1
|
Camargo ES, Silva RR, Rodrigues ÁOLJ, Andreis PKDS, Maciel JVB, Luczyszyn SM, de Souza EM, Carneiro E, Vanzela NJ, Carlini JL. Multidisciplinary Treatment: Follow-Up of Dental Autotransplantation for 10 Years. Eur J Dent 2024; 18:692-699. [PMID: 38262465 PMCID: PMC11132790 DOI: 10.1055/s-0043-1777048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
The objective is to present a clinical case of dental autotransplantation managed with surgery, orthodontics, endodontics, periodontics, and aesthetic rehabilitation. A 10-year-old boy sought treatment after avulsion of the maxillary left central incisor, which was not reimplanted. Based on anamnesis, clinical examination, and complementary examinations, agenesis of the maxillary and mandibular second premolars except the mandibular right second premolar was observed. After a multidisciplinary planning, the space in the maxillary left central incisor region was opened to receive the transplanted mandibular right second premolar. The receptor site was created in a single surgical procedure. Pulp necrosis was noted in the transplanted tooth, which was treated endodontically, and the agenesis spaces were closed using fixed orthodontic appliances. After removing the appliance, gingivectomy with osteotomy was performed in the maxillary right central incisor and the transplanted tooth regions to harmonize the height and shape of the gingival contour. Next, aesthetic readjustment was performed with tooth whitening, using office and home techniques, followed by microabrasion of the vestibular surface of the maxillary right central incisor. Direct composite resin restorations were placed in the maxillary incisors, and the teeth were rehabilitated using incisal and palatal guides. A multidisciplinary approach is essential for reestablishing the function and aesthetics of complex cases involving dental autotransplantation.
Collapse
Affiliation(s)
- Elisa Souza Camargo
- Graduate Program in Dentistry – Orthodontics, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Rhafaela Ribeiro Silva
- Graduate Program in Dentistry – Restorative Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Ádelin Olívia Lopes Joly Rodrigues
- Graduate Program in Dentistry – Colletive Health, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazi
| | - Patricia Kern Di Scala Andreis
- Graduate Program in Dentistry – Orthodontics, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | | | - Sônia Mara Luczyszyn
- Undergraduate Program in Dentistry - Periodontology, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Evelise Machado de Souza
- Graduate Program in Dentistry – Restorative Dentistry, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Everdan Carneiro
- Graduate Program in Dentistry – Endodontics, School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Nathália Juliana Vanzela
- Undergraduate Program in Dentistry – School of Medicine and Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - João Luiz Carlini
- Undergraduate Program in Dentistry - Maxillofacial Surgery, Health Sciences Department, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
| |
Collapse
|
2
|
Brasil DM, Merken K, Binst J, Bosmans H, Haiter-Neto F, Jacobs R. Monitoring cone-beam CT radiation dose levels in a University Hospital. Dentomaxillofac Radiol 2023; 52:20220213. [PMID: 36802857 PMCID: PMC9944015 DOI: 10.1259/dmfr.20220213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 12/24/2022] [Accepted: 01/10/2023] [Indexed: 02/23/2023] Open
Abstract
OBJECTIVE To present patient dose levels for different CBCT scanners, acquired by a dose monitoring tool in a University Hospital, as a function of field of view (FOV), operation mode, and patient age. METHODS An integrated dose monitoring tool was used to collect radiation exposure data [type of CBCT unit, dose-area product (DAP), FOV size, and operation mode] and patient demographic information (age, referral department) performed on a 3D Accuitomo 170 and a Newtom VGI EVO unit. Effective dose conversion factors were calculated and implemented into the dose monitoring system. For each CBCT unit, the frequency of examinations, clinical indications, and effective dose levels were obtained for different age and FOV groups, and operation modes. RESULTS A total of 5163 CBCT examinations were analyzed. Surgical planning and follow-up were the most frequent clinical indications. For the standard operation mode, effective doses ranged from 35.1 to 300 µSv and 9.26-117 µSv using 3D Accuitomo 170 and Newtom VGI EVO, respectively. In general, effective doses decreased with increasing age and FOV size reduction. CONCLUSIONS Effective dose levels varied notably between systems and operation modes.Operation mode selection and FOV size were indication-oriented, with larger FOV sizes election serving surgical planning and follow-up. Seeing the influence of FOV size on effective dose levels, manufacturers could be advised to move toward patient-specific collimation and dynamic FOV selection. Systematically monitoring patient doses could be recommended for steering future CBCT optimization.
Collapse
Affiliation(s)
| | - Karen Merken
- Department of Imaging and Pathology, KU Leuven, Division of Medical Physics & Quality Assessment, Leuven, Belgium
| | - Joke Binst
- Department of Radiology, UZ Leuven, Leuven, Belgium
| | | | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | |
Collapse
|
3
|
Gómez Meda R, Abella Sans F, Esquivel J, Zufía J. Impacted maxillary canine with curved apex: Three-dimensional guided protocol for autotransplantation. J Endod 2021; 48:379-387. [PMID: 34929261 DOI: 10.1016/j.joen.2021.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/08/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Maxillary canines play a crucial role in dental and facial aspect, arch expansion, and efficient occlusion. When surgical exposure measures cannot be executed or the patient does not agree to take the treatment, autotransplantation should be considered. The aim of this case report was to describe a novel surgical technique using virtually planned three-dimensional(3D)-printed templates for guided apicoectomy and guided drilling of the recipient site for an autotransplantation of an impacted maxillary canine with a curved apex. METHODS A 42-year-old male complaining of pain and increased mobility in the maxillary left primary canine came to the clinic. Autotransplantation of the impacted canine was completed using altered methods from guided implant surgery to manufacture 3D-printed templates. Following a full-thickness mucoperiosteal flap elevation, the surgical template for the guided osteotomy and apicoectomy was inserted. This 3D-printed guided allowed the clinician to perform a quick and precise removal of the curved apex, providing an atraumatic extraction of the impacted canine throughout the cyst. Three further 3D surgical guides for implant burs and a 3D replica tooth were printed to modify the recipient socket. After the final position, the tooth was semi-rigid splinted to the adjacent teeth. RESULTS Follow-up at 2 years showed complete regeneration of the palatal defect and remodeling of the bone surrounding the maxillary canine. CONCLUSIONS Digitally planned procedures can facilitate the complex execution of an autotransplantation reducing the treatment chair-time and the morbidity for the patient as well as increasing the predictability of the result.
Collapse
Affiliation(s)
| | - Francesc Abella Sans
- Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.
| | | | | |
Collapse
|