RESUMEN
Teeth with root fracture generally have a poor prognosis requiring extraction; however, some patients do not wish to have these teeth extracted. Dentists do not have enough information regarding the prognosis of teeth with root fracture. This study retrospectively examined the prognosis of teeth with root fracture in the maintenance phase of periodontal treatment and assessed the factors influencing the prognosis of teeth with root fracture. The clinical records of 100 patients, who had entered the maintenance phase of periodontal therapy in a university hospital and had experienced fracture of tooth root, were analyzed. The following parameters were included in the evaluation: age and gender of the subjects, tooth type, restoration and root-filling of the teeth with root fracture, and number of teeth present. Survival probability was assessed using Kaplan-Meier analysis. The median survival time (95% confidence interval) was 42 months (22-62 months). Teeth with horizontal fracture had a significantly higher survival probability compared with teeth with vertical fracture. No significant differences were found in the survival probability with regard to gender and tooth type. In conclusion, teeth with horizontal root fracture have a better prognosis compared with teeth with vertical root fracture in patients undergoing periodontal maintenance.
Asunto(s)
Enfermedades Periodontales/terapia , Tratamiento del Conducto Radicular , Fracturas de los Dientes/complicaciones , Pérdida de Diente/prevención & control , Raíz del Diente/lesiones , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Periodontales/prevención & control , Estudios Retrospectivos , Análisis de Supervivencia , Extracción Dental/estadística & datos numéricos , Fracturas de los Dientes/clasificación , Pérdida de Diente/etiología , Pérdida de Diente/terapia , Resultado del TratamientoRESUMEN
AIMS: To examine differences in the craniofacial morphology of skeletal Class III patients before treatment and growth-related changes during treatment with a maxillary protraction appliance (MPA) between patients who were treated only orthodontically (orthodontic group) and those who eventually received orthognathic surgery (surgical group). METHODS: The orthodontic and surgical groups consisted of 6 boys and 9 girls and 4 boys and 6 girls, respectively. Lateral cephalograms taken at the first visit and at the end of treatment with the MPA were measured. The Mann-Whitney U test and Wilcoxon signed-rank test were used. RESULTS: Before treatment, the Wits appraisal was significantly smaller and the gonial angle was significantly larger in the surgical group. During treatment, both the SNA and ANB angles were significantly increased in the orthodontic group, whereas only the SNB angle was significantly increased in the surgical group. Moreover, significant lingual inclination of the mandibular incisors was found in the orthodontic group. CONCLUSION: The Wits appraisal and gonial angle were useful for distinguishing between the two groups at the first visit. Facilitation of forward maxillary growth, modification of the direction of mandibular growth, and lingual tipping of the mandibular incisors may be important ways to avoid orthognathic surgery.
Asunto(s)
Aparatos de Tracción Extraoral , Huesos Faciales/patología , Maloclusión de Angle Clase III/terapia , Cráneo/patología , Cefalometría , Niño , Huesos Faciales/crecimiento & desarrollo , Femenino , Estudios de Seguimiento , Humanos , Incisivo/patología , Masculino , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Mandíbula/crecimiento & desarrollo , Mandíbula/patología , Maxilar/crecimiento & desarrollo , Maxilar/patología , Diente Molar/patología , Cráneo/crecimiento & desarrollo , Técnicas de Movimiento DentalRESUMEN
Anterior maxillary osteotomy is frequently applied to skeletal Class II cases with maxillary protrusion. In addition to the anteroposterior problem, these cases are often accompanied with a long midfacial appearance and display of incisors and gingiva during smiling. In the application of anterior maxillary osteotomy to such patients, it is necessary to move the anterior maxillary segments upward as well as backward. Since the upward movement occasionally interferes with the intranasal endotracheal tube, orotracheal intubation is recommended for the operation. Recently, the use of a resin replica of the mandibular dental arch was introduced to place the anterior maxillary segment correctly in the planned position and to obtain the correct occlusion. This article reports on 3 maxillary protrusive skeletal Class II patients with deep overbites and vertical esthetic problems treated by this method. The treatment results show that all 3 patients exhibited large upward and backward movements of the anterior maxillary segments and desirable facial profiles, with a reduction of the deep overbites after the treatment. This case report demonstrates that the anterior maxillary osteotomy under orotracheal intubation with the use of a resin replica is a useful method to treat maxillary protrusive skeletal Class II patients with a large alveolar height.