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Amaral MF, Casatti CA, Naqvi AR, Debortoli CVL, Atili Brandini D. Histological changes in pulp-dentin complex in tooth subjected to traumatic occlusion and subluxation. Saudi Dent J 2024; 36:321-327. [PMID: 38420008 PMCID: PMC10897626 DOI: 10.1016/j.sdentj.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 03/02/2024] Open
Abstract
Background This study evaluated the influence of traumatic occlusion in the dentin-pulp complex a molar teeth submitted to subluxation. Material and methods Ninety Wistar rats were divided into groups Naïve (N), Subluxation (S) and Subluxation with traumatic occlusion (STO) and submitted to histological analysis after 7 and 21 days. A quantitative analysis was submitted to one-way ANOVA and Tukey's post-hoc test, and Chi-square and Bonferronís post-hoc test. Results S and STO showed a significant increase in blood vessels area (p < 0.0005), amorphous fundamental substance (p < 0.0005) and reactionary dentin formation (p < 0.0005), as well as a decrease in the nuclear profile (p < 0.0005), odontoblast layer (p = 0.013 and p < 0.0005) by day 7 when compared with N. These changes normalized by day 21, except for the reactionary dentin (p < 0.0005) in both S and STO groups. Interestingly, the STO group exhibited significant changes in the increase of pulp calcification (p < 0.0005), presence of tubules with nuclei (p < 0.0005), and inflammatory infiltrate (p < 0.0005), as well reduction of nuclear profile (p < 0.0005), odontoblast layer (p < 0.0005) compared with N and S at day 21. Conclusions STO impaired the defence response and decreased pulp regeneration capacity by increasing the inflammatory infiltrate and pulp calcification, and decreasing the nucleated cell number in the odontoblast layer and central pulp.
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Affiliation(s)
- Marina Fuzette Amaral
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Cláudio Aparecido Casatti
- Department of Physiology and Morphology, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
| | - Afsar Raza Naqvi
- Mucosal Immunology Lab, The University of Illinois at Chicago, College of Dentistry, Dept. of Periodontics, Chicago, IL, United States
| | | | - Daniela Atili Brandini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Araçatuba, São Paulo, Brazil
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Beyene MMR, Bårdsen A, Klock KS, Sulo G, Thelen DS. Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey. Dent Traumatol 2023; 39:469-477. [PMID: 37254307 DOI: 10.1111/edt.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIM Orthodontic treatment of patients with traumatic dental injuries is challenging, with limited evidence of routines and outcomes. The aims of this study were: (i) to describe how orthodontists perceive the information on traumatic dental injuries received by referral from the Public Dental Health Service before orthodontic treatment and (ii) to assess orthodontists' knowledge and working routines in managing traumatic dental injuries. MATERIALS AND METHODS Data were obtained through a survey of all practicing orthodontists registered as members of the Norwegian Association of Orthodontists (n = 203). RESULTS Eighty-three orthodontists were enrolled, most of whom had received their dental degree (73.0%) and specialist orthodontic training (88.5%) in Norway. They reported examining patients with a history of traumatic dental injury at weekly (34.2%) or monthly (38.0%) basis. In 85.5% of cases, they obtained a history of traumatic dental injury from patients. Half of the respondents (51.3%) favoured two-phase early orthodontic treatment for patients with an overjet ≥6 mm. The observation time and treatment strategy showed considerable discrepancies across traumatic dental injury diagnoses. Most (59.1%) orthodontists considered the information on previous traumatic dental injuries provided by the Public Dental Health Services referral 'inadequate', more commonly in cases of mild (83.5%) than severe (57.5%) traumatic dental injuries. CONCLUSIONS Orthodontic management of patients with traumatic dental injuries was characterised by lack of uniformity in both recommended observation time before orthodontic treatment and management strategy. The referral routines by the Public Dental Health Services for patients with traumatic dental injuries were perceived as 'inadequate' in terms of frequency and quality. The results indicate the requirement of standardisation of routines related to orthodontic management of traumatic dental injuries and referral routines by the Public Dental Health Services.
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Affiliation(s)
| | - Asgeir Bårdsen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kristin Solveig Klock
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Oral Health Center of Expertise in Western Norway, Bergen, Norway
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Duarte PHM, Weissheimer T, Michel CHT, Só GB, da Rosa RA, Só MVR. Do orthodontic movements of traumatized teeth induce dental pulp necrosis? A systematic review. Clin Oral Investig 2023; 27:4117-4129. [PMID: 37335397 DOI: 10.1007/s00784-023-05102-2] [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: 03/10/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION Usually, orthodontic movements encompass children and young adult patients, which are more susceptible to the occurrence of traumatic dental injuries. It is necessary to understand whether the effects of orthodontic movements on traumatized teeth could induce pulp necrosis. The aim of this study was to answer the following question: "Do orthodontic movements of traumatized teeth induce dental pulp necrosis?". MATERIAL AND METHODS Searches were performed for studies published up to May 11, 2023, in the MEDLINE/PubMed, Cochrane Library, Scopus, SciELO Citation Index, Web of Science, EMBASE, and Grey Literature Report databases, without restriction for language or year of publication. The revised Cochrane risk of bias tools for nonrandomized interventions (ROBINS-I) was used to assess the quality of the included studies. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS Of 2671 potentially relevant studies, five were included. Four were classified as having a moderate risk of bias and one as a serious risk of bias. It was reported a higher susceptibility to pulp necrosis in teeth subjected to orthodontic movements with history of trauma involving periodontal tissues. Additionally, orthodontic movements of traumatized teeth with total pulp obliteration had an increased risk of pulp necrosis. GRADE analysis presented a moderate certainty of evidence. CONCLUSIONS An increased risk for pulp necrosis when traumatized teeth are subjected to orthodontic movements was verified. However, this is based on evaluations performed with subjective tests. Further well-designed studies are necessary to confirm this trend. CLINICAL RELEVANCE Clinicians must be aware of the possibility of pulp necrosis. However, endodontic treatment is recommended when verified signs and symptoms of pulp necrosis.
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Affiliation(s)
- Pedro Henrique Marks Duarte
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Theodoro Weissheimer
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil.
- Department of Conservative Dentistry, Federal University of Rio Grande Do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, Rio Grande Do Sul, RS, 90035-003, Brazil.
| | - Carolina Horn Troian Michel
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Gabriel Barcelos Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Porto Alegre, RS, Brazil
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Hakami Z, Marghalani HY, Hedad I, Khawaji M, Abutaleb G, Hakami A, Almoammar S, Alshehri A. Comparison of Tooth Color and Enamel and Dentinal Thickness between Orthodontically Treated and Untreated Individuals. Diagnostics (Basel) 2023; 13:2066. [PMID: 37370961 DOI: 10.3390/diagnostics13122066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/08/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
This study compared tooth color and enamel and dentinal thickness between orthodontically treated and untreated individuals. (1) Methods: A matched case-control study was conducted. The sample included 26 patients who had received orthodontic treatment and 31 matched controls. The color assessment was performed subjectively using the VITA 3D-Master (VM) shade guide and objectively using the VITA Easyshade (VE) spectrophotometer. Differences in L*, a*, and b* (lightness, red/green, and blue/yellow) were calculated. The color change was evaluated using ΔE*ab and the whiteness index (WID). Tooth structure thickness (labiolingual, labial enamel, and labial dentin) was evaluated using cone-beam computerized tomography. The correlations between overall tooth color and tooth structure thickness were evaluated. (2) Results: A total of 228 teeth were evaluated. Color assessment using VM showed significant differences between orthodontically treated and untreated teeth (p < 0.001), while VE revealed no significant differences. Both groups showed no difference in tooth enamel and dentinal thickness. Significant differences in tooth color (p < 0.05) were observed between genders. Both VM and VE showed weak to moderate correlations with tooth color and enamel and dentinal thickness (p < 0.05). (3) Conclusions: Orthodontic treatment may demonstrate visually perceptible but acceptable and clinically undetectable tooth color alteration.
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Affiliation(s)
- Zaki Hakami
- Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Hussain Ya Marghalani
- Orthodontic Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ismaeel Hedad
- Jazan Dental Specialists Center, Ministry of Health, Jazan 82943, Saudi Arabia
| | - Mazen Khawaji
- Prince Fahd Bin Sultan Primary Care, Ministry of Health, Tabuk 47311, Saudi Arabia
| | - Ghadah Abutaleb
- Samtah General Hospital, Ministry of Health, Jazan 23437, Saudi Arabia
| | - Amjad Hakami
- Private Dental Center, Jazan 84521, Saudi Arabia
| | - Salem Almoammar
- Department of Orthodontics and Pediatric Dentistry, College of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Abdulrahman Alshehri
- Division of Orthodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
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Parashos P. Endodontic-orthodontic interactions: a review and treatment recommendations. Aust Dent J 2023; 68 Suppl 1:S66-S81. [PMID: 37961018 DOI: 10.1111/adj.12996] [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] [Accepted: 10/19/2023] [Indexed: 11/15/2023]
Abstract
The literature is replete with articles describing the many and varied interactions between endodontic treatment and orthodontic tooth movement (OTM), often reporting conflicting views and findings, which creates confusion for clinicians. Original research and review articles have described aspects such as apical root resorption and potential pulpal complications of teeth related to OTM. Some interactions are of relatively minor clinical significance, whilst others may have adverse consequences. A history of dental trauma before or during OTM further complicates the interactions. This review re-assesses the historical literature on endodontic-orthodontic interactions in light of more recent research and presents guidelines for managing clinical situations involving both disciplines. © 2023 Australian Dental Association.
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Affiliation(s)
- P Parashos
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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Moga RA, Olteanu CD, Botez M, Buru SM. Assessment of the Maximum Amount of Orthodontic Force for Dental Pulp and Apical Neuro-Vascular Bundle in Intact and Reduced Periodontium on Bicuspids (Part II). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1179. [PMID: 36673936 PMCID: PMC9859427 DOI: 10.3390/ijerph20021179] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 06/01/2023]
Abstract
This study examines 0.6 N-4.8 N as the maximum orthodontic force to be applied to dental pulp and apical NVB on intact and 1-8 mm reduced periodontal-ligament (PDL), in connection with movement and ischemic, necrotic and resorptive risk. In addition, it examines whether the Tresca finite-element-analysis (FEA) criterion is more adequate for the examination of dental pulp and its apical NVB. Eighty-one (nine patients, with nine models for each patient) anatomically correct models of the periodontium, with the second lower-premolar reconstructed with its apical NVB and dental pulp were assembled, based on X-ray CBCT (cone-beam-computed-tomography) examinations and subjected to 0.6 N, 1.2 N, 2.4 N and 4.8 N of intrusion, extrusion, translation, rotation, and tipping. The Tresca failure criterion was applied, and the shear stress was assessed. Forces of 0.6 N, 1.2 N, and 2.4 N had negligible effects on apical NVB and dental pulp up to 8 mm of periodontal breakdown. A force of 4.8 N was safely applied to apical NVB on the intact periodontium only. Rotation and tipping seemed to be the most invasive movements for the apical NVB. For the dental pulp, only the translation and rotation movements seemed to display a particular risk of ischemia, necrosis, and internal orthodontic-resorption for both coronal (0-8 mm of loss) and radicular pulp (4-8 mm of loss), despite the amount of stress being lower than the MHP. The Tresca failure criterion seems more suitable than other criteria for apical NVB and dental pulp.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
| | - Mircea Botez
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
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Moga RA, Buru SM, Olteanu CD. Assessment of the Best FEA Failure Criteria (Part II): Investigation of the Biomechanical Behavior of Dental Pulp and Apical-Neuro-Vascular Bundle in Intact and Reduced Periodontium. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315635. [PMID: 36497708 PMCID: PMC9738171 DOI: 10.3390/ijerph192315635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 06/01/2023]
Abstract
The aim of this study was to biomechanically assess the behavior of apical neuro-vascular bundles (NVB) and dental pulp employing Tresca, Von Mises, Pressure, S1 and S3 failure criterions in a gradual periodontal breakdown under orthodontic movements. Additionally, it was to assess the accuracy of failure criteria, correlation with the maximum hydrostatic pressure (MHP), and the amount of force safe for reduced periodontium. Based on cone-beam computed tomography, 81 3D models of the second lower premolar were subjected to 0.5 N of intrusion, extrusion, rotation, tipping, and translation. A Finite Elements Analysis (FEA) was performed. In intact and reduced periodontium apical NVB, stress (predominant in all criteria) was significantly higher than dental pulp stress, but lower than MHP. VM and Tresca displayed identical results, with added pulpal stress in translation and rotation. S1, S3 and Pressure showed stress in the apical NVB area. 0.5 N seems safe up to 8 mm periodontal breakdown. A clear difference between failure criteria for dental pulp and apical NVB cannot be proved based only on the correlation quantitative results-MHP. Tresca and VM (adequate for ductile materials) showed equivalent results with the lowest amounts of stress. The employed failure criteria must be selected based on the type of material to be analyzed.
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Affiliation(s)
- Radu Andrei Moga
- Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Str. Motilor 33, 400001 Cluj-Napoca, Romania
| | - Stefan Marius Buru
- Department of Structural Mechanics, School of Civil Engineering, Technical University of Cluj-Napoca, Str. Memorandumului 28, 400114 Cluj-Napoca, Romania
| | - Cristian Doru Olteanu
- Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania
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Incisal Interference Correction after Severe Extrusive Luxation Trauma during Orthodontic Treatment. Case Rep Dent 2022; 2022:7181481. [DOI: 10.1155/2022/7181481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/14/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
This case report presents the treatment of a 12-year-old boy who suffered serious dental trauma, accompanied with buccal alveolar socket wall fractures, during orthodontic treatment. The maxillary right lateral incisor and canine were severely extruded and laterally luxated to the palatal side, resulting in an anterior crossbite and creating an incisal interference that prevented the jaws from closing in normal occlusion. During emergency treatment, the dentist attempted manual repositioning, but both severely extruded teeth were found to be immobile. One day after trauma, orthodontic repositioning was started using full fixed appliances with light 0.012″ nickel–titanium round wires, and this occlusal interference was corrected within 3 weeks. In the various internationally recognized treatment guidelines, the options for orthodontic repositioning for dental luxation trauma are only marginally described. Internationally accepted dental treatment guidelines may include immediate orthodontic repositioning after trauma as a treatment option in the management of dental extrusive and lateral luxation trauma.
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Bauss O, Vassis S. Unilateral palatally impacted canines: Evaluation of pulpal condition after surgical exposure and orthodontic alignment. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2021.100214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Van Gorp G, Bormans N, Vanham I, Willems G, Declerck D. Orthodontic treatment recommendation and expected adverse reactions in patients with a history of dental trauma: A survey among general dentists, paediatric dentists, and orthodontic specialists. Int J Paediatr Dent 2020; 30:360-369. [PMID: 31803975 DOI: 10.1111/ipd.12603] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 10/21/2019] [Accepted: 12/02/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Trauma-induced adverse reactions may trigger complications when moving teeth orthodontically. AIM The purpose of this study was to evaluate the knowledge of dental practitioners about this topic. DESIGN A questionnaire survey was organized among general dentists, paediatric dentists, and orthodontists in Flanders (Belgium). Three clinical cases describing trauma-induced tooth damage (tooth ankylosis, apical root resorption, and pulp/root canal obliteration) were presented, followed by a set of questions. RESULTS The questionnaire was completed by 121 general dentists (GD), 47 paediatric dentists (PD), and 99 orthodontic specialists (OS). In the case with ankylosis, impossibility to move the tooth orthodontically was reported as most frequent adverse reaction (82.8% of GD, 95.7% of PD, and 100.0% of OS) (P < .001). In the situation of apical root resorption, the most frequently reported adverse event was progressive apical root resorption (78.9%, 85.7%, and 88.8% respectively; P = .265). Most frequently mentioned adverse reaction in the case with pulp and root canal obliteration was tooth discoloration (64.1%, 57.1%, and 78.3%; P = .055), followed by apical root resorption (57.4%, 56.8%, and 68.7%; P = .283). Orthodontic treatment recommendation differed among specific clinical situations but also among groups of dental practitioners. CONCLUSIONS Important knowledge gaps exist regarding the orthodontic managment of traumatized teeth. This topic requires more attention in undergraduate training, specialist training, and continuing education.
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Affiliation(s)
- Gertrude Van Gorp
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
| | - Naomi Bormans
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Ingrid Vanham
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Guy Willems
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
| | - Dominique Declerck
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,University Hospitals Leuven, Leuven, Belgium
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Van Gorp G, Bormans N, Vanham I, Willems G, Declerck D. Knowledge of orthodontic treatment approach of traumatized teeth by a group of Belgian general dentists, pediatric dentists, and orthodontists. Dent Traumatol 2019; 35:233-240. [PMID: 30963684 DOI: 10.1111/edt.12474] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND/AIM Traumatized teeth are more susceptible to complications during orthodontic tooth movement. The aim of this study was to explore current practices among Belgian dental practitioners regarding orthodontic treatment of children with a history of dental trauma. MATERIAL AND METHODS A questionnaire survey was organized among general dentists, pediatric dentists, and orthodontists in Flanders (Belgium). Questionnaires were distributed at the occasions of annual meetings or symposia. They consisted of questions regarding exposure to dental trauma and orthodontic treatment approach for patients with a dental trauma history. RESULTS The questionnaire was completed by 121 general dentists, 47 pediatric dentists, and 99 orthodontists. A history of dental trauma influenced referral for orthodontic treatment by general dentists and pediatric dentists moderately (median VAS scores of 5 and 6, respectively, on a scale of 0 (not at all) to 10 (utmost)), indicating uncertainty and doubt. Additional checkups during tooth movement were usually not organized by general dentists in 33.6% and by pediatric dentists in 19.1% of cases (P = 0.006). One-third of the orthodontists (33.3%) experienced tooth loss linked to orthodontic movement of a tooth with dental trauma history in at least one patient. Only a minority of the practitioners knew of the existence of specific guidelines (7.6%, 15.6% and 22.7%, respectively, of general dentists, pediatric dentists, and orthodontists) (P = 0.007). The Dental Trauma Guide was the guideline mentioned most frequently, although this tool does not contain recommendations regarding orthodontic treatment after trauma. CONCLUSION In the group of Belgian general dental, pediatric and orthodontists surveyed, there was uncertainty regarding the orthodontic management of patients with a history of dental trauma especially among general practitioners. Further educational training is recommended.
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Affiliation(s)
- Gertrude Van Gorp
- KU Leuven Department of Oral Health Sciences, Population Studies in Oral Health, Leuven, Belgium
| | | | | | - Guy Willems
- KU Leuven Department of Oral Health Sciences Orthodontics, KULeuven and Dentistry, UHLeuven, Leuven, Belgium
| | - Dominique Declerck
- KU Leuven Department of Oral Health Sciences, Population Studies in Oral Health, Leuven, Belgium
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Moga RA, Cosgarea R, Buru SM, Chiorean CG. Finite element analysis of the dental pulp under orthodontic forces. Am J Orthod Dentofacial Orthop 2019; 155:543-551. [DOI: 10.1016/j.ajodo.2018.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 12/29/2022]
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Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. Am J Orthod Dentofacial Orthop 2018; 154:15-25. [DOI: 10.1016/j.ajodo.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 10/28/2022]
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Hourfar J, Bister D, Lisson JA, Ludwig B. Incidence of pulp sensibility loss of anterior teeth after paramedian insertion of orthodontic mini-implants in the anterior maxilla. Head Face Med 2017; 13:1. [PMID: 28061791 PMCID: PMC5217250 DOI: 10.1186/s13005-016-0134-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/21/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this retrospective investigation was to evaluate the incidence of loss to pulp sensibility testing (PST) of maxillary front teeth after paramedian (3 to 5 mm away from the suture) orthodontic mini-implant (OMI) insertion in the anterior palate. METHODS A total of 284 patients (102 males, 182 females; mean age was 14.4 years (±8.8) years at time of OMI-Insertion) with a total of 568 OMIs (1.7 mm diameter, length 8 mm) were retrospectively investigated. A binomial regression analysis was performed to explore covariates, such as age, gender, inclination of upper central incisors, dentition status and insertion position of OMIs that could have contributed to loss of sensibility. Statistical significance was set at p < 0.05. RESULTS Loss of response to PST was encountered during retention in 3 out of 284 patients and the respective OMIs had been placed at height of the second rugae (R-2). Affected teeth were a right canine, a left lateral and a left central incisor. Subsequent root canal treatment was successful. Results of the binomial regression analysis revealed that the covariate insertion position (R-2) of OMIs (p = 0.008) had statistically significant influence on loss of response to PST. CONCLUSIONS (1) Although there was no radiographic evidence for direct root injury, the proximity of the implants to the anterior teeth was nevertheless statistically related to loss of PST. (2) In all cases of PST loss OMIs were inserted at the second rugae. Therefore OMIs should be placed either more posteriorly, at the third rugae or in the median plane. (3). Loss of PST was not increased for patients with palatal OMI (0.18%) compared to samples without OMI (0.25%).
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Affiliation(s)
- Jan Hourfar
- Department of Orthodontics, University of Heidelberg, Heidelberg, Germany
| | - Dirk Bister
- Department of Orthodontics, Guy's and St Thomas' NHS Foundation Trust and King's College Dental Institute, London, UK
| | - Jörg A Lisson
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany
| | - Björn Ludwig
- Department of Orthodontics, University of Saarland, Homburg/Saar, Germany. .,Private Practice, Am Bahnhof 54, 56841, Traben-Trarbach, Germany.
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Alani A, Kelleher M. Restorative complications of orthodontic treatment. Br Dent J 2016; 221:389-400. [DOI: 10.1038/sj.bdj.2016.725] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 11/09/2022]
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16
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Bernard-Granger C, Gebeile-Chauty S. [Vitality loss: influence of orthodontic process]. Orthod Fr 2015; 86:161-7. [PMID: 26337093 DOI: 10.1051/orthodfr/2014024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 09/13/2014] [Indexed: 11/15/2022]
Abstract
Vitality loss is an unusual event that can occur before, during or after an orthodontic treatment. It can lead to loss of sensitivity, color change or necrosis of the pulp tissue. Before starting the orthodontic treatment, we have to identify the tooth's risk (injured tooth, included occlusal trauma...). Knowing that, if an endodontic treatment has to be done, it is better to do it before starting orthodontic forces. Lamps do not provide problems except high intensity halogen ones. RPE on children, Le Fort I and mandibular osteotomies, corticotomies, genioplasties are responsible of a transitory ischemia without reaching a pathogen level. Mini-screws or mini-plates may be iatrogenic, if they impact the root. The repair options depend on the delay before removing the miniscrew and the nature of injured tissue.
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Javed F, Al-Kheraif AA, Romanos EB, Romanos GE. Influence of orthodontic forces on human dental pulp: a systematic review. Arch Oral Biol 2014; 60:347-56. [PMID: 25463910 DOI: 10.1016/j.archoralbio.2014.11.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 09/13/2014] [Accepted: 11/17/2014] [Indexed: 12/25/2022]
Abstract
AIM The aim of the present study was to systematically review the influence of orthodontic force on human dental pulp. METHODS AND RESULTS The addressed focused question was "Do orthodontic forces affect the human dental pulp?" which was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a specific question was constructed according to the PICO (Participants, Interventions, Control, Outcomes) principle. Databases were explored from 1952 up to and including August 2014 using different combinations of the following keywords: "orthodontic force"; "dental pulp"; "reaction" and "tooth movement". Literature reviews, letters to the editor, commentaries and case-reports were excluded. Thirty studies were included. Six studies assessed the effect of orthodontic forces on pulpal blood flow and 20 studies investigated the pulpal cellular responses to orthodontic forces. In 4 studies, pulpal responses to orthodontic forces were compared between previously traumatized- and non-traumatized teeth. CONCLUSIONS There is insufficient scientific validation regarding the association between orthodontic forces and human dental pulp. However, a history of dental trauma maybe considered a risk factor for loss of pulp vitality during orthodontic treatment.
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Affiliation(s)
- Fawad Javed
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - AbdulAziz A Al-Kheraif
- Research Chair for Dental Biomaterials, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh 11541, Saudi Arabia
| | - Enisa B Romanos
- Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA
| | - Georgios E Romanos
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY, USA.
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18
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Qassem A, Martins NDM, da Costa VPP, Torriani DD, Pappen FG. Long-term clinical and radiographic follow up of subluxated and intruded maxillary primary anterior teeth. Dent Traumatol 2014; 31:57-61. [DOI: 10.1111/edt.12135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Aya Qassem
- Federal University of Pelotas; Pelotas RS Brazil
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19
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Abstract
This review considers oral trauma and its relationship to orthodontics with respect to prevention and primary, secondary, and tertiary care. The level of evidence is not high in regard to this topic, but recommendable approaches to trauma at each stage are discussed on the basis of available literature and published guidelines. Simplified biomechanics are presented to aid treatment.
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20
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Qassem A, Goettems M, Torriani DD, Pappen FG. Radicular maturity level of primary teeth and its association with trauma sequelae. Dent Traumatol 2013; 30:227-31. [PMID: 24118894 DOI: 10.1111/edt.12072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2013] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the influence of the radicular maturity level of primary teeth on the sequelae of traumatic dental injury (TDI). MATERIALS AND METHODS A longitudinal retrospective study that collected data from dental records and radiographs of patients with TDI in one or both maxillary primary central incisors was conducted. Sequelae such as crown discoloration, pulp canal obliteration (PCO) and inflammatory root resorption (IRR) were evaluated during a 12- to 18-month follow-up period after the trauma. RESULTS Of the 132 patients included in the study, 103 (78%) had luxations and 29 (22%) had dental fractures. At the initial postinjury examination, 12 teeth (9.1%) were found to have immature roots, 107 (81.1%) had closed apexes and 13 (9.8%) had visible root resorption. Inflammatory root resorption occurred mostly in traumatized teeth that presented with physiological root resorption at the moment of trauma (P = 0.004). The frequency of PCO was higher in teeth with a closed apex at the moment of the injury (P = 0.026). There was also an association between the type of injury and the occurrence of crown discoloration (P = 0.008) as well as between the type of injury and the development of PCO (P = 0.001). CONCLUSIONS The occurrence of TDI sequelae can be determined by the type of injury as well as by the radicular maturity level of the primary teeth at the moment of injury.
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Affiliation(s)
- Aya Qassem
- Post-Graduate Program in Pediatric Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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21
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Malinowska-Jedraszczyk A, Wozniak K. Partial luxation and displacement of tooth during treatment of malocclusion using light-wire fixed appliances - therapeutic procedure. Aust Dent J 2013; 58:256-61. [DOI: 10.1111/adj.12061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 08/13/2012] [Accepted: 08/13/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | - K Wozniak
- Pomeranian Medical University; Department of Orthodontics; Szczecin; Poland
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22
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Chen E, Goonewardene M, Abbott P. Monitoring dental pulp sensibility and blood flow in patients receiving mandibular orthognathic surgery. Int Endod J 2011; 45:215-23. [PMID: 22007609 DOI: 10.1111/j.1365-2591.2011.01964.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- E Chen
- School of Dentistry, The University of Western Australia, Perth, WA, Australia
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Görür I, Orhan K, Can-Karabulut DC, Orhan AI, Oztürk A. Low-level laser therapy effects in traumatized permanent teeth with extrusive luxation in an orthodontic patient. Angle Orthod 2010; 80:968-74. [PMID: 20578871 DOI: 10.2319/110109-612.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this case report was to present and evaluate the effect of low-level laser therapy on traumatized permanent teeth with extrusive luxation in an orthodontic patient. The treatment and follow-up evaluation of two orally luxated maxillary permanent central incisors in a 19-year-old man is described. Detailed anamnesis was taken, and extraoral, intraoral, radiographic examinations and electrical and thermal pulpal tests were performed to determine the type of the luxation and the further treatment protocol. Teeth were splinted with composite resin, and antibiotic therapy was prescribed. Low-level laser therapy was applied for 25 sessions. No root canal treatment was applied to the teeth. Continuation of the orthodontic treatment was restarted after 6 months. No sign of clinical or radiographic pathology was detected after 2 years from the end of the treatment. Teeth were identified healthy and sound without any root canal intervention. Treatments with low-level laser applications may be evaluated as noninvasive alternative treatment options in comparison with endodontic treatment for teeth with extrusive luxation more than 2 mm, especially for those who have orthodontic treatment needs.
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Affiliation(s)
- Ilker Görür
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Ankara, Ankara, Turkey
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