A Pilot Retrospective Study on the Effect of Bone Grafting After Wisdom Teeth Extraction
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Endodontic Therapy of Maxillary Second Molar Showing an Unusual Internal Anatomy
ISSN: Printed version: 1806-7727 Electronic version: 1984-5685 RSBO. 2012 Apr-Jun;9(2):213-7 Case Report Article Endodontic therapy of maxillary second molar showing an unusual internal anatomy Carlos Eduardo Fontana1 Carolina Davoli Macedo Ibanéz2 Felipe Davini1 Alexandre Sigrist De Martin1 Cláudia Fernandes de Magalhães Silveira1 Daniel Guimarães Pedro Rocha1 Carlos Eduardo da Silveira Bueno1 Corresponding author: Carlos Eduardo Fontana Avenida 02, n.º 1.220 CEP 13500-411 – Rio Claro – SP – Brasil E-mail: [email protected] 1 Department of Endodontics, São Leopoldo Mandic Post-graduation Center – Campinas – SP – Brazil. 2 Private practice – São Paulo – SP – Brazil. Received for publication: October 10, 2011. Accepted for publication: November 11, 2011. Abstract Keywords: internal anatomy; endodontic Introduction: The knowledge of the complex anatomy of maxillary treatment; maxillary molars and location of extra canals are essential for diagnosis second molar; dental and endodontic treatment success. Objective: The purpose of this operating microscope. study was to report a clinical case showing a varying number of palatal roots in a second maxillary molar with the aid of operating microscope (OM). Case report: A four-rooted maxillary permanent second molar with 2 separated palatal canals undergone endodontic therapy. After endodontic access, examination of the chamber floor using an operating microscope revealed two distinct palatal canals orifices. A radiograph was taken after the working lengths of each canal were estimated by means of an electronic apex locator which clearly identified the four roots with independent four canals. The canals were instrumented with ProTaper™ rotatory instruments under irrigation with 5% sodium hypochlorite, obturated with Pulp Canal Sealer® and continue wave technique. -
Anatomical Variations in Mandibular Second Molar: a Case Series
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Case Report Anatomical Variations in Mandibular Second Molar: A Case Series Bala Saraswathi. K1, Dr. C. Sunil Kumar2, Dr. S. Datta Prasad3, Jahnavi. B1 1Post graduate, 2Professor, 3Professor & HOD, Department of Conservative Dentistry and Endodontics, C.K.S Theja Institute of Dental Sciences and Research, Tirupathi. Corresponding Author: Bala Saraswathi. K ABSTRACT Anatomic variations may be present in any tooth. Knowing the typical morphology and their variations helps in better prognosis of the treatment performed. The result of successful endodontics revolves around knowledge, respect, and appreciation for root canal anatomy, and careful, thoughtful, meticulously performed cleaning and shaping procedures. Knowledge of pulpal anatomy, it’s possible variations is critical for success in endodontic and lack of such knowledge may lead to treatment failure. The most typical anatomy of a mandibular second molar is the presence of two roots and three root canals, but variations in the number of roots as well as canal morphology are not uncommon. This includes single canal, two canals, three and four canals, five canals and C-shaped canal system. Because proper cleaning, shaping, and three dimensional obturation of the entire root canal system is regarded as an important determinant to good prognosis, the variations in root canal system, thus, represents a challenge to its proper diagnosis, debridement and obturation. Key words: Mandibular second molar, Root canal anatomy, Endodontic treatment. INTRODUCTION identify alterations, such as supplementary A general trend towards the roots or canals. [5] retention of teeth rather than extraction is According to Vertucci, the evident today, the scope of endodontics is to mandibular second molar is similar to the render the affected tooth biologically first, except that the roots are shorter, the acceptable, symptom free and functional. -
Risks and Complications of Orthodontic Miniscrews
SPECIAL ARTICLE Risks and complications of orthodontic miniscrews Neal D. Kravitza and Budi Kusnotob Chicago, Ill The risks associated with miniscrew placement should be clearly understood by both the clinician and the patient. Complications can arise during miniscrew placement and after orthodontic loading that affect stability and patient safety. A thorough understanding of proper placement technique, bone density and landscape, peri-implant soft- tissue, regional anatomic structures, and patient home care are imperative for optimal patient safety and miniscrew success. The purpose of this article was to review the potential risks and complications of orthodontic miniscrews in regard to insertion, orthodontic loading, peri-implant soft-tissue health, and removal. (Am J Orthod Dentofacial Orthop 2007;131:00) iniscrews have proven to be a useful addition safest site for miniscrew placement.7-11 In the maxil- to the orthodontist’s armamentarium for con- lary buccal region, the greatest amount of interradicu- trol of skeletal anchorage in less compliant or lar bone is between the second premolar and the first M 12-14 noncompliant patients, but the risks involved with mini- molar, 5 to 8 mm from the alveolar crest. In the screw placement must be clearly understood by both the mandibular buccal region, the greatest amount of inter- clinician and the patient.1-3 Complications can arise dur- radicular bone is either between the second premolar ing miniscrew placement and after orthodontic loading and the first molar, or between the first molar and the in regard to stability and patient safety. A thorough un- second molar, approximately 11 mm from the alveolar derstanding of proper placement technique, bone density crest.12-14 and landscape, peri-implant soft-tissue, regional anatomi- During interradicular placement in the posterior re- cal structures, and patient home care are imperative for gion, there is a tendency for the clinician to change the optimal patient safety and miniscrew success. -
Distal Caries of the Second Molar in the Presence of a Mandibular Third Molar – a Prevention Protocol
VERIFIABLE CPD PAPER PRACTICE Distal caries of the second molar in the presence of a mandibular third molar – a prevention protocol V. Toedtling,*1 P. Coulthard2 and G. Thackray3 InIn brief brief Highlights the growing problem and increasing Identifies distal caries risk factors and emphasises the Provides a decision-making protocol for primary care incidence of distal caries in lower second molars in importance of a caries risk assessment, caries to improve the outcomes of second molars adjacent the post-prophylactic removal era. prevention strategy and the need for timely wisdom to asymptomatic partially erupted mandibular third tooth assessments. molars. Objectives The objectives of the prospective study were to establish the prevalence of distal caries (DC) in the mandibular second molar and to assess the outcomes of these diseased teeth in our population. Further aims were to identify associated risk factors and to design a protocol for prevention. Methods Clinical and radiographic data from 210 consecutive patients were ascertained over a three-month period. The sample population included all patients who had been referred to a hospital oral surgery department for a lower wisdom tooth assessment. Results A total of 224 mandibular third molars were included and assessed. The prevalence of caries affecting the distal aspect of the second molar was 38% (n = 85) in this population. In 18% of patients there was evidence of early enamel caries. Fifty-eight percent of caries was managed with restorative treatment but 11% of patients required second molar extraction and 13% of patients required the removal of the second and third molars. The prevalence of distal caries was significantly higher in patients with partially erupted wisdom teeth positioned below the amelocemental junction (P <0.05) of the adjacent second molar and in patients who presented with mesioangular impactions (P <0.001). -
Root Canal Morphology and Configuration of 123 Maxillary
OPEN International Journal of Oral Science (2017) 9,33–37 www.nature.com/ijos ORIGINAL ARTICLE Root canal morphology and configuration of 123 maxillary second molars by means of micro-CT Thomas Gerhard Wolf1, Frank Paqué2, Anja-Christin Woop1, Brita Willershausen1 and Benjamín Briseño-Marroquín1 The aim of this study was to investigate the root canal configuration, accessory canals and number of main foramina of 123 maxillary second molars by means of micro-computed tomography. The teeth were scanned and reproduced with 3D software imaging. The root canal configuration and number of main foramina were evaluated by means of a four-digit system. The morphological complexity of human maxillary second molars is depicted by the number of accessory and connecting canals. The most frequently observed root canal configurations in the mesiobuccal root were 2-2-2/2 (19.5%), 2-2-1/1 (14.6%) and 2-1-1/1 (13.0%). A 1-1-1/1 configuration was observed in 93.5% and in 96.7% in the distobuccal and palatal roots, respectively. The MB1 root canal had one accessory canal (18.7%), and 8.9% of the MB2 root canal had one or two accessory canals. The distobuccal (11.3%) and palatal (14.6%) root canals had at least one accessory canal, and connecting canals were observed in 16.3% of mesiobuccal roots. The MB1, MB2, distobuccal and palatal root canals had one main foramen in 99.2%, 43.1%, 98.4% and 99.2% of samples, respectively. In the mesiobuccal root, one accessory foramen was detected in 14.6%, two were detected in 7.3%, and three were detected in 5.7%. -
Eruption Abnormalities in Permanent Molars: Differential Diagnosis and Radiographic Exploration
DOI: 10.1051/odfen/2014054 J Dentofacial Anom Orthod 2015;18:403 © The authors Eruption abnormalities in permanent molars: differential diagnosis and radiographic exploration J. Cohen-Lévy1, N. Cohen2 1 Dental surgeon, DFO specialist 2 Dental surgeon ABSTRACT Abnormalities of permanent molar eruption are relatively rare, and particularly difficult to deal with,. Diagnosis is founded mainly on radiographs, the systematic analysis of which is detailed here. Necessary terms such as non-eruption, impaction, embedding, primary failure of eruption and ankylosis are defined and situated in their clinical context, illustrated by typical cases. KEY WORDS Molars, impaction, primary failure of eruption (PFE), dilaceration, ankylosis INTRODUCTION Dental eruption is a complex developmen- at 0.08% for second maxillary molars and tal process during which the dental germ 0.01% for first mandibular molars. More re- moves in a coordinated fashion through cently, considerably higher prevalence rates time and space as it continues the edifica- were reported in retrospective studies based tion of the root; its 3-dimensional pathway on orthodontic consultation records: 2.3% crosses the alveolar bone up to the oral for second molar eruption abnormalities as epithelium to reach its final position in the a whole, comprising 1.5% ectopic eruption, occlusion plane. This local process is regu- 0.2% impaction and 0.6% primary failure of lated by genes expressing in the dental fol- eruption (PFE) (Bondemark and Tsiopa4), and licle, at critical periods following a precise up to 1.36% permanent second molar iim- chronology, bilaterally coordinated with fa- paction according to Cassetta et al.6. cial growth. -
Uprighting Impacted Mandibular Second Molar Using a Skeletal Anchorage: a Case Report
dentistry journal Case Report Uprighting Impacted Mandibular Second Molar Using a Skeletal Anchorage: A Case Report Federica Altieri , Rosanna Guarnieri, Martina Mezio, Gabriella Padalino, Angela Cipollone, Ersilia Barbato and Michele Cassetta * Department of Oral and Maxillofacial Sciences, “Sapienza” University of Rome, 6-00161 Rome, Italy; [email protected] (F.A.); [email protected] (R.G.); [email protected] (M.M.); [email protected] (G.P.); [email protected] (A.C.); [email protected] (E.B.) * Correspondence: [email protected]; Fax: +39-06-5016612 Received: 5 November 2020; Accepted: 17 November 2020; Published: 18 November 2020 Abstract: The aim of this case report is to present an innovative combined orthodontic-surgical technique to disimpact mandibular second molar (MM2) using an orthodontic miniscrew and an elastic chain. The impact on the Oral health-related quality of life (OHRQoL) was also evaluated. Using the present techinique, it is possible to expose the impacted tooth, insert a self-drilling miniscrew in the retromolar area, and remove the bud of third mandibular molar. At the same time the orthodontic force is applied with the use of an elastomeric chain that connects the head of miniscrew and vestibular and oral buttons bonded on MM2. A close traction is performed for the whole treatment time without the reactivation of the elastic force. The use of skeletal anchorage allowed the disimpaction of impacted MM2 in a short treatment time (about three months) avoiding the typical biomechanical side effects of traditional orthodontic appliance and increasing the effectiveness of the treatment. Further studies are necessary to evaluate the real advantages and disadvantages of this combined orthodontic-surgical approach. -
Unusual Anatomy of a Second Maxillary Molar - a Rare Four- Root Configuration Case Report
ARC Journal of Dental Science Volume 1, Issue 2, 2016, PP 13-15 ISSN No. (Online): 2456-0030 http://dx.doi.org/10.20431/2456-0030.0102003 www.arcjournals.org Unusual Anatomy of a Second Maxillary Molar - a Rare four- Root Configuration Case Report Dr. Thiago de Almeida Prado Naves Carneiro,DDS, MSc PhD student, Department of Occlusion, Fixed Prostheses, and Dental Materials, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais Brazil. [email protected] Abstract: Although it is a very rare situation, four-rooted maxillary second molars can occur. The existence of two palatal roots is extremely rare and ranges about only 0.4%. The aim of this study is to present and document a very rare anatomic configuration of a four-rooted maxillary second molar. Anatomic variation in the number of roots and root canals can occur in any tooth, although some cases can be extremely rare as the one presented here.Clinicians should be aware of this possibility before considering any kind of treatment. Keywords: Molar, Dental Anatomy, Anatomical Variation 1. INTRODUCTION Usually the maxillary second molars are described in the literature as a teeth that have 3 roots with 3 or 4 root canals. Understanding of the presence of additional roots and unusual root canals is essential and determines the success of endodontic treatment1. The existence of maxillary second molars with 4 roots (2 buccal and 2 palatal) is extremely rare and ranges about only 0.4%.This information comes from a study that showed, after the examination of two different horizontally angled radiographs of 1,000 maxillary second molars, just four with four roots2. -
Morphologic Variations of Maxillary Molars Palatal Root and the Importance of Its Knowledge for Endodontic Practice: a Case Series
10.5005/jp-journals-10024-1024 RobertaCASE REPORT Kochenborger Scarparo et al Morphologic Variations of Maxillary Molars Palatal Root and the Importance of Its Knowledge for Endodontic Practice: A Case Series Roberta Kochenborger Scarparo, Letícia Pereira, Diana Moro, Grasiela Gründling Maximiliano Gomes, Fabiana Soares Grecca ABSTRACT treated of root canals greatly decreases the chances of 1-5 Aim: The present report describes and discusses root canal treatment success. The maxillary first molar usually variations in the internal morphology of maxillary molars. presents three roots and four canals (one canal in the palatal 4 Background: Dental internal anatomy is directly related to all root, two in the mesiobuccal root and one in the distal root). the technical stages of the endodontic treatment. Even though, On the contrary, the maxillary second molar often shows in some situations a typical anatomical characteristics can be three roots and three canals (one canal in the palatal root, faced, and the professional should be able to identify them. one in the mesiobuccal root and one canal in the distobuccal Case descriptions: This clinical report describes five cases 4 with different pulpar and periapical diagnostics where the root). However, due to the complexity of the root canal 1-6 endodontic treatment was performed, in which during the system, some variations have been reported. treatment the unusual occurrence of two or three canals in the Clinical studies confirm the presence of four root canals palatal root ‘or even two distinct palatal roots’ of first and second on maxillary first molars as the anatomical feature most maxillary molars, were described and important details for 7 achieving treatment success were discussed. -
Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar—A Case Report
dentistry journal Case Report Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar—A Case Report Konstantina Tsironi 1,* , Emmanouil Inglezos 1, Emmanouil Vardas 2 and Anastasia Mitsea 3 1 Posidonos 14, Imia square, Voula, 16673 Athens, Greece 2 Clinic of Hospital Dentistry, Dental School, National and Kapodistrian University of Athens, Thivon 2 Goudi, 11527 Athens, Greece 3 Department of Oral Diagnosis and Radiology, Dental School, National and Kapodistrian University of Athens, Thivon 2 Goudi, 11527 Athens, Greece * Correspondence: [email protected]; Tel.: +30-698-682-7064 Received: 3 April 2019; Accepted: 21 May 2019; Published: 27 June 2019 Abstract: The purpose of this paper is to present a case of an impacted mandibular first molar associated with a dentigerous cyst and a missing mandibular second molar in an 11-year-old girl that was treated with combined surgical and orthodontic procedures. After clinical and radiographic evaluation, marsupialization of the cyst was decided, and a molar attachment was bonded on the buccal side of the impacted molar as a part of a full orthodontic treatment with fixed appliances. After 18 months of orthodontic traction, the molar was moved to a more advantageous position, and new bone apposition was observed on the site of the cystic lesion. Histological examination confirmed a dentigerous cyst. The molar was left to erupt spontaneously for 14 more months. A functional occlusion was finally achieved. An interdisciplinary approach proved to be an effective modality in treating a large dentigerous cyst associated with a deeply impacted first mandibular molar, presenting many advantages, such as new bone apposition and patient comfort. -
Mandibular Second Molar Eruption Difficulties Related to the Maintenance of Arch Perimeter in the Mixed Dentition
ORIGINAL ARTICLE Mandibular second molar eruption difficulties related to the maintenance of arch perimeter in the mixed dentition Rebecca Lash Rubin,a Tiziano Baccetti,b,y and James A. McNamara, Jrc West Bloomfield and Ann Arbor, Mich, and Florence, Italy Introduction: In this prospective longitudinal study, we compared the prevalence of mandibular second molar eruption difficulties in patients treated with appliances to maintain mandibular arch perimeter. Other independent variables (age, molar angulation, space-width ratio, treatment time, and sex) were tested for their value as predictors of eruption difficulty. Methods: Three hundred one patients and subjects were divided into 4 groups: patients treated with a Schwarz appliance, patients treated with a mandibular lingual holding arch, patients treated with a combination of both appliances, and subjects who received no treatment (controls). Logistic re- gression analysis was used to determine the statistical significance of the possible predictors of eruption diffi- culty. Panoramic radiographs were analyzed at 2 times—before and after treatment. The radiograph before treatment was evaluated for the angulation of the mandibular second molars and space available for these un- erupted teeth. The radiograph after treatment was used to determine the incidence of mandibular second molar eruption difficulty. Results: All 3 treatment groups had higher incidences of mandibular second molar eruption difficulty when compared with the controls; the increased prevalence was significant for the protocols incorpo- rating the Schwarz appliance. Initial molar angulation, space-width ratio, age, and sex of the patient were not significant predictors of disturbances in the eruption pattern of the mandibular second molars. Conclusions: Orthodontic appliances intended to maintain mandibular arch perimeter in the mixed dentition increase the probability of eruption disturbances of the mandibular second molars. -
CHAPTER 5Morphology of Permanent Molars
CHAPTER Morphology of Permanent Molars Topics5 covered within the four sections of this chapter B. Type traits of maxillary molars from the lingual include the following: view I. Overview of molars C. Type traits of maxillary molars from the A. General description of molars proximal views B. Functions of molars D. Type traits of maxillary molars from the C. Class traits for molars occlusal view D. Arch traits that differentiate maxillary from IV. Maxillary and mandibular third molar type traits mandibular molars A. Type traits of all third molars (different from II. Type traits that differentiate mandibular second first and second molars) molars from mandibular first molars B. Size and shape of third molars A. Type traits of mandibular molars from the buc- C. Similarities and differences of third molar cal view crowns compared with first and second molars B. Type traits of mandibular molars from the in the same arch lingual view D. Similarities and differences of third molar roots C. Type traits of mandibular molars from the compared with first and second molars in the proximal views same arch D. Type traits of mandibular molars from the V. Interesting variations and ethnic differences in occlusal view molars III. Type traits that differentiate maxillary second molars from maxillary first molars A. Type traits of the maxillary first and second molars from the buccal view hroughout this chapter, “Appendix” followed Also, remember that statistics obtained from by a number and letter (e.g., Appendix 7a) is Dr. Woelfel’s original research on teeth have been used used within the text to denote reference to to draw conclusions throughout this chapter and are the page (number 7) and item (letter a) being referenced with superscript letters like this (dataA) that Treferred to on that appendix page.