Estimación de la edad por medio del grado de mineralización dental: método de Demirjian

La Odontología Legal constituye una especialidad de real importancia, tanto en el proceso de identificación humana, como en cuestiones relacionadas con el derecho civil, penal o laboral. En este escenario, la estimación de la edad es un factor coadyuvante, al aportar informaciones que orientan dichas acciones. Esta investigación tuvo como objetivo evaluar la posibilidad de aplicar el método radiográfico de estimación de edad de Demirjian et al. (1973), en una muestra uruguaya. Se estudiaron 1013 ortopantomografías digitales, obtenidas del archivo de una institución de asistencia colectivizada, de Montevideo, Uruguay, de las cuales 620 pertenecen a pacientes del sexo femenino y 393 al masculino, con edades comprendidas entre los 5 y 25 años. El algoritmo de Demirjian demostró ser poco efectivo, para la muestra estudiada. Los datos obtenidos para los terceros molares sugieren que este método podría aplicarse para la población uruguaya, aunque se requieran adaptaciones que permitan alcanzar mejores resultados.

A Odontologia Legal é uma especialidade de real importância, tanto no processo de identificação humana, quanto em questões relacionadas ao direito civil, penal ou do trabalho. Nesse cenário, a estimativa de idade é um fator adjuvante, fornecendo informações que norteiam tais ações. O objetivo desta pesquisa foi avaliar a probabilidade de aplicação do método radiográfico de estimativa da idade de Demirjian et al. (1973), em uma amostra populacional uruguaia. Foram estudadas 1013 radiografias panorâmicas digitais obtidas do arquivo de uma instituição de assistência coletivizada, em Montevidéu, Uruguai. 620 radiografias pertenciam ao sexo feminino e 393 ao sexo masculino, com idades entre 5 e 25 anos. O algoritmo Demirjian aplicado à amostra estudada mostrou-se ineficaz. Os dados obtidos para os terceiros molares sugerem que esse método poderia auxiliar no processo de identificação da população uruguaia, embora sejam necessárias adaptações para obter melhores resultados.

Legal Dentistry is a specialty of real importance, either in the process of human identification as well as in questions raised by civil, criminal or labor law. Age estimation is a helpful factor, by providing information that orientates these actions. The aim of this study was to evaluate the applicability of Demirjian et al (1973) radiographic method of age estimation, in a Uruguayan sample. 1013 digital panoramic radiographs were studied, obtained from a private institution, in Montevideo, Uruguay. 620 radiographs belonged to female patients and 393 to male, aged between 5 and 25 years old. The Demirjian algorithm applied to the sample studied proved to be ineffective. The data obtained for third molars, suggest that this method could help in the process of identification of the Uruguayan population, although adaptations are required for better results.

Detección de drogas en saliva: aspectos metodológicos y legales / Detection of drugs in saliva: methodological and legal aspects

El análisis de drogas en saliva es una alternativa no invasiva para evidenciar su presencia en el organismo. La finalidad es amplia, pero se ha utilizado en medicina legal y forense, en especial para drogas ilícitas. La recolección de saliva no implica riesgo, ni personal especializado. El objetivo fue valorar diversos aspectos metodológicos y de validez del test de drogas en saliva para el diagnóstico de su consumo. Asimismo, se analizaron algunos aspectos relativos a la legislación de drogas. Las sustancias psicoactivas a evaluar fueron marihuana, cocaína, anfetaminas y opiáceos. Se realizó una búsqueda en las bases de Pubmed/MEDLINE, Embase, LILACS, Scopus, SciELO y de literatura gris. La identificación de drogas en fluidos biológicos incluye técnicas inmunoquímicas, cromatográficas y procedimientos espectrométricos. Resultados positivos obtenidos mediante una técnica deberían confirmarse con un segundo análisis basado en distintos principios químicos o físicos. Se han detectado en saliva marihuana, cocaína, opiáceos y anfetaminas, entre otras, mediante métodos analíticos, como inmunoensayo y cromatografía de gases / espectrometría de masas en tándem. En el fluido oral, se pueden detectar drogas de abuso durante 5-48 horas posteriores al consumo, a un nivel bajo de nanogramos por mililitro. Se concluyó que la detección de drogas en saliva es una opción indicada ante sospecha de su consumo, por signos o síntomas que sugieren abuso de drogas o para la vigilancia del usuario en un centro de tratamiento por dependencia. En el aspecto legal el uso de test de drogas en saliva es una posibilidad para determinadas circunstancias.

The analysis of drugs in saliva is a non-invasive alternative to demonstrate their presence in the body. The purpose is broad, but it has been used in forensic and legal medicine, especially for illicit drugs. The collection of saliva is not risky and does not require specialized personnel. The objective was to assess various methodological and validity aspects of the saliva drug test for the diagnosis of drug use. Likewise, some aspects related to drug legislation were analyzed. The psychoactive substances to be evaluated were marijuana, cocaine, amphetamines and opiates. A search was carried out in the Pubmed / MEDLINE, Embase, LILACS, Scopus, SciELO and gray literature databases. Identification of drugs in biological fluids was found to include immunochemical, chromatographic and spectrometric procedures. Positive results obtained by one technique must be confirmed with a second analysis based on different chemical or physical principles. Marijuana, cocaine, opiates and amphetamines, among other drugs, have been detected in saliva by various analytical methods, like immunoassay and gas chromatography / tandem mass spectrometry. In oral fluid, drugs of abuse can be detected for 5-48 hours post-consumption, at a low level of nanograms per milliliter. It was concluded that the detection of drugs in saliva is an option that is indicated in the event of suspected drug use, for signs or symptoms that suggest drug abuse, or for monitoring the user in a dependency treatment center. In the legal aspect, the use of drug tests in saliva is a possibility for certain circumstances.

Sexual dimorphism of mandibular measures from computed tomographies / Dimorfismo sexual de medidas mandibulares a partir de tomografias computadorizadas

ABSTRACT Objetive: The objective of this study was to analyze mandibular measurements obtained from 225 computed tomography scans of the Osteological and CT Biobanks of Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas, aiming to verify the existence of a relationship between these measures and sexual dimorphism and ancestry. Methods: We sought to establish a mathematical model capable of estimating sex and ancestry. Of these scans, 126 were male, 94 were female and 5 were unidentified, aged 15 to 100 years, and ancestry known for the skin color phenotype (white, black, brown and yellow). Measurements were made between the following points: right lateral condylion and left lateral condylion; right lateral condylion and pogonion; left lateral condylion and pogonion; mesial border of right mental foramen and mesial border of left mental foramen. The area delimited by the triangle formed by the measurements between right lateral condylion and left lateral condylion was also analyzed; right lateral condylion and pogonion; and left lateral condylion and pogonion. Student t test for homogeneous variances showed that there was statistical difference in the means as a function of sex, except for the area measure, which was not used in the model. Results: It was possible to establish a mathematical model with accuracy of 69.2%. There was no statistical difference in the averages as a function of ancestry. Conclusion: It is concluded that the measures investigated help in the process of estimating sex, but were not adequate to estimate ancestry. The proposed methodology should be expanded to other population groups so that it can be improved.

RESUMO Objetivo: Analisar medidas mandibulares obtidas de 225 tomografias computadorizadas do "Biobanco Osteológico e Tomográfico da Faculdade de Odontologia de Piracicaba Universidade Estadual de Campinas", visando verificar a existência de relação entre essas medidas, o dimorfismo sexual e a ancestralidade. Métodos: Buscou-se estabelecer um modelo matemático capaz de estimar sexo e ancestralidade. Destas tomografias, 126 eram do sexo masculino, 94 do sexo feminino e 5 estavam sem identificação, com idades entre 15 e 100 anos, e ancestralidade conhecida para o fenótipo cor da pele (branco, negro, pardo e amarelo). Foram realizadas medidas entre os pontos: kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; kondylion lateral esquerdo e pogônio; borda mesial do forame mentoniano direito e borda mesial do forame mentoniano esquerdo. Analisou-se também a área delimitada pelo triângulo formado pelas medidas entre kondylion lateral direito e kondylion lateral esquerdo; kondylion lateral direito e pogônio; e kondylion lateral esquerdo e pogônio. O teste t de Student para variâncias homogêneas demonstrou que houve diferença estatística nas médias em função do sexo, à exceção da medida de área, que não foi utilizada no modelo. Resultados: Foi possível estabelecer um modelo matemático com acurácia de 69,2%. Não houve diferença estatística nas médias em função da ancestralidade. Conclusão: Conclui-se que as medidas investigadas auxiliam no processo de estimativa do sexo, porém não foram adequadas para estimar a ancestralidade. A metodologia proposta deve ser expandida para outros grupos populacionais para que possa ser aperfeiçoada.

Cuerpo esqueletizado identificado por análisis morfológico del seno frontal y características del material de osteosíntesis - relato de caso pericial / Skeletonized body identified by analysis of frontal sinus morphology and characteristics of osteosynthesis material: a forensic case report

La odontología legal resulta fundamental para la identificación de víctimas en descomposición avanzada, carbonizadas o esqueletizadas. Este trabajo relata un caso de identificación humana, por medio de análisis morfológico del seno frontal y material de osteosíntesis. Un cuerpo esqueletizado fue sometido a examen antropológico, evidenciándose la existencia de tres placas de osteosíntesis en ambas regiones periorbitarias. Parientes de la supuesta víctima aportaron radiografías ante-mortem, en las que se aprecia una sola placa de osteosíntesis. Empero, tras la realización de exámenes imagenológicos del esqueleto, con la misma incidencia de los efectuados ante-mortem, se constató una clara semejanza morfológica del seno frontal y de la única placa de osteosíntesis presente en las imágenes ante-mortem y post-mortem. Así, fue posible identificar positivamente a la víctima, allanando el camino a la investigación criminal y realzando el rol de las imágenes radiográficas y caracteres anatómicos en el proceso de identificación humana.

Forensic dentistry is essential for the identification of highly decomposed and charred bodies, as well as skeletal remains. This study reports a case of human identification by analyzing the morphology of the frontal sinuses and osteosynthesis material. In the anthropological assessment of skeletal remains a surgical plate used for osteosynthesis was detected in the periorbital regions. Relatives of the potential victim provided ante-mortem (AM) radiographs which revealed the presence of an osteosynthesis plate. Post-mortem (PM) imaging exams were performed to reproduce the AM data. Similarities were observed between the AM and PM radiographs, especially regarding the morphology of the frontal sinuses and the position and outline of the surgical plate used for osteosynthesis. The comparison of AM and PM images made it possible to identify the victim and to aid the criminal investigation. It also highlighted the role of radiographs and anatomical characteristics in the process of human identification.

Stature Estimate by the Upper Arch: Carrea´s Method Modified / Estimación de la Estatura por Medio del Arco Superior: Método de Carrea Modificado

The Carrea's index is an alternative to estimate the human stature. However, in cases when the jaw is affected, this technique becomes impracticable. Expanding the use of the Carrea's index, by extending it to the upper elements, would increase the chances of the method, especially in cases when only the skull is available for analysis. The aim of the study was to test a new denominator for Carrea's index, so that it could be used for the upper arch, aiming at a new feature to estimate human stature. Plaster models of the arch and the string of the upper arch of 107 dentistry students, aged between 18 and 30 years, previously submitted to anthropometric analysis, were measured with a digital caliper. The data found were inserted in software developed to find a denominator that would result in a higher number of correct answers to real statures, evaluating the left and the right hemiarch, and their average. For the right hemiarch, the denominator with more accuracy for the real stature was the interval from 2.573 to 2.583, with 58.9 %. For the left hemiarch, the best values were from 2.553 to 2.554 with 63.6 %. The average of hemiarchs had as ideal denominator values between 2.579 and 2.581, with 60.7 %. We found no significant statistical difference between denominators. It was possible to obtain a new denominator to apply Carrea's index for the upper arch. The new method had satisfactory accuracy rate and should be tested in other populations to verify its applicability.

El índice de Carrea constituye una alternativa para la estimación de la estatura humana. Sin embargo, esta técnica se torna inviable cuando la mandíbula se encuentra comprometida. Su aplicación a partir de elementos dentales superiores, resultaría de utilidad en los casos en que sólo se dispusiese del cráneo para examinar. El objetivo del estudio fue proponer un nuevo denominador para que el índice de Carrea pueda ser utilizado para el arco superior, en la búsqueda de otro recurso para estimar la estatura humana. El arco y la cuerda fueron medidos, con un calibre digital, sobre los respectivos modelos de yeso superiores de 107 estudiantes de Odontología, que tenían entre 18 y 30 años de edad y habían sido sometidos a análisis antropométricos previos. Los datos obtenidos fueron analizados matemáticamente mediante un programa desarrollado para encontrar un denominador, que proporcionase un mayor número de aciertos para las estaturas reales, evaluando el hemiarco derecho, izquierdo y la media de los hemiarcos. Para el hemiarco derecho, el denominador más apropiado para la estatura real correspondió al intervalo 2,573-2,583, con 58,9 % de acierto. Para el hemiarco izquierdo, los mejores valores quedaron comprendidos entre 2,553 y 2,554, con 63,6 % de acierto. La media de los hemiarcos determinó guarismos ideales, oscilantes entre 2,579 y 2,581, con 60,7 % de acierto. No hubo diferencia estadísticamente significativa entre los denominadores hallados. Se obtuvo un nuevo denominador, que permitió el empleo del índice de Carrea para el arco superior, con una tasa de acierto satisfactoria. No obstante, este método debe ser probado y validado para otras poblaciones, verificando su aplicabilidad.

El fenómeno piercing en Uruguay: aspectos patológicos y socioculturales / Piercing phenomenon in Uruguay: pathological and sociocultural aspects

El piercing se exterioriza como una práctica intrínsecamente vinculada a la conformación de las diversas organizaciones colectivas humanas. Numerosos autores han tipificado las lesiones orgánicas acaecidas por su utilización, pero no así, el marco sociocultural en el que se encuadran. Objetivos: este estudio buscó analizar los alcances patológicos y socioculturales concernientes al uso de piercing,en una muestra uruguaya. Metodología: consistió en la aplicación de un cuestionario, con 26 preguntas estructuradas y abiertas, a los estudiantes de un instituto de educación media de la ciudad de Rivera, Uruguay. Resultados: 21 (40.38%) de los 52 poseedores depiercings padecieron complicaciones provenientes de su uso, en tanto que 24 (46.15%), 26 (50%) y 14 (58.33% de los que trabajaban),respectivamente, no notaron reacciones sociales, familiares ni laborales. Conclusiones: trátase de un comportamiento potencialmenteriesgoso, a pesar de que en esta oportunidad, la totalidad de las alteraciones se topografió localmente, la mayoría de los usuarios realizabadeportes y un porcentaje significante de ellos, no advirtió ninguna repercusión en su vida cotidiana.

Piercing is externalized as a practice intrinsically linked to the construction of diverse human collective organizations. Numerous authorshave typified organic lesions occurred by its use, but not sociocultural framework that characterize it. Objectives: the aim of this paperwas to analyse pathological and sociocultural scopes concerning the use of piercing in a Uruguayan sample. Methods: the research wasdeveloped by applying a questionnaire with 26 structured and open questions, answered by students of a secondary education institute of the city of Rivera, Uruguay. Results: 21 (40.38%) of the 52 pierced individuals suffered complications from its use, while 24 (46.15%),26 (50%) and 14 (58.33% of those who worked), respectively did not notice social, family or employment impacts. Conclusions: piercingis a potentially risky behaviour, although in this opportunity all alterations were locally situated, most users performed sports, and asignificant percentage of them did not point out no repercussion on their daily life.

Alternativas para injertos epitelial y detejido conjuntivo en periodoncia: revisión de literatura / Alternatives to the epithelial and connective tissue grafts in periodontics - literature review

La mucosa queratinizada es el tejido que se extiende desde el margen gingival hasta la línea mucogingival, siendo de fundamental importancia para el mantenimiento de la salud periodontal. Su altura debe ser de por lo menos 2 mm., y su espesor, el suficiente para no permitir la visualización de los tejidos por transparencia. El presente estudio tuvo como objetivo llevar a cabo una revisión de literatura sobre las técnicas quirúrgicas utilizadas para incrementar la mucosa queratinizada, haciendo hincapié en el injerto gingival libre, injerto de tejido conjuntivo y los biomateriales sustitutos de uso en Periodoncia. Las conclusiones fueron que: la mucosa queratinizada resulta fundamental para el establecimiento y mantenimiento de la salud periodontal; en los casos en que no tengamos el mínimo de altura y espesor gingival, se impone restablecerlo quirúrgicamente; en regiones no estéticas, el injerto gingival libre, que representa el patrón oro,debe ser la técnica de elección; en regiones estéticas, estß indicado el injerto de tejido conjuntivo; y que los biomateriales no muestran la misma eficacia que los injertos autógenos, en lo que se refiere al aumento de mucosa queratinizada, estando indicados en pacientesque no poseen sitios donadores suficientes o cuando se persigue minimizar las molestias posoperatorias...

The keratinized tissue is the tissue that extends from the gingival margin to the mucogingival line; it is of fundamental importance for the maintenance of periodontal health. Its height should be at least 2 mm and your thickness should be sufficient to not allow viewing by transparency of tissues. This study aimed to make a literature review of surgical techniques to gain keratinized tissue, highlighting the free gingival graft, connective tissue graft and substitutes biomaterials used in Periodontics. The conclusions were that the keratinized tissue is critical to the establishment and maintenance of periodontal health. When we do not have the minimum height and thickness of gingival tissue, we must reestablish surgically. In regions not aesthetic free gingival graft, is the gold standard, and is the indicated technique and in aesthetic areas, it is indicated the connective tissue graft. The biomaterials do not show the same efficacy than autografts in regard to gain keratinized tissue and is indicated where the patient does not have sufficient donor sites or when it wants to minimize the postoperative discomfort...

Indenização por danos estéticos e morais decorrentes de fratura mandibular ocasionada por acidente de trabalho - relato de perícia odontológica trabalhista / Indemnity for aesthetic and moral damages resulting mandibular fracture for work accident - reporting dental labor expertise

Introdução: a perícia trabalhista odontológica visa verificar e quantificar as lesões no aparelho estomatognático, e suas repercussões, decorrentes de trauma produzidos durante a atividade laborativa. Nos casos onde as lesões geram danos estéticos e/ou funcionais, cabe ao expert reportar a presença dasmesmas, seu aspecto estático e dinâmico, e as consequências para o trabalhador. Objetivo: relatar um caso de perícia odontológica trabalhista em que mesmo havendo trauma facial com sequela estética de pequena monta, houve condenação do empregador para pagamento de danos morais e estéticos. Relatode Caso: um trabalhador foi soterrado durante a sua atividade laboral e, em decorrência do trauma,fraturou a mandíbula (fratura não exposta) e ficou com parestesia nesta região. Em primeira instância, foideterminada uma avaliação médica, onde o perito médico não verificou lesões e/ou sequelas que inviabilizassem o exercício da atividade do reclamante e/ou que fosse digno de reparação. Após orecurso, foi anulada a sentença inicial e determinada uma nova perícia, porém, nomeou-se um expertespecialista em Odontologia Legal que encontrou evidências da referida parestesia, bem como, que amesma era de caráter permanente e irreversível, caracterizando-se nexo causal, o que levou o magistrado a sentenciar o pagamento de danos estéticos e morais. Conclusão: conclui-se com o referidorelato de caso pericial que uma alteração estética de pequena monta na face, decorrente de fratura mandibular não exposta, associada a prejuízos funcionais e sensoriais no complexo maxilomandibular pode resultar em danos estéticos indenizáveis, cabendo ao perito judicial expor adequadamente estasalterações para que o magistrado possa julgar e fazer justiça em cada caso.

Introduction: labor dental expertise aims to verify and quantify injuries and impacts on stomatognathicsystem resulting from trauma suffered at work. In cases where injuries cause aesthetic and/or functionaldamages, the expert must report them as well as their static and dynamic aspect and the consequencesfor the worker. Objective: to report a case of labor dental expertise in which even having facial trauma withslight aesthetic sequel, there was employer condemnation for payment of moral and aesthetic damages.Case Report: a worker was buried during his labor activity, and as a result of trauma, he fractured hismandible (unexposed fracture) staying with paresthesia in this region. In the first instance, it was made amedical evaluation and the medical expert found no injuries and/or sequels that made it impossible toexercise the claimant's activity and/or it was worthy of indemnity. After the appeal, the initial sentence wasoverturned and another expertise determined, but with a new expert, a specialist in forensic dentistry, whofound evidence of permanent and irreversible paresthesia, establishing causal link and leading themagistrate to sentence the payment of aesthetic and moral damages. Conclusion: it is concluded that aslight facial aesthetic alteration resulting from unexposed mandibular fracture, associated with functionaland sensory impairments of maxilomandibular complex, can result in compensable aesthetic damages,falling to the court expert to properly expose these alterations so that the magistrate can judge and dojustice in each case.

¿Son los índices caninos mandibular y maxilar herramientas fidedignas para la determinación del sexo? / Are mandibular and maxillary canine indexes reliable tools for sex determination?

Los dientes, elementos medulares del sistema estomatognático, se erigen como una espléndida materia prima para investigaciones paleontológicas, arqueológicas, antropológicas, genéticas y forenses, dada su colosal resistencia a las más extremas condiciones intra vitam y/o post mortem. La información relativa a su tamaño ha permitido la aplicación de procedimientos tendientes a estimar la edad y determinar el sexo, contribuyendo así, con el propio proceso de identificación humana. Objetivos: este estudio buscó verificar si los índices caninos mandibular y maxilar, constituían instrumentos confiables y válidos para la determinación del sexo, en una muestra uruguaya. Metodología: se trató de un análisis odontométrico de 1000 modelos de yeso (475 superiores – 238 de individuos del sexo femenino y 237 del masculino -, y 525 inferiores – 261 y 264 -, respectivamente), pertenecientes a pacientes, con edades comprendidas entre 18 y 60 años, asistidos en una clínica de ortodoncia de la ciudad de Montevideo, Uruguay, consistente en las mediciones del diámetro mesiodistal de los caninos y la distancia intercanina, y el cálculo de los correspondientes índices caninos. Resultados: La tasa de acierto global fue del 45.9% para el índice canino mandibular y del 50.52% para su homólogo superior. Conclusiones: los índices caninos mandibular y maxilar no permitieron una determinación segura del sexo en la muestra cuestionada...

Teeth, essential components of stomatognathic system, stand as a splendid raw material for paleontological, archaeological, anthro-pological, genetic and forensic researches by virtue of their colossal resistance to extreme intra-vitam and/or post-mortem conditions. Information on their size has allowed the application of procedures for age estimation and sex determination, thus contributing to the process of human identification itself. Objectives: the aim of this paper was to verify whether mandibular and maxillary canine indexes were reliable and valid instruments for sex determination in a Uruguayan sample. Methods: the survey was an odontometric analysis of 1000 dental stone casts (475 upper – 238 from females and 237 from males -, and 525 inferior – 261 and 264 - respectively) belonging to patients, aged between 18 and 60 years, assisted in one orthodontic clinic of Montevideo, Uruguay, consisting of measurements of mesiodistal diameter of canines and intercanine distance, and calculation of canine indexes. Results: the overall success rate was 45.9% for the mandibular canine index and 50.52% for the maxillary canine index. Conclusions: mandibular and maxillary canine indexes did not allow safe sex determination in the questioned sample...

Contribución de la antropología dental en la determinación de la identidad uruguaya / Contribution of dental anthropology in determining the Uruguayan identity

Los dientes constituyen un excelente material para investigaciones de carácter antropológico, genético, odontológico y forense, gracias asu fácil accesibilidad y estructura casi indestructible. El análisis de sus rasgos morfológicos ha resultado de suma utilidad en la determinacióndel grado de variación de los grupos poblacionales y en el propio proceso de identificación humana. Objetivos: este estudio buscó verificar la presencia de algunas características anatómicas dentales en uruguayos, en la procura de correlacionarlas con la ascendenciade los mismos. Metodología: consistió en una evaluación cualitativa de nueve caracteres morfológicos dentales, llevada a cabo sobre los respectivos juegos de modelos de yeso de 544 individuos, 273 del sexo femenino y 271 del masculino, con edades comprendidas entre 18 y 60 años, asistidos en una clínica de ortodoncia de la ciudad de Montevideo. Resultados: se constató la predominancia de segundosmolares inferiores con cuatro cúspides, seguidos en orden decreciente, por segundos molares superiores con tres cúspides, incisivos en forma de pala y molares superiores con tubérculo de Carabelli. Conclusiones: la muestra observada presentó nítida influencia delcomplejo dental caucasoide y cierta similitud con el mongoloide.

Teeth constitute an excellent material for anthropological, genetic, odontologic and forensic investigations by virtue of their easy accessibilityand almost unbreakable structure. The analysis of morphological traits has proven very useful in determining the degree of human variation and in the proper identification process. Objectives: the aim of this paper was to verify the presence of some dentalanatomical features in Uruguayans, in attempts to correlate them with their ancestry. Methods: the research consisted in a qualitative assessment of nine dental morphological characters, performed on the respective sets of plaster models of 544 individuals, 273 females and 271 males, aged between 18 and 60 years, assisted in one orthodontic clinic of Montevideo. Results: it was found predominanceof mandibular second molars with four cusps, followed in decreasing order by upper second molars with three cusps, shovel-shaped incisors and upper molars with Carabelli’s trait. Conclusions: the sample showed clear influence of Caucasoid dental complex and somesimilarity to Mongoloid dental complex.

Sex determination in Uruguayans byodontometric analysis

Sex assessment plays an important role in the forensic and bioarchaeological spheres. Teeth are invaluable elements in non-living populations for sex determination, since they commonly resist post-mortem damages and are latent sources of information about dimorphism. Aim: The present study consisted in an odontometric analysis willing to examine sexual dimorphism in Uruguayans. Methods: One hundred and twelve inferior dental stone casts, 56 from males and 56 from females, aged between 21 and 60 years, from one orthodontic clinic of Montevideo, capital of Uruguay, were analyzed. Several measurements and calculations were made, such as mesiodistal diameter and gingivoincisal length of mandibular canines, intercanine distance, mandibular canine index and the area of a virtual triangle. Results: Only mesiodistal diameter and gingivoincisal length of right canine, and the area of the triangle showed statistically significant differences between both sexes. The authors obtained a logistic regression model for sex determination with a reliability rate of 72.3% and a classification and regression tree with an accuracy of 77.7%. Conclusions: The results revealed that this method can be applied in forensic anthropology, as an auxiliary tool in human identification.

Comparación antropométrica entre mandíbulas de las poblaciones uruguaya y brasileña / Anthropometric comparison between mandibles from Uruguayan and Brazilian populations

Las mandíbulas humanas pertenecientes a la población uruguaya presentan ciertas diferencias anatómicas con las de la brasileña. Tal hecho parecería deberse a las particularidades raciales y étnicas de cada país. Este estudio examinó las características morfológicas de 100 mandíbulas de uruguayos y las cotejó con las correspondientes a idéntico número de piezas óseas de brasileños, por medio de trece mediciones estipuladas por Humphrey et al. (1999). Las variaciones significativas entre los valores promedios fueron determinadas mediante el test de Mann-Whitney (alfa=5 por ciento). Se constataron expresivas discrepancias entre algunas de las dimensiones analizadas, producto de las modificaciones de forma y estructura de las mandíbulas de ambos grupos. Las uruguayas exhibieron guarismos clara o ligeramente superiores en prácticamente todas las medidas realizadas, salvo en lo que respecta a la altura de la sínfisis (sutilmente mayores en sus homólogas brasileñas). Las divergencias más evidentes correspondieron a la altura de la incisura, altura de la rama y longitud mandibular, y las menos notorias al ancho mandibular, altura de la sínfisis y ancho bicoronoideo. Los factores que pueden haber inducido a las mismas resultan realmente profusos, incluyendo tanto a las adaptaciones funcionales del sistema estomatognático como a las biomecánicas, estimuladas por la diferente consistencia de la dieta, o la propia miscegenación.

The human mandibles belonging to Uruguayan population present some anatomic differences with those belonging to Brazilian population. This appears to be determined by racial and ethnic characteristics of each country. This study examined the morphological characteristics of 100 Uruguayan mandibles and compared them with similar number of Brazilian bones, using thirteen measurements stipulated by Humphrey et al. (1999). The significant variations in mean values were calculated by Mann-Whitney test (alpha=5 percent). Expressive discrepancies were observed between the two populations regarding some of analyzed dimensions. The Uruguayan mandibles showed higher values in almost all measurements when compared to the Brazilian ones, except for the mandibular symphysis height, which was lightly higher in Brazilian mandibles. Differences were observed in notch and ramus height, mandibular length, mandibular width, symphysis height and bicoronoid width. Several factors could be responsible for these morphological discrepancies, including functional and biomechanical adaptations of stomatognathic system, stimulated by different consistency of the diet or miscegenation.

Responsabilidade legal sobre modelos de prótese parcial removível / Legal liability concerning stone casts

Objetivo: Verificar junto aos laboratórios que realizam próteses parciais removíveis na cidade de Piracicaba, São Paulo, como eles recebem os modelos enviados pelos cirurgiões-dentistas para confecção dessas próteses. Métodos: A legislação pertinente sobre a responsabilidade civil de todos os envolvidos na confecção e utilização deste tipo de prótese foi igualmente verificada. Para tanto, foi utilizado um questionário com questões estruturadas e abertas, abordando todos os aspectos inerentes ao estudo; submetido e preenchido pelo Técnico em Prótese Dentária responsável pelos laboratórios. Os dados foram analisados por meio de estatística descritiva. Resultados: Verificou-se que o Técnico em Prótese Dentária (100%) é o responsável por todos os laboratórios pesquisados e estes (100%) sabem que cabe ao cirurgião-dentista o planejamento das próteses parciais removíveis. Os respectivos modelos de próteses parciais removíveis representavam uma cavidade bucal praticamente sem preparo prévio à moldagem e estes são enviados sem os respectivos planejamentos. Conclusão: Concluiu-se que todos os profissionais envolvidos com este tipo de trabalho possuem conhecimentos parciais com relação às diversas fases necessárias para obtenção de sucesso neste tipo de tratamento e conhecimentos precários sobre a legislação que norteia suas funções. A responsabilidade civil do cirurgião-dentista, no tocante à área de Próteses Parciais Removíveis, independente da sua classificação (classe I, II, III e IV de Kennedy), é considerada como responsabilidade de meio. No entanto, deve-se destacar que a propaganda e a publicidade podem alterar tal consideração caso o cirurgião-dentista venha a prometer previsibilidade estética, conforme estabelecido no Código de Proteção e Defesa do Consumidor.

Objective: The present study checked how the laboratories that make partial dentures in Piracicaba, São Paulo (Brazil), receive the plaster casts sent by dental surgeons in order to make these kinds of prostheses. Methods: The law regarding civil liability of those involved in manufacturing and using removable partial dentures were also checked out. To this end, aquestionnaire, containing structured and open questions addressing all the aspects associated with the study, was sent to and completed bythe lab technicians responsible for removable partial dentures. The data collected were analyzed by means of descriptive statistics. Results: It was ascertained that the Dental Prosthetics Technician (100%) is the individual responsible for all the laboratories analyzed and theselaboratories (100%) know that the planning of the Removable Partial Dentures is the obligation of the dental surgeon. The respective modelsof removable partial dentures represented an oral cavity with practically no preparation prior to molding and these are sent without therespective planning. Conclusion: It was concluded that the professionals involved in this kind of work have only a partial knowledge of the various stages required to gain success with this kind of treatment and have poor knowledge of the laws that regulate their work. The dentist?s civil liability, with regard to the of Removable Partial Dentures, regardless of classification (Kennedy class I, II, III, IV), is considered to be shared liability. However, it is important to stress that advertising and publicity may change this consideration in cases where the dentist makes promises about esthetical outcomes, as per the Consumer Protection Code.

Uso efectivo del marketing odontológico en el ámbito cooperativo uruguayo / Effective use of dental marketing in Uruguayan cooperative field

Objetivos: el presente estudio buscó verificar el uso efectivo del marketing por parte de los miembros de la Cooperativa Odontológica de Montevideo – Red Dentis -, determinar el grado de conocimiento de los mismos a este respecto, así como discutir los aspectos éticos y legales inherentes al tema. Metodología: consistió en la aplicación de un cuestionario, con 32preguntas estructuradas y abiertas, a los odontólogos cooperativistas. Resultados: se constató que los encuestados utilizaban pocos recursos de marketing en su consultorio y que, en general, lo confundían con propaganda. Tal situación imposibilitó laevaluación de costos y retorno del mismo. Conclusiones: la mayoría de los profesionales hizo gala de un conocimiento parcial sobre marketing y manifestó ignorar la legislación uruguaya vigente relativa a la propaganda y publicidad en el área de la salud, haciéndose la salvedad que dicho marco normativo no aborda específica ni completamente esta temática.

Objectives: the aims of the present paper was to verify the effective use of marketing by members of Montevideo Dental Cooperative – Red Dentis -, determinate their knowledge about it, as well as to discuss the ethical and legal aspects associated with this topic. Methods: the research was developed by applying a questionnaire with 32 structured and open questions, answered by cooperative dentists. Results: it was found that respondents use few marketing resources in their dental office and that, in general, confuse marketing with advertising. This fact makes nearly impossible to evaluate costs and feedback related to it. Conclusions: most professionals from the sample exhibited partial knowledge with reference to marketing and manifested to ignore the current Uruguayan legislation linked to advertising and publicity in health area. Also, it should be noted that such regulatory framework does not fully address this specific issue.

Conocimiento del odontólogo y su equipo auxiliar sobre contaminación por mercurio / Knowledge of dentists and their assistants about mercury contamination

Objetivos: el presente estudio buscó determinar el grado de conocimiento del Odontólogo y su equipo auxiliar sobre los peligros de exposición y contaminación por mercurio, evaluar los mecanismos por ellos utilizados para evitar esta última, así como proponer una representación gráfica de sus diversas formas, en el ámbito del consultorio odontológico. Metodología: una vez aprobado el proyecto de trabajo por el Comité de Ética de la Faculdade de Odontologia São Leopoldo Mandic, según protocolo 05/342, se procedió a recabar los datos mediante la aplicación de cuestionarios, con preguntas estructuradas y abiertas, a los Odontólogos, Higienistas y Asistentes en Odontología de la ciudad de Santa Bárbara D’Oeste, Estado de São Paulo, Brasil.Resultados: 81% de los Odontólogos y 86% de los auxiliares de la muestra considerada, están convencidos que el mercurio existente en la amalgama de plata puede tener efectos nocivos sobre su propia salud. Conclusiones: los grupos entrevistados hicieron gala de un conocimiento parcial en lo que respecta a los peligros de exposición y contaminación por mercurio, nopercibiéndose ninguna postura preventiva en tal sentido; no obstante, se destaca que fue posible proponer un diagrama sobre la contaminación por mercurio en los consultorios odontológicos.

Objectives: The aims of the present paper is to determine the knowledge of dentists and their assistants regarding the hazards of exposure and contamination by mercury, evaluate their measures to avoid contamination by this metal and propose oneflowchart about the different kinds of mercury contamination related to the dental office. Methods: After the project approval by the Ethical Committee of São Leopoldo Mandic College, under the protocol 05/342, the research was developed by applying questionnaires with structured and open questions, answered by dentists and assistants from the city of Santa Bárbara D’Oeste,in São Paulo State, Brazil. Results: 81% of the dentists from the sample believe that the mercury existent in silver amalgam can harm their own health, and 86% of the assistants agree with that. Conclusions: it was concluded that the professionals from the sample present a partial degree of knowledge about mercury exposure and contamination. It wasn’t detected any preventive measure among the interviewed groups, and it was possible to propose a flowchart about mercury contamination in dentaloffices.