Objective: The aim of this study was to investigate whether labial tooth inclination and alveolar bone loss affect the moment per unit of force ($M_t/F$) in controlled tipping and consequent stresses on the periodontal ligament (PDL). Methods: Three-dimensional models (n = 20) of maxillary central incisors were created with different labial inclinations ($5^{\circ}$, $10^{\circ}$, $15^{\circ}$, and $20^{\circ}$) and different amounts of alveolar bone loss (0, 2, 4, and 6 mm). The $M_t/F$ necessary for controlled tipping ($M_t/F_{cont}$) and the principal stresses on the PDL were calculated for each model separately in a finite element analysis. Results: As labial inclination increased, $M_t/F_{cont}$ and the length of the moment arm decreased. In contrast, increased alveolar bone loss caused increases in $M_t/F_{cont}$ and the length of the moment arm. When $M_t/F$ was near $M_t/F_{cont}$, increases in Mt/F caused compressive stresses to move from a predominantly labial apical region to a palatal apical position, and tensile stresses in the labial area moved from a cervical position to a mid-root position. Although controlled tipping was applied to the incisors, increases in alveolar bone loss and labial tooth inclination caused increases in maximum compressive and tensile stresses at the root apices. Conclusions: Increases in alveolar bone loss and labial tooth inclination caused increases in stresses that might cause root resorption at the root apex, despite the application of controlled tipping to the incisors.
Toyokawa-Sperandio, Katia Cristina;Conti, Ana Claudia de Castro Ferreira;Fernandes, Thais Maria Freire;de Almeida-Pedrin, Renata Rodrigues;de Almeida, Marcio Rodrigues;Oltramari, Paula Vanessa Pedron
The korean journal of orthodontics
/
v.51
no.5
/
pp.329-336
/
2021
Objective: To compare the magnitude of external apical root resorption (EARR) 6 months after starting orthodontic treatment using orthodontic aligners (OAs) and fixed appliances (FAs). Methods: This parallel randomized clinical trial included 40 patients randomized into two groups: OA group (n = 20, 160 incisors) and FA group (n = 20, 160 incisors). For evaluation of the tooth length, periapical radiographs and standardized linear measurements of the maxillary and mandibular incisors were acquired before (T0) and 6 months after treatment initiation (T1). EARR was calculated through the difference in length between the two time points (T1-T0). Statistical comparisons were performed by means of using t-tests, chi-squared test and covariance analysis (a = 5%). Results: Rounding of the root apex was observed in both groups; the resorption involved 2.88% of the root length, so 97.12% of the tooth length remained intact. Intragroup comparisons between the two time points revealed a significant difference, with (T1-T0) ranging from -0.52 to -0.88 mm in the FA group and from -0.52 to -0.85 mm in the OA group. In the intergroup comparisons, only tooth #21 presented a statistically significant difference (OA: -0.52 ± 0.57 mm, FA: -0.86 ± 0.60 mm); however, the overall differences between groups were not clinically relevant, ranging from 0.03 to 0.35 mm. Conclusions: OA and FA treatment resulted in a similar degree of EARR in the maxillary and mandibular incisors at 6 months after treatment initiation. However, the amount of resorption was small and does not impair tooth longevity.
The purpose of this study was to analyze the stress distribution at supporting bone according to the types of connection modality between implant and tooth in the superstrcture. This investigation evaluated the stress patterns in a photoelastic model produced by three different types of dental implants such as Branemark, Steri-Oss, IMZ and resin tooth using the techniques of quasi three dimensional photoelasticity. The teeth-supported bridge had a first molar pontic supported by second premolar and second molar as a control group. The implant and toothsupported bridge had a first molar pontic supported by second premolar and implant posterior retainer as an experimental group. Prostheses were mechanically connected to an adjacent second premolar by the rigid of nonrigid connection, Nonrigid connection used an attachment placed between the tooth-supported and fixture-supported component. The female(keyway) of attachment was placed on the distal end of the retainer supported by the tooth ; the male(Key) of attachment connected to the osseointegrated bridge was engaged into the keyway. All prostheses were casted in the same nonprecious alloy and were cemented and screwed on their respective abutments and implants. 16㎏ of vertical loads on central fossae of second premolar, first molar pontic, implant of second molar were applied respectively and 6.5㎏ of inclined load on middle buccal surface of first molar pontic was applied. The results were as follows : 1. Under the vertical load on the central fossa of first mloar pontic, the stress developed at the apex of tooth of implat was more uniformly distributed in the case of nonrigid connection than in the case of rigid connection. 2. Under the vertical load on the central fossa of first molar pontic, the stress developed around the cervical area of tooth of implant was larger in the case of rigid connection than in the case of nonrigid connection because the bending moment was more occured in the case of rigid connection than in the case of nonrigid connection. 3. Stress was more restricted to the loaded side of nonrigid connection than to that of rigid connection 4. Under the inclined load. The set screw loosening of implant was more easily occured in the case of nonrigid connection than in the case of rigid connection due to torque moment. 5. In the case of Branemark implant, the stress concentration in second premolar was larger and the stress developed around the cervical area of implant was lower than any other cases under the vertical load, because Branemark implant with the flexible gold screw was showed in incline toward second premolar by a bending moment. 6. The stress developed around the apex of tooth or implant was more uniformly distributed in the case of Steri-Oss implant with stiff screw than in the case of Branemark implant under the vertical load. But, the stress developed around the cervical area of the Steri-Oss implant was larger than that of any other implants because bending moment was occured by vertical migration of second premolar. 7. The stress distribution in the case of IMZ implant was similar to the case of natural teeth under small vertical load. But, the residual stress around the implant was showed to occurdue to deformation of IMC and sinking of screw under larger vertical load.
Journal of the korean academy of Pediatric Dentistry
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v.26
no.2
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pp.317-322
/
1999
Dens invaginatus is a developmental anomaly resulting from an invagination of the enamel organ. The incidence is highest with maxillary permanent lateral incisors. The reported occurrence ranges from 0.04 to 10%. This anomaly may involve the pulp and periapical tissues and cause pulpal inflammation, loss of vitality, apical and lateral periodontitis, periapical abscesses and cysts and stimulate internal resorption. Oehlers describes dens invaginatus as occurrence in three forms. In treating type 3 invaginatus, treatment strategy can be determined by considering the complexity and accessibility of invagination. In this case, showing simple invagination, it could be treated by simple endodontic treament confining to invagination without loss of vitality of tooth. After treatment of the present case, the results were as follows: 1. In type 3 dens invagiantus, if the tooth is vital and there is no evidence of communicating between invagination and pulp, we can save the vitality of the tooth and resolve the lesion by endodontic treament confining to the invagination. 2. In the invagination with opened apex, the closure of apex can be induced by apexification procedure doing this, we can avoid the neccessity of surgical intervention.
Kim, Jee-Hwan;Yoon, Chol-Wook;Kim, Taehyeon;Kim, Han-Sung;Woo, Dae-Gon;Lee, Keun-Woo;Shim, June-Sung
The Journal of Korean Academy of Prosthodontics
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v.52
no.4
/
pp.305-311
/
2014
Purpose: When the full veneer crown was treated in the tooth with abfraction lesion due to various causes, the prognosis of it may be compromised according to the location of the finish line, but there is few study about the location of its buccal finish line. The purpose of this study was to investigate the effect of location of the finish line of the full veneer crown on stress distribution of the tooth with abfraction lesion. Materials and methods: The two dimensional finite element model was developed to express tooth, surrounding tissue and full veneer crown. The stress distribution under eccentric 144 N occlusal load was analyzed using finite element analysis. The location of finish line was set just at the lower border of the lesion (Group 0), 1 mm (Group 1) and 2 mm (Group 2) below the lower border of the lesion. Results: In the Group 0, von Mises stress was concentrated at the finish line and the apex of the lesion. Also, the stress at the bucal finish line propagated to the lingual side. In the Group 1 and Group 2, stress distribution was similar each other. Stress was concentrated at the apex of lesion, but the stress at the buccal finish line did not propagate to the lingual side. That implied decrease of the possibility of horizontal crown fracture. Conclusion: Full veneer crown alleviated the stress concentrated at the apex of the abfraction lesion, when the finish line of full veneer crown was set below the lower border of abfraction lesion.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.21
no.2
/
pp.367-375
/
1991
The clinical and radiographic features of 1,171 mesiodenses were studied with periapical radiograms and/or pantomograms in 942 persons visited the Department of Oral Radiology, School of Dentistry, Kyung Hee University during January 1980 to December 1989. The obrained results were as follows; 1. The incidence of mesiodens was higher in males (75.4%) than in females (24.6%). 2. In number of mesiodenses per individual, a single mesiodens was found to be 75.9%, 2-mesiodenses to be 23.8%, and 3-mesiodenses to be 0.2%. 3. In mesiodenses according to erupted and impacted status, the erupted mesiodens was found to be 16.5%, the impacted mesiodens in the interdental alveolar bone to be 66.6%, and in the region below root apex to be 16.9%. 4. In impacted mesiodenses according to direction of tooth crown, the inverted impaction was found to be 68.8%, the vertical impaction to be 15.1%, and the angulated impaction to be 16.1%. Among the impacted mesiodenses, a palatally located impaction was 87.5%, a middle 4.9%, and a labially 7.6%. 5. In mesiodenses according to shape of the tooth crown, a incisor-like type was found to be 1.6%, a canine-like type to be 6.8%, a conical type to be 79.2%, and a tuberculated type to e 12.4%. 6. In effect of mesiodens on adjacent tooth, non-specific influences were found to be 73.4%, crowding to be 0.3%, diastema to be 11.8%, rotation to be 5.7%, delayed eruption to be 3.8%, root resorption to be 2.6%, and dentigerous cyst to be 2.4%.
Bari, Roberto Di;Coronelli, Roberto;Cicconetti, Andrea
Imaging Science in Dentistry
/
v.43
no.3
/
pp.135-143
/
2013
Purpose: This study was performed to obtain a quantitative evaluation of the cortical and cancellous bone graft harvestable from the mental and canine regions, and to evaluate the cortical vestibular thickness. Materials and Methods: This study collected cone-beam computed tomographic (CBCT) images of 100 Italian patients. The limits of the mental region were established: 5 mm in front of the medial margin of each mental foramen, 5 mm under the apex of each tooth present, and above the inferior mandibular cortex. Cortical and cancellous bone volumes were evaluated using SimPlant software (SimPlant 3-D Pro, Materialize, Leuven, Belgium) tools. In addition, the cortical vestibular thickness (minimal and maximal values) was evaluated in 3 cross-sections corresponding to the right canine tooth (3R), the median section (M), and the left canine tooth (3L). Results: The cortical volume was $0.71{\pm}0.23mL$ (0.27-1.96 mL) and the cancellous volume was $2.16{\pm}0.76mL$ (0.86-6.28 mL). The minimal cortical vestibular thickness was $1.54{\pm}0.41mm$ (0.61-3.25 mm), and the maximal cortical vestibular thickness was $3.14{\pm}0.75mm$ (1.01-5.83 mm). Conclusion: The use of the imaging software allowed a patient-specific assessment of mental and canine region bone availability. The proposed evaluation method might help the surgeon in the selection of the donor site by the comparison between bone availability in the donor site and the reconstructive exigency of the recipient site.
A long-term follow-up study of a case of impacted teeth associated with a large dentigerous cyst in the left maxilla is presented. The patient was a 30-year-old man who had a large dentigerous cyst in the premaxilla and left posterior maxilla, which impacted the canine and supernumerary tooth. This is one of the most prevalent types of odontogenic cysts associated with an erupted or developing tooth, particularly the mandibular third molars. The other teeth commonly affected in order of frequency are the maxillary canines, maxillary third molars and rarely, the central incisor. Radiographically, the cyst appears as huge ovoid well-demarcated unilocular radiolucency with a sclerotic border and causes ectopic displacement of the inferior border of the maxillary sinus without destruction. Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. These cysts appear to be associated with a supernumerary tooth in the maxillary anterior incisors region called the mesiodens and impacted canine. The present case report describes the surgical enucleation of a dentigerous cyst involving the permanent maxillary left canine and mesioden. After surgery, left maxillary sinus recovered their normal size and apposition of bone was observed around the apex of the posterior teeth. During the subsequent years, there was no recurrence of the cystic lesion but the inflammation was evoked in the anterior maxilla after 42 months. This complication appeared to have correlated with bony healing in the enucleation site of the cyst. We report the healing status of a huge dentigerous cyst in the maxilla for 5 years with a review of the relevant literature.
This study was performed to investigate the age distribution with tooth calcification and degree of eruption of permanent teeth. For the study, healthy 184 patients from 5 to 19 years old without any previous serious dental treatment were randomly selected, and intraoral standard films and dental casts were taken for evaluation of stage of calcification and degree of eruption, respectively. Tooth calcification of 13 stages, designed by the author based on the Nolla's classification and eruption level of 4 or 5 degree was used. Data were processed by SAS/Stat program and the obtained results were as follows; 1. The age of root completed with open apex in lower posterior teeth were 13.8 years for first premolar, 14.0 years for second premolar, 10.5 years for first molar, and 14.2 years for second molar. There were no significant difference between right and left side. 2. As for the sequence of eruption, first molar was the first teeth erupted in upper arch, while central incisor was the first teeth in lower arch. In general, eruption of lower teeth were slightly earlier than the corresponding teeth of upper arch. 3. There were no difference of age of the same stage of development between Nolla's and the author's classification. From the results, the author's classification can be used for estimation of age with more finely in age of 8 to 15 years old. 4. Multiple regression equations for age with Nolla's(Ns) and the author's(Ks) classification of tooth calcification, and degree of eruption(DE) were as follow; Age(by #34) = 7.55 + 0.76Ks34 + 0.80DE34 - 0.72Ns34 Age(by #35) = 7.10 + 0.81Ks35 + 0.6IDE35 Age(by #37) = 6.61 + 0.82Ks37 + 0.5IDE37. Age(by #44) = 7.02 + 0.62Ks44 + 0.82DE44 Age(by #45) = 8.04 + 0.93Ks45 + 0.64DE45 - 0.89Ns45 Age(by #47) = 6.40 + 0.86Ks47 + 0.56DE47.
The Journal of Korea Assosiation for Disability and Oral Health
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v.12
no.2
/
pp.72-76
/
2016
Traumatic dental injury (TDI) is a common problem in children and adolescent. The prevalence of dental trauma among children with disability as compared to healthy children. The TDI of an immature permanent tooth can lead to the loss of pulp vitality and arrested root development. Traditionally, the treatment of choice for necrotic immature tooth is apexification, which is induction of hard tissue barrier at the apex to produce more favorable conditions for conventional root canal filling. This case report describes the treatment of a necrotic immature permanent central incisor with complicated crown fracture. The patient had multiple disabilities (cerebral palsy, congenital heart disease, developmental delay, and gait disturbance) and suffered from She was suffered from repetitive traumatic injury. Apexification and resin restoration was performed under general anesthesia, and favorable clinical results were achieved.
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