Tooth Extraction Research Articles

L-PRF como alternativa para tratamento de Comunicações Bucossinusais: uma revisão integrativa

Oroantral communication is defined as a direct access between the sinus cavity and the oral cavity. This condition is often accidentally caused during the dental extraction of a tooth whose roots are closely associated with the floor of the maxillary sinus, in addition to oral pathologies and even traumas. The technique of using the L-PRF membrane associated with flaps is widely used for extensive communications and has several advantages. The present study aims to analyze the efficacy of L-PRF in the treatment of existing oroantral communications in the most current literature. An integrative literature review was conducted to list and analyze the efficacy of L-PRF in tissue healing when obtaining the closure of oroantral communications. Scientific articles from 2014 to 2023, published in full in Portuguese and English, were selected and excluded were literature reviews and systematic reviews, articles in languages other than Portuguese and English, repeated articles in the databases, and articles that deviated from the theme proposed in the guiding question chosen. The data search was conducted in Google Scholar, LILACS, and PubMed, through the combination, using the Boolean operator “AND,” of the descriptors in English: “Oroantral Communication,” “L-PRF,” “Maxillary Sinus.” A total of 205 articles were found, but only 9 satisfactorily met the listed criteria. After a careful analysis, it was observed that the authors suggest that the use of the L-PRF membrane insertion technique for tissue healing involved in oroantral communication associated with sutures or flaps for its closure is feasible, effective, and widely spread in modern Dentistry.

Evaluation of the Relationship Between the Maxillary Sinus and Nasopalatine Canal of Maxillary Impacted Canines by Cone Beam Computed Tomography

Introduction. One of the critical parameters evaluated while planning orthodontic treatment for impacted canines in clinical practice is the relationship between impacted canines and adjacent anatomical structures. The nasopalatine canal (NPC) and maxillary sinus are anatomical formations that may be in close proximity to impacted canines. This study aimed to determine the relationship between palatally impacted canines, the maxillary sinus, and the NPC. Methods. A total of 105 impacted canines from 93 patients were evaluated using cone beam computed tomography (CBCT) images. The relationship between the impacted canine teeth, maxillary sinus, and NPC was assessed inside, outside, and at the border of the maxillary sinus floor and NPC walls. The millimetric distance between the impacted canine teeth and the borders of the maxillary sinus, the NPC, and the cortical bone of the palate was measured. Additionally, NPC morphology was assessed on the axial and sagittal CBCT images. Results. Of all the impacted teeth, 47.6% (3.8% inside, 43.8% at the border) were associated with the sinus, while 42.8% (15.2% inside, 27.6% at the border) were associated with the NPC. A significant moderate negative correlation (-0.32) was observed between age and the distance between impacted left canine teeth and the cortical bone of the palate. Additionally, when a Y-shaped NPC was present, the impacted canines were predominantly situated outside the canal. Conclusions. In this study, nearly half of the canines were located inside or at the border of the maxillary sinus and the NPC. Therefore, clinicians should carefully evaluate the relationship of impacted teeth with the maxillary sinus and the NPC during both orthodontic treatment and the extraction of impacted teeth.

An Injectable Black Phosphorus Hydrogel for Rapid Tooth Extraction Socket Healing.

The excess production of reactive oxygen species (ROS) will delay tooth extraction socket (TES) healing. In this study, we developed an injectable thermosensitive hydrogel (NBP@BP@CS) used to treat TES healing. The hydrogel formulation incorporated black phosphorus (BP) nanoflakes, recognized for their accelerated alveolar bone regeneration and ROS-scavenging properties, and dl-3-n-butylphthalide (NBP), a vasodilator aimed at enhancing angiogenesis. In vivo investigations strongly demonstrated that NBP@BP@CS improved TES healing due to antioxidation and promotion of alveolar bone regeneration by BP nanoflakes. The sustained release of NBP from the hydrogel promoted neovascularization and vascular remodeling. Our results demonstrated that the designed thermosensitive hydrogel provided great opportunity not only for ROS elimination but also for the promotion of osteogenesis and angiogenesis, reflecting the "three birds with one stone" concept, and has tremendous potential for rapid TES healing.

Open Reduction and Internal Fixation of Mandibular Body and Parasymphyseal Fractures with Maxillomandibular Fixation and Broken Tooth Extraction

Open Reduction and Internal Fixation of Mandibular Body and Parasymphyseal Fractures with Maxillomandibular Fixation and Broken Tooth Extraction

Prevalence and Factors Influencing Post-Operative Complications following Tooth Extraction: A Narrative Review

Background. Complications from dental extractions may result in multiple post-operative visits and adversely affect the patient’s life. Preventing complications may decrease post-operative morbidity for the individual as well as lower societal costs, such as lost time from work and healthcare costs. Objectives. This narrative review aims to assess the prevalence and factors influencing post-operative complications following tooth extraction, helping clinicians minimise the risk. Data Sources. Cross-sectional studies. Study Eligibility and Participants. Patients undergoing dental extractions. Our exclusion criteria included in vitro studies, animal studies, terminally ill patients, and tooth loss not due to dental extraction. Literature was collected from “PubMed” and “Web of Science” through search criteria based on the “PICO” framework. Twenty articles were used to formulate a prevalence table, and 156 articles were included for the factors influencing complications. Study Appraisal and Synthesis Methods. This narrative review was reported using the SANRA (a scale for the quality assessment of narrative review articles) checklist. Due to the scope of our narrative review and its associated objectives, the quality of cross-sectional studies (AXIS) will be conducted from the studies outlining the prevalence. Results. Alveolar osteitis appears to be the most prevalent post-operative complication following tooth extraction. Predisposing factors can be significant in their ability to alter the risk of postoperative complications, and clinicians should provide patient-centred care to mitigate this risk. Limitations. Due to the breadth of context, a systematic review was not feasible, as it may have introduced heterogeneity. Conclusion. This narrative review has highlighted an array of factors which can influence the prevalence of post-operative complications. Future research would benefit from individually reporting post-operative complications, reducing the heterogeneity in definitions of the complications, and including greater detail on the predisposing factors studied.

Longitudinal analysis of microcirculatory parameters in gingival tissues after tooth extraction in patients with different risk profiles for wound healing disorders – a pilot study

ObjectivesWe aimed to establish a risk profile for intraoral wound healing disorders based on measurements of microcirculation in gingival tissues.Materials and methodsOxygen saturation (SO2) and blood flow in gingival tissues were measured with tissue spectrometry and laser doppler spectroscopy in 37 patients before/after tooth extractions. Patients were assigned to four groups: anamnestically and periodontally healthy patients (n = 7), anamnestically healthy but suffering from periodontitis (n = 10), anamnestically healthy but smoking and suffering from periodontitis (n = 10) and suffering from diabetes and periodontitis (n = 10). Measurements were performed at three different time points: Baseline measurement (T0), one day post extractionem (p.e.) (T1) and seven days p.e. (T2).ResultsBaseline SO2 values were higher in control patients (p = .038). This effect was most evident in comparison to smokers suffering from periodontitis (p = .042), followed by diabetics suffering from periodontitis (p = .09). An opposite trend was seen for blood flow. Patients suffering from periodontitis demonstrated higher blood flow values (p = .012). Five patients, which belonged to the group of smokers suffering from periodontitis, showed clinically a delayed wound healing.ConclusionDifferences in SO2 and blood flow of gingival tissue could be detected in different groups of patients with existing periodontitis compared to control patients.Clinical RelevanceLower baseline SO2 values could be a warning signal for possible wound healing disorders after oral surgery.

Clinical and radiographic outcomes of a novel technique for socket healing: a protocol for a split-mouth randomized controlled trial

Abstract Tooth extraction is one of the most common routine procedures in the dental clinic. Tooth extraction is followed by an inevitable bone resorption that leads to alveolar ridge reduction in the horizontal and vertical directions. The dimensions of alveolar ridge after socket healing are the result of a balance between the resorption and remodeling mechanisms that occur naturally after tooth extraction. The aim of this study is to evaluate the clinical and radiographic outcomes of the socket decortication technique for socket healing through a split-mouth randomized controlled trial. The proposed research protocol will investigate the effectiveness of this technique in promoting optimal healing and reducing bone loss following tooth extraction. By comparing radiographic data from the intervention side with the control side within the same individual, the study seeks to provide valuable insights into the potential benefits of the novel approach. The findings of this study have the potential to advance current knowledge in the field of dentistry and contribute to improved clinical practices for socket healing.

Efficacy of Celecoxib and Naproxen Sodium After Non-Surgical Extraction of Permanent Teeth: A Randomized Control Study

Objective: To compare the level of pain relief that two NSAID salts offer following a simple closed tooth extraction technique, as well as to assess patient adherence to the prescribed dosage schedule. Methodology: This Randomized Control Design study was conducted at Islamabad medical & dental college, from 2018-2019. 150 patients made up the sample, who were split into two equal groups using a computerized lottery system: the experimental group and the control group. Following tooth extraction under local anesthesia, participants in the experimental group were told to take one 200 mg tablet of celecoxib orally for two days, while the control group was administered two 550 mg tablets of Naproxen Sodium orally twice a day. The standard Visual Analogue Scale (VAS) was used to assess post-extraction pain after 24 and 48 hours. Patients' adherence was verified by having them fill out a Performa form by phone call after 48 hours. After collection of Data, analysis was done with the help of SPSS version 21.0. Results: After tooth extraction, both medications were similarly effective in reducing pain, although participants adhered to the OD dose of celecoxib substantially more than the BD dose of naproxen sodium. Conclusion: There was statistically insignificant difference in pain relief provided by Celecoxib and Naproxen Sodium after 24 and 48 hours of single tooth extraction.

Root Regeneration with Photobiomodulation of an Upper Lateral Incisor Associated with Root Resorption Due to an Impacted Maxillary Canine: A Case Report.

Objective: To present a case report of maxillary lateral incisor root regeneration after severe root resorption, treated with photobiomodulation (PBM). Background: Impacted maxillary canines often come with the risk of maxillary lateral incisor root resorption, which is widely recognized as the predominant adverse effect in these situations. This progressive process of root resorption is currently irreversible, with no known way to reverse it. Materials and methods: A male patient was 14 years old. Radiographically it was observed that canine 23 is impacting against the root of 22 producing signs of root resorption and having a less than 1:1 crown-to-root ratio with mobility grade 1. From the beginning of the treatment, PBM-assisted orthodontics was proposed. To address the patient's dental concerns, the treatment plan outlined the extraction of the deciduous upper left canine tooth leaving the lateral as long as possible in the mouth. During each appointment, PBM was applied with a diode laser. The wavelength was 810 nm, Ap = 0.2 W, 4.4 J, 22 sec every 21 days, 13 applications in total (57.2J), with a 400 μm inactive surgical tip, in a scanning movement, 1 mm from the mucosa while moving following the vestibular surface of the upper left lateral and canine roots. Results: After 12 months, the 22 had root neoformation and complete closure of the apex with vitality. Conclusions: PBM with an 810 nm diode laser in this clinical case promoted root regeneration of an upper lateral incisor, with severe root resorption, owing to an impacted maxillary canine while still vital.

Management of Endo-Perio lesion in a Tooth with an Unfavorable Prognosis: a Clinical Case Report with an 18-Month Follow-Up

The aim of this case study is to report a successful clinical case of an endo-perio lesion in a tooth with an initially unfavorable prognosis, followed up for 18 months. A male patient, public servant, non-smoker, without a history of diabetes, and married sought dental treatment in 1995 due to periodontal problems. He was then 40 years old and diagnosed with moderate to advanced periodontal disease. The initial treatment consisted of supra and subgingival scaling, followed by the extraction of teeth indicated for removal. After discharge, the patient adhered to a preventive periodic maintenance (PPM) program to control periodontal disease recurrence. In 2021, tooth 43 showed an unfavorable endo-perio lesion during a routine check-up. Despite treatment options, the patient opted for conservative treatment with endodontic and periodontal procedures. Simultaneously, PPM sessions were performed. The patient was monitored every six months, showing regression of periodontal pockets and significant improvement after 18 months. This case highlights the importance of patient adherence to PPM, demonstrating that a conservative approach and proper maintenance can lead to positive clinical outcomes even in cases with an initially unfavorable prognosis.

A Systematic Review on the Role of Antibiotics and Analgesics in Systemically Ill Patients Undergoing Tooth Extraction

A Systematic Review on the Role of Antibiotics and Analgesics in Systemically Ill Patients Undergoing Tooth Extraction

The impact of the COVID-19 pandemic on 397 631 elective dental admissions among the under-25s in England: a retrospective study.

COVID-19 caused widespread disruptions to health services worldwide, including reductions in elective surgery. Tooth extractions are among the most common reasons for elective surgery among children and young people (CYP). It is unclear how COVID-19 affected elective dental surgeries in hospitals over multiple pandemic waves at a national level. Elective dental tooth extraction admissions were selected using Hospital Episode Statistics. Admission trends for the first 14 pandemic months were compared with the previous five years and results were stratified by age (under-11s, 11-16s, 17-24s). The most socioeconomically deprived CYP comprised the largest proportion of elective dental tooth extraction admissions. In April 2020, admissions dropped by >95%. In absolute terms, the biggest reduction was in April (11-16s: -1339 admissions, 95% CI -1411 to -1267; 17-24s: -1600, -1678 to -1521) and May 2020 (under-11s: -2857, -2962 to -2752). Admissions differed by socioeconomic deprivation for the under-11s (P<0.0001), driven by fewer admissions than expected by the most deprived and more by the most affluent during the pandemic. Elective tooth extractions dropped most in April 2020, remaining below pre-pandemic levels throughout the study. Despite being the most likely to be admitted, the most deprived under-11s had the largest reductions in admissions relative to other groups.

Osteonecrosis of the Jaw Associated with Bisphosphonates Infusion for Treatment of Plasma Cell Myeloma-A Retrospective Observational Study of Northern Portuguese Population.

Objectives: To verify medication-related osteonecrosis of the jaw (MRONJ) frequency among patients with plasma cell myeloma (PCM) that had been treated with bisphosphonates, to identify predisposing factors that could influence the development of osteonecrosis. Methods: This observational retrospective study was performed at the Department of Hematology of Hospital Center of Porto (CHUP), Portugal. Results: The study population (n = 112) had a 15.2% (n = 17) prevalence of osteonecrosis. Clinically, bone exposure was the most frequently observed sign, present in 100% (n = 17) of the patients, followed by inflammation in 82.4% (n = 14), orofacial pain in 70.6% (n = 12), suppuration in 47.1% (n = 8), and intra or extra-oral fistula in 17.6% (n = 3) of the cases. The most frequent triggering local factor was dental extraction (82.4%). There was a dependence between the presence of extractions and the development of MRONJ (p < 0.001) but not with the time elapsed from the initiation of infusions with BPs and dental extractions (p = 0.499). In the sample of patients with multiple myeloma (MM), 13.8% were found to be more likely to develop MRONJ after an extraction. Conclusions: The most common local predisposing factor was dental extraction. No dependence was observed between the development of osteonecrosis and the time elapsed from the beginning of treatment with bisphosphonates infusions to surgical procedures.

A Comparative Study of Two Smartphone Applications and a Traditional Orthodontic Model Analysis Method

Introduction An orthodontic study used to determine whether teeth are positioned appropriately and whether there is an opportunity for orthodontic therapy or tooth extractions by model analysis. While certain manual model studies can be laborious and time-consuming, there are smartphone applications that can simplify the mathematical calculations necessary for orthodontic cast model analysis.  Objective The purpose of this research is to compare the outcomes and processing times of model analysis utilizing two smartphone apps, such as Model Analysis App and iModel Analysis, and the traditional technique.  Materials And Methods This is a comparative analytic study. The samples are made up of thirty dental casts that underwent several model studies, including as the Boltons, Ashley-Howe, Carey’s and Arch Perimeter assessments. A comparison in results and time was carried out for these model analyses using three methods - conventional method, iModel Analysis App and Model Analysis App.  Results The conventional technique gave results for a Bolton's overall ratio analysis of 3.3967±3.44579, iModel Analysis produced results of 3.4333±3.77709, while the Model Analysis app produced results of 4.6200±6.83744. The conventional technique yielded results for Bolton's anterior ratio analysis of 4.9133±5.81969; iModel Analysis produced results of 4.7700±5.57743; and the Model Analysis app produced results of 4.7500±5.59068. The results of arch perimeter discrepancy analysis for conventional method were 4.0000±3.15135, those for iModel Analysis was 4.0000±3.15135, and for Model Analysis app it was 4.0000±3.15135. The results of Carey’s discrepancy analysis for conventional method were 3.8667±2.59620, those for iModel Analysis was 3.8667±2.59620, and for Model Analysis app it was 3.8667±2.59620. The results of Ashley - Howe PMBAW% analysis for conventional method were 44.0200±3.71255, those for iModelAnalysis was 42.1367±5.74531, and for Model Analysis app it was 43.8133±3.71787. The results of Pont’s expansion analysis for conventional method, iModel Analysis and for Model Analysis app showed p value 0.114 (not significant = p&gt;0.05). The results of period required for the analysis by conventional method were 903.3000±30.19951, while those for iModelAnalysis was 399.2000±42.94375, and for Model Analysis app it was 392.0333±35.58233.  Conclusion There was no critical distinction within the results of the examinations done by the different methods. However, there was a noteworthy contrast within the time duration required to carry out the examination by conventional methods and that of iModelAnalysis and Model Analysis App.

The value of a remote orthodontic assessment for children having permanent teeth extracted under general anaesthesia.

Introduction The number of children undergoing dental extractions under general anaesthetic (GA) remains high. The newly published Royal College of Surgeons guidelines in 2023 take a less prescriptive approach on balancing and compensating extractions for first permanent molars. In an effort to maintain an effective and efficient patient care pathway, an orthodontic remote assessment triage model was developed in West Dorset for the special care dentistry and community dental service.Aims The orthodontic triage form is now used across Dorset. This service evaluation assesses whether the form is still effective despite the upscaling. Furthermore, qualitative feedback was obtained from the clinicians involved in referring and triaging.Design The sample of 352 forms consisted of children aged 16 years or younger undergoing GA for dental extractions for whom orthodontic triage had been requested between March 2019 and March 2023. The clinician feedback was collected using a questionnaire.Results This service evaluation found that 53.1% of patients had their treatment plan modified following an orthodontic assessment. Positive feedback from all clinicians involved suggests there is potential to expand this model to other services.Discussion Involving the orthodontist can address orthodontic concerns which has the potential to simplify or obviate the need for future orthodontic treatment. Remote assessment reduces the need for face-to-face appointments. The clinician perspective influences willingness to further develop and expand the current pathway.Conclusion Remote triage has proved successful in Dorset. There is potential to build an initiative between primary and secondary care in the hopes of creating a universal national proforma to increase access to orthodontic opinions for children requiring dental extractions.

The relevance of dental management prior to radiation therapy with severe oral mucositis in head and neck cancer patients

Background/purposeDental management prior to radiotherapy is often time-critical, and there are no studies on whether manipulations such as tooth extraction influence the risk of severe radiation-induced oral mucositis (ROM) during radiotherapy. Therefore, the aim of this study was to describe the relationship between dental management and the incidence of severe ROM. Materials and methodsA retrospective analysis was conducted on 144 head and neck cancer (HNC) patients who received dental management before radiotherapy at Peking University Cancer Hospital, from January 2016 to December 2017. Demographic characteristics, primary tumor features, cancer treatment characteristics, and severity of oral mucositis during radiotherapy were recorded. Univariate analysis and logistic regression analysis were used to explore factors associated with severe radiation-induced oral mucositis. ResultsThe incidence of grade 3 mucositis was 14.5% (22/144); univariate analysis showed that the number of extracted teeth (OR = 1.313; 95%CI = 1.012–1.702; P = 0.040) and patients with primary oral cancer had a higher risk of developing grade 3 mucositis (OR = 3.848; 95% CI = 1.508–9.822; P = 0.005). No statistical correlation was found between pre-radiation therapy prophylaxis, dental restoration, endodontic treatment, and grade 3 mucositis (P > 0.05). Logistic regression analysis showed that the number of extracted teeth (OR = 1.421, 95%CL = 1.071–1.885, P = 0.015) and primary tumor location in the oral cavity (compared with other head and neck cancers) (OR = 5.165, 95%CL = 1.636–16.311, P = 0.005) were significantly associated with grade 3 mucositis. ConclusionIn HNC patients undergoing radiotherapy, the primary site located in the oral cavity and a higher number of teeth extracted are independent risk factors for the development of severe mucositis.

Efficacy of dexamethasone injection at different sites on postoperative sequelae after extracting mandibular impacted third molars: a randomized controlled trial

BackgroundDexamethasone, an efficacious anti-inflammatory agent, is widely used after tooth extraction. However, its optimal injection site has yet to be investigated. PurposeWe compare the efficacy of dexamethasone injection at different sites on postoperative sequelae after extracting mandibular impacted third molars (MITMs). Study design, setting, and sampleA prospective randomized controlled trial was conducted. Healthy adults with fully MITMs scheduled for extraction were included. Exclusion criteria were 1) Patients with the systemic alteration that prevented the surgical procedure; 2) pregnancy, breastfeeding, premenstrual period; 3) hypersensitivity to the drug under test; and 4) those who did not return for postoperative follow-up at one, three, and seven days. Exposure variableThe subjects were randomized to three groups. An online randomization plan generator assigned each subject to a single treatment by randomly permuting blocks. Different sites for postoperative dexamethasone injections included the buccal side of the adjacent second molar and extraction sockets. Dexamethasone injection (4 mg) on the buccal side of the adjacent second molar (group 1), an injection on the buccal side of extraction sockets (group 2), an injection of physiological saline (0.8 mL) on the buccal side of the adjacent second molar (control). Outcome variablesThe outcome variables were postoperative facial swelling, limitation of the mouth opening, postoperative pain, and postoperative quality of life evaluation. The pain was assessed using a visual analog scale (VAS) at one, three and seven days, postoperatively. The quality of life was recorded throughout the Posse scale at seven days. CovariatesThe covariates are age, sex, length of operation, and type of impacted teeth and surgery. AnalysesThe statistical analysis was performed using ANOVA, repeated measures ANOVA, Chi-square, or Fisher’s exact tests with P-values < 0.05 considered statistically significant. ResultsOur study included 58 participants with a mean age of 19.48 ± 3.31 years; group 1 (n = 24), group 2 (n = 20), and control group (n = 14). On day three postoperative, the swelling and trismus were significantly less in group one than in the other two groups (P < 0.05), and group one had an overall postoperative quality of life compared to other groups (P < 0.05). Unaffected speech function was present in 73.7% of patients in group 1, while 50% of patients in group 2 had affected speech function three days after the operation (p < 0.05). The "unable to open mouth" of the “Eating subscale” and “felt tingling” had statistical significance (p < 0.05). ConclusionsDexamethasone injections on the buccal side of the adjacent second molar can be a viable option for treating facial swelling and limitation of mouth opening after total MITMs extraction.

Socket Preservation Following Tooth Extraction Using Polilactide-Poliglicolide Acid Scaffold: Radiological and Histological Evaluation.

Following tooth extraction, the healing process comprises bone resorption and soft tissue contraction, which have the potential to obstruct the optimal placement of implants, causing both functional and aesthetic limitations. This study is aimed at assessing the healing process of the extraction socket and the dimensional changes that occur after alveolar ridge preservation, utilizing a polylactide-co-glycolide scaffold (PLGA). The present study involved the extraction of 28 teeth from 14 patients. The total number of sockets was 28, which were divided into two groups consisting of 14 study and 14 control sockets. The study group (SG) was subjected to socket preservation with PLGA scaffold while the control group (CG) was left for spontaneous healing. Measurements were taken before and after the operation, with cone beam computed tomographies (CBCT) being conducted at both the baseline and 4-month intervals. Samples for histological examination were obtained via trephine core biopsy and the implants were subsequently placed. According to the histologic analyses, the PLGA scaffold was resorbed within four months. CBCT imaging revealed a decrease in the horizontal dimension of the crest at three distinct coronoapical levels in the SG, measuring 2.05±1.05 mm at -1 mm, 1.51±0.89 mm at -3 mm, and 0.92±0.7 mm at -5 mm level. The CG showed readings of 1.22±1 at -1 mm, 0.92±0.67 at -3 mm, and 0.73±0.69 at -5 mm levels. In comparison to CG, SG showed a significant reduction in horizontal losses at the -1 mm level. Vertical dimension of the crest decreased by 1.64±1.11 mm on the buccal bone height, 1.56±1.08 mm on lingual bone height in SG; in the CG, the buccal and lingual bone height had mean values of 2.08±1.44 mm and 1.73±1.27 mm, respectively. There was no significant statistical difference observed in the vertical losses between the groups. Following a period of 4 months, it can be concluded that the PLGA scaffold was completely resorbed. Based on CBCT measurements, it was observed that horizontal resorption was lower than CG at the -1 mm coronal level.

Clinical, radiographic features and prognosis of cemental tear: a retrospective study of 63 teeth

Cemental tears are often misdiagnosed due to their scarcity. In this study, we reported the second largest cohort of cemental tears thus far. By reviewing the radiographic data and medical records of 63 cemental tear teeth, we found that periapical periodontitis was the most frequent diagnosis, followed by cracked tooth/root fracture and periodontitis. Most of the cemental tear teeth that did not have root canal treatment had vital pulp. The apical third of the root was the most prominent site of cemental tears. Cemental tears occurred more frequently in the palatal root of the maxillary molars and in the mesial root of the two-root mandibular molars. Uncontrollable bone loss and tooth mobility were the two main reasons for the extraction of teeth with cemental tears. We suggest that cemental tears should be included in the differential diagnosis of periapical periodontitis, cracked tooth, vertical root fracture and periodontitis, especially for teeth with periapical radiolucency and vital pulp. We believe our study could provide more insights into cemental tears, which will aid clinicians in the early diagnosis and proper treatment of cemental tears.

Minimally invasive extractions with physics forceps - clinical evaluation and comparison.

Tooth extraction is still one of the most common dental procedures, routinely performed for a variety of reasons. Tooth extraction forceps and elevators are well-known extraction instruments which have been the standard in tooth extraction procedures for well over a hundred years. Physics forceps are one possible alternative, aiming to perform less traumatic and more predictable extractions.