SURVIVAL RATES OF IMPLANTS COMPROMISING ADJACENT TEETH AND THE ASSOCIATED COMPLICATIONS: AN OPG RETROSPECTIVE STUDY.

Purpose: This retrospective study evaluated the survival rates of implants compromising adjacent teeth and the associated complications. Methodology: Medical records and orthopantomographic images of 1,132 patients and 1,478 implants were retrospectively analyzed. Finally, 96 patients (52 females, 44 males) with 111 malpositioned implants were included in the study. The mean follow-up of the study was 32 ± 14 months. The patients were divided into two core groups: 1) adjacent teeth and dental implants were considerably close but tangent to each other (TAN), and 2) dental implant cutting the roots of the adjacent tooth (CUT). In addition, the CUT group was divided into two subcategories considering the possible cause of malangulation as angled implant (AI) or angled adjacent tooth (AT). Damage to adjacent teeth, future treatment requirements, and the survival rates of the implants were recorded. Results. Among the 111 implants, 4 (3.6%) implants failed, all of which belonged to the CUT category and the AI subgroup. Among the 88 preoperatively vital adjacent teeth, root canal treatment was performed in 18 (20.5%) teeth, whereas 2 (2.3%) teeth were extracted due to malpositioned implanting in follow-ups. Conclusions. The placement of implants too close to the adjacent teeth and even cutting direction did not have a statistically significant effect on the survival rates of implants. However, this could cause adjacent teeth to undergo unnecessary root canal treatment or extraction. Clinical relevance. Patients with malpositioned adjacent teeth or dilacerated root(s) adjacent to the edentulous area are at a higher risk for malpositioned implant complications. Most implant malposition complications are observed in the first premolar region (37% cases). Therefore, more attention should be given while placing implants in the first premolar region.

Impact of Mesioangular Mandibular Impacted 3rd Molar on Peridontal Health of Adjacent Tooth

Objective: The aim of this study is to determine the impact of mesioangular mandibular 3rd molar impaction on periodontal health of adjacent tooth in patients. Study Design: Retrospective/observational study Place and Duration: Department of Oral & Maxillofacial Surgery, MMDC Multan, during from Oct 2020 to September 2021. Methods: Total of seventy patients of both genders was presented in this study. Detailed demographic data of enrolled cases age, sex, body mass index, symptoms and complications were recorded after taking informed written consent. All the patients had mesioangular impactions of mandibular third molars. The impaction depth, relationship with ramus, and angulation of 70 IMTMs and their association with 2nd molar distal caries and root resorption, pathological states, and closeness to the mandibular canal were assessed on panoramic radiographs. Pell and Gregory classification was used to determine position of impacted third molar. The odds ratio (OR) and 95% confidence interval (CI) of IMTM's position on the related complications (credible interval for Bayesian models). Statistical significance was defined as a two-tailed p-value 0.05. SPSS 24.0 version was used to analyze complete data. Results: There were 42 (60%) males and 28 (40%) females with mean BMI 23.13±6.46 kg/m2. Most of patients 31 (44.3%) were aged between 20-35 years. Mean attachment level was 3.03±2.34 and probing depth was 3.34±3.35. Caries, pain and swelling were the most common symptoms found among cases. Distal second molar root caries 21 (30%) and pocket formation 17(24.3%) were the most common pathologies. As per histological findings periapical inflammation was majority found in 37 (52.9%) cases followed by dental follicle in 19 (27.1%) and cyst in 11 (15.7%). Conclusion: In this study, we found that the impacted mandibular third molar was most linked with distal second molar root caries and the creation of a pocket between the impacted tooth and the second molar tooth. The most common pathology associated with the impacted molar was distal second molar root caries and the creation of a pocket between the affected tooth and the second molar. Keywords: Mesioangular, Impacted mandibular third molar, Pathology, Complication

Laterally Positioned Flap with Subepithelial Connective Tissue Graft Modified One-Stage Procedure for the Treatment of Deep Isolated Gingival Recessions in Mandibular Incisors

The laterally positioned flap (LPF) has been proposed as a promising treatment for isolated gingival recessions (GRs) in mandibular incisors. Several modifications have been proposed to reduce the risk of gingival recession (GR) at the donor tooth site. Therefore, the aim of this was to describe a modified one-stage procedure of performing the LPF associated with the subepithelial connective tissue graft (LPF + SCTG) with the modifications for the treatment of deep isolated GR in mandibular incisors. The modified one-stage technique (LPF + SCTG) is unique because it was presented being bilaminar with tunneled connective tissue graft (CTG) in the adjacent tooth and extended to the flap donor site, without a submarginal incision in the adjacent tooth, taking the entire band of the keratinized tissue (KT) into the flap. In addition, 3 clinical cases were described using this surgical technique. Three healthy patients with Cairo RT1 or RT2 GRs on teeth 31 or 41 were treated with the LPF + SCTG technique. Probing depth (PD), clinical attachment level (CAL), complete root coverage (CRC), mean root coverage (MRC), recession depth (RD), and keratinized tissue width (KTW) were assessed at baseline and in the follow-up periods of 18, 24, and 48 months, in the cases 1, 2, and 3, respectively. The LPF + SCTG with the modifications presented is a predictable approach for the treatment of deep isolated RT1 and RT2 GRs in mandibular incisors that are well positioned in the bone envelope with the presence of KTW adjacent to GR and adequate vestibule depth in the donor area of the flap.

Long term clinical result of implant induced injury on the adjacent tooth

The purpose of the retrospective study was to investigate the long-term result of implant-induced injury on the adjacent tooth. The subjects of this retrospective study were patients who had received implants and had tooth injury; direct invasion of root (group I), root surface contact (group II), or < 1 mm distance of the implant from the root (group III). Clinical and pathological changes were periodically examined using radiographs and intra-oral examinations. Paired t-tests and chi-square tests were used to evaluate the implant stability quotient (ISQ) of implant and tooth complications, respectively (α = 0.05). A total of 32 implants and teeth in 28 patients were observed for average 122.7 (± 31.7, minimum 86) months. Seven teeth, three of which were subsequently extracted, needed root canal treatment. Finally, 90.6% of the injured teeth remained functional. Complications were significant and varied according to the group, with group I showing higher events than the others. The ISQs increased significantly. One implant in group I resulted in osseointegration failure. The implant survival rate was 96.9%. In conclusion, it was found even when a tooth is injured by an implant, immediate extraction is unnecessary, and the osseointegration of the invading implant is also predictable.

Variation in dental occlusal schemes two years after placement of single-implant posterior crowns. A preliminary study

Some authors have recommended that implant-supported single crowns should only contact during heavy clenching. However, a lack of occlusal contact with moderate clenching may cause supra-eruption of antagonist natural teeth. The main objective of this study was to assess changes in the occlusal contacts of posterior implant-supported single crowns with natural antagonist teeth two years after placement. The occlusal schemes of 14 patients who received 16 implant-supported single crowns in molar and premolar regions were assessed in this prospective study. Just after crown placement, at 6 months and after 2 years a silicone maxillomandibular relationship and T-scan records were obtained during the intercuspal position with light and heavy clenching, determined using near half of the maximum force and maximum force respectively. Occlusal contacts were assessed quantitatively and qualitatively in the implant-supported single crowns, contralateral tooth and adjacent tooth; the latter two were used as controls. After six months and two years, no significant variations were observed in any region of the occlusal scheme in any assessments, including silicone record or T-Scan, using light or heavy clenching, and qualitative or quantitative occlusal contact assessment. In this preliminary study, the occlusal scheme did not vary at the intercuspal position two years after placing posterior implant-supported single crowns.

Comparison of Three-Dimensional and Conventional Orthodontic Imaging Modalities for Localization of Impacted Maxillary Canines in Patients With Alveolar Cleft

Objective: The purpose of this study was to identify which diagnostic parameters related to impacted maxillary canines can be reliably detected by the conventional orthodontic radiographic modalities and which factors need to be assessed by cone-beam computed tomography (CBCT). Design: In this cross-sectional study, 8 orthodontists evaluated 7 parameters related to the position and anatomy of the impacted canines by means of 2-dimensional (2D) records. After 1 month, the same process was repeated by means of CBCT by the same clinicians. Setting: Qazvin University of Medical Sciences. Patients and Participants: Thirty-two patients with alveolar cleft and impacted maxillary canines who had CBCT scans, lateral cephalograms, and orthopantomographs as pretreatment records. Main Outcome Measure: The diagnostic accuracy of 2D and 3-dimensional (3D) radiographic modalities was compared with each other and also with the gold standard by 3 radiologists. Results: The diagnostic accuracy of 2D and 3D imaging modalities was not significantly different regarding the mesiodistal inclination of the impacted tooth ( P = .09), apex anatomy ( P = .10), and mesiodistal position of the apex ( P = .19). Cone-beam computed tomography had significantly higher diagnostic accuracy than conventional radiographic modalities regarding overlapping the adjacent tooth ( P = .001), labio–palatal and apico–coronal position of the crown tip, and root resorption of the adjacent tooth ( P = .01). Conclusion: The conventional orthodontic radiographic modalities were as accurate as CBCT for determination of impacted canine inclination, apex anatomy, and mesiodistal position of the apex. Cone-beam computed tomography showed higher diagnostic accuracy for other parameters.

Impact of proximal cavities and primary molar absence on space in the dental arches

Background A recently proposed treatment protocol for dental caries in primary teeth, called Ultra Conservative Treatment (UCT), keeps medium to large cavities open so that children can keep them clean with tooth brushing and fluoride toothpaste. However, carious lesions have been related to malocclusion and decrease of space for the eruption of the permanent successor. Methods This cross-sectional study evaluated dental casts of 235 schoolchildren, aged 6–7 years old of six public schools in deprived suburban areas, and with at least two cavitated dentin carious lesions. The casts were grouped according to the location of cavitated dentin lesions into non-proximal cavity (NPC), proximal cavity with buccal or lingual surface contact point to adjacent tooth (PCCP) and proximal cavity without contact to adjacent tooth (PCWC), as well as the absence of primary molars due carious lesions (PMA). The relationship between location of cavitated dentin lesions or absence of primary molars with C+D+E and D+E space was analyzed. Results Children with absence of primary molars exhibited the smallest C+D+E and D+E space in the maxilla (P < 0.001) and mandible (P < 0.001), followed by proximal cavity without buccal or lingual surface contact. No significant difference was observed between NPC and PCCP groups in upper and lower arches. Discussion PCWC are associated with minor (less than the leeway space) C+D+E and D+E space loss in both arches, and additional space loss is noted when primary molars are prematurely lost. These results may have implications for orthodontic and restorative dental care decisions in children.