Complex odontoma at the upper right maxilla: Surgical management and histomorphological profile

BACKGROUND

Odontomas are hamartomatous developmental malformations of the dental tissues. Usually asymptomatic, their presence is often revealed on routine radiographs. The study aimed to establish the efficacy of this conventional approach in treating odontomas, analysing clinical outcome, follow-up, and histomorphological profile.

CASE REPORT

A case is presented with a review of the international literature. The patient, aged 8 years, had a complex odontoma localised on the front upper jaw. She was treated following the conventional surgical procedure. Post-operative course and healing were uneventful. Orthodontic treatment was necessary to realign the teeth. At the 12-month follow-up there was no recurrence or failure. Healing was excellent.

CONCLUSION

Variations in normal tooth eruption are a common finding, but significant deviations from established norms should alert the clinician to further investigate the patient's health and development.

Pixel gray measurement for the diagnosis of dental ankylosis in cone beam computed tomography images

OBJECTIVE

The aim of this study was to investigate dental ankylosis in unerupted or partially erupted teeth by using cone beam computed tomography (CBCT) to quantify pixel intensity.

STUDY DESIGN

In total, 157 CBCT images from individuals with a total of 206 unerupted or partially erupted teeth with suspected ankylosis were evaluated. CBCT images were analyzed for the presence of ankylosis by 2 oral radiologists by quantifying mean pixel intensities (analysis 1) and variations in pixel intensities (analysis 2) in normal and ankylosed regions. The association between ankylosis and demographic and tooth-related factors was also examined.

RESULTS

Ankylosis was diagnosed in 57 teeth (27.7%). The diagnosis was established with all 3 multiplanar reconstruction views in 22 of these teeth (38.6%). In analysis 1, a higher pixel intensity was observed in areas with ankylosis compared with normal periodontal ligament (PDL) density as a result of bone deposition in this region, which is characteristic of ankylosis (P < .001). In analysis 2, reductions in pixel intensity were greater in the PDL areas than in the ankylosed areas. Ankylosis was significantly associated with the anterior teeth, the maxillary arch, single-rooted teeth, and impacted teeth (P ≤ .026).

CONCLUSIONS

Our results suggest that CBCT measurement of pixel intensity may be useful for the diagnosis of ankylosis.

Effect of audiovisual eyeglasses on intraoperative pain, anxiety, and hemodynamic changes during mandibular third molar extraction: a randomized controlled clinical trial

OBJECTIVES

To determine the effect of audiovisual eyeglasses in terms of anxiety relief, hemodynamic changes, and intraoperative pain in patients undergoing surgical removal of a mandibular third molar.

METHOD AND MATERIALS

A randomized controlled clinical trial with two parallel groups was carried out in patients undergoing mandibular third molar extraction. Fifteen patients watched a video with multimedia eyeglasses during the surgical procedure, whereas 15 controls had their eyes covered during extraction. The patients completed anxiety questionnaires before and after surgery. Hemodynamic changes, intraoperative pain, duration of the surgery, and overall satisfaction were recorded.

RESULTS

Thirty patients were analyzed. Intraoperative pain and the need for supplemental anesthesia were significantly more frequent in the control group (53.3% versus 13.3%; P < .05). The surgical procedure was also briefer when the eyeglasses were used (17.2 versus 28.1 minutes). Overall satisfaction was similar in both groups. No significant differences were found between the two study groups in terms of anxiety and hemodynamic parameters.

CONCLUSIONS

The use audiovisual eyeglasses should be routinely considered during mandibular third molar extraction since these devices allow reduction of intraoperative pain and surgery time. However, patient anxiety level and hemodynamic parameters seem to remain unaltered.

Clinical efficacy of a new fully piezoelectric technique for third molar root extraction without using manual tools: a clinical randomized controlled study

OBJECTIVE

The aim of this randomized controlled clinical study was to evaluate the efficacy of a new technique fully based on the use of a piezoelectric device for third molar root extraction versus the conventional technique based on the use of manual and rotary instruments.

METHOD AND MATERIALS

Patients referred to the hospital of Bolzano for third molar extraction were randomly divided into two groups and treated by two experienced oral surgeons. In the test group all the procedures were performed using piezoelectric instruments and a specially designed piezoelectric lever, whereas in the control group conventional manual and rotary instruments were used. The main outcome measure was patient's pain perception, and the secondary outcome measures were complications, duration of the surgical treatment, and soft tissue healing. The study had a 1-week follow-up.

RESULTS

Fifty patients (23 females and 27 males) out of 90 were included in the study, and 100 third molars (50 maxillary and 50 mandibular) were extracted. All patients completed the expected follow-up. No differences were found between the two groups regarding patient's pain perception, complications, and soft tissue healing. However, the new piezoelectric extraction technique took less than half the time when compared to the conventional technique (4.6 ± 4.5 minutes versus 10.2 ± 13.1 minutes; P = .049).

CONCLUSIONS

The new piezoelectric third molar root extraction technique allowed third molar extraction in less than one half the surgical time required by the traditional technique. The advantages seem to be more pronounced in difficult cases. However, both surgeons who performed the procedures were very experienced and all the patients were young. Therefore, caution should be given to the generalization of the results. Multicenter studies with a larger variety of patients are needed to confirm the promising results of this study.

En Bloc Autotransplantation of Retained Canine in the Mandible: A Case Presentation

Missing canines compromise function and esthetics and therefore should be restored. In case of a retained canine, there can be a conservative approach of classic orthodontic eruption. If that is not effective, an alternative treatment method is to remove the retained tooth, followed by implant placement or transalveolar autotransplantation of the retained canine. En bloc autotransplantation of a retained canine, with surrounding bone, preserves canine periodontium and increases chances for revascularization and vitality of the transplanted tooth. This paper presents an en bloc autotransplantation of retained canines in the mandible in two female patients resulting in canine vitality after 1.5 years with proper pocket depth, physiologic tooth mobility, and positive reaction to ethyl chloride.

[Relationship between eruption status of mandibular third molars and thickness of the lingual bone]

PURPOSE

To estimate the relationship between the eruption status of the mandibular third molars and the thickness of the lingual bone.

METHODS

Cone-beam CT (CBCT) data of 187 patients who underwent mandibular third molar extraction from Jan 2016 to Dec 2018 were selected. Lingual bone thickness at the levels of mid-root and root-apex of the third molars were measured using GALIEOS Viewer software, and the relationship between the eruption status of the mandibular third molars and the thickness of the lingual bone was estimated. SPSS 22.0 software package was used for Wilcoxon test, univariate and multivariate logistic regression analysis.

RESULTS

The mean thickness of the lingual bone at the mid-root of the third molars was significantly less than that at the root apex (P<0.01). There was a significant correlation between the thickness of the lingual bone at the mid root and the mesiodistal angulations of the third molars. The thickness of the lingual bone at the mid root of mesioangularly and horizontally impacted third molars were significantly thinner (P<0.01). There was a significant correlation between the thickness of the lingual bone at the root apex and the impaction depth of the third molars. The thickness of the lingual bone at the root apex of medium and low positioned third molars were significantly thinner (P<0.05).

CONCLUSIONS

The thickness of the lingual bone is associated with the eruption status of the mandibular third molars. Mesially angulated and lower positioned third molars are considered as the risk factors for the thinner lingual bone, so that lingual plate fracture should be prevented during tooth extraction.

[Clinical evaluation of mandibular impacted third molar removed without surgical flaps]

PURPOSE

To evaluate the effect of impacted mandibular third molars extracted without surgical flaps.

METHODS

Ninety-eight patients with impacted mandibular third molars were collected. A total of 112 teeth were divided into non-surgical flap group and surgical flap group. In non-surgical flap group, the teeth were removed by transection method or T-shaped truncation method, and triangular flaps were designed in the surgical flap group. Postoperative complications at 1 day, 3 days, and 1 week after operation were recorded, and statistical analysis was performed using SPSS 17.0 software package.

RESULTS

Complications such as hemorrhage, swelling, pain, mouth opening limitation and impact on daily life at postoperative 1 day and 3 day in non-surgical flap group were significantly lower than in surgical flap group (P<0.05).There was no significant difference in average operation time between the two groups (P>0.05).

CONCLUSIONS

Impacted mandibular third molar can be removed without surgical flaps in selected patients. It helps alleviate patients'postoperative complications and improve their quality of life.

Relationship of Lower Lingual Arch Appliance Use and Impaction of Second Molars: A Retrospective Study

Purpose: The purpose of this study was to determine the prevalence of permanent mandibular second molar impaction in pediatric patients treated with a lower lingual holding arch (LLHA) to maintain lower arch perimeter. Methods: In this retrospective study, 259 radiographs of nine- to 17-year-old pediatric patients were examined for permanent mandibular second molar impaction. A total of 127 patients with LLHA were compared to a control group of 132 patients who had not received LLHA. Other independent variables (sex and treatment age) were also tested for their value as predictors of impaction difficulty. For statistical analysis, the chi-square test was used. Logistic regression analysis was used to determine the statistical significance of the possible predictors of second molar impaction. Results: The mean age of the subjects was 9.2±1.7 (standard deviation) years old. The prevalence of permanent mandibular second molar impaction was 7.1 percent in patients with LLHA compared to 1.5 percent in the control group. The LLHA group had a likelihood of second molar impaction 6.53 times higher than controls after controlling for age. The relationship was significant with P-value of 0.021. Conclusions: The lower lingual holding arch is associated with an increased risk of second molar impaction in patients nine to 17 years old.

Different Management Approaches in Impacted Maxillary Canines: An Overview on Current Trends and Literature

AIM

This study aimed to overview and collect the current trends and techniques in managing maxillary impacted canines by retrieving recent literature, in a chronological manner from the prevention to the very late stages of treatment in adults.

BACKGROUND

We performed a review on the recent literature regarding the current trends on the management of impacted canines. We have researched various types of available articles such as clinical trials and case presentations, meta- and systematic analyses, and literature reviews focusing on clinical management of impacted canines and their outcome evaluations. We adhered to those articles published within the last decade with a focus on treatment planning for impacted and displaced canines.

REVIEW RESULTS

Depending on the diagnosis and its timing of it, a maxillary impacted canine can be managed by either prevention or interception, surgical opening followed by autonomous eruption or orthodontically traction, autotransplantation, and at last by removal and space closure. These techniques are elaborated one by one according to the age and severity of the diagnosis.

CONCLUSION

Impaction of the canines is a manageable abnormality which is highly dependent on the timing and localization of the displaced tooth. Early detection will give the upper hand to orthodontists to engage by either prevention through extraction of deciduous canines or intercepting via assistant devices to create more space. According to the clinical situation, open or closed surgical uncovering might be required to bond an attachment. However, generally, those techniques did not show any significant clinical distinction in the outcome assessments.

CLINICAL SIGNIFICANCE

These approaches are highly technique sensitive and require collaborations with other specialties. Proper diagnosis and prognosis assessment are necessary before making any decision to bring an impacted canine in alignment.

[Application of β-TCP for bone defect restore after the mandibular third molars extraction: A splitmouth clinical trial]

OBJECTIVE

To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone.

METHODS

A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant.

RESULTS

Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups.

CONCLUSION

The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.

[Application of β-TCP for bone defect restore after the mandibular third molars extraction: A splitmouth clinical trial]

OBJECTIVE

To evaluate the effect of bone defect regeneration and the periodontal status of the second molars after mandibular third molars extraction using β-tertiary calcium phosphate (β-TCP) in the test side compared with the spontaneously healed side. To the bone defect of mandibular second molars as a result of surgical removal of impacted mandibular third molars is a common phenomenon, many research shows that the mandibular second molars alveolar bone regeneration was about 1.5 mm and the periodontal pocket >7 mm was greater than 43.3% after mandibular third molars extraction. There has been significant progress researches in the repair of bone defect after the third molar removal, and bone graft filling was one of the effective methods. The bone graft substitutes include autogenous bone, allograft bone, xenograft bone and synthetic bone.

METHODS

A split mouth, randomized clinical study was designed. Fifteen patients with mandibular third molars in the same jaw planned to be extracted were enrolled in the study. One of the sockets of each patient was randomly selected and filled with easy-graftTMCLASSIC (test group). The contralateral socket was left to heal spontaneously (control group). cone beam computed tomography (CBCT) scans were performed the day after the extraction and after 6 months. The horizontal dimensional changes of the sockets were recorded. The newly formed bone volume in the bone was analyzed by CBCT, and the probing depth (PD) was recorded. Student's t test was used to evaluate the difference between the two groups for each parameter, and the P value lower than 0.05 was considered to be statistically significant.

RESULTS

Fifteen patients (30 sockets) completed the flow-up, and all the 30 sockets healed uneventfully. After 6 months' healing, the new bone volume fraction of the test group was 63.3%±2.2%, while the new bone volume fraction of the control group was 50.1%±1.9%. The vertical dimensional increment of the test group was (5.53±0.39) mm, while the vertical change of the control group was (1.53±0.27) mm. The distal buccal site PD of the second molar was (3.0±0.7) mm in the test group, and (6.5±0.8) mm in the control group. Statistically significant differences were detected between the two groups.

CONCLUSION

The randomized controlled clinical trial showed that the application of β-TCP for bone defect repair after the mandibular third molars extraction resulted in more vertical bone regeneration and less probing depth when compared with what was spontaneously healed.

Treatment of periodontal pockets at the distal aspect of mandibular second molar after surgical removal of impacted third molar and application of L-PRF: a split-mouth randomized clinical trial

OBJECTIVES

Presence of clinical attachment loss on the distal aspect to the second molar may be associated with malposition of the third molar. The aim of this study was to evaluate the reduction of clinical attachment loss at the distal aspect of the second molar after third molar extraction and application of leukocyte- and platelet-rich fibrin (L-PRF).

METHOD AND MATERIALS

Eighteen subjects with a clinical attachment loss on the distal site to the second molar associated with impacted third molar in both sides of the jaw were recruited for the study. For each subject the teeth were randomly allocated in test and control groups. After surgical removal of the impacted third molar, the L-PRF was inserted in the fresh alveolar socket of test sites; in the control sites no graft was inserted after extraction. Full-mouth plaque score, full-mouth bleeding score, clinical attachment level (CAL), probing depth, and gingival recession were assessed at baseline and 6 months later.

RESULTS

After 6 months, mean CAL change was 1.99 ± 1.18 mm in the test group and 1.15 ± 1.01 mm in the control group; probing depth change was 1.33 ± 0.87 mm in the test group and 0.50 ± 0.63 mm in the control group. Statistically significant differences (P < .05) were observed between groups in terms of CAL and probing depth changes. No differences were found in gingival recession changes.

CONCLUSION

Within the limits of the present study, the sites treated by means of application of L-PRF after impacted third molar extraction showed better results in terms of CAL gain and probing depth reduction when compared with control sites.

Ectopic eruption of the second premolar: an analysis of four different treatment approaches

PURPOSE

Ectopic second premolars may lead to impaction and loss of space in the jaws, and in rare cases even to resorption of the first permanent molar. The aim of this study was to analyse different treatment strategies of ectopic second premolars and if possible give guidelines on when to favour different treatment approaches.

MATERIALS AND METHODS

The study was a retrospective, non-randomised, outcome analysis of treatment on 41 ectopic second premolars in 37 patients (24 females and 13 males). In all cases oral examination, radiographs (pre-, peri-, and post) and full medical history were obtained. The treatment options included: (a) spontaneous eruption, (b) spontaneous eruption + extraction of primary tooth, (c) surgical exposure, (d) surgical uprighting, and (e) surgical uprighting + orthodontic extrusion. For evaluation each tooth was scored according to: (1) stage of root development, (2) distance between edges of the premolar and first permanent molar, (3) depth of impaction, (4) inclination, (5) horizontal position of the tooth. The level of significance was set to 5%.

RESULTS

Only mild cases of ectopic second premolars are self-correcting. Based on the position of the tooth in the jaw different treatment options may be chosen, these may include: extraction of primary predecessor (impaction depth < 5 mm, inclination < 55°), surgical exposure of tooth germ (impaction depth < 5.5 mm, inclination < 95°) or surgical uprighting (impaction depth > 5.5 mm with no inclination limit).

CONCLUSION

If there is no sign of self-correction after a short observation period, it is important to consider active treatment to help guiding the tooth into the correct eruption pathway.

Autogenous Dentin Grafting of Osseous Defects Distal to Mandibular Second Molars After Extraction of Impacted Third Molars

Bone loss at the distal aspect of mandibular second molars frequently is reported after extraction of impacted third molars. Typically, osseous grafting of the extraction site is not routinely performed. This study examined osseous healing following guided bone regeneration treatment of osseous defects distal to mandibular second molars after surgical removal of impacted mesioangularly or horizontally inclined third molars using the processed third molar as the graft material. For the study, 13 patients who required impacted third molar extractions were selected based on angulation of impaction. Patients requiring bilateral extractions were designated for a split-mouth study, while others were selected based on impaction angulation as a random study group. After surgical extraction of the third molars, the extracted teeth were stripped of any soft tissue, including the periodontal ligament, then ground and disinfected using a dentin grinding protocol to produce an autogenous dentin graft (ADG). This graft was then placed into the extraction socket and covered with a hemostatic sponge prior to site closure. Patients in the control group underwent the same procedure as those in the study group except that no ADG was placed in the socket and only a hemostatic sponge was placed prior to wound closure. Clinical and radiological examinations were performed, including panoramic radiographs and probing depths at 3 months and 12 months postoperatively. The alveolar bone level distal to the second molar was established by both probing depths and radiographic evaluation, which were compared between the two groups. At 12 months postoperative the study group showed probing distal to the second molar with a mean depth of 1.15 mm, whereas the control group showed probing with a mean depth of 4.45 mm. The authors conclude that autogenous dentin grafting is a viable option for use in the treatment of osseous defects distal to mandibular second molars following extraction of impacted third molars.

[Effect of bone grafting on the repair of distal alveolar bone defect of the second molar after extraction of mandibular impacted third molar]

PURPOSE

To observe the effect of bone grafting during the extraction of mandibular third molar on repair of distal alveolar bone defect distal to the second molar.

METHODS

The risks of the distal alveolar bone defect in the second molar were estimated after removal of the impacted teeth according to the position of the third molar and second molar before operation. It was divided into three groups: low risk group, medium risk group and high risk group. The medium risk group and high risk group were further divided into bone graft subgroup (group A) and non-bone graft subgroup (group B). There were 36 cases in group A and 45 cases in group B. Postoperative re-examination indicators included subjective perception of the patients, depth of probing and height of alveolar bone in the distal molar of the second molar by X-ray examination. The data were analyzed with SPSS 19.0 software package.

RESULTS

Six months after operation, in mediun risk group, 0 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 6 cases, the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (2.93±0.34) mm in group A and (2.95±0.50) mm in group B. There was no significant difference between 2 groups (P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (3.31±1.02) mm in group A, (3.10±1.72) mm in group B, the difference was not significant (P=0.794). In high risk group, 4 cases in group A had subjective feelings of cold and heat stimulation; in group B, the number was 10 cases,the difference was significant (P<0.05). Distal periodontal probing depth of the second molar was (3.08±0.37) mm in group A and (3.24±0.41) mm in group B. There was no significant difference between 2 groups(P=0.931). X-ray examination of the alveolar bone height increment of the second molar Δh: (5.21±1.79) mm in group A, (2.99±2.42) mm in group B, the difference was significant (P<0.05).

CONCLUSIONS

Risk classification of the second molar distal bone defects after extraction of the impacted teeth is essential, which is helpful to determine whether bone grafting is needed during operation. Autologous bone mixed with Bio-Oss artificial bone powder can promote recovery of the alveolar bone height of the second molar, especially in high risk group, and discomfort caused by exposure can be reduced.

Vital Autotransplantation and Orthodontic Treatment of Ectopic Maxillary Canines

The purpose of this article was to present the case of a 13-year-old patient with impacted, ectopic, permanent maxillary canines that were repositioned into their natural positions via autotransplantation without endodontic treatment and aligned into ideal occlusion via orthodontic treatment. The autotransplanted canines demonstrated normal masticatory function, physiologic mobility, and long-term tooth vitality. Clinical considerations, clinical procedures, and the rationale behind this alternative approach in managing this common growth and developmental dental anomaly are also discussed.

Consequences of 660 nm Diode Laser Following Postsurgical Exodontia in Patients under Contraceptive Pills: A Randomized Double-blinded Clinical Trial

AIM

The photobiomodulation (PBM) effect of 660 nm diode laser in reducing pain, edema, trismus and promote healing subsequently to the transalveolar extraction of mandibular third molars in female patients taking contraceptive pills were evaluated.

MATERIALS AND METHODS

Fifty female patients participated in our study. The 660 nm diode laser was applied immediately on randomly selected patients of the study group (n = 25) over the surgical site for 1 minute with continuous laser beam application. For the control group (n = 25), the same extraction procedure was performed without the application of 660 nm diode laser. Pain intensity, swelling, trismus, and healing was evaluated before extraction and during recall visits 24 hours, 48 hours, and 7 days postoperatively.

RESULTS

The values of pain, swelling, and trismus were significantly inferior in the study group compared to the control group (p < 0.05) at T2 and T3; while the values of the healing index were significantly superior in the study group compared to the control group (p < 0.001) at T1, T2, and T3.

CONCLUSION

Using 660 nm diode laser reduced the postsurgical discomforts (pain, edema, and trismus) and promote healing associated following transalveolar extraction of the lower third molar.

CLINICAL SIGNIFICANCE

To develop a framework based on the results regarding the PBM effect of 660 nm diode laser following transalveolar extraction of lower third molar in a female patient taking oral contraceptive pills, which may help to improve the treatment services provided to the community.

Machine learning in orthodontics: Introducing a 3D auto-segmentation and auto-landmark finder of CBCT images to assess maxillary constriction in unilateral impacted canine patients

OBJECTIVES

To (1) introduce a novel machine learning method and (2) assess maxillary structure variation in unilateral canine impaction for advancing clinically viable information.

MATERIALS AND METHODS

A machine learning algorithm utilizing Learning-based multi-source IntegratioN frameworK for Segmentation (LINKS) was used with cone-beam computed tomography (CBCT) images to quantify volumetric skeletal maxilla discrepancies of 30 study group (SG) patients with unilaterally impacted maxillary canines and 30 healthy control group (CG) subjects. Fully automatic segmentation was implemented for maxilla isolation, and maxillary volumetric and linear measurements were performed. Analysis of variance was used for statistical evaluation.

RESULTS

Maxillary structure was successfully auto-segmented, with an average dice ratio of 0.80 for three-dimensional image segmentations and a minimal mean difference of two voxels on the midsagittal plane for digitized landmarks between the manually identified and the machine learning-based (LINKS) methods. No significant difference in bone volume was found between impaction ([2.37 ± 0.34] [Formula: see text] 104 mm3) and nonimpaction ([2.36 ± 0.35] [Formula: see text] 104 mm3) sides of SG. The SG maxillae had significantly smaller volumes, widths, heights, and depths (P < .05) than CG.

CONCLUSIONS

The data suggest that palatal expansion could be beneficial for those with unilateral canine impaction, as underdevelopment of the maxilla often accompanies that condition in the early teen years. Fast and efficient CBCT image segmentation will allow large clinical data sets to be analyzed effectively.

Autotransplantation of impacted maxillary canines into surgically modified sockets and orthodontic treatment: a 4-year follow-up case report

The permanent maxillary canine is the second most frequently impacted or displaced tooth. The standard treatment for an impacted canine includes, among other things, surgical exposure and orthodontic alignment. Surgical techniques for this procedure vary depending on whether the tooth is labially or palatally impacted, while orthodontic techniques vary according to clinical judgment and experience. Autotransplantation is a treatment alternative for impacted canines with complete root formation. The success of tooth transplantation depends on the vitality of the periodontal ligament (PDL) attached to the donor tooth, and its viability decreases when it is exposed extraorally. This article reports on maxillary canine autotransplantations combined with connective tissue grafts (CTGs) and orthodontics. The recipient mesiodistal space was created orthodontically and the recipient socket was prepared using dental implant drills. Following transplantation, bone defects were grafted using guided bone regeneration (GBR). At 4 years post-transplantation, the soft tissue level was stable and periapical radiographs showed a practically normal contour of the alveolar crest around teeth 13 and 23. The two permanent canines presented no root resorption and ankylosis, and no signs of inflammation or bleeding were observed. The procedure used in this case report demonstrates that canine transplantation combined with GBR, plastic surgery procedures, and orthodontic treatment may yield acceptable and predictable esthetic results.

Piezoelectric bone surgery compared with conventional rotary instruments in oral surgery and implantology: Summary and consensus statements of the International Piezoelectric Surgery Academy Consensus Conference 2019

PURPOSE

Piezoelectric bone surgery was introduced into clinical practice almost 20 years ago as an alternative method for cutting bone in dental surgical procedures, in an attempt to reduce the disadvantages of using conventional rotary instruments. The aim of this Consensus Conference was to evaluate the current evidence concerning the use of piezoelectric surgery in oral surgery and implantology.

MATERIALS AND METHODS

Three working groups conducted three meta-analyses with trial sequential analysis, focusing on the use of piezoelectric surgery in impacted mandibular third molar extraction, lateral sinus floor elevation and implant site preparation. The method of preparation of the systematic reviews, based on comprehensive search strategies and following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, was discussed and standardised.

RESULTS

Moderate/low evidence suggests that piezoelectric surgery is significantly associated with a more favourable postoperative course (less pain, less trismus) after impacted mandibular third molar extraction than conventional rotary instruments. Moderate evidence suggests that implants inserted with piezoelectric surgery showed improved secondary stability during the early phases of healing compared with those inserted using a drilling technique. Strong/moderate evidence suggests that piezoelectric surgery prolongs the duration of surgery in impacted mandibular third molar extraction, sinus floor elevation and implant site preparation, but it is unclear whether the slight differences in duration of surgery, even if statistically significant, represent a real clinical advantage for either operator or patient. Weak evidence or insufficient data are present to draw definitive conclusions on the other investigated outcomes.

CONCLUSIONS

Further well-designed trials are needed to fully evaluate the effects of piezoelectric surgery, especially in implant site preparation and sinus floor elevation.

Kinesio taping use to reduce pain and edema after third molar extraction surgery: A randomized controlled split-mouth study

OBJECTIVE

Evaluating Kinesio Taping (KT) use to reduce pain and edema in individuals subjected to surgical extraction of impacted mandibular third molars.

MATERIALS AND METHODS

Thirteen individuals (5 men and 8 women, mean age: 23.25 years) were subjected to mutual extraction of two mandibular third molars based on the same surgical protocol and pharmacological approach. All individuals were subjected to kinesio taping application on one side of patients' face (test group - KT), in the immediate postoperative period. The other side of the face was not subjected to KT application, and it was used as control (No KT). An examiner assessed individuals' pain and edema based on the visual analog scale (VAS) and on the Todorović-Marković method, respectively, at the preoperative, immediate postoperative, and second and fifth postoperative days. Statistical analysis was based on the Scheirer-Ray-Hare test.

RESULTS

Edema (48 h and 120 h after surgery) and pain intensity (24 h, 48 h and 120 h after surgery) were lower on the KT side (p < 0.05). Moreover, edema and pain intensity fully reduced on the KT side 120 h after surgery (p < 0.05).

CONCLUSION

Kinesio taping adopted in the current study was effective in reducing edema and postoperative pain in patients subjected to oral surgery.

CLINICAL RELEVANCE

KT enables patients to experience a more comfortable postoperative period and helps improving their quality of life.