Quiste dentígero en relación con tercer molar inferior retenido / A Dentigerous Cyst Related to Retained Lower Third Molar

Introducción: El quiste dentígero es un quiste odontogénico, casi siempre asociado a la corona de un diente retenido. Sus ubicaciones más frecuentes son la zona de tercer molar inferior y canino superior. Objetivo: Caracterizar la presentación de un quiste dentígero en un paciente adulto. Presentación de caso: Se presentó el caso de una paciente de 27 años de edad que acude a consulta por presentar sensación de opresión, dolor e inflamación en región de tercer molar inferior izquierdo. Al examen oral se observa tejido dentario en correspondencia con molar 38 parcialmente brotado con ligero edema de la mucosa a su alrededor. En radiografía panorámica se observa imagen radiolúcida en relación con cara mesial del 38 con discreto halo radiopaco, redondeada, compatible con un quiste dentígero. Conclusiones: Un diagnóstico a tiempo de estas lesiones constituye la clave para un tratamiento exitoso y menos invasivo, lo cual evitaría complicaciones mayores como la malignización, el crecimiento exagerado que puede ocasionar deformidad facial y la disfunción masticatoria permanente(AU)

Introduction: Dentigerous cyst is an odontogenic cyst, almost always associated with the crown of a retained tooth. Its most frequent locations are the areas of the lower third molar and the upper canine. Objective: To characterize the presentation of a dentigerous cyst in an adult patient. Case presentation: The case is presented of a 27-year-old female patient who came to the clinic with a sensation of pressure, pain and inflammation in the region of the lower left third molar. Oral examination permits to observe some dental tissue corresponding with molar 38 partially erupted with slight edema of the surrounding mucosa. Panoramic radiograph shows a radiolucent image related to the mesial side of 38, with a discrete radiopaque halo, rounded, compatible with a dentigerous cyst. Conclusions: A timely diagnosis of these lesions is the key to a successful and less invasive treatment, which would avoid major complications, such as malignization, the exaggerated growth that can cause facial deformity and permanent masticatory dysfunction(AU)

Aspectos descriptivos del odontoma: revisión de la literatura / Descriptive aspects of odontoma: literature review

Resumen: Los odontomas corresponden a los tumores odontogénicos más comunes (35-76%). Es un tumor benigno originado a partir de una alteración de células odontogénicas epiteliales y mesenquimatosas diferenciadas con capacidad de formar esmalte, dentina y cemento. Se clasifican en compuestos y complejos en una relación de 2:1, siendo la diferencia entre ambos la organización del tejido dentario. La etiología es desconocida pero se ha explorado la ocasión a infecciones, anomalías hereditarias, hiperactividad odontoblástica y traumatismos. El 75% de los casos se diagnostican antes de la segunda década de vida debido a un retraso en la erupción dental permanente, ya que son asintomáticos. El tratamiento es la enucleación tratando de conservar el diente permanente, siendo las recidivas poco frecuentes.

Abstract: Odontoma is the most commonly found odontogenic tumor (3576%). Odontoma is a benign tumor originating from an alteration of differentiated mesenchymal and epithelial odontogenic cells; it has the capacity of forming enamel, dentin and cement. They are classifi ed into compound and complex, in a 2:1 relationship, the difference between both being dental tissue organization. Etiology is still unknown but relation to infections, hereditary anomalies, odontoblastic hyperactivity and trauma has been explored. Since these tumors are asymptomatic, 75% of all cases are diagnosed before the second decade of life, due to a delay in eruption of permanent teeth. Treatment of choice for these tumors is enucleation, attempting to preserve the tooth; relapse is very uncommon.

Electromyographic study of the masseter muscle after low-level laser therapy in patients undergoing extraction of retained lower third molars / Estudio electromiográfico del músculo masetero tras terapia con láser de baja intensidad en pacientes sometidos a extracción de tercer molar mandibular retenido

The surgery for extraction of the retained lower third molar is one of the most commonly performed procedures in the field of maxillofacial surgery. During this procedure, the surgical trauma can cause damage to the function of muscles involved in mandibular movements, such as the masseter muscle. In order to accelerate post-surgical recovery, many physiotherapy resources are employed, including laser therapy. The aim was to analyze the electrical activity of the masseter muscle treated with Low-level Laser (LLL) after surgical trauma. Assessments of masseter muscle on a sample of 60 patients were performed by surface electromyography in four instances: immediate preoperative, postoperative at 7, 14 and 21 days. The patients were divided into two groups: 1- untreated group with LLL in the postoperative; 2- group treated with LLL (810 nm; 10 J/cm2) in the immediate postoperative and at 3, 6 and 9 days after surgery. On the seventh day after surgery 23.3 % of the patients in the group receiving LLL showed recovery of their muscle activity as they presented in the immediate preoperative, versus only 3.3 % of the untreated group. On the 14th day, 73.3% of treated patients showed functional rehabilitation, versus 6.7% in the untreated group, and on the 21st, 80% versus 10% in the untreated group. On the 14th postoperative day the electrical activity of the masseter muscle treated with LLL after surgical trauma was compatible with a condition of complete functional recovery. The findings of this electromyographic study indicated that LLL proved to be an efficient physiotherapeutic method for stimulating the masseter muscle functional recovery after surgery of retained lower third molars.

La cirugía para extracción del tercer molar mandibular retenido es uno de los procedimientos más realizados en el campo de la cirugía maxilofacial. Durante este procedimiento, el trauma quirúrgico puede causar daño a la función de los músculos involucrados en los movimientos mandibulares, entre ellos el músculo masetero. Con el objetivo de acelerar la recuperación postoperatoria, son utilizados muchos recursos de fisioterapia, incluyendo la terapia con láser. El objetivo de este estudio fue analizar la actividad eléctrica del músculo masetero tratado con láser de baja intensidad (LBI) después del trauma quirúrgico. Se realizaron evaluaciones del músculo masetero en una muestra de 60 pacientes, a través de electromiografía de superficie en cuatro momentos: preoperatorio inmediato, postoperatorio a los 7, 14 y 21 días. Los pacientes fueron divididos en dos grupos: 1 - grupo no tratado con LBI en el postoperatorio; 2 - grupo tratado con LBI (810 nm; 10 J/cm2) en el postoperatorio inmediato y a los 3, 6 y 9 días tras cirugía. Al séptimo día tras cirugía el 23,3 % de los pacientes del grupo tratado con LBI presentaron recuperación de su actividad muscular equivalente a lo presentado en el preoperatorio inmediato, frente a sólo el 3,3 % del grupo no tratado. En el día 14, el 73,3% de los pacientes tratados presentaron rehabilitación funcional, frente al 6,7% del grupo no tratado y en el vigésimo primer día, el 80% frente al 10% del grupo no tratado. En el dia 14 postoperatorio la actividad eléctrica del músculo masetero tratado con LBI después del trauma quirúrgico fue compatible con una condición de recuperación funcional completa. Los hallazgos de este estudio electromiográfico indicaron que el LBI es un eficiente método fisioterápico para estimular la recuperación funcional del músculo masetero tras cirugía de terceros molares mandibulares retenidos.

Presentación de un paciente geriátrico con retención de tercer molar mandibular / Presentation of a Geriatric Patient with Third Molar Retention

Se presentó un paciente masculino de 80 años de edad con retención del tercer molar inferior, que acudió a cuerpo de guardia con cuadro inflamatorio subagudo y dolor de moderada intensidad. El examen radiográfico evidenció la presencia del tercer molar inferior retenido en posición horizontal, el cual presentaba en su corona área radiolúcida compatible con caries dental. El paciente fue tratado con antibiótico, analgésico y antiinflamatorio y una vez rebasada la fase aguda fue intervenido quirúrgicamente con excelente evolución.

A 80-year-old male patient with retention of third lower molar that was admitted at Emergency Service with inflammatory sub-acute status and pain of moderated intensity is presented. The radiographic exam evidenced the presence of the third molar retained at horizontal position, which presented in its crown, a dark area compatible with dental cavity. The patient was treated with antibiotic, analgesic and anti-inflammatory and when acute phase was over, the third molar was extracted. The surgery was completed without complications with an excellent evolution.

Análise radiográfica da prevalência de terceiros molares retidos efetuada na clínica de odontologia do Centro Universitário Positivo / Radiographic analysis of prevalence of impacted third molars in the odontological office of the university - Centro Universitário Positivo

A ocorrência de terceiros molars retidos é comum, e uma análise criteriosa torna-se necessária para uma adequada conduta clínica, sendo o exame radiográfico fundamental. A retenção dentária é um problema cada vez mais frequente em consultórios odontológicos. Em termos estatísticos, o maior volume dessas retenções fica por conta dos terceiros molares. A prevalência de terceiros molares retidos foi analisada por meio de exames radiográficos em panorâmicas. Os autores avaliaram a distribuição dos terceiros molares retidos em 221 radiografias panorâmicas, levando em consideração dados pessoais como sexo e idade, retirados dos prontuários clínicos dos pacientes. Os dados obtidos em relação ao posicionamento dos terceiros molares basearam-se nas classificações de Winter, Pell e Gregory. Os resultados mostram que a retenção dos terceiros molares inferiores é mais recorrente do que a dos superiores, a posição distoangular foi a de maior prevalência, as posições C e classe III apresentaram mais frequência e o sexo feminino mostrou-se predominante. Assim, conclui-se que a avaliação pré-operatória baseada nas classificações existentes e nos exames complementares é de fundamental importância no diagnóstico e planejamento cirúrgico

The occurrence of impacted third molars is a common situation in dental offices, consequently, a critical analysis is imperative for a correct diagnosis and treatment plan. Concerning this approach, the panoramic x-ray is of fundamental importance during the planning process. In this study, the prevalence of impacted third molars was analyzed through 221 panoramic x-rays and a proper form was fulfilled with age and sex of each patient. The data obtained from the third molars was classified according to Winter, Pell and Gregory. The results showed the lower third molars and a higher frequency of impactation than the upper ones; female sex had a prevalence of a 3:1 ratio. Concerning Winter's classification the disto-angular position was more prevalent, and related to Pell and Gregory, the position C and class III were the most frequent situations. Thus, the pre-operative assessment, based on the existing classifications and on the radiological exams is of fundamental importance for a correct diagnosis and treatment plan