Clinical application of open vertical helical loop in the treatment of ectopic eruption of first permanent molar / 中国医师杂志

Objective:To explore the clinical application effect of open vertical helical loop to correct ectopic eruption of the first permanent molar, and to provide reference for the selection of treatment timing and methods for ectopic eruption of the first permanent molar.Methods:A total of 30 patients with unilateral or bilateral ectopic eruption of maxillary first permanent molars, aged from 7 to 8.5 years old, who visited the Affiliated Hospital of Jining Medical University from 2020 to 2021, were retrospectively selected. The first permanent molars were moved to their normal positions by bonding buccal tubes between the second primary molars and the first permanent molars with a vertical loop. We compared and analyzed the mesial inclination angle of the first permanent molar, the length of the lateral dental arch, and the root resorption status of the second deciduous molar before and after treatment.Results:All 30 patients underwent complete orthodontic treatment, with the first permanent molar adjusted to its normal position. The inclination angle of the first permanent molar after treatment was (91.3±5.1)°, which was statistically significant compared to (78.1±6.3) ° before treatment ( t=-10.023, P=0.014); The length of the lateral dental arch after treatment was (34.0±1.0)mm, which was significantly increased compared to (31.61±1.1)mm before treatment, and the difference was statistically significant ( t=-25.96, P=0.007). After treatment, the degree of root resorption of the affected second molar significantly increased compared to that before treatment (χ 2=12.002, P<0.001); There was no statistically significant change in root resorption before and after treatment of the healthy second molar ( P=0.818). Conclusions:The use of open vertical helical loop correction for ectopic eruption of maxillary first permanent molar can effectively adjust the mesial inclination angle of patients with ectopic eruption of maxillary first permanent molar. However, close attention should be paid to the root resorption of the second primary molar, and early detection and treatment should be carried out in clinical practice. If the root resorption of the second primary molar is severe after treatment, a retainer should be made in a timely manner to maintain the arch length.

Terceiro Molar Ectópico em Incisura Mandibular / Ectopic Third Molar in the Mandibular Notch

Dentes ectópicos são frequentemente encontrados, entretanto, terceiros molares inferiores ectópicos são inco-muns, com etiologia obscura e pouco descritos na literatura pertinente. Sua localização já foi relatada nas regiões condilar, subcondilar, incisura mandibular, ângulo e borda inferior da mandíbula. Devido à importância do plane-jamento terapêutico, manejo adequado e variedade das manifestações clínicas desta condição, este trabalho teve como objetivo relatar um caso clínico de terceiro molar inferior ectópico na região de incisura mandibular, com radiolucência aumentada ao redor da coroa, em um paciente do gênero masculino, de 28 anos e sem sintomato-logia. Acompanhamento radiográfico pode ser indicado, no entanto, em pacientes sintomáticos ou com alterações patológicas associadas, a extração deve ser considerada. Diante disso, o tratamento de escolha foi a extração do dente 38 sob anestesia geral, por via intraoral, tendo em vista a posição dentária, radiolucência e morbidade as-sociada à cirurgia. O tecido mole circundante foi enviado para análise anatomopatológica. O paciente evoluiu sem intercorrências durante avaliação pós-operatória (AU)

Ectopic teeth are frequently found, however, ectopic lower third molars are uncommon, with obscure etiology and little described in the pertinent literature. Its location has been reported in the condylar, subcondylar, mandibular notch, angle and lower edge of the mandible. Due to the importance of therapeutic planning, adequate manage-ment and variety of clinical manifestations of this condition, this study aimed to report a clinical case of an ectopic lower third molar in the region of the mandibular notch, with increased radiolucency around the crown, in a male gender pacient, 28 years old and without symptoms. Radiographic follow-up may be indicated, however, in symp-tomatic patients or patients with associated pathological changes, extraction should be considered. Therefore, the treatment of choice was the extraction of tooth 38 under general anesthesia, intraorally approach, considering the dental position, radiolucency and morbidity associated with the surgery. The surrounding soft tissue was sent for anatomopathological analysis. The patient evolved uneventfully during the postoperative evaluation (AU)

Eficiência dos tratamentos interceptivos na irrupção espontânea de caninos com desvio de irrupção / Interceptive treatments efficiency on the eruption of displaced canine

Estudos prévios relataram os benefícios da interceptação dos desvios irruptivos de caninos superiores com uso de procedimentos isolados. O objetivo dessa pesquisa foi investigar os resultados de combinações de procedimentos interceptores para tratamento de caninos desviados, como extração supervisionada de dentes decíduos (EDD), expansão rápida da maxila (ERM) e distalização de dentes posteriores superiores para ganho de espaço no arco (GE), para evitar a exposição cirúrgica e tração ortodôntica desses dentes. Avaliou-se 114 caninos com desvio de irrupção submetidos a tratamentos interceptores. Radiografias panorâmicas realizadas antes (T0) e após (T1) o tratamento foram estudadas. Em T0, caninos permanentes superiores foram considerados com desvio de irrupção quando sua inclinação em relação à linha média excedia 25°, a posição da coroa estava localizada pelo menos no setor 1 (entre o centro do longo eixo e a face distal da raiz do incisivo lateral) ou a radiografia final mostrasse impacção do canino. Em T1, a irrupção espontânea do canino foi considerada como sucesso do tratamento. Teste t para amostras independentes foi utilizado para comparação entre os grupos. Utilizou-se teste Mann-Whitney para avaliação de diferenças de setor e correlação de Spearman para relacionar setor e inclinações iniciais e finais com a taxa de sucesso. A taxa de sucesso na irrupção de caninos superiores foi de 90,4%. Apenas 11 caninos não irromperam após o tratamento. Concluiu-se que a combinação de tratamentos interceptores promoveram mudanças favoráveis na angulação e setor de caninos superiores desviados. A irrupção espontânea do canino aconteceu em grande parte da amostra (AU)

Previous investigations have reported the benefit of isolated interceptive measures in the early treatment of displaced maxillary canines. The purpose of this study was to investigate whether the combination of several clinical approaches, such as supervised primary teeth extraction (PTE), transverse maxillary arch enlargement by means of rapid maxillary expansion (RME); and distalization of maxillary posterior teeth as space gainer (SG) resulted in an improvement of permanent canine position, preventing a surgical procedure. The sample comprised 114 displaced permanent maxillary canines that underwent interceptive treatment.Panoramic radiographs taken before (T0) and after (T1) orthodontic treatment were examined. Canine was considered displaced when its inclination to a vertical line passing through the midline exceeded 25°, the crown position of the canine were located at least in sector 1 or the final radiography showed canine impaction. The full passive eruption of the previously impacted canines at T1 was considered as the success of the treatment. Independent T-test was used in the comparison between groups. Mann-Whitney test was used for evaluation of the differences of "sector" and Spearman´s correlation between the initial and final inclination and position of the permanent cuspid and the success rate. The success rate in the eruption of canines was 90.4%. Only 11 maxillary canines failed to passively erupt. Statistically significant changes in the position of impacted maxillary canines were observed after interceptive measures. Early interceptive treatment resulted in favorable changes in the maxillary canines angulation and irruptive sector. The success rate was 90,4% of this sample. (AU)

Cone beam computed tomography findings of ectopic mandibular third molar in the mandibular condyle: report of a case

Impaction of third molar is a common developmental abnormality. However, ectopic impaction of the mandibular third molar in condylar region is an extremely rare condition. This report describes a case of impacted tooth in the mandibular condyle without any associated pathologic condition. Also, this report presents the spatial relationship of the impacted mandibular third molar to the surrounding anatomic structures using cone beam computed tomography.

Space management during dentition development: a case report / Supervisão do espaço durante o desenvolvimento da dentição: relato de caso clínico

This case report describes a significant follow-up of a patient who had ectopic eruption. A 10-year-old child presenting a lower right second premolar with an eruption deviation was passively corrected. The 11 years follow-up showed the tooth with good root length, closed apex and functionally active. For proper positioning of the permanent tooth, the developmental phases of dentition as well as its eruption sequence, symmetry, and chronology were early observed by the practitioner. This unusual long-term follow-up case showed that space management during dentition development and opportune diagnosis can avoid more complicated orthodontic treatments in some cases.

Este caso clínico descreve um significativo acompanhamento de uma paciente com erupção ectópica. A paciente, com 10 anos de idade, apresentava o segundo pré-molar inferior direito com desvio de erupção, que foi passivamente corrigido. O acompanhamento de 11 anos do caso mostrou o dente com bom comprimento de raiz, ápice fechado e funcionalmente ativo. Para o correto posicionamento do dente permanente, as fases de desenvolvimento da dentição, assim como a sequência de erupção, simetria e cronologia foram observadas desde o início pelo profissional. Este interessante caso com acompanhamento em longo prazo demonstrou que a supervisão de espaço durante desenvolvimento da dentição e o diagnóstico oportuno podem evitar tratamentos ortodônticos mais complicados em alguns casos.