Exodontia de primeiro molar superior permanente em criança: relato de caso / Clínico maxillary first permanent molar extraction in a child: case report

Entre as perdas precoces de um elemento dental ocorre em grande frequência a do primeiro molar permanente, que normalmente tem o seu irrompimento por volta dos 6 anos de idade, e são propensos a serem acometidos por lesões cariosas que se não cuidadas precocemente pode-se levar a perda do elemento dental. Há também outros agentes que ocasionam a perda do elemento como o trauma de baixa intensidade, tais como, os cálculos dentários, os hábitos bucais deletérios e principalmente a falta de motivação de higiene oral. Diante disto, este trabalho visa a apresentação de um caso clínico de um paciente de 9 anos de idade, sem alterações sistêmicas, com grande destruição coronária no dente 26. Os exames de imagens foram colaboradores para diagnóstico e definição da extração. Foi realizada a exodontia em campo aberto. O paciente foi instruído quanto à higiene bucal e futuramente encaminhado para um tratamento ortodôntico. Conclui-se que o Cirurgião Dentista tem papel fundamental no diagnóstico e tratamento dessas alterações dentais, enfatizando a importância do tratamento restaurador de lesões cariosas precocemente, remoção de qualquer agente irritante de baixa intensidade e na motivação da higiene bucal(AU)

Among the early loss of a dental element, the loss of the first permanent molar occurs very frequently, which usually has its eruption around the age of 6 years, and they are prone to be affected by carious lesions that, if not treated early, can if it leads to loss of the dental element. There are also other agents that cause the loss of the element, such as low-intensity trauma, such as dental calculi, deleterious oral habits and especially the lack of motivation for oral hygiene. Therefore, this work aims to present a clinical case of a 9-year-old patient, without systemic alterations, with great coronary destruction in tooth 26. The imaging exams collaborated for the diagnosis and definition of the extraction. The extraction was performed in an open field. The patient was instructed about oral hygiene and later referred for orthodontic treatment. It is concluded that the Dental Surgeon has a fundamental role in the diagnosis and treatment of these dental alterations, emphasizing the importance of an early restorative treatment of carious lesions, removal of any low-intensity irritant and in the motivation of oral hygiene(AU)

Métodos para medir asimetrías sagitales y transversales en los modelos de estudio de ortodoncia / Methods to measure sagittal and transverse asymmetries in orthodontic study models

Introducción Para el diagnóstico acertado en el tratamiento de los pacientes de ortodoncia se requiere de una serie de exámenes auxiliares, que son herramientas esenciales en ortodoncia; sin embargo, encontramos cierto grado de dificultad para la valoración de asimetrías dentarias en los hemiarcos de cada arcada dentaria; la importancia de la correcta valoración de las asimetrías es ya ampliamente mencionada en diferentes estudios, porque nos ayudará con la localización co-rrecta, de los dientes en su arcada,al final del tratamiento En la actualidad existe poca literatura sobre los métodos para evaluar y diagnosticar las alteraciones por hemiarcos, especialmente en el plano transversal. Objetivo acer una revisión de literatura sobre los métodos de medición de las asimetrías dentarias intra-arco para poder identificar y cuantificar las alteraciones dentarias en los tres planos del espacio en su respectiva arcada dentaria, el Método para los términos de búsqueda de la información fueron: dental and facial asymmetry, molar asymmetry in ortho-dontics, arch width prediction indices, as well as transverse discrepancies, para tal efecto se empleó Pubmed, Medline, Scielo, Schoolar Google, de los cuales se recopilaron 80 artículos relacionados con nuestro tema de estudio y solo se eligieron 30 artículos y 6 libros de ortodoncia en los que se sustenta este artículo. Resultados En el presente artículo presentamos las herramientas con las que contamos para el diagnóstico de la asimetría dentaria intra-arcos como la placa de Sthmuch y la placa milimetrada de Korkhaus, y finalmente proponemos un método que nos permite cuantificar objetivamente la asimetría en los tres plano del espacio de una manera sencilla, reproducible y de fácil almacenaje en un computador. Conclusión La etapa del diagnóstico es importante porque permitirá obtener la mayor y mejor información de las alteraciones dentarias que presenta el paciente, siendo las alteraciones transversales las más difíciles de cuantificar por que la mayoría de los estudios e índices, ya que solo evidencian las distancias de dientes contra laterales, los cuales son datos limitados pero que aún así contribuyen en el diagnóstico, el método de la placa de Sthmuch, Korkhaus y Bernklau son propuesta para medir las asimetrías dentarias intraarcos, no en tanto es desgastador para el operador y sus resultados objetivos radica en la experiencia del operador; el método KLO nos permite cuantificar objetivamente la falta de sime-tría dentaria en cada arcada de una manera fácil, reproducible y de almacenaje en un computador o en un archivo.

Introduction The correct diagnosis in the treatment of orthodontic patients requires a series of auxiliary examinations, which are essential tools in orthodontics, however we found a certain de-gree of difficulty in assessing dental asymmetries in the hemiarchs of each dental arch; The im-portance of the correct assessment of asymmetries is already widely mentioned in different stud-ies, because it will help us with the correct location of the teeth in their arch, at the end of the treatment. Currently there is little literature on the methods to evaluate and diagnose hemiarchal alterations, especially in the transverse plane. Objective Is to review the literature on the methods of measuring intra-arch dental asymmetries in order to identify and quantify dental al-terations in the three planes of space in their respective dental arch. Method The search terms of the information were: dental and facial asymmetry, molar asymmetry in orthodontics, arch width prediction indices, as well as cross-sectional discrepancies. Pubmed, Medline, Scielo, Schoolar Google, of which 80 articles related to our study topic were collected and only 30 articles and 6 orthodontic books were chosen on which this article is based, Results Also in this article we present the tolos that we have for the diagnosis of intraarch dental asymmetry such as the Sth-much plate and the Korkhaus millimeter plate, and finally we propose a method that allows us to objectively quantify the asymmetry in the three space plan in a simple, reproducible way and easy to store on a computer. Conclusión The stage of diagnosis is important because it will allow obtain-ing the greatest and best information on the dental alterations that the patient presents, being the transversal alterations the most difficult to quantify because most studies and indices, since they only show the distances of Contralateral teeth, which are limited data but still contribute to the diagnosis, the Sthmuch, Korkhaus and Bernklau plate method are proposed to measure intra-arch dental asymmetries, not as it is wearisome for the operator and his patients. objective results lies in the experience of the operator; The KLO method allows us to objectively quantify the lack of dental symmetry in each arch in an easy, reproducible way that can be stored on a computer or in a file.

Factors associated with severe permanent first molar caries among adolescents from Acapulco, Guerrero / Factores asociados a caries severa del primer molar permanente en adolescentes de Acapulco, Guerrero

RESUMEN Objetivo: Identificar los factores asociados a caries severa del primer molar permanente en adolescentes de Acapulco, Guerrero, México. Material y métodos: Estudio transversal en una muestra de 173 adolescentes de primer a tercer grado de una secundaria pública. Se usó un cuestionario autoadministrado que obtuvo datos sociodemográficos, nivel socioeconómico, salud oral, hábitos tóxicos y dietéticos. Se identificó la caries severa con base en los códigos combinado 5-6 del Sistema Internacional de Clasificación y Gestión de Caries. Se realizó un análisis multivariado con el software estadísitico CIETmap, el cual identificó factores asociados a caries severa con la razón de prevalencia y su intervalo de confianza del 95% como estimación de la fuerza de asociación. Resultados: Fueron revisados 692 primeros molares permanentes. El 54% de los adolescentes (94/173) presentó caries severa en al menos un molar. Se encontraron dos factores asociados, consumo de 6 o más cigarros al día (RPa: 7,18, IC95%= 2,07 - 24,22) y el uso de auxiliares en la higiene oral (RPa: 0,41, IC95%= 0,34 - 0,78). Conclusión: La prevalencia de caries severa fue similar a la reportada a otros estudios. Se deben realizar acciones de promoción de la salud que ayuden a disminuir la afección en esta población.

ABSTRACT Objective: To identify the factors associated with severe caries of the first permanent molar among adolescents from Acapulco, Guerrero, Mexico. Material and methods: Cross-sectional study in a sample of 173 adolescents from first to third grade of a public high school. A self-administered questionnaire was used to obtain sociodemographic data, socioeconomic level, oral health, toxic and dietary habits. Severe caries was identified based on the combined codes 5-6 of the International Caries Classification and Management System. A multivariate analysis was performed with CIETmap statistical software, which identified factors associated with severe caries with the prevalence ratio and its 95% confidence interval as an estimate of the strength of association. Results: A total of 692 permanent first molars were examined. The 54% of the adolescents (94/173) presented severe caries in at least one molar. Two associated factors were found, consumption of 6 or more cigarettes per day (RPa: 7.18, IC95%= 2.07 - 24.22), and use of oral hygiene aids (RPa: 0.41, IC95%= 0.34 - 0.78). Conclusion: The prevalence of severe caries was similar to that reported in other studies. Health promotion actions should be carried out to help reduce caries in this population.

A case report of Joubert syndrome caused by KIAA0586 gene mutation / 中华实用儿科临床杂志

The main clinical phenotypes, imaging features and genetic test results of a child with Joubert syndrome treated in Shenzhen Children′s Hospital in July 2020 were analyzed retrospectively, and the literature on Joubert syndrome was summarized.The main manifestations of the protester during infancy were respiratory abnormalities and developmental retardation.The brain magnetic resonance imaging (MRI) showed a " molar sign" , which was consistent with the diagnosis of Joubert syndrome.Genetic testing suggested that the protestor carried complex heterozygous variations of KIAA0586 gene.Two variants were not reported previously, one of which was synonymous mutation.The child is the first case of Joubert syndrome caused by KIAA0586 gene in China.Joubert syndrome is a rare congenital brain development malformation characterized by high clinical heterogeneity and MRI molar signs.It may involve multiple systems.Early identification and intervention can improve outcomes.

Instrumentação reciprocante em canal mésiovestibular de molar superior após fratura de lima endodôntica: relato de caso / Reciprocal instrumentation in the mesiobuccal canal of the upper molar after endodontic file fracture: case report

Objetivo: reportar um caso clínico de ultrapassagem de instrumento endodôntico fraturado em terço médio de canal mésiovestibular de molar superior permanente, utilizando a técnica de instrumentação reciprocante associada à instrumentação convencional manual e ao gel de E.D.T.A. 24%. Relato de caso: paciente do sexo masculino, 24 anos, normossistêmico, compareceu ao consultório odontológico privado com queixa de dor espontânea e encaminhamento para tratamento endodôntico do dente 17. O diagnóstico foi pulpite irreversível sintomática com indicação de tratamento endodôntico primário. A lima principal escolhida foi a Reciproc® R25 M-wire (VDW), que, durante a instrumentação do canal mésiovestibular, sofreu fratura por torção em terço médio, inviabilizando a continuação em direção apical. Considerações finais: a associação da técnica convencional manual das limas Hedströen com a técnica reciprocante de corte reverso da lima Wave One® Gold Primary e o uso do gel de E.D.T.A. 24% permitiram ultrapassagem do fragmento de lima fraturado em terço médio do canal mésiovestibular do dente 17, promovendo selamento hermético, limpeza, modelagem e obturação satisfatórias.(AU)

Objective: to report a clinical case of a fractured endodontic instrument in the middle third of the permanent maxillary molar maxillary canal using the technique instrumentation reciprocation with technique to conventional manual instrumentation and the E.D.T.A. 24% gel. Case report: a 24-yearold normosystemic male patient came to the private dental office complaining of spontaneous pain and referred for endodontic treatment of tooth 17. The diagnosis was irreversible symptomatic pulpitis with indication for primary endodontic treatment. The main file chosen was the Reciproc® R25 M-wire (VDW), which during the instrumentation of the mesiobuccal canal suffered torsional fracture in the middle third, preventing continuity in the apical direction. Final considerations: the association of the conventional manual Hedströen file technique with the reciprocal reverse cutting technique of the Wave One® Gold Primary file and the use of E.D.T.A. 24% gel allowed the fractured file fragment to be overcome in the middle third of the mesiobuccal canal of tooth 17, promoting hermetic sealing, cleaning, modeling and satisfactory filling. (AU)

Newborn with multiple congenital anomalies in newborn, intensive care unit suggestive of joubert syndrome and related disorder with an atypical presentation

Joubert syndrome (JS) is a rare autosomal recessive disorder with key finding of cerebellar vermis hypoplasia with a complex brainstem malformation that comprises the molar tooth sign on axial magnetic resonance images. This syndrome is difficult to diagnose clinically because of its variable phenotype. Molar tooth sign is not specific for JS. Another entity is termed as Joubert syndrome and related disorders (JSRD). Although the molar tooth sign and other important clinical features of the JS may be seen in these syndromes, they usually have supplementary prominent features. Author present a case of Joubert syndrome and related disorder in a term newborn delivered in the hospital of Government Medical College, Haldwani with multiple congenital anomalies. Macrocephaly, facial dysmorphism, polydactyly left hand and bilateral ballotable lumbar lump (multicystic dysplastic kidney). MRI showed molar tooth configuration of superior cerebellar peduncles, dilatation of lateral and third ventricles with aqueductal stenosis with arachnoid cyst (unusual association).

Morphometric Study Of Bony Palate Among Dry Skulls Of South India Population

Background: Hard palate forms an important area in the skull, between the oral cavity and the nasal cavity. It isformed anteriorly by the palatine process of maxillae and posteriorly by the horizontal plates of palatine bonesof both sides, forming a cruciform suture in the midline. The hard palate play a crucial role in articulation ofspeech and any significant variations in its morphology may lead to alterations in the speech of an individual.Materials and Methods: The present study was conducted on 50 dry skulls of unknown sex and age obtained fromthe department of Anatomy, K S Hegde Medical Academy, Mangaluru. Various morphometric measurments weretaken from the skull using digital vernier calipers.Results: The length, breadth and height of the hard palate was 50.45mm±2.86mm, 39.38mm±2.28mm and10.31mm±2.21mm respectively. The distance between the greater palatine foramen and middle maxillary suturewas 14.80mm±1.14mm on right and 14.83mm±1.08mm on left side. The position of greater palatine foramen in82% of the skulls was opposite 3rd molars and 18% was between 2nd and 3rd molars. The palatine index showedthat, 66% were Leptostaphyline, 18% were Mesostaphyline and 16% were Brachystaphyline The palatine heightindex showed that 56% were Chamestaphyline, and 44% were Orthostaphyline.Conclusion: The present study identifies the commonest location of greater palatine foramen to be opposite the3rd maxillary molars which is useful for clinicians to perform procedures on palate. The morphometry is usefulin comparing the skulls of various origin.

Estudo Comparativo do Preparo Transversal Produzido pelo Emprego de Instrumentos de NiTi e Manual em Molares Inferiores / Comparative Study of the Transversal Preparation Carried Out by NiTi and Manual Instruments in Lower Molars

Objetivo: avaliar o desgaste dentinário promovido por instrumentação rotatória com diferentes sistemas de NiTi e instrumentação manual em raízes mesiais de molares inferiores. Material e Métodos: Foram selecionados 60 molares inferiores extraídos que foram divididos em 6 grupos (n=10). Nos grupos A, B, C e D os canais radiculares foram preparados utilizando-se os sistemas de NiTi ProFile®, ProTaper Universal®, K3® e Race®, respectivamente. No grupo E, os canais radiculares foram preparados com limas manuais do tipo K Flexofile®, e no grupo F os canais radiculares não foram preparados (controle). Após os preparos, foram realizados dois cortes perpendiculares ao longo eixo da raiz mesial, sendo um no terço cervical e outro no terço apical. As imagens dos cortes foram capturadas por meio de microscópio e analisadas através de software. Para cada corte, foram realizadas três medidas correspondentes à menor espessura da parede dentinária, sendo obtida uma média de cada espécime. As comparações entre os grupos das medidas obtidas foram realizadas pelo teste t, com nível de significância de 5%. Resultados: Tanto no terço cervical quanto apical houve diferença significante entre o grupo E (Flexofile) e os grupos de sistemas de NiTi, bem como entre o grupo controle. No terço apical foi observada diferença significante entre o grupo A (Profile®) e o grupo D (Race®) em comparação ao grupo controle. Conclusões: Pôde-se concluir que as técnicas que utilizaram instrumentos de NiTi preservaram mais estrutura dentinária quando comparados à técnica que se utilizou de limas manuais.

Objective: to evaluate dentinal wear promoted by rotary instrumentation with different NiTi systems and manual instrumentation in mesial roots of lower molars. Material and Methods: Sixty extracted lower molars were selected and divided into 6 groups (n = 10). In groups A, B, C and D the root canals were prepared using the NiTi ProFile®, ProTaper Universal®, K3® and Race® systems, respectively. In group E, the root canals were prepared with manual files of type K Flexofile®, and in group F the root canals were not prepared (control). After the preparation, two perpendicular cuts were made along the axis of the mesial root, one in the cervical third and the other in the apical third. The images of the cuts were captured by means of a microscope and analyzed through software. For each cut, three measurements were made corresponding to the lowest thickness of the dentin wall, obtaining an average of each specimen. The comparisons between the groups of measures obtained were performed by the t test, with a significance level of 5%. Results: In both the cervical and apical thirds there was a significant difference between the group E (Flexofile) and the groups of NiTi systems, as well as between the control group. In the apical third, a significant difference was observed between group A (Profile®) and group D (Race®) compared to the control group. Conclusions: It could be concluded that the techniques that used NiTi instruments preserved more dentin structure when compared to the technique used of manual files.

Restablecimiento de guía anterior dental mediante restauraciones directas / Anterior dental guide reestablishment by direct restorations

OBJETIVO: evaluar la presencia de desoclusión en dientes molares durante los movimientos excursivos, después del restablecimiento de la guía anterior dental, para brindar estabilidad oclusal y estética en pacientes mujeres que asisten a la clínica de Rehabilitación Oral y Estética de la Universidad Mayor de San Simón. MÉTODOS: la presente investigación es de tipo descriptivo, transversal. Los sujetos de estudio fueron pacientes mujeres que acuden a la Clínica de Posgrado Rehabilitación Oral y Estética de la Universidad Mayor de San Simón, quienes presentan desgaste dental patológico tipo I en los dientes caninos e incisivos; durante la gestión 2016. RESULTADOS: se demuestra la presencia de 100% de desoclusión, durante los movimientos excéntricos de protrusiva; 80% de desoclusión en movimientos excéntricos de lateralidad derecha, debido a que 20% de los pacientes estudiados, no pueden realizar la desoclusión en lateralidad derecha por falta de alineación tridimensional (curva de Wilson ) en el lado derecho. Y 100% de desoclusión en movimientos excéntricos de lateralidad izquierda; restablecida la guía anterior dental con resinas fotopolimerizables. CONCLUSIONES: la guía anterior dental como un factor de la desoclusión tanto en movimientos protrusivos como movimientos laterales, es un mecanismo importante de protección hacia los dientes posteriores y a la articulación temporomandibular, lo que trasciende en la necesidad imperiosa de la rehabilitación de la misma, en el desgaste dental patológico tipo I donde el desgaste es menos severo y no hay pérdida de dimensión vertical de oclusión, con restauraciones directas, porque existe menos desgaste de estructura dental. Es un tratamiento reversible, estético y genera resultados funcionales adecuados.

OBJETIVE: to evaluate the de-occlusion presence in molar teeth during the excursion movements, after the reinstatement of the anterior dental guide, to give occlusal and aesthetic stability to female patients who attend the clinic of Oral and Aesthetic Rehabilitation Clinic of Universidad Mayor de San Simon. METHODS: the current research is a descriptive and transversal type. The subject of study were female patients, that attend the Postgraduate Clinic Oral and Aesthetic Rehabilitation of San Simon University who have a pathological tooth wear in canino teeth, and incisive teeth during 2016 administration. RESULTS: it is shown the presence of the de- occlusion in 100% during the protrusive eccentric movements, 80% in eccentric movements of rigth laterality because of the non-existent tridimensional alignment (Wilson's curve) in the right side. And 100% in eccentric movements of the left laterality; the anterior dental guide was reinstated with light-curing resins. CONCLUSIONS: the anterior dental guide asa de-occlucsion factor in both movements, protrusive and lateral, is an important protection mechanism for the posterior teeth and for temporomandibular joint. It transcends the urgent need for the rehabilitation of it, in pathological tooth wear type I where the wear is less severe and there is no loss of vertical dimension of occlusion, with direct restorations, because there is less wear of dental structure. It is a reversible and aesthetic treatment and it generates adequate functional results.

Anatomia radicular dos primeiros pré-molares inferiores em uma população do nordeste do Brasil / Root anatomy of the mandibular first premolars in a population of northeast Brazil

Objetivo: Avaliar a anatomia radicular de primeiros pré- -molares inferiores em uma população do Nordeste do Brasil, por meio da análise externa das raízes, radiografia digital e diafanização. Materiais e Método: Cem dentes extraídos foram selecionados. A análise clínica avaliou as características radiculares e incluiu o número de raízes, a presença e o tipo de sulcos radiculares nas superfícies proximais, ocorrência e tipo de dilaceração da raiz, tamanho e forma da raiz. Dois exames radiográficos (ortogonal e mesio-distal) foram realizados, e em seguida a diafanização. Resultados: Os resultados revelaram maior ocorrência de raiz única (96%), com formato piramidal cônica (53%), presença de sulcos radiculares (71%) e dilaceração apical (46%). Na posição ortogonal, 75% dos dentes apresentaram um canal, enquanto no mesio-distal esse valor foi de 57% (p = 0,00). Na diafanização, a ramificação mais comum foi a intercanal (38,9%) e, para o tipo Vertucci, o tipo I foi o mais frequente (63%). Ao comparar a classificação de Vertucci na radiografia e na diafanização, houve diferença estatisticamente significante (p = 0,00). Conclusões: Os primeiros pré-molares inferiores, na população estudada, apresentaram grande variação da anatomia radicular, o que pode gerar dificuldades durante o tratamento endodôntico.

Objetive: To evaluate the root anatomy of the mandibular first premolars in a population of the Northeast of Brazil, through the external root analysis, digital radiography and diaphanization. Material and Method: One hundred extracted mandibular first premolar were selected. The analysis included the number of roots, the presence and type of radicular grooves at the proximal surfaces, the presence and type of root dilaceration, the root size and shape. Two radiographic examinations (orthogonal and mesio-distal) were performed, followed by diaphanization of the teeth. Results: The results revealed a higher prevalence of single rooted teeth (96%), with conical pyramidal aspect (53%), radicular grooves (71%) and apical dilaceration (46%). At the orthogonal position, 75% of the teeth presented one canal, whereas in the mesio-distal this value was 57% (p=0.00). In the diaphanization, the most common branch was the intercanal (38.9%) and regarding the Vertucci's classification, type I was the most frequent (63%). When comparing the Vertucci's classification in the radiography and in the diaphanization, there was a statistically significant difference (p = 0.00). Conclusions: The mandibular first premolars, in the study population, presented a great variation of the root anatomy, which may generate difficulties during endodontic treatment.

Qual material possui maior longevidade em molares decíduos: resina composta ou cimento de ionômero de vidro? - revisão sistemática da literatura / Which material has the highest longevity in primary molars: composite resin or glass ionomer cement? - a systematic review of the literature

Introdução: Diversos materiais restauradores são indicados para a restauração de dentes decíduos posteriores, como amálgama, resina composta, cimento de ionômero de vidro convencional, cimento de ionômero de vidro modificado por resina e resinas compostas modificadas com poliácidos (compômeros). Entretanto, uma dúvida ainda persiste quanto ao desempenho clínico do cimento de ionômero de vidro, em decorrência de suas propriedades, para ser utilizado como material restaurador definitivo em molares decíduos. Objetivo: Realizar uma revisão sistemática da literatura acerca da taxa de sobrevivência de restaurações realizadas em molares decíduos utilizando resina composta e cimento de ionômero de vidro, buscando com base em evidências científicas, responder a PICO question: "Qual material possui maior longevidade em molares decíduos: resina composta ou cimento de ionômero de vidro?". Material e métodos: Para este fim foram realizadas buscas em duas bases de dados, PubMed e Web of Science, utilizando uma estratégia de busca previamente determinada, para selecionar artigos de acordo com critérios de inclusão e exclusão criados para esse trabalho por dois examinadores calibrados. Resultados: A seleção dos artigos foi realizada de acordo com o fluxograma do PRISMA e foi criada uma tabela para avaliação qualitativa dos artigos selecionados. Foram encontrados 398 artigos na base de dados PubMed e 375 na Web of Science, sendo 153 coincidentes em ambas. Quarenta e seis artigos foram selecionados para leitura completa, dentre eles 42 foram excluídos, e quatro artigos foram incluídos para esta revisão. Conclusão: Os artigos desta revisão demonstraram que a resina composta possuiu maior longevidade em molares decíduos comparada aos cimentos de ionômero de vidro. Porém futuros estudos clínicos necessitam ser conduzidos para comprovar qual o material mais indicado para restaurá-los, já que os cimentos de ionômero modificados por resina mostraram taxas de sobrevivência clínica satisfatórias.

Introduction: Several restorative materials are indicated for restoration of posterior deciduous teeth, such as amalgam, composite resin, conventional glass ionomer cement, resin modified glass ionomer cement and composite resins modified with polyacids (compomers). However, a doubt still persists related to the clinical performance of the glass ionomer cements to be used to restore deciduous molars, due to its properties. Objective: To perform a systematic review of the literature about the survival rate of composite resin and glass ionomer cement restorations performed in deciduous molars aiming scientific evidence to answer the PICO question: "Which material has greater longevity in deciduous molars: resin composite or glass ionomer cement?" Material and methods: The research was performed on two databases, PubMed and Web of Science, using a predetermined search strategy to select articles according to the inclusion and exclusion criteria, evaluated by two calibrated examiners. Results: The selection of the articles was carried out according to the PRISMA flowchart and a table was created for the qualitative evaluation of the included articles. It was found 398 articles in the PubMed database and 375 in the Web of Science, 153 of which were coincident in both. Forty-six articles were selected for complete reading, 42 of which were excluded, and four articles were included in this review. Conclusion: The articles investigated in this review demonstrated that composite resin has a higher longevity in deciduous molars compared to glass ionomer cements. However, future clinical studies are needed to attest which material is better to restore them, since the resin modified glass ionomer cements showed satisfactory clinical survival rates.

Examination of paramolar tubercles in Turkish population using cone beam computed tomography / Estudio de los tuberculos paramolares en una población turca mediante tomografía computarizada de haz cónico

SUMMARY: Paramolar tubercle (PT) is an additional cusp occuring on buccal surface of both upper and lower permanent molars. PT is also known as parastyle when tubercle is present in upper molars, as protostylid when tubercle is present in lower molars. The aim of this study was to evaluate prevalence of PTs in Turkish population with cone beam computed tomography (CBCT). Presence of PT in molar teeth were evaluated retrospectively using CBCT images of 210 patients (102 male, 108 female) between 18-77 years old. A total of 909 teeth were analyzed. Because of various reasons some teeth were excluded and final analyze was done with 653 teeth. Prevalence of PT was found as 2.76 % (18 out of 653). Highest frequency of PT was detected 5 in #27, 4 in #17, 2 in #48 among all molar teeth respectively. In two cases; 2 PTs were on the same tooth, bilateral PT was found only in one case. PT was undetected on upper first molars. Prevalence of PTs on permanent molars is a rare phenomenon in the studied population. Use of CBCT in such anatomic variations will provide valuable and detailed information during treatment modalities. Since this pilot study represents Turkish subpopulation, comprehensive studies with increased number of cases should be undertaken to clarify the prevalence of paramolars in Turkish population. Advanced imaging techniques like CBCT will be more helpful in understanding and detecting exact morphological and anatomical variations of PTs during treatment modalities.

RESUMEN: El tubérculo paramolar (TP) es una cúspide adicional que está en la superficie vestibular de los molares permanentes superiores e inferiores. El objetivo de este estudio fue evaluar la predisposición de TP en la población turca con tomografía computarizada de haz cónico (TCHC). Presencia de TP en dientes molares se evaluaron retrospectivamente utilizando imágenes de tomografia de 210 pacientes (102 hombres, 108 mujeres) entre 18-77 años de edad. Se analizó un total de 909 dientes. Por varias razones, algunos dientes fueron excluídos y el análisis final se realizó con 653 dientes. Prevalencia de PTP se encontró en el 2,76 % (18 dientes de 653). La frecuencia más alta de TP se detectó: 5 en # 27, 4 en # 17, 2 en # 48, entre todos los dientes molares, respectivamente. En dos casos, 2 de los TP fueron observados en el mismo diente; TP bilateral sólo se encontró en un caso. El TP no fue detectado en los primeros molares superiores. La prevalencia de TP en los molares permanentes es un fenómeno poco frecuente en la población estudiada. El uso de la TCHC en tales variaciones anatómicas, proporcionará información valiosa y detallada para definir la aplicación de diferentes modalidades de tratamiento. Dado que este estudio piloto representa a una subpoblación turca, estudios exhaustivos con un mayor número de casos deben llevarse a cabo para determinar la prevalencia en la población turca total. Técnicas avanzadas de imagen como TCHC serán más útiles para detectar variaciones morfológicas y anatómicas exactas de TP durante diversas modalidades de tratamiento.

Correlation between transverse maxillary discrepancy and the inclination of first permanent molars: a pilot study / Correlación entre la discrepancia maxilar transversal y la inclinación de los primeros molares permanentes: estudio piloto

ABSTRACT. Introduction: the development and growth of craniofacial structures allow some dental alterations to be compensated with maxillary reactions. The purpose of this study was to correlate transversal maxillo-mandibular discrepancy with the bucco-lingual inclinations of first permanent maxillary and mandibular molars in a population aged 10 to 16 years, by means of cone beam computed tomography (CBCT). Methods: the sample included 18 CT scans of patients selected by convenience, prior authorization from the radiographic center and with validation of the Bioethics Committee of Universidad Autónoma de Manizales (Agreement No. 51, 2015). The transverse mandibular and maxillary distance was measured, calculating discrepancy and correlating with the bucco-lingual inclination of first permanent molars. Results: average mandibular transverse distance was higher than maxillary transverse distance (p < 0.05). On average, lower molars had greater inclination degree than upper molars. Average discrepancy rate was 1.86 mm (0.90 mm-2.82 mm CI). The analysis grouped by discrepancy type showed significant correlations between positive maxillary discrepancy (> 5º) and the inclination of molars (p < 0.05). There was also moderate correlation in patients with negative maxillary discrepancy (< 5º). Conclusion: transverse maxillomandibular discrepancy is related to the bucco-lingual inclination of first permanent maxillary and mandibular molars in two different ways according to discrepancy type-positive or negative-. The reaction of the maxillary is a process that requires more studies to understand the timing and extent of the adaptation.

RESUMEN. Introducción: el crecimiento y el desarrollo craneofacial permiten que algunas alteraciones dentales sean compensadas con respuestas maxilares. El propósito de este estudio consistió en relacionar la discrepancia maxilo-mandibular en sentido transversal con las inclinaciones bucolinguales de los primeros molares permanentes maxilares y mandibulares en una población con edades entre 10 y 16 años, por medio de tomografías computarizadas de haz de cono (CBCT). Métodos: la muestra estuvo conformada por 18 tomografías de pacientes seleccionados a conveniencia, previa autorización del centro radiográfico y con el aval del Comité de Bioética de la Universidad Autónoma de Manizales (Acta N.º 51 de 2015). Se midió la distancia transversal mandibular y maxilar, se calculó la discrepancia y se correlacionó con la inclinación bucolingual de primeros molares permanentes. Resultados: la distancia transversal mandibular en promedio fue mayor que la distancia transversal maxilar (p < 0,05). Los molares inferiores tuvieron mayor grado de inclinación en promedio que los molares superiores. El promedio del índice de discrepancia fue 1,86 mm (IC 0,90 mm-2,82 mm). El análisis agrupado por tipo de discrepancia mostró correlaciones significativas entre la discrepancia maxilar positiva (> 5º) y la inclinación de los molares (p < 0.05). En cuanto a los pacientes con discrepancia maxilar negativa (< 5º), también hubo correlación moderada. Conclusión: la discrepancia maxilomandibular en sentido transversal está relacionada con la inclinación bucolingual de los primeros molares permanentes maxilares y mandibulares en dos formas diferentes según el tipo de discrepancia, ya sea positiva o negativa. La respuesta maxilar es un proceso que requiere más estudios para entender el momento y la magnitud de la adaptación.

Establishment of first mandibular molar development of the time sequence in ICR mice / 中国比较医学杂志

Objective This study aims to understand the characteristics of the time sequence of ICR mouse first mandibular molar tooth germ development through dynamic observation.Methods Tooth germ of Embryos (E11.5,E12.5,E13.5,E14.5,E15.5,E16.5,E17.5 and E18.5) and postnatal (PN1,PN2) mice were obtained.The heads (E11.5-E15.5) and mandibles (E16.5-PN2) of mice were dissected,fixed and embedded for serial sections and HE staining.All the results were assessed under light microscopy.Results The tooth germ underwent various development stages including the bud,cap and bell stages.Mouse odontogenesis was initiated at E11.5.Proliferation of oral epithelium formed the bud stage at E13.5.Then the cap stage was observed at E14.5-E15.5 and the bell stage was appeared beginning from E16.5.The pre-dentin was observed at PN1,as well as the dentin at PN2.Conclusions Establishing the regular development pattern of the first mandibular molar of ICR mice will provide a reliable basis for the future use in the specific tooth germ developmental research.

O emprego de mini-implantes para intrusão do molar inferior / The use of mini-implants for mandibular molar intrusion

O aumento no número de pacientes adultos na clínica ortodôntica faz com que o profissional se depare com más oclusões causadas pela perda de um ou mais elementos dentários. Frequentemente são observadas extrusões de dentes antagonistas impossibilitando total ou parcialmente a reabilitação protética da região. A utilização de dispositivos de ancoragem temporária fixa abrange diversas mecânicas. O objetivo deste trabalho é descrever um caso clínico de uma paciente adulta, com necessidade de reabilitação protética e extrusão do elemento 46, devido à perda de seu antagonista, em que foi realizada a intrusão por meio de dois mini-implantes com resultados bastante satisfatórios. (AU)

Due to the increasing number of adult patients searching for orthodontic treatment the professional faces several malocclusions caused by the loss of one or more dental elements. Extrusions of antagonist teeth are often observed hindering total or partially the prosthetic rehabilitation of the region. The use of fixed temporary anchorage devices includes various mechanics. The objective of this work is to describe a clinical case of an adult patient, requiring prosthetic rehabilitation and extrusion of the element 46 due to the loss of its antagonist, in which the intrusion was performed using two mini-implants with very satisfactory results. (AU)

Avaliação da mineralização dos segundos molares inferiores como parâmetro para a classificação da idade biológica / Evaluation of the mineralization of permanent second molars as a parameter to classify the biological age of the individual

O presente trabalho teve como objetivo avaliar se a mineralização dos segundos molares inferiores permanentes pode ser usado como parâmetro para classificar a idade biológica do indivíduo. A amostra foi constituída por 129 radiografias panorâmicas, sendo 71 indivíduos do sexo feminino e 58 indivíduos do sexo masculino, na faixa etária de 7 anos à 12 anos e 1 mês. Para a análise da mineralização dental foi utilizada a tabela proposta por Nolla (1960). Os resultados da análise foram documentados numa planilha do programa Microsoft Excel 2010 contendo o nome completo, data de nascimento, data da tomada radiográfica, idade em anos e meses, número do prontuário, estágio de Nolla (1960) lado direito e lado esquerdo. Foi realizada a análise estatística (Mann-Whitney, Wilcoxon e correlação de Spearman) e pôde-se concluir que na amostra estudada não foi encontrado dimorfismo sexual, que a mineralização dentária ocorre de forma similar do lado direito e esquerdo, e que a mineralização dos segundos molares inferiores permanentes podem ser usadas como parâmetro para estimar a idade biológica e cronológica de um indivíduo.(AU)

This paper aimed to evaluate if the mineralization of permanent second molars can be used as a parameter to classify the biological age of the individual. The sample was composed of 129 panoramic radiographs, being 71 females and 58 males, aged 7 years and 12 years and 1 month. For the analysis of dental mineralization it was used a table proposed by Nolla (1960) with X-rays on the negatoscope (light box). The analysis results were documented in a Excel spreadsheet containing the full name, date of birth, date of the radiographic procedure, age in years and months, medical record number, stage of Nolla (1960) right and left side. Performed a statistical analysis, we concluded in our survey that the tooth mineralization occurs similarly in the right and left side, there is a certain precocity when compared to chronological age and the stage of mineralization in females compared to males. We also conclude that within the same chronological age, girls and boys have different mineralization stages, indicating that the dental mineralization can be used to identify the biological age, and the same is poorly correlated with chronological age.(AU)

Use of miniplates as a method for orthodontic anchorage: a case report

ABSTRACT Introduction: Temporary anchorage devices (TADs) have been developed to be used as direct adjuncts in orthodontic treatment and have facilitated treatment of more complex orthodontic cases, including patients with dental impaction. Objectives: This clinical case reports the applicability of TADs in the orthodontic treatment of a patient with impacted mandibular second molars. Surgical and orthodontic procedures related to the use of miniplates were also discussed in this study. Conclusions: The use of temporary anchorage devices, such as miniplates, can be suggested as an alternative to treat patients with impacted mandibular second molars.

RESUMO Introdução: os dispositivos de ancoragem temporária vêm sendo desenvolvidos para uso como coadjuvantes no tratamento ortodôntico. Esses dispositivos facilitam o tratamento ortodôntico de casos mais complexos, incluindo pacientes com dentes impactados. Objetivos: o presente relato de caso reporta a aplicabilidade dos dispositivos de ancoragem temporária no tratamento ortodôntico de um paciente com segundos molares inferiores impactados. Os procedimentos cirúrgicos e ortodônticos relacionados ao uso das miniplacas também são discutidos nesse estudo. Conclusões: o uso de dispositivos de ancoragem temporária, tais como as miniplacas, pode ser sugerido como uma alternativa no tratamento de pacientes com segundos molares inferiores impactados.

Association between maxillary sinus pathologies and healthy teeth / Relação entre doenças no seio maxilar e dentes hígidos

ABSTRACT INTRODUCTION: The proximity of the roots to the maxillary sinus can create a variety of risks. OBJECTIVE: To evaluate the relationship between the roots of healthy teeth and the maxillary sinus, as well as the occurrence of sinus pathologies. METHODS: Three radiologists analyzed 109 cone beam computed tomography (CBCT) images. The Kappa test was used to assess the intra- and inter-rater agreement. The chi-squared test and prevalence ratio were used to test the hypothesis that roots of healthy teeth in the maxillary sinus favored the occurrence of sinus pathologies ( p = 0.01). RESULTS: Intra- and inter-rater agreement ranged from good to excellent. The chi-squared test demonstrated a statistically significant difference ( p = 0.006) between the tooth roots in diseased maxillary sinuses (6.09%) and those in normal sinuses (3.43%). The prevalence ratio test showed a statistically significant higher prevalence of tooth roots in diseased sinuses than in normal sinuses ( p < 0.0001). Roots in the maxillary sinus were 1.82 times more associated with diseased sinuses. CONCLUSION: Dental roots in the maxillary sinus are almost twice as likely to be associated with diseased sinuses than normal sinuses. Healthy teeth whose roots are inside the maxillary sinus may induce an inflammatory response in the sinus membrane. It is suspected that dental procedures may exacerbate the condition.

RESUMO INTRODUÇÃO: A proximidade das raízes com o seio maxilar pode criar uma variedade de riscos. OBJETIVO: Avaliar a relação entre as raízes dos dentes hígidos com o seio maxilar, assim como com a ocorrência de doenças sinusais. MÉTODO: Três radiologistas analisaram 109 imagens de tomografia computadorizada de feixe cônico (TCFC). O teste Kappa avaliou a concordância intra e interexaminadores. Os testes de Qui-quadrado e Razão de Prevalência foram utilizados para testar a hipótese de que raízes de dentes hígidos dentro do seio maxilar favorecem a ocorrência doenças sinusais (nível de significância = 0,01). RESULTADOS: A concordância intra e interexaminadores variou de boa a excelente. O teste Qui-quadrado mostrou uma diferença estatisticamente significante (p = 0,006) entre as raízes dentárias dentro do seio maxilar patológico (6,09%) e aquelas dentro do seio normal (3,43%). O teste de Razão de Prevalência mostrou uma ocorrência de raízes dentárias dentro de seios patológicos estatisticamente maior do que dentro de seios normais (p < 0,0001). As raízes dentro do seio maxilar foram encontradas 1,82 vezes mais associadas a seios patológicos. CONCLUSÃO: Raízes dentárias dentro do seio maxilar são quase duas vezes mais associadas a seios patológicos do que a seios normais. Dentes hígidos que têm raízes dentro do seio maxilar podem induzir uma resposta inflamatória da mucosa sinusal. Suspeita-se que procedimentos odontológicos possam agravar tal situação.

A study on the incidence of retromolar foramen in South Indian adult dried human mandibles and its clinical relevance.

Background: The retromolar foramen is one of the most important non-metrical anatomical variants in the mandible. The present study describes the incidence of retromolar foramen in South Indian adult dried mandibles and its clinical relevance. Methods: One hundred South Indian adult dried mandibles of unknown sex were studied at the Department of Anatomy, MVJ Medical College, Bangalore for the presence of retromolar foramen. Its location, size, shape, distance of the foramen if present from the posterior border of socket for 3rd molar tooth, anterior border of ramus of the mandible were measured. Results: Retromolar foramen was present in 16 (16%) of the mandibles. Out of the 16 mandibles, it was present bilaterally in 3 (3%) mandibles and unilaterally in 13 (13%) mandibles (In 3 (3%) on the right side and in 10 (10%) on the left side). The mean diameter of the foramen was 1.33mm (range - 1.10-1.92 mm). It was oval in shape in 9 (9%) and rounded in shape in 7 (7%) mandibles. The mean distance of retromolar foramen from the posterior border of socket for 3rd molar tooth and anterior border of ramus were 6.15 mm (2.23-12.10) and 8.02 mm (3.24-13.12) respectively. Conclusions: The knowledge about the incidence of the retromolar foramen is important for dental surgeons during various anaesthetic, implantation and surgical procedures of the mandible, especially during extraction of the lower last molar tooth.

A Case of Joubert Syndrome Accompanied with Retinal Abnormality

PURPOSE: Joubert syndrome is a rare disorder which affects the cerebellum and the brain stem. Herein, we report a case of Joubert syndrome accompanied with retinal abnormality. CASE SUMMARY: A 9-year-old female visited our hospital with chief complaints of low vision in both eyes, nystagmus, and lack of gaze movement. The best-corrected visual acuity in her right eye was 20/80 and in the left 20/80 and heterotropia was not observed. She appeared to have incomplete total color blindness on the color vision test. The anterior segment test showed no abnormal findings other than diffuse pigmentation and degeneration of the peripheral retina, vascular attenuation, and pale optic disc in both eyes on fundus examination. The patient showed overall developmental delay and decreased muscle tension, but genetic and congenital metabolic disease tests were normal. The molar tooth sign of the midbrain, defect in the lower part of the cerebellum and dilatation of the fourth ventricle were observed on magnetic resonance imaging. CONCLUSIONS: Appropriate evaluation of retinitis pigmentosa and visual function should be performed in Joubert syndrome patients.