Non-vital Teeth

  • 文章类型: Journal Article
    鼻腭管囊肿,也被称为根管囊肿,是上颌骨最常见的发育囊肿.它是由创伤或感染刺激的鼻腭导管残留物的增殖引起的。在这篇文章中,作者报告了一个罕见的病例,在57岁的男性中,一个广泛的鼻腭管囊肿与非重要牙齿相关。临床检查显示面部不对称与疼痛和压痛的肿胀相关。相关的临床和放射学发现,诊断为鼻腭管囊肿,组织病理学检查证实了鼻腭管囊肿的诊断。这个案例强调了知道鼻腭管囊肿可能与非生命牙齿有关的重要性,挑战它们与重要牙齿完全相关的假设。
    在线版本包含补充材料,可在10.1007/s12070-024-04513-1获得。
    Nasopalatine duct cyst, which is also known as incisive canal cyst, is the most common developmental cyst of the maxilla. It arises from the proliferation of the remnants of the nasopalatine duct stimulated by trauma or infection. In this article, the authors report a rare case of an extensive nasopalatine duct cyst in a 57-year-old Male associated with non-vital tooth. Clinical examination revealed facial asymmetry associated with swelling that is painful and tender. Correlating clinical and radiological findings, a diagnosis of nasopalatine duct cyst was formed, and the histopathological examination confirmed the diagnosis of nasopalatine duct cyst. This case highlights the importance of knowing that nasopalatine duct cyst can be associated with non-vital teeth, challenging the assumption that they are exclusively associated with vital teeth.
    UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-024-04513-1.
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  • 文章类型: Journal Article
    在当前的修复牙科实践中使用Endocrown型修复体作为其他修复体的替代方案的机会,成熟的冠状神经根修复方法和不断发展的粘合材料调色板使这些修复在过去几年中更受欢迎。
    目的是回顾有关Endocrown修复体的机械性能-断裂强度和阻力的可用文献,存活率,准备设计-边际和内部适应,和美学。
    搜索是在四个数据库上进行的:PubMed,Scopus(ScienceDirect),WebofScience,和Scielo使用以下术语:“内冠”,“牙髓冠”,和“没有堆积冠”。最初,共选择了在2015年至2021年5月期间发表的163篇文章.在重复之后,论文仅作为摘要提出,除英语以外的任何其他语言的文章,和评论文章被删除;共有72篇文章有待考虑。在评估了72篇经过审议的文章之后,选择了37名适合本次审查。取消其他35篇文章的原因是:它们的主要重点不是内冠词,例如,直接修复,活牙的间接修复;病例报告;研究方案。
    从所选的37篇文章中,34个专注于机械性能,包括制剂设计的影响,关于存活率,其中也有一个关于美学的观点。
    这篇综述中包含的文献表明,在某些情况下,内冠状体的表现与其他冠状体相似甚至更好。然而,这种说法必须谨慎解释,鉴于大多数文章是体外或有限元分析研究。鉴于这篇综述中包含的文章中发现的高度矛盾的结果,作者认为,结论是合理的,需要进一步的研究,以确认的可行性和材料的最佳选择。
    UNASSIGNED: The opportunity of using Endocrown-type restorations in the current prosthetic dentistry practice as an alternative to other, well-established methods of corono-radicular restorations and the evolving palette of adhesive materials has made these restorations more popular in the last few years.
    UNASSIGNED: The purpose is to review the available literature about Endocrown restorations regarding mechanical properties - fracture strength and resistance, survival rate, the preparation design - marginal and internal adaptation, and esthetics.
    UNASSIGNED: The search was carried out on four databases: PubMed, Scopus (ScienceDirect), Web of Science, and Scielo using the following terms: \"endocrowns\", \"endodontic crown\", and\" no buildup crown\". Initially, a total of 163 articles published between 2015 and May 2021 were selected. After the duplicates, papers presented only as abstracts, articles in any other languages except English, and review articles were eliminated; a total of 72 articles remained to be considered for this review.After assessing the 72 considered articles, 37 were chosen as fit for this review. The reasons for the elimination of the other 35 articles were: their main focus was other than endocrowns, e.g., direct restorations, indirect restorations of vital teeth; case reports; study protocols.
    UNASSIGNED: From the 37 articles selected, 34 were focused on mechanical properties, including the influence of the preparation design, and three on survival rate, of which one also had a point of view regarding esthetics.
    UNASSIGNED: The literature included in this review shows that endocrowns perform similarly or even better in some cases than other coronal restorations. However, this statement must be interpreted cautiously, given that most articles were in vitro or finite element analysis studies. Given the high degree of conflicting results found in the articles included in this review, the authors consider as reasonable to conclude that further studies are needed to confirm the feasibility of endocrowns and the best choice of material.
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  • 文章类型: Journal Article
    如今,陶瓷贴面方法可以被认为比直接复合贴面更可预测。迄今为止,缺乏比较在活生牙(VT)和非活生牙(NVT)上骨水泥的前贴面的临床表现的研究。这项纵向临床研究调查了陶瓷贴面在VT或前NVT中的性能。在研究中评估了总共55名患者。根据牙齿的活力状况定义了两组(93颗重要牙齿和61颗非重要牙齿)。美国公共卫生服务(USPHS)标准用于评估临床状态。使用Mann-WhitneyU检验对数据进行统计学评估。所有修复都被认为是可以接受的,VT中只有一个单板不符合继发性龋齿的标准。在评估的任何标准中都没有统计学上的显着差异(p≤0.671)。评估的陶瓷贴面在VT和NVT中均显示出令人满意的临床表现。
    Nowadays, the ceramic veneer approach can be considered more predictable than direct composite veneer. To date, there is a lack of studies comparing the clinical performance of anterior veneers cemented on vital teeth (VT) and non-vital teeth (NVT). This longitudinal clinical study investigated the performance of ceramic veneers in VT or anterior NVT. A total of 55 patients were evaluated in the study. Two groups were defined based on the vitality status of the teeth (93 teeth-vital and 61 teeth-non-vital). The United States Public Health Service (USPHS) criteria were used to assess the clinical status. The data were evaluated statistically with the Mann-Whitney U test. All restorations were considered acceptable, and only one veneer in VT failed for the criteria of secondary caries. There were no statistically significant differences in any of the criteria evaluated (p ≤ 0.671). The ceramic veneers evaluated showed a satisfactory clinical performance both in VT and NVT.
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  • 文章类型: Journal Article
    OBJECTIVE: The purpose of this article is to discuss the considerations that need to be evaluated when considering the replacement of an existing maxillary anterior fixed dental prosthesis (FDP) with another FDP, or when to consider converting to implants and individual crowns on the previous abutment teeth.
    BACKGROUND: The need to replace unesthetic or failing maxillary anterior FDPs is something all restorative dentists will be faced with multiple times in their careers. Given the emphasis over the past few decades on utilizing implants for tooth replacement as opposed to a tooth supported FDP, the question becomes when is converting the existing FDP to implants and single crowns an appropriate choice, as opposed to redoing a new FDP. This article will focus on the risks of choosing to convert to an implant solution, and the risks of redoing the tooth supported FDP. Multiple systematic reviews on each approach will be used to aid in the decision process. The most significant risks for both approaches will be identified, and a chart of the key parameters to assess will be presented, along with their impact.
    CONCLUSIONS: The statistical outcomes at 5 and 10 years of tooth supported FDPs, and Implant based restorations are very similar if certain clinical parameters are met, namely vital healthy abutment teeth for the FDP, and adequate bone and soft tissue for the implant-based restoration. If one abutment tooth is compromised the long-term prognosis drops significantly and converting to an implant-based restoration may be more predictable. Similarly, if adequate bone and soft tissue cannot be obtained through surgical augmentation procedures, using a connective tissue graft for the ridge, and redoing the FDP may obtain a more acceptable esthetic result.
    CONCLUSIONS: A significant number of maxillary anterior FDPs exist that will need replacement in the future. Given the desire of many dentists to utilize implants when possible, there can be a tendency to automatically treatment plan an implant-based approach for replacement of the existing FDP. Certainly, most clinicians would favor an implant-based tooth replacement rather than preparing unrestored teeth to place an FDP, but when an existing FDP exists, the teeth have already been prepared for full coverage in most instances. In addition, for most long term existing FDPs, there is a significant change in the vertical and horizontal dimension of the bone and soft tissue that can make getting an acceptable esthetic result with an implant challenging. This article provides a systematic approach to identifying when redoing the FDP may be preferable, or when converting to an implant-based approach is a better choice.
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  • 文章类型: Journal Article
    UNASSIGNED: Fracture resistance of endodontically treated tooth is affected due to large cavity designs and access cavities and an appropriate material capable to resist fracture plays an important role. This review aims to evaluate the effect of fibre-reinforced composite (FRC) as a post-obturation material on fracture resistance of endodontically treated teeth.
    UNASSIGNED: To systematically gather and evaluate the fracture resistance of fibre-reinforced composite as a post-obturation restorative material in endodontically treated teeth.
    UNASSIGNED: A systematic search was conducted using PubMed, Ebsco Host, Scopus, Google Scholar, Hinari and manual search library resources from 1st Jan 2000 to 30th November 2019 to identify appropriate studies.
    UNASSIGNED: A total of 157 articles were examined out of which 55 articles were selected after reading the title. After removing the duplicates, 27 articles were screened for abstract and 1 article was eliminated as it did not meet the eligibility criteria. A thorough reading of the full text of the remaining 26 selected articles was assessed for eligibility. Amongst these, 1 article was then excluded from the study as the full text was not accessible. Lastly, 25 articles were included in the study.
    UNASSIGNED: FRC as a core material increases fracture resistance of endodontically treated teeth but they do not have the fracture resistance similar to the intact tooth. Both polyethylene and short fibre-reinforced composites showed greater fracture resistance when compared to glass FRC and restoration without reinforcement. Also, the fracture resistance increases if restored with FRC along with retention slots and are placed on the occlusal third surfaces of cavities. Also, favourable fractures were most commonly seen and it usually occurred at the level of enamel and dentin and adhesive fractures were seen.
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  • 文章类型: Journal Article
    牙齿脱落代表影响全球人口的扩散病理状况。风险因素已经在两个一般特征(吸烟,糖尿病,经济状况)和局部牙齿相关因素(龋齿,牙周炎)。在这项回顾性研究中,为了确定牙齿脱落的具体危险因素,我们检查了366例接受维持治疗的大量剩余牙齿(≥25颗)患者的数据.剩余的牙齿数量,非重要牙齿的数量,研究了咬合单位的数量与牙齿脱落的相关性。患者的平均随访时间为9.2年(范围5至14年)。牙齿脱落具有统计学意义的危险因素被确定为基线时剩余牙齿的数量(p=0.05)。咬合单位数(p=0.03),和后区非活生齿的数量(p<0.001)。多元逻辑回归显示,后区的咬合单位数量和非活生齿数量与更大的牙齿脱落风险显着相关(比值比分别为1.88和3.17)。这些结果证实,不仅剩余的牙齿数量,但他们的生命或非生命状态以及前后区域之间的分布也会影响长期生存。
    Tooth loss represents a diffused pathologic condition affecting the worldwide population. Risk factors have been identified in both general features (smoking, diabetes, economic status) and local tooth-related factors (caries, periodontitis). In this retrospective study, we examined the data of 366 patients with a large number of remaining teeth (≥25) undergoing maintenance therapy in order to identify specific risk factors for tooth loss. The number of remaining teeth, number of non-vital teeth, and number of occlusal units were investigated for their correlation with tooth loss. The mean follow-up of patients was 9.2 years (range 5 to 14). Statistically significant risk factors for tooth loss were identified as number of remaining teeth at baseline (p = 0.05), number of occlusal units (p = 0.03), and number of non-vital teeth in posterior regions (p < 0.001). Multiple logistic regression showed that the number of occlusal units and number of non-vital teeth in the posterior regions were significantly associated with a greater risk of tooth loss (odds ratio 1.88 and 3.17, respectively). These results confirm that not only the number of remaining teeth, but also their vital or non-vital status and the distribution between the anterior and posterior regions influence the long-term survival.
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  • 文章类型: Journal Article
    OBJECTIVE: The decision-making process when restoring a non-vital tooth is influenced by multiple factors. This study aimed to survey the dentists\' preferences regarding cast post-and-core and fiber post techniques for the reconstruction of non-vital teeth and to identify a correlation between reconstruction technique and practitioners characteristics, or dental characteristics.
    METHODS: The survey instrument was a questionnaire, which included a general part with questions regarding the practitioner\'s profile (gender, age, years of experience, pattern and location of practice, etc.) and the dental characteristics (anterior or posterior position of the tooth on the arch, the amount of dental remaining tissues, etc.) and a technical part, containing more specific questions regarding the manufacture and performance of root-coronal reconstructions.
    RESULTS: Among the surveyed practitioners (n=35), 69.7% use more often cast post-and-core reconstructions (CPR) while 30.3% choose fiber post reconstructions (FPR). No difference in the reconstruction type was observed regarding patient\'s age (p=0.23) or gender (p=0.092). The para-function criterion was considered important by 8.23% of the participants. When deciding the type of the root-coronal reconstruction depending on the remaining dentine walls, CPRs are significantly more frequently used in posterior areas (p=0.043) or when para-functional habits exist (p=0.022).
    CONCLUSIONS: Cast post-and-core represent the most frequently used type of reconstruction for non-vital teeth. Fiber post reconstructions are indicated in the aesthetic zone and when the amount of healthy remaining dental structure is higher.
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  • 文章类型: Journal Article
    Dental fractures resulting in pulp exposure will lead to an endodontic infection with microbes from the oral cavity. However, data on the endodontic microbial composition in veterinary dentistry is lacking. The aim of this study was to examine the microbiome of naturally occurring primary endodontic infections in client-owned dogs. The endodontic microbiome of 10 non-vital teeth with exposed pulp cavities was assessed using a 16S rRNA gene sequencing approach. The results were compared to the microbiome of the subgingival plaque of the same teeth. Analysis revealed an abundant mixed microflora of a comparable richness and diversity and with mostly the same phyla obtained from sulcal and endodontic samples. However, further analysis revealed significant differences between sulcal and endodontic samples in the relative abundance of the most abundant phyla and genera, with the relative abundance of Bacteriodetes being significantly higher in endodontic samples. Although each sample presented a particular profile regarding the genera identified, Bacteroides was the most abundant genus in the endodontic samples. Snowella was also significantly more abundant in endodontic samples, while Porphyromonas and Fusobacterium were significantly more abundant in sulcal samples. We confirmed that the microbiome of the diseased endodontic system is comparably abundant with microorganisms to the healthy subgingival plaque indicating that previous culture-based studies of primary endodontic infections in dogs underestimated the richness and diversity of the endodontic microbiota.
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  • 文章类型: Comparative Study
    Recombinant amelogenin protein (RAP) is reported to induce complete root apex formation in dog model when used as apexification therapy. It also induces pulp regeneration in 85% of the treated group. Thus, the aim of this study was to investigate the nature of the remaining regenerated calcified tissues of the RAP group that showed no pulp regeneration compared to the calcium hydroxide treated group (CH).
    A total of 240 dogs\' open apex root canals were used, after establishment of canals contamination. Canals were cleaned, irrigated, and filled with RAP as an apexification material and compared with CH. Treated teeth were assessed by H&E, trichrome staining, and/or immunohistochemistry technique, at 1, 3, and 6 months.
    A time-dependent increase in the calcified tissue barrier was observed in the apex of the RAP-treated group compared to the CH-treated group. The newly formed dentin in this RAP group was mainly tubular dentin and was functionally attached to the bone by periodontal ligament, while the CH group showed dentin-associated mineralized tissue (DAMT) associated with the newly formed apical barrier.
    Out results suggest that RAP can be used as novel apexification material, resulting in a thickening and strengthening of the canal walls, and achieving apical closure.
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  • 文章类型: Journal Article
    The purpose of this study was to investigate whether number of non-vital teeth was an indicator of tooth loss during maintenance. Thirty-three general practitioners provided data on 321 patients undergoing maintenance over 10 years. The number of present teeth (PT), smoking status, level of bone loss, number of non-vital teeth, and reason for tooth loss during that period were investigated. Multiple logistic regression was performed to identify whether the number of non-vital teeth was associated with tooth loss. The average number of lost teeth was 1.07±1.82; that of PT at baseline was 24.4±3.9; and that of non-vital teeth at baseline was 5.4±4.5. Multiple logistic regression revealed a significant association between >8 non-vital teeth and tooth loss during maintenance (odds ratio [OR]: 2.40; 95% confidence interval [CI]: 1.18-4.87). It also demonstrated relationships between >8 non-vital teeth and root fracture or caries (OR: 3.90; 95%CI: 1.68-9.03 or OR: 2.85, 95%CI: 1.14-7.10, respectively). The number of non-vital teeth was associated with tooth loss during maintenance. The results suggest that patients with many non-vital teeth before commencement of maintenance are particularly at risk of tooth loss due to root fracture or caries. Therefore, the number of non-vital teeth offers a useful indicator of potential tooth loss.
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