Impacted

受影响
  • 文章类型: Journal Article
    犬类嵌塞是一种常见的牙齿异常,需要多学科的方法,从诊断到治疗。常规的二维(2D)射线照片能够可视化牙齿是否受到撞击,但无法具体定位它,并确定是否有任何与之相关的根吸收。锥形束计算机断层扫描(CBCT)能够三维确定其位置,协助诊断和治疗计划。主要缺点是被添加到患者的辐射量,并且在儿科患者中可能甚至更显著。口腔内超声(io-US)是一种新的非侵入性和非辐射实时椅旁成像方法,有可能帮助定位受影响的牙齿。本文介绍了4例需要CBCT来定位和治疗上颌受累犬的情况,并且还进行了口腔超声扫描。然后将图像与CBCT检查进行比较,以验证新方法。通过这些案例,我们强调了io-US定位受影响犬科动物的能力。io-US的其他优点可能包括对手术计划和执行重要的软组织厚度和脉管系统的评估。
    Canine impaction is a common dental anomaly that requires a multidisciplinary approach, from diagnosis to treatment. The regular two-dimensional (2D) radiographs are able to visualize if the tooth is impacted, but unable to specifically localize it, and determine if there are any root resorptions associated to it. The cone-beam computed tomography (CBCT) is able to three-dimensionally determine its location, aiding to the diagnosis and treatment plan. The major disadvantage is the amount of radiation that is added to the patient and can be even more significant in pediatric patients. The intra-oral ultrasound (io-US) is a new non-invasive and non-radiating real-time chairside imaging method that has the potential to aid in locating the impacted tooth. This paper presents 4 cases that required a CBCT for the location and treatment planning of impacted maxillary canines and were also scanned with intra-oral ultrasound. The images were then compared to the CBCT exam for validation of the new method. Through these cases, we highlight the capability of the io-US to locate the impacted canines. Other advantages of io-US might include evaluation of soft tissue thickness and vasculature that are important for surgical planning and execution.
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  • 文章类型: Journal Article
    牙齿嵌塞是牙齿未达到其正常位置的情况,并且由于空间不足,经常在第三下颌磨牙中观察到。这项研究旨在调查受影响的第三磨牙的患病率和构型,重点是埃塞俄比亚人口样本中的角度方向。这项横断面研究包括对亚的斯亚贝巴一家私人牙科诊所档案中的291份患者记录和骨科成像数据的回顾性分析,在2020年12月至2022年11月的研究期间。使用冬季分类评估了人口统计详细信息以及有关受影响的第三磨牙的位置和水平的数据。分析数据的频率分布。患牙的患病率为22%(n=64),右侧发生率较高(60.9%),下颌骨发生率较高(67.2%)。垂直角(32.8%),其次是近角测角(31.2%),是最常见的撞击模式。结果强调需要改进第三磨牙撞击的治疗方案,强调下颌骨的普遍性和解决垂直嵌塞的重要性。定期的牙科检查对于评估第三磨牙嵌塞和计划适当的管理至关重要。这些数据可以为埃塞俄比亚人口中受影响的第三磨牙的决策和治疗考虑提供信息。
    Tooth impaction is a condition in which a tooth does not reach its normal position and is often observed in the third mandibular molar due to inadequate space. This study aimed to investigate the prevalence and configuration of the impacted third molars with an emphasis on angular orientations in a sample of the Ethiopian population. This cross-sectional study included a retrospective analysis of 291 patient records and orthopantomography data from the archives of a private dental clinic in Addis Ababa, during the study period from December 2020 to November 2022. Demographic details and data on the position and level of the impacted third molars were evaluated using the Winter classification. Data were analyzed for frequency distribution. The prevalence of impacted third molars was 22% (n = 64), with a greater incidence on the right side (60.9%) and a higher frequency in the mandible (67.2%). Vertical angulation (32.8%), followed by mesioangular angulation (31.2%), was the most common impaction pattern. The results highlight the need for improved treatment protocols for third molar impaction, emphasizing the prevalence in the mandible and the importance of addressing vertical impaction. Regular dental check-ups are essential for assessing third molar impaction and planning appropriate management. These data can inform policymaking and treatment considerations for impacted third molars in the Ethiopian population.
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  • 文章类型: Journal Article
    目的:这项研究的主要目的是评估KPG指数在预测涉及上颌阻生犬牙的治疗难度方面的有效性。次要目标是评估指标的可靠性和可重复性。
    方法:对60例13-35岁患者的96只上颌阻生犬(MIC)进行了回顾性研究。锥形束计算机断层扫描(CBCT)扫描用于使用KPG指数预测MIC的治疗难度。评估患者病例档案在治疗MIC中遇到的实际困难。Cohen的kappa相关系数用于观察者内部可靠性,Kendell的W检验用于观察者之间的可靠性。采用Spearman相关系数检验评估预测治疗与实际治疗的相关性。
    结果:容易和中度困难的病例在实际和预测的治疗结果之间表现出中度相关性,而困难的病例显示出微弱的相关性。仅在极其困难的情况下观察到完美的相关性。使用KPG指南评估CBCT扫描的观察者内部可靠性为0.88,评估者之间的可靠性为0.94。
    结论:KPG指数显示87%,71%,50%和100%的有效性,中等难度,困难,和极其困难的案件,分别。该指标具有良好的可靠性和重现性。然而,必须考虑许多其他因素,包括病人的年龄,相邻牙齿中存在相关的牙根吸收,和治疗持续时间,在手术暴露和拔除之间做出明智的决定。
    OBJECTIVE: 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.
    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.
    CONCLUSIONS: 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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  • 文章类型: Journal Article
    评估和比较2D修改的EasyBox的有效性以及在标准常规正像图(OPG)与3D锥形束计算机断层扫描(CBCT)OPG构造视图上测量的Beta角。
    回顾性协议研究。
    这项研究的目的是在标准的常规OPG上构建EasyBox,并通过将其与3DCBCT上的EasyBox方法进行比较来验证这种新颖的方法。伦理委员会批准后,OPG和CBCTX光片是从同一地点的部门记录和五个私人诊所获得的研究(印多尔,印度)。在研究开始之前,根据记录的可用性和参与者的书面同意选择X射线照片。对记录进行了分析,以进行比较,并评估3DCBCT和标准常规OPG射线照片上EasyBox构造的准确性。在两个视图上都确定了受影响的犬科动物在EasyBox边界内的位置和β角的测量值。
    将3DEasyBoxCBCT分析与OPG上的2D改良EasyBox进行比较,获得了完美的一致性(Kappa=1.0)。Bland-Altman(LoA)分析显示,在3D和2DOPG射线照相上的Beta角比较中没有成比例的偏差。
    与3DCBCTOPG构造视图上的EasyBox相比,常规OPG上的Beta角和2D修改的EasyBox产生类似的结果。标准的OPG是有价值和成本效益的,特别是在诊断和治疗计划的早期阶段,作为替代或当CBCT不可用时。
    UNASSIGNED: 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.
    UNASSIGNED: A retrospective agreement study.
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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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  • 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: Case Reports
    多余的磨牙是一种罕见的异常,可以发生在颌面部复合体,指的是牙弓中存在额外的牙齿。这种情况通常与几种罕见的疾病有关,如加德纳综合征,锁骨发育不良,Ehler-Danlos综合征,和唐氏综合症然而,在非综合征性关联中很少观察到。它们在上颌骨中比在下颌骨中更常见。这项研究代表了一个独特的案例研究,探索了17岁男性患者的上颌和下颌弓中共存的未萌出的副牙轮和磨牙旁卵泡。这些卵泡的发现是偶然的,因为患者在最初的正像图扫描中没有表现出症状。尽管没有明显的症状,随着时间的推移,我们采取了警惕的监测和观察。随后,随着外科和正畸方法的整合,管理方法发生了重大转变,指导喷发策略,和合作,多学科努力。
    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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  • 文章类型: English Abstract
    犬齿嵌塞是一种异常现象,在这种异常情况下,牙齿无法萌出。当喷发被推迟并且有放射学证据时,就会发生这种情况。
    通过不同的分析,根据受累犬在上颌骨中的位置确定其预后:Ericson&Kurol,WarfordandPower&Short;2015年至2020年在亚松森市私人诊所就诊的患者。
    设计是观察性描述性的,横截面,使用全景射线照片测量。结果:样本包括37例患者和48例犬。研究发现,受影响的犬类在女性中更常见(69.44%),单侧位置(70.27%)和腭位置(68.75%)。在超过一半的病例中,预后不良,然而,一致性只有75%。Warford的预后与Power&Short的预后有更大的一致性(95.91%),而与Ericson&Kurol的一致性较低(81.25%)。
    在巴拉圭样本中,受影响的犬科动物的频率在雌性中较高,单侧定位并由腭定位。在超过一半的情况下是不利的。建议结合分析进行预测。
    UNASSIGNED: 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.
    UNASSIGNED: 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.
    UNASSIGNED: 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%).
    UNASSIGNED: 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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  • 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
    受影响和换位的牙齿会导致牙齿萌出和运动的后果,导致美学和功能的结果。需要考虑治疗时间和费用的适当治疗计划来治疗它们。这项研究报告了使用正畸和保护之间的多学科方法对一名23岁的男性患者进行上颌骨受累和转位犬的治疗。根据病人的回忆,当他还是个孩子的时候,他的上足弓中线有一颗额外的牙齿。考虑到治疗的持续时间和费用,优选和可管理的治疗方法是使用固定的正畸矫治器进行矫正,该矫治器具有仔细的力学和牙髓成形术,以实现美学和功能目标。
    The impacted and transposed teeth cause consequences in tooth eruption and movement, resulting in aesthetic and functional outcomes. A proper treatment plan with treatment duration and cost consideration is necessary to treat them. This study reported treatment for a 23-year-old male patient with impacted and transposed canine in maxilla using a multidisciplinary method between orthodontic and conservation. According to the anamnesis of the patient, his upper arch midline contained an extra tooth when he was a child. With the consideration of the duration and cost of treatment, the preferable and manageable treatment fell into the correction using a fixed orthodontic appliance with careful mechanics and enameloplasty to achieve the aesthetic and functional goal.
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  • 文章类型: Journal Article
    目的:探索知识,态度,非医学生关于阻生牙和与KAP相关因素的实践(KAP)。
    方法:这项横断面研究在2022年12月至2023年2月期间在中国东北的两所大学(东北大学和沈阳音乐学院)招募了非医学生。分数>70%被定义为足够的知识,积极的态度,积极的实践。
    结果:共有519名非医学生参加了这项研究。大多数参与者是男性(54.72%),≤20岁(72.83%),和新生(36.03%)。平均知识得分为4.98±3.46(可能范围:0-10),表示知识贫乏(49.80%)。多变量分析表明,患牙与足够的知识独立相关(OR=3.114,95%CI:1.589-6.103,P=0.001)。平均态度得分为24.65±3.78(可能范围:7-35),表明态度良好(70.43%)。知识(OR=1.182,95%CI:1.116-1.251,P<0.001),初中(OR=0.541,95%CI:0.327-0.895,P=0.017),高年级及以上(OR=0.477,95%CI:0.274-0.829,P=0.009),和阻生拔牙史(OR=2.386,95%CI:1.048-5.436,P=0.038)与良好态度独立相关。平均练习分数为21.45±5.64(可能范围:6-30),表明积极实践(71.50%)。知识(OR=1.074,95%CI:1.017-1.133,P=0.010)和女性(OR=1.501,95%CI:1.052-2.141,P=0.025)与主动实践独立相关。
    结论:非医学生对阻生牙的认识较差,但态度良好,实践良好。非医学生需要额外的教育和意识到早期发现和管理阻生牙的重要性。
    结论:该研究强调了非医学生对患牙的教育和认识的需要。
    OBJECTIVE: To explore the knowledge, attitudes, and practice (KAP) of non-medical students regarding impacted teeth and the factors associated with KAP.
    METHODS: This cross-sectional study enrolled non-medical students at two universities (Northeastern University and Shenyang Conservatory of Music) in northeastern China between December 2022 and February 2023. Scores > 70% were defined as adequate knowledge, positive attitudes, and proactive practice.
    RESULTS: A total of 519 non-medical students participated in this study. Most participants were male (54.72%), ≤ 20 years of age (72.83%), and freshmen (36.03%). The mean knowledge score was 4.98 ± 3.46 (possible range: 0-10), indicating poor knowledge (49.80%). The multivariable analysis showed that having impacted teeth were independently associated with adequate knowledge (OR = 3.114, 95% CI: 1.589-6.103, P = 0.001). The mean attitude score was 24.65 ± 3.78 (possible range: 7-35), indicating favorable attitudes (70.43%). The knowledge (OR = 1.182, 95% CI: 1.116-1.251, P < 0.001), junior grade (OR = 0.541, 95% CI: 0.327-0.895, P = 0.017), senior grade and above (OR = 0.477, 95% CI: 0.274-0.829, P = 0.009), and a history of impacted tooth extraction (OR = 2.386, 95% CI: 1.048-5.436, P = 0.038) were independently associated with the good attitudes. The mean practice score was 21.45 ± 5.64 (possible range: 6-30), indicating positive practice (71.50%). The knowledge (OR = 1.074, 95% CI: 1.017-1.133, P = 0.010) and female (OR = 1.501, 95% CI: 1.052-2.141, P = 0.025) were independently associated with the proactive practices.
    CONCLUSIONS: Non-medical students had poor knowledge but favorable attitudes and good practice toward impacted teeth. Non-medical students require additional education and awareness about the importance of early detection and management of impacted teeth.
    CONCLUSIONS: The study highlights the need for improved education and awareness among non-medical students regarding impacted teeth.
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