Purpose: This study was conducted to characterize the relationship of the angulation between the tooth root axis and alveolar bone axis with anterior alveolar(AA) arch forms and sagittal root position (SRP) in the anterior esthetic region using cone-beam computed tomography (CBCT) images. Materials and Methods: CBCT images that met the inclusion and exclusion criteria were categorized using a recent classification of AA arch forms and a SRP classification. Then, the angulation of the root axis and the alveolar bone axis was measured using mid-sagittal CBCT images of each tooth. The relationships of the angulation with each AA arch form and SRP classification were evaluated using 1-way analysis of variance and a linear regression model. Results: Ninety-eight CBCT images were included in this study. SRP had a greater influence than the AA arch form on the angulation of the root axis and the alveolar bone axis(P<0.05). However, the combination of AA arch form and SRP was more predictive of the angulation of the root axis and the alveolar bone axis than either parameter individually. Conclusion: The angulation of the root axis and alveolar bone axis demonstrated a relationship with the AA arch form and SRP in teeth in the anterior esthetic region. The influence of SRP was greater, but the combination of both parameters was more predictive of root-to-bone angulation than either parameter individually, implying that clinicians should account for both the AA arch form and SRP when planning implant placement procedures in this region.
Purpose: The aim of this study was to investigate and identify the main causes of periodontal tissue change associated with labial gingival recession by examining the anterior region of patients who underwent orthodontic treatment. Methods: In total, 45 patients who had undergone orthodontic treatment from January 2010 to December 2015 were included. Before and after the orthodontic treatment, sectioned images from 3-dimensional digital model scanning and cone-beam computed tomography images in the same region were superimposed to measure periodontal parameters. The initial labial gingival thickness (IGT) and the initial labial alveolar bone thickness (IBT) were measured at 4 mm below the cementoenamel junction (CEJ), and the change of the labial gingival margin was defined as the change of the distance from the CEJ to the gingival margin. Additionally, the jaw, tooth position, tooth inclination, tooth rotation, and history of orthognathic surgery were investigated to determine the various factors that could have affected anterior periodontal tissue changes. Results: The mean IGT and IBT were 0.77±0.29 mm and 0.77±0.32 mm, respectively. The mean gingival recession was 0.14±0.57 mm. Tooth inclination had a significant association with gingival recession, and as tooth inclination increased labially, gingival recession increased by approximately 0.2 mm per 1°. Conclusions: In conclusion, the IGT, IBT, tooth position, tooth rotation, and history of orthognathic surgery did not affect labial gingival recession. However, tooth inclination showed a significant association with labial gingival recession of the anterior teeth after orthodontic treatment.
Purpose: This study investigated the prevalence of developmental and acquired pathologic conditions associated with impacted third molars (3Ms) in a Southern Brazilian population and evaluated whether demographic and tooth characteristics were correlated with the presence of bone or tooth lesions. Materials and Methods: Panoramic radiographs were assessed for developmental (bone-related) or acquired (tooth-related) pathoses associated with impacted upper or lower 3Ms. Data on tooth positioning, tooth development, and patient demographics were collected. A trained, calibrated postgraduate student evaluated all images. Binary and multivariate logistic regression models were used to assess associations between outcomes and the demographic and radiographic variables. The threshold for statistical significance was set at 5% (P<0.05). Results: The sample comprised panoramic radiographs from 2054 patients, predominantly female (59.2%), with a mean age of 27.2±11.5 years. Overall, 4066 impacted 3Ms were evaluated, revealing 471 (11.6%) developmental and 710 (17.5%) acquired pathoses. Among the developmental pathoses, 460 (95.2%) were indicative of dentigerous cysts. Male sex, lower 3M location, vertical or distoangular positioning, and incomplete root formation were associated with an elevated likelihood of developmental pathology. Lower tooth position, complete root formation, and partial eruption were linked to an increased probability of an acquired pathology in the third or second molar. Conclusion: The prevalence of pathologic conditions associated with impacted 3Ms was low. Male sex, lower 3M placement, horizontal or distoangular positioning, and incomplete root formation were associated with developmental pathoses, while lower tooth position, complete root formation, and partial eruption were related to acquired pathoses.
Tho osseointegrated dental prosthetic treatment has develped for the edentulous patient with severely resorbed alveolar ridge, and has given us a successful clinical results to date. Nowadays the partially edentulism is included among the indications of the osseointegrated prosthetic treatment. 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 superstructure. Two dimensional finite element stress analysis was applied for this study. FEM models were created using software Super SAP for MBM 16bit personal computer. Three modalities of connection were modeled and analyzed under load condition. The results were as follws: 1. The stress develped at tooth and implant in the cancellous bone was lower in the case of rigid connection than in the case of norigid connection, but higher between the two implants in the case of rigid connection than in the case of nonrigid connection. 2. The stress developed at the cortical bone and at the supporting bone interface was lower in the case of rigid connection than in the case of nonrigid connection 3. The stress developed at the supporting tissue interface of the implant nearby the tooth, was lower in the case of rigid connection than in the case of nonrigid connection. 4. The stress developed at the supporting tissue interface of posteriormost implant, was same between the cases of rigid and nonrigid connection. 5. The stress distribution related to the freestanding case was generally similar to the stress distribution pattern of nonrigid connection case. 6. The magnitude of applied load which produces deformation within elastic limit, had influence on the absolute value of stress, but had no influence on the pattern of stress distribution of the same case.
Purpose: To evaluate the safety and efficiency of bone regenerative abilities of silk fibroin nanomembrane(Nanoguide-S) Material and Methods: The objects were 38 patients who had large defect at extraction sockets caused by chronic periodontitis and silk fibroin nano matrix were used on experimental group(N=19) and PLA/PLGA matrix were used on control group(N=19). The width, height, and length by crown-apical direction(socket depth) of defects were measured with the occlusal plane as a reference plane, and tooth axis direction, perpendicular to tooth axis direction were measured on radiographs at 3 months pre-operative, 3 months post-operative. Result: Tissue response to silk fibroin nano matrix and Biomesh were clinically satisfactory and complications such as swelling, exudation, ulceration and vesicles were not found except the ordinary discomfort of operated portion. 3 months later, the width, height, and length by crown-apical direction (socket depth) of defects were clinically improved in both groups with no significant difference. 3 months later radiolucency of tooth axis direction and perpendicular to tooth axis direction were all increased in both groups with no significant difference. Conclusion: By these results biodegradadable silk fibroin nano matrix was efficient in GBR on alveolar bone resorption caused by periodontitis compared to Biomesh.
Kim, Jung-Ju;Amara, Heithem Ben;Chung, Inna;Koo, Ki-Tae
Journal of Periodontal and Implant Science
/
v.51
no.2
/
pp.100-113
/
2021
Purpose: Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. Methods: A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. Results: The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). Conclusions: The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.
In this study, we attempt to investigate the mechanisms by which PDL cells regulate osteoclast formation and also tc know whether PDL retained their characteristic phenotype during tooth eruption and interdental separation. Rats were prepared at developmental days 21 (pre-root formation), 27(toot development), 34(advanced root formation/eruption) and at later times(adult rats). To induce severe resorption state of alveolar bone and tooth root, interdental separation with brass wire was performed between the lower first and second molars for 2 weeks in adult rats. Rat mandibles were demineralized and embedded in paraffin, and horizontal and frontal section were prepared for immuno-histochemical analysis using PDL-specific protein 22 (PDLs22), receptor activator of NFKB ligand (RANKL) and osteoprotegerin (OPG) antibodies. 1. Root formation and eruption stage of tooth development. 1) PDLs22 immunolocalization was observed in tooth follicle/PDL cells and osteoblasts throught out the root formation and eruption stages of tooth development. 2) RANKL expression became stronger at eruption stage than root formation stage of tooth development. 3) Strong expression of OPG was detected in follice/PDL cells of toot formation stage but it was decreased with tooth eruption. 2. Interdental separation between lower first and second molar 1) Comparared to normal animal, multinucleated osteoclasts and odontoclasts were markedly induced in the alveolar bone and tooth root with PDL remodeling in hematoxylin-eosin section. 2) PDLs22 expression was decreased with interdental separation. 3) RANKL expression was Increased with interdental separation in PDL fibroblasts, osteoblasts, odontoclasts and it lacunae, resorting dentin, cementum and bone matrix. 4) OPG expression was slightly decreased in the PDL cells adjacent to the alveolar bone and root surface with interdental separation. These results suggested that during tooth eruption and tooth movement, RANKL and OPG in the periodontal tissues are important determinants regulating balanced alveolar bone and tooth root resorption. And it is also suggested that PDL cells retained their characteristic phenotype during tooth eruption and interdental separation except for the short period of PDL remodeling.
There are evidences that exogenous electric currents are capable of enhancing bone formation and resolution, and that the conversion of the bioelectric response to biochemical activity provides the directional component of orthodontic tooth movement. In addition, evidence has implicated cyclic nucleotides in alveolar bone cellular activation mechanism during orthodontic tooth movement. In view of these evidences, this study was performed to investigate the effects of exogenous electric currents on cyclic nuclotide levels in feline alveolar bone and the possible clinical application of electric currents as an additional orthodontic tool. In the first study, three groups of three adult cats were subjected to application of a constant direct current of $10{\pm}2$ microamperes to gingival tissue near maxillary canine noninvasively for 1, 3, and 7 days respectively. In the second study, three groups of three adult cats each were treated by an electric-orthodontic procedure for 1, 3, and 7 days respectively. The left maxillary (control) canine received an orthodontic force of 80gm alone at time of initiation, while the right maxillary (experimental) canine received combined force-electric stimulation (80gm of force and $10{\pm}2$ microamperes of a constant D.C. currents). Alveola, bone samples were obtain from the mesial (tension and/or cathode) and the distal (compression and/or anode) sites surrounding maxillary canines as well as from contralateral control sites. The samples were extracted, boiled, homogenized, and the supernatants were assayed for cyclic nucleotides (cAMP, cGMP) by a radioimmunoassay method. And also the amount of tooth movement was measured in the second study. On the basis of this study, the following conclusions can be drawn: 1. The fluctuation pattern of cyclic nucleotide levels in alveolar bone treated by exogenous electric currents was similar to that treated by orthodontic force. 2. The cAMP levels in alveolar bone of electrically treated teeth significantly elevated above the control values. And of electrically treated teeth, the values of the anode sites were higher than those of the cathode sites. 9. The cGMP levels in alveolar bone of electrically treated teeth elevated above the control values at the initiation phase of treatment, but dropped below the control values at time of termination. And of electrically treated teeth, the values of the cathode sites were higher than those of the anode sites. 4. The rate of tooth movement in teeth . treated by force-electric combination increased with the length of treatment as compared to that treated by mechanical force alone.
Journal of the Korean Academy of Esthetic Dentistry
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v.25
no.1
/
pp.15-24
/
2016
It is considered an implant failure when there is esthetic problems in the anterior area although the prosthesis function normally. In 2003, Dr. Kan et al stated that implant bone level is determined by the adjacent teeth. After that many scholars have studied how can achieve the esthetics result on adjacent teeth bone loss cases. In 2012, Dr. Takino published an article in Quintessence. He summarized previous articles and reclassified the defects from class 1 through 4. Class 1 and 2 depicts a situation where there is no bone loss on adjacent teeth. In Class 3 and 4, interproximal bone loss extends to the adjacent tooth. If one side is involved, it is Class 3. If both sides are involved, it is Class 4. The clue for esthetic implant restoration is whether bone loss extends to adjacent tooth or not. If the bone level of adjacent tooth is sound, we can easily achieve the esthetic but the bone level is not sound, the surgery will be complicated and the esthetic result will be unpredictable. So regenerative surgery for adjacent tooth is necessary for long-term maintenance. But the options and process were so complicated, the purpose of this article is to report the method simplify the surgery and gain a similar outcome.
The purpose of this study was to analyse the center of resistance of the maxillary first molar using the 3-dimension finite element method. An extracted maxillary first molar of normal shape and average root length was selected and sectioned every 1.5mm parallel to the cementoenamel junction. Each section was traced and digitized to construct 3-D finite element model of the maxillary first molar. After a certain magnitude of counterbalancing moment(M) was applied to the tooth, a varying single force(F) of distomesial direction was applied to a certain point of th tooth until the tooth was translated. The force producing translation(Ft) was substituted to the equation ${\Delta}d=M/Ft$ to calculate the center of resistance of the maxillary first molar. And reducing the alveolar bone level 1.68mm, and 3.36mm below to the cementoenamel junction, the tooth movement was analysed to see the effect of reducing the alveolar bone level to the location of the center of resistance. The results were as follows ; 1. The center of resistance of the maxillary first molar was 3.72mm apical, 1.10mm buccal, and 0.71mm mesial to the geometric center of the horizontally sectioned surface at the cementoenamel junction. This point was 0.36mm apical, 1.20mm buccal, and 0.71mm mesial to the trifurcation point, indicating that it was not on the tooth root. 2. As the alveolar bone level was reduced, the center of resistance of the maxillary first molar was moved to the apical direction.
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