxillary sinus is extremely rare, accounting for only about 1% of cases. CASE REPORT A 20-year-old female patient without any clinical symptoms underwent an oral examination, during which a dense dental shadow was identified within the maxillary sinus, surrounded by a low-density shadow. Physical examination revealed absence of the left maxillary third molar, with intact mucosa. The patient reported no history of tooth extraction. X-ray and cone-beam computed tomography revealed a high-density image within the left maxillary sinus, resembling a tooth and surrounded by a soft-tissue shadow, which exhibited a greater density in comparison to conventional odontogenic cysts. The initial diagnosis was odontogenic keratocyst in the maxillary sinus with an ectopic maxillary third molar. Surgical enucleation of the cyst and extraction of the impacted tooth were carried out utilizing the Caldwell-Luc approach. Histopathological analysis confirmed the presence of OKC. No significant recurrence was noted during the 6 months of follow-up. CONCLUSIONS Odontogenic keratocysts in the maxillary sinus with ectopic third molar are rare and may not have any symptoms in the early stage. Surgery can be performed using the Caroler-Luke approach to achieve ideal treatment results. In view of the high recurrence rate of OKC, close follow-up should be conducted after surgery.
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  • 文章类型: Journal Article
    Most of the maxillary impacted third molars are located in the maxillary tuberosity, where the vision and operation space are limited. This paper reports a case of surgical extraction of the left maxillary horizontal superhigh impacted third molar, which is located between the roots of the adjacent teeth and is closely related to the maxillary sinus. The digital simulation technology was used to reconstruct a three-dimensional visual image of the patient\'s maxilla, related teeth, and other adjacent anatomical structures to assist in finding the optimal surgical method accurately. Root dislocation before the crown not only protects the roots of the adjacent tooth, but also reduces the risk of maxillary sinus lining damage or perforation during operative procedures, improves the efficiency of the operation, and reduces surgical trauma, which conforms to the concept of minimally invasive surgery and provides a new idea and experience for the clinical extraction of such maxillary impacted third molars.
    上颌阻生第三磨牙多位于上颌结节区,此区域手术操作空间小、视野差。本文报道1例牙冠位于邻牙两牙根之间、与上颌窦关系密切的上颌水平超高位阻生第三磨牙的拔除。利用数字化模拟技术三维重建患者部分上颌骨、相关牙齿等毗邻解剖结构,精准制定最佳手术方案,采用牙根先脱位、牙冠后脱位法拔除阻生牙。该法既保护了邻牙牙根,也降低了上颌窦黏膜损伤以及穿孔的风险,提高了手术效率,减小了手术创伤,符合微创牙槽外科理念,为临床上拔除此类埋伏阻生牙提供了新思路和经验。.
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