The endodontic treatment of necrotic primary teeth with missing successors presents a unique clin... more The endodontic treatment of necrotic primary teeth with missing successors presents a unique clinical challenge. The purpose of this report was to describe the clinical and radiological outcomes of regenerative endodontic treatment (revascularization) of necrotic primary molars. Four infected necrotic primary second molars with missing premolars were treated with a two-visit revascularization protocol. The crowns were restored with amalgam or acid-etch composite resin. The teeth were followed-up clinically and radiographically for 18 months. At six months, all teeth demonstrated radiographic evidence of complete periradicular healing and positive response to cold test, and remained symptomless thereafter.
Introduction: Regenerative endodontic procedures (REPs) using autologous platelet concentrates as... more Introduction: Regenerative endodontic procedures (REPs) using autologous platelet concentrates as scaffolds can improve the biologic outcome of treatment. This prospective, randomized trial compared the clinical and radiographic performance of REPs using platelet‐rich plasma (PRP), platelet‐rich fibrin (PRF), a platelet pellet (PP), and an induced blot clot (BC). Methods: Sixty‐seven healthy children (aged 8–11 years) with 88 immature necrotic incisors were included. After the root canal disinfection step, the teeth were randomly assigned into 1 of the following groups (n = 22/group) according to the scaffold used: PRP, PRF, PP, and BC. In the PRP, PRF, and PP groups, the platelet concentrates were introduced into the root canal without prior induction of apical bleeding. Treatment outcomes were assessed using a combined clinical and radiographic scoring system, whereas the changes in root dimensions were compared using linear measurements of root length and width with ImageJ (National Institutes of Health, Bethesda, MD) and Turboreg (Biomedical Imaging Group, Swiss Federal Institute of Technology, Lausanne, Switzerland) and planar measurements using the radiographic root area (RRA) and radiographic canal area (RCA) techniques. One‐way analysis of variance, the Duncan multiple range test, the Kruskal‐Wallis test, the Mann‐Whitney U test, and chi‐square dependency tests were used for statistical analysis of data (all P = .05). Results: Except for 2 teeth in the PRF and BC groups, all teeth showed similar and high success scores (periapical healing, radiographic root development, and positive response to sensitivity tests) after an average follow‐up time of 28.25 ± 1.2 months. Of all teeth, 73.9% showed complete apical closure with similar closure rates among groups (P > .05) and a greater tendency for conical‐shaped apical closure than a blunt apex. Although linear measurements indicated a similar increase in root length and width among all groups (P > .05), the RRA of the BC group was significantly greater than those of the PRF and PP groups, and the RCA of the BC group was significantly greater than PRP, PRF, and PP (all P < .05) when the follow‐up time was not used as a factor. Eighty‐six percent of the teeth showed a positive response to sensitivity tests with similar initial response times (P > .05). Conclusions: PRP, PRF, and PP can yield similar clinical and radiographic outcomes to BC without the need for prior apical bleeding and with significantly less tendency for root canal obliteration. RRA and RCA may reveal minor differences that cannot be determined by linear measurements.
International Journal of Pediatric Otorhinolaryngology, 2011
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
International Journal of Pediatric Otorhinolaryngology, 2011
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
Anomalies in amelogenesis may be due to developmental defects or abnormalities in different compo... more Anomalies in amelogenesis may be due to developmental defects or abnormalities in different components of developing teeth and can affect dental development. We compared dental development in a group of children with molar-incisor hypomineralization (MIH) with that in age- and sex-matched controls. Dental age was determined using panoramic radiographs of 105 children (59 girls, 46 boys) aged 7-11 years with severe MIH, and the findings were compared with those from 105 healthy age- and sex-matched controls. Although accelerated dental development was noted in the MIH group, the difference between the MIH and control groups was not statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Furthermore, no relationship was found between number of affected teeth and the difference between dental and chronological age. In conclusion, children with severe MIH had slightly accelerated dental development as compared with controls.
Despite a wide range of treatment options available, traumatized teeth may be inevitably lost on ... more Despite a wide range of treatment options available, traumatized teeth may be inevitably lost on certain occasions. This case report presents an alternative treatment option for the premature loss of a traumatized maxillary central incisor because of extensive root resorption and mobility. A fixed appliance-type provisional prosthesis was fabricated by using the patient's natural clinical crown from the extracted tooth. This measure proved to be a very adequate, esthetic treatment solution before a permanent restorative plan could be developed in the future.
Inversion of premolars is an extremely rare condition, which usually requires extraction. This ca... more Inversion of premolars is an extremely rare condition, which usually requires extraction. This case report describes the inversion of an impacted maxillary second premolar in an 11-year-old male, and the multidisciplinary treatment approach for bringing the tooth into a normal position within the arch. In order to provide sufficient space for surgical reimplantation of the tooth, the mesially-drifted neighbouring maxillary first molar was first endodontically treated, followed by orthodontic distalization of the tooth. The inverted tooth was removed surgically and reimplanted without the use of splints for stabilization. After a 12-month follow-up period, the tooth maintained its vitality without any root resorption. Reimplantation of impacted inverted premolars can be a viable treatment alternative to extraction.
The endodontic treatment of necrotic primary teeth with missing successors presents a unique clin... more The endodontic treatment of necrotic primary teeth with missing successors presents a unique clinical challenge. The purpose of this report was to describe the clinical and radiological outcomes of regenerative endodontic treatment (revascularization) of necrotic primary molars. Four infected necrotic primary second molars with missing premolars were treated with a two-visit revascularization protocol. The crowns were restored with amalgam or acid-etch composite resin. The teeth were followed-up clinically and radiographically for 18 months. At six months, all teeth demonstrated radiographic evidence of complete periradicular healing and positive response to cold test, and remained symptomless thereafter.
Introduction: Regenerative endodontic procedures (REPs) using autologous platelet concentrates as... more Introduction: Regenerative endodontic procedures (REPs) using autologous platelet concentrates as scaffolds can improve the biologic outcome of treatment. This prospective, randomized trial compared the clinical and radiographic performance of REPs using platelet‐rich plasma (PRP), platelet‐rich fibrin (PRF), a platelet pellet (PP), and an induced blot clot (BC). Methods: Sixty‐seven healthy children (aged 8–11 years) with 88 immature necrotic incisors were included. After the root canal disinfection step, the teeth were randomly assigned into 1 of the following groups (n = 22/group) according to the scaffold used: PRP, PRF, PP, and BC. In the PRP, PRF, and PP groups, the platelet concentrates were introduced into the root canal without prior induction of apical bleeding. Treatment outcomes were assessed using a combined clinical and radiographic scoring system, whereas the changes in root dimensions were compared using linear measurements of root length and width with ImageJ (National Institutes of Health, Bethesda, MD) and Turboreg (Biomedical Imaging Group, Swiss Federal Institute of Technology, Lausanne, Switzerland) and planar measurements using the radiographic root area (RRA) and radiographic canal area (RCA) techniques. One‐way analysis of variance, the Duncan multiple range test, the Kruskal‐Wallis test, the Mann‐Whitney U test, and chi‐square dependency tests were used for statistical analysis of data (all P = .05). Results: Except for 2 teeth in the PRF and BC groups, all teeth showed similar and high success scores (periapical healing, radiographic root development, and positive response to sensitivity tests) after an average follow‐up time of 28.25 ± 1.2 months. Of all teeth, 73.9% showed complete apical closure with similar closure rates among groups (P > .05) and a greater tendency for conical‐shaped apical closure than a blunt apex. Although linear measurements indicated a similar increase in root length and width among all groups (P > .05), the RRA of the BC group was significantly greater than those of the PRF and PP groups, and the RCA of the BC group was significantly greater than PRP, PRF, and PP (all P < .05) when the follow‐up time was not used as a factor. Eighty‐six percent of the teeth showed a positive response to sensitivity tests with similar initial response times (P > .05). Conclusions: PRP, PRF, and PP can yield similar clinical and radiographic outcomes to BC without the need for prior apical bleeding and with significantly less tendency for root canal obliteration. RRA and RCA may reveal minor differences that cannot be determined by linear measurements.
International Journal of Pediatric Otorhinolaryngology, 2011
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
International Journal of Pediatric Otorhinolaryngology, 2011
To evaluate the horizontal migration of the human mental foramen before and after birth. 54 forma... more To evaluate the horizontal migration of the human mental foramen before and after birth. 54 formalin-fixed fetuses between 17 and 32 weeks of gestation, and 94 panoramic radiographs of children aged between 4 and 12 years were investigated. The distances between the mental foramen and mental symphysis, and the distances between the posterior border of the mandibular ramus and mental foramen were determined according to development periods. Our results confirm that the mental foramen moves in a posterior direction during the development of the mandible. The horizontal location of the pre- and postnatal mental foramen changes in a posterior direction as the development progresses, however, prenatal mental foramen features an irregular behavior, while the postnatal mental foramen gradually migrates posteriorly in a regular pattern.
Anomalies in amelogenesis may be due to developmental defects or abnormalities in different compo... more Anomalies in amelogenesis may be due to developmental defects or abnormalities in different components of developing teeth and can affect dental development. We compared dental development in a group of children with molar-incisor hypomineralization (MIH) with that in age- and sex-matched controls. Dental age was determined using panoramic radiographs of 105 children (59 girls, 46 boys) aged 7-11 years with severe MIH, and the findings were compared with those from 105 healthy age- and sex-matched controls. Although accelerated dental development was noted in the MIH group, the difference between the MIH and control groups was not statistically significant (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Furthermore, no relationship was found between number of affected teeth and the difference between dental and chronological age. In conclusion, children with severe MIH had slightly accelerated dental development as compared with controls.
Despite a wide range of treatment options available, traumatized teeth may be inevitably lost on ... more Despite a wide range of treatment options available, traumatized teeth may be inevitably lost on certain occasions. This case report presents an alternative treatment option for the premature loss of a traumatized maxillary central incisor because of extensive root resorption and mobility. A fixed appliance-type provisional prosthesis was fabricated by using the patient's natural clinical crown from the extracted tooth. This measure proved to be a very adequate, esthetic treatment solution before a permanent restorative plan could be developed in the future.
Inversion of premolars is an extremely rare condition, which usually requires extraction. This ca... more Inversion of premolars is an extremely rare condition, which usually requires extraction. This case report describes the inversion of an impacted maxillary second premolar in an 11-year-old male, and the multidisciplinary treatment approach for bringing the tooth into a normal position within the arch. In order to provide sufficient space for surgical reimplantation of the tooth, the mesially-drifted neighbouring maxillary first molar was first endodontically treated, followed by orthodontic distalization of the tooth. The inverted tooth was removed surgically and reimplanted without the use of splints for stabilization. After a 12-month follow-up period, the tooth maintained its vitality without any root resorption. Reimplantation of impacted inverted premolars can be a viable treatment alternative to extraction.
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