The interradicular distance and the distance between the contact point and the alveolar crest have independent and combined effects on the presence or absence of the interdental papilla.
Introduction: Limited studies investigated whether orthodontic movement should be performed in patients with periodontal disease and severe intrabony defects. The purpose of this study is to assess the stability of the periodontal complex combining regeneration treatment with enamel matrix derivative (EMD) and collagen bovine mineral bone, followed by early orthodontic movement.
Case Series: In a prospective case series, 10 patients with radiographic vertical defects with probing depths (PDs) ≥6 mm and pathologic tooth migration were enrolled. Each patient contributed one infrabony defect treated with a combination of EMD and collagen bovine mineral bone. All patients started the alignment stage 1 month after periodontal surgery with 0.014 nickel–titanium wires, and the treatment lasted a mean time of 9 ± 3.2 months. Clinical measurements (PD, clinical attachment level [CAL], and gingival recession) were calculated from baseline to the end of orthodontic treatment. Mean PD reduction was 3.7 ± 1.77 mm, with an average residual PD of 4 ± 1.05 mm; mean CAL gain was 4.4 ± 1.71 mm, with a residual CAL of 5.5 ± 1.72 mm. Both differences are statistically significant (P <0.001).
Conclusions: A reconstructive procedure that combines EMD and collagen bovine mineral bone as a periodontal preorthodontic procedure seem to provide excellent clinical results. In this clinical case series, early orthodontic movement, even if it takes place in immature bone during the healing time, has not adversely affected the maturation process of the entire periodontal apparatus.
Attention and awareness towards musculoskeletal disorders (MSDs) in the dental profession has increased considerably in the last few years. From recent literature reviews, it appears that the prevalence of MSDs in dentists concerns between 64 and 93%. In our clinical trial, we have assessed the dentist posture during the extraction of 90 third lower molars depending on whether the operator performs the intervention by the use of the operating microscope, surgical loupes, or with the naked eye. In particular, we analyzed the evolution of the body posture during different interventions evaluating the impact of visual aids with respect to naked eye interventions. The presented posture assessment approach is based on 3D acquisitions of the upper body, based on planar markers, which allows us to discriminate spatial displacements up to 2 mm in translation and 1 degree in rotation. We found a significant reduction of neck bending in interventions using visual aids, in particular for those performed with the microscope. We further investigated the impact of different postures on MSD risk using a widely adopted evaluation tool for ergonomic investigations of workplaces, named (RULA) Rapid Upper Limb Assessment. The analysis performed in this clinical trial is based on a 3D marker tracker that is able to follow a surgeon’s upper limbs during interventions. The method highlighted pros and cons of different approaches.
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