Clinical and socio-demographic factors associated with dental extractions in a clinical sample

Abstract The objective of the present study was to identify the reasons for dental extractions in patients seeking dental care in a university dental clinic in Mexico. This is a cross-sectional study that assessed 284 consecutive patients at the School of Dentistry, Autonomous University of the State of Mexico between August 2017 and November 2018. In total, 505 extractions were performed. The dependent variable was the reason for extraction: 0) dental caries and ensuing sequels (reference category); 1) periodontal disease and ensuing sequels; and 2) other reasons. Sociodemographic, socioeconomic, and clinical variables were included as independent variables. The analysis was done with multinomial logistic regression (Stata 14.0). Out of all extractions, 63.6% (n=321) were due to dental caries and ensuing sequels; 22.0% (n=111) were due to periodontal disease and ensuing sequels; 5.3% (n=27) endodontic failure; 5.1% (n=26) prosthetic indications; 1.6% (n=8) orthodontic indications; and the rest (2.4%) were due to other reasons. In the multivariate model extractions due to periodontal disease vs dental caries were associated with occasionally smoking tobacco (Odds Ratio, OR=3.90) or daily tobacco use (OR=3.19); the tooth to be extracted having been previously restored (OR=2.35); extracted anterior as opposed to posterior teeth (OR =2.63); and patients with multiple extractions (OR=2.68). In the case of extractions due to "other reasons", no variable was significant. Dental caries and periodontal disease were the main reasons for dental extraction in this sample. Several variables, mostly clinical, were associated with extractions for periodontal reasons.

Resumo O objetivo do presente estudo foi identificar os motivos das extrações dentárias em pacientes que procuram atendimento odontológico em uma clínica odontológica universitária no México. Este é um estudo transversal que avaliou 284 pacientes consecutivos na Faculdade de Odontologia da Universidad Autónoma del Estado de México entre agosto de 2017 e novembro de 2018. No total, foram realizadas 505 extrações. A variável dependente foi o motivo da extração: 0) cárie dentária e sequelas subsequentes (categoria de referência); 1) doença periodontal e sequelas subsequentes; e 2) outros motivos. Variáveis sociodemográficas, socioeconômicas e clínicas foram incluídas como variáveis independentes. A análise foi feita com regressão logística multinomial (Stata 14.0). De todas as extrações, 63,6% (n=321) foram devidas a cárie dentária e sequelas subsequentes; 22,0% (n=111) foram devidas a doença periodontal e sequelas subsequentes; 5,3% (n=27) a insucesso endodôntico; 5,1% (n=26) a indicações protéticas; 1,6% (n=8) a indicações ortodônticas; e o restante (2,4%) foi devido a outros motivos. No modelo multivariado, as extrações por doença periodontal vs. cárie dentária foram associadas ao tabagismo ocasional (Odds Ratio, OR=3,90) ou ao uso diário de tabaco (OR=3,19); ao fato de o dente a ser extraído ter sido restaurado anteriormente (OR=2,35); à extração de dentes anteriores em vez de posteriores (OR=2,63); e a pacientes com extrações múltiplas (OR=2,68). No caso de extrações devido a "outros motivos", nenhuma variável foi significativa. A cárie dentária e a doença periodontal foram os principais motivos de extração dentária nessa amostra. Diversas variáveis, principalmente clínicas, foram associadas às extrações por motivos periodontais.

Demographic Profile of Patients Undergoing Orthodontic Extractions- An Institution Based Cross Sectional Study

Background: Extraction in Orthodontics has always been a topic of debate and is one of the controversies in Orthodontics. There are numerous studies available regarding the frequency of Orthodontic extraction in clinics, but very less such institution borne studies have been reported. It is important to have demographic data on the prevalence of extraction. The present study was aimed to determine the epidemiological data regarding the prevalence of extraction in Orthodontic patients with respect to various demographic features.Material & Methods:This cross sectional study was done over a period of five months prospectively. Prevalence of Orthodontic extractions was obtained with regard to Gender, Age group, Education level. Various Orthodontic extraction patterns and overall extraction frequencies in relation to malocclusions was evaluated. Chi-square test was used to determine correlations between variables, Shaperio?Wilk W test and independent ‘t’ test was used for comparison between two groups.Results:Majority of the patients reporting for Orthodontic Extraction were females (65.1%).. Most of the patients belonged to ?19 age group, with higher secondary education level and belonging to urban area. The most commonly extracted tooth for Orthodontic treatment was premolar and the most common extraction pattern was all first premolars which was seen in Class I malocclusion. Females underwent more Orthodontic extractions.Conclusion:The data from this study is a dental tertiary institution borne data and reveals the frequency of Orthodontic patients indicated and reporting for extraction. The epidemiologic data from this study has given a comparison of extraction rates among gender, age, education level, residence and provides an insight about the most commonly extracted tooth and extraction pattern in orthodontic patients with various malocclusions. This study revealed a more trend towards all four premolar extraction. Prevalence of Orthodontic extraction was more among females (65.1%). The mean rate of extraction was found to be 4.14 with standard deviation of 1.04.

Very early orthodontic treatment: when, why and how?

ABSTRACT Introduction: Several orthodontic problems should already be treated at an early age to prevent the necessity of future complex and expensive procedures. Scientific evidence suggests that posterior crossbites, mild to moderate Class III, as well as certain Class II malocclusions, open bites and arch length discrepancies can benefit from simple, but efficient interceptive therapy. Objective: To summarize the existing evidence-based literature on early orthodontic treatment, and to illustrate its application and effectiveness by showcasing multiple clinical examples. Conclusion: Early short-term interceptive orthodontic treatment with simple appliances, in the deciduous or early mixed dentition phase, can efficiently correct certain malocclusions and help to either reduce the complexity or even avoid the necessity of complex and expensive procedures during puberty. For certain patients with significant arch length discrepancy the concept of serial extractions should be part of the orthodontic armamentarium.

RESUMO Introdução: Vários problemas ortodônticos devem ser tratados já em idade precoce, para evitar a necessidade de procedimentos futuros de maior complexidade e custo. A evidência científica sugere que as seguintes más oclusões podem se beneficiar de terapias interceptivas simples mas eficientes: mordidas cruzadas posteriores, Classe III leve a moderada, certas más oclusões de Classe II, mordidas abertas e discrepâncias no tamanho das arcadas. Objetivo: Resumir a evidência científica existente sobre o tratamento ortodôntico precoce e ilustrar sua aplicação e efetividade, por meio da exposição de múltiplos casos clínicos. Conclusão: O tratamento ortodôntico interceptivo precoce de curto prazo com aparelhos simples na fase da dentição decídua ou início da dentição mista pode corrigir eficientemente certas más oclusões e ajudar a reduzir a complexidade ou, até mesmo, evitar a necessidade de procedimentos complexos e onerosos durante a puberdade. Para certos pacientes com discrepância significativa no comprimento das arcadas, o conceito de extrações seriadas deve fazer parte do arsenal de recursos ortodônticos.

Treatment of adult patient with hyperdivergent retrognathic phenotype and anterior open bite: report of a case with non-surgical orthodontic approach

ABSTRACT Adult patients with anterior open bite and hyperdivergent retrognathic phenotype demand complex treatments, as premolar extractions, molar intrusion or orthognathic surgery. In the present clinical case, a young adult patient without significant growth, with Class I and anterior open bite, was treated with four premolar extractions. The therapeutic result shows good intercuspation, good facial esthetic, good function balance, and stability in a two-year post-fixed treatment follow-up.

RESUMO Pacientes adultos com mordida aberta anterior e fenótipo hiperdivergente retrognata demandam tratamentos complexos, com extrações de pré-molares, intrusão de molares ou cirurgia ortognática. No presente caso clínico, uma jovem adulta sem potencial significativo de crescimento, apresentando Classe I e mordida aberta anterior, foi tratada com extrações de quatro primeiros pré-molares. O resultado terapêutico alcançou boa intercuspidação, boa estética facial e bom equilíbrio funcional, e mostrou-se estável depois de dois anos da remoção do aparelho fixo.

Characteristics and Dental Treatments of Children under General Anaesthesia

@#The goal of this retrospective study was to determine the types of dental treatments provided to paediatric patients under general anaesthesia (GA) at the Advanced Medical and Dental Institute, Universiti Sains Malaysia, Pulau Pinang, Malaysia. Records of the 113 patients under 18 years old who had undergone dental treatment under GA from November 2015 to February 2019 were retrieved and reviewed. The median age for subjects was six years old and the data were skewed to the left. Subjects were diagnosed with early childhood caries (n = 94) where total oral rehabilitation was performed for most subjects (n = 82). Higher number of deciduous teeth were extracted (n = 488) with average number per person of 5.5 as compared to permanent teeth (n = 43) with 2.9 average number per person. The leading cause of surgical cases was removal of supernumerary and impacted teeth. Tooth colour restoration and stainless-steel crowns were commonly used in restorative procedures. Although most of the patients were in the American Society of Anaesthesiology categories I and II, treatments were performed under GA because complete oral rehabilitation was required. In conclusion, dental treatment under GA is essential for providing complete oral rehabilitation in young patients, especially those with early childhood caries or medical and behavioural problems.

Tendencia de actividades odontológicas realizadas en atención primaria del Servicio de Salud Valparaíso - San Antonio, chile: 2008 a 2018 / The evolution of dental services carried out in primary health care centers of the valparaíso - san antonio health service in chile: 2008-2018

INTRODUCCIÓN: La actual Política de Salud Bucal chilena indica que la atención odontológica está orientada a la promoción y prevención, reforzando la atención odontológica en Atención Primaria de Salud (APS). Se desconoce cómo esta política se ha materializado en el tiempo, pues, a la fecha, no existen estudios que analicen la tendencia de este tipo de actividades. El objetivo de este estudio fue analizar la tendencia de las actividades odontológicas, realizadas en adultos y adultos mayores, en APS del Servicio de Salud Valparaíso - San Antonio (SSVSA). MATERIAL Y MÉTODOS: Se realizó un estudio ecológico de tipo mixto entre los años 2008-2018, en 8 de las 9 comunas del SSVSA. Se analizó la tendencia del porcentaje de actividades promocionales-preventivas (APP) y de exodoncias utilizando las bases de datos "Resúmenes Estadísticos Mensuales-A09" (REM-A09). RESULTADOS: El 24,53% y 11,36% de las actividades realizadas correspondieron a APP y a exodoncias, respectivamente. El grupo de 20-64 años presentó un mayor porcentaje de APP y un menor porcentaje de exodoncias que el grupo de 65 y más años, en cada una de las comunas. Hubo una tendencia al aumento del porcentaje de APP y a la disminución del porcentaje de exodoncia en la mayoría de las comunas estudiadas. DISCUSIÓN: La tendencia de las actividades odontológicas realizadas en APS ha evolucionado a lo largo de los años, con diferencias entre comunas del SSVSA. Para poder determinar cuáles son los motivos que explican los resultados encontrados, se sugiere realizar otros estudios enfocados a la gestión odontológica local de APS. (AU)

BACKGROUND: The current Chilean Oral Health Policy indicates that dental care is aimed at promotion and prevention, thus reinforcing the presence of dental programs in Primary Health Care (PHC) Centers. It is unknown how this policy has materialized over time, since no studies to date have analyzed the trend of dental services carried out in PHC. The objective of this study was to analyze the evolution of dental services carried out in adults in PHC of the Valpa-raíso - San Antonio Health Service (VSAHS). MATERIALS AND METHODS: A mixed ecological study was carried out between 2008 and 2018, in 8 of the 9 municipalities of the VSAHS. The per-centage trends of promotional-preventive services (PPS) and extractions were analyzed, using the databases "Resúmenes Estadísticos Mensuales-A09" (REM-A09). RESULTS: The percentage of dental services dedicated to PPS and extractions were 24.53% and 11.36%, respectively. The group of adults between 20 and 64 years of age presented a higher percentage of PPS and a lower percentage of extractions than the 65 and over group in each municipality. There was also a trend of the percentage of PPS services increasing over time, while the percentage of extractions decreased in most of the municipalities studied. DISCUSSION: The type of den-tal services carried out in PHC has evolved over time, and differences were found between municipalities of the VSAHS. To explain these results, future studies should focus on the local management of dental services in PHC. (AU)

Efectividad analgésica del clonixinato de lisina asociado con el paracetamol en el tratamiento posoperatorio de exodoncias / Analgesic Effectiveness of Lysine Clonixinate Associated with Paracetamol in the Postoperative Treatment of Exodontias / Efetividade analgésica do clonixinato de lisina associado ao paracetamol no tratamento pós-operatório de exodontias

Resumen Introducción : el uso de terapias analgésicas para controlar el dolor postexodoncia es muy variado y depende muchos factores. El objetivo de este estudio fue comparar la efectividad analgésica del paracetamol asociado con el clonixinato de lisina y compararlo con monoterapias de paracetamol e ibuprofeno en el tratamiento posoperatorio de exodoncias. Materiales y métodos : la muestra estuvo conformada por 39 pacientes distribuidos aleatoriamente en tres grupos. El dolor posoperatorio se midió utilizando la Escala Visual Análoga (EVA) 1 h, 8 h y 24 h postexodoncia. El análisis estadístico de la evolución de las tres terapias, se realizó empleando el test t de Student, ANOVA y test de Tuckey, con un nivel de significancia de p < 0.05. Resultados : los valores obtenidos demostraron que la combinación analgésica de paracetamol asociado con el clonixinato de lisina fue más efectiva 1 h y 8 h después. A las 24 h no existieron diferencias en los tres grupos de estudio. Conclusión : la analgesia de la terapia combinada de Paracetamol asociada con el Clonixinato de lisina es superior a la producida por la dosis estándar de Ibuprofeno y Paracetamol en el tratamiento del dolor posoperatorio de exodoncias simples.

Abstract Introduction : The use of analgesic therapies to control post-exodontia pain is very varied and depends on many factors. The study had two aims: to compare the analgesic effectiveness of paracetamol associated with lysine clonixinate and to compare it with monotherapies of paracetamol and ibuprofen in exodontias' postoperative treatment. Materials and methods : The sample consisted of 39 patients randomized into three groups. The postoperative pain was measured using the Visual Analogue Scale (VAS), at 1h, 8h, and 24h after exodontia. Statistical analysis of the evolution of the three therapies was performed using Student's t-test, ANOVA and Tuckey's test, with a level of significance of p <0.05. Results : The values obtained showed that the analgesic combination of paracetamol associated with clonixinate of lysine was more effective at 1h and 8h. At 24h, there were no differences in the three study groups. Conclusion : The analgesia of the combined therapy of paracetamol associated with clonixinate of lysine is superior to that produced by the standard dose of ibuprofen and paracetamol in the treatment of post-operation pain of simple extractions.

Resumo Introdução : o uso de terapias analgésicas para controlar a dor pós-exodontia é muito variada e depende de muitos fatores. O objetivo deste estudo foi comparar a efetividade analgésica do paracetamol associado ao clonixinato de lisina e compará-lo com monoterapias de paracetamol e ibuprofeno no tratamento pós-operatório de exodontias. Materiais e métodos : a amostra esteve conformada por 39 pacientes distribuídos aleatoriamente em três grupos. A dor pós-operatória mediu-se utilizando a Escala Visual Análoga (EVA) às 1 h, 8 h e 24 h pós-exodontia. A análise estatística da evolução das três terapias, se realizaram empregando o teste t de Student, ANOVA e teste de Tuckey, com um nível de significancia de p<0.05. Resultados : os valores obtidos demostraram que a combinação analgésica de paracetamol associado a clonixinato de lisina, foi mais efetiva às 1 h e 8 h. Às 24 h, não existiram diferenças nos três grupos de estudo. Conclusão : a analgesia da terapia combinada de Paracetamol associado a Clonixinato de lisina, é superior à produzida pela dose standard de Ibuprofeno e Paracetamol no tratamento da dor pós-operatória de exodontias simples.

A Questionnaire Based Survey on the Antibiotic Prescription Pattern of Dentists in Eastern Part of India

Introduction: Recent surveys reported that dentists inseveral countries have restricted knowledge about prescribingantibiotics. The aim of this study was to investigate theknowledge and attitude of a group of dentists in Jharkhandtowards antibiotic prescription.Material and Methods: The present study was conductedamongst a group of dentists in Jharkhand, a state in easternpart of India. A questionnaire was mailed to 150 dentists outof which 131 responded back. The questionnaire includedquestions about the knowledge and attitudes of dentists towardprescribing antibiotics to dental patients.Results: Amoxicillin and amoxicillin clauvanic acid were themost popular antibiotics. More than 66% of the sample prescribed antibiotics daily.Conclusion: There is a need to improve awareness of dentistsregarding antibiotic prescribing to patients particularly in theaspects of type of antibiotic and its clinical indications.

Água-régia como extrator alternativo para o diagnóstico ambiental de áreas impactadas por resíduos industriais: estudo de caso Centres (Queimados, RJ) / Aqua regia as an alternative extractor for the environmental diagnosis of areas impacted by industrial waste: case study Centres (Queimados, RJ)

RESUMO Áreas contaminadas por metais podem configurar sério risco à saúde pública e ao meio ambiente. Na década de 1980 foi instalado um pátio de estocagem provisória de resíduos industriais perigosos (CENTRES), no município de Queimados, Rio de Janeiro, o que causou um grande impacto ambiental ao solo da região. A legislação brasileira para o diagnóstico de áreas contaminadas limita a extração de metais em solos aos métodos recomendados pela United States Environmental Protection Agency (USEPA) 3050 e 3051A. Entretanto, muitos pesquisadores utilizam o método com água-régia para a extração de metais em solo, mas são escassos estudos que comparem as concentrações de metais extraídos por água-régia e USEPA 3051A. Logo, o objetivo deste trabalho foi avaliar se o método de extração de metais em solos por água-régia é estatisticamente diferente do método USEPA 3051A. Os resultados obtidos revelaram que as concentrações de Cd, Cr, Cu, Ni, Pb e Zn utilizando ambas as extrações (água-régia e USEPA 3051A) foram estatisticamente semelhantes. Também foi possível identificar que as concentrações de Cu, Ni, Pb e Zn foram superiores ao valor de investigação industrial, o que caracteriza essa área como altamente contaminada e solo classe 4.

ABSTRACT Metal contaminated areas lead to environmental and public health risks. In the 1980s, dangerous industrial waste storage was initiated in the CENTRES area in the municipality of Queimados, Rio de Janeiro, Brazil. The inadequate management of these wastes has promoted a large environmental impact to this region's soils. The Brazilian legislation for diagnostics of contaminated areas limits the extraction of metals on soils to USEPA 3050-B and USEPA 3051-A methods. However, many researchers use the aqua regia method for extracting metals in soil, but there are few studies comparing concentrations of metals extracted by aqua regia and USEPA 3051A. Therefore, the objective of this work was to evaluate if the method of extracting metals in soils by aqua regia is statistically different from US EPA 3051A. The results showed that the Cd, Cr, Cu, Ni, Pb and Zn concentrations using both extractions were statistically similar. It was also observed that Cu, Ni, Pb and Zn concentrations were higher than the industrial investigation value which characterizes this area as highly contaminated and soil class 4.

Parenteral nanosuspensions: a brief review from solubility enhancement to more novel and specific applications

Advancements in techniques of lead molecule selection have resulted in the failure of around 70% of new chemical entities (NCEs). Some of these molecules are getting rejected at final developmental stage resulting in wastage of money and resources. Unfavourable physicochemical properties affect ADME profile of any efficacious and potent molecule, which may ultimately lead to killing of NCE at final stage. Numerous techniques are being explored including nanocrystals for solubility enhancement purposes. Nanocrystals are the most successful and the ones which had a shorter gap between invention and subsequent commercialization of the first marketed product. Several nanocrystal-based products are commercially available and there is a paradigm shift in using approach from simply being solubility enhancement technique to more novel and specific applications. Some other aspects in relation to parenteral nanosuspensions are concentrations of surfactant to be used, scalability and fate. At present, there exists a wide gap due to poor understanding of these critical factors, which we have tried to address in this review. This review will focus on parenteral nanosuspensions, covering varied aspects especially stabilizers used, GRAS (Generally Recognized as Safe) status of stabilizers, scalability challenges, issues of physical and chemical stability, solidification techniques to combat stability problems and fate.

ldentification of Viola yedoensis Makino and Viola inconspicua by FT-l R / 中国药科大学学报

The different extracts and of Viola yedoensis Makino and Viola inconspicua were analyzed and identi-fied by Fourier transform infrared spectroscopy (FT-IR). One-dimensional infrared spectrum showed that the extracts of Viola yedoensis Makino and Viola inconspicua contained the aromatics,volatile substances and glyco-sides,with not significant differences from each other. However,different extraction sites of the two medicinal materials in second derivation spectrum were obviously different,especially the number of automatic peaks and peak intensity in the range of 970 800 cm-1. Viola yedoensis Makino displayed 5 automatic peaks,6 automatic peaks and 6 automatic peaks,while Viola inconspicua displayed 7 automatic peaks,4 peaks,4 peaks in the second derivation spectrum of petroleum ether extraction site,chloroform extraction site and the ethyl acetate extraction site. In addition,the peak position of the strongest peak in the second derivative of the ethyl acetate extraction site was 1 467 cm-1,while the strongest peak of the Viola inconspicua was at 1 384 cm-1,so the two medicinal mate-rials can be distinguished by the strongest peak position of ethyl acetate extraction site in second derivation spec-trum. Studies demonstrated that one-dimensional infrared spectroscopy combined with the second-order derivative analysis could achieve the accurate identification between Viola yedoensis Makino and Viola inconspicua. This research provides new ideas and new methods for the identification of Viola and other adulterants.

Third molars and premolars extraction in conventional orthodontics and in treatments based on maxillary bone remodeling with temporary anchorage: indications and care

ABSTRACT A bone is an anatomic structure in constant remodeling, with different, mutant and wonderfully inconstant designs. With every new and immediate functional demand, there are changes in cortical thickness, trabecular bone density and also in direction and size of trabeculae. Bones' non-stopping search is for adjusting to the functions induced by forces and movements required by a certain life style. Conventional orthodontic planning or with temporary anchorage based on bone remodeling takes into consideration the spaces that are - or may be - occupied by the teeth, in the formation of a functional and esthetic dental arch for the patient. In case it is necessary to extract a tooth and the options are the third molars, partially or totally unerupted, and teeth that belong to other dental groups, obviousness recommends - due to mouth anatomy and physiology, as well as pathologic reasons - extracting the third molars, due to of the several reasons described in the present study.

RESUMO O osso é uma estrutura anatômica em constante remodelação, com designs diferentes, mutantes e maravilhosamente inconstantes. A cada nova e imediata demanda funcional, mudam a espessura das corticais, a densidade do trabeculado, a direção e o tamanho das trabéculas. A busca incessante do osso é para se adequar às funções induzidas pelas forças e movimentos decorrentes do modo de viver. O planejamento ortodôntico convencional ou com ancoragem transitória baseada na remodelação óssea leva em consideração os espaços que os dentes ocupam, ou podem ocupar, na formação de uma arcada dentária funcional e estética para o paciente. Se for necessário extrair algum dente e houver a opção entre os terceiros molares, parcial ou totalmente não irrompidos, e os dentes de outros grupos dentários, a obviedade recomenda - por conta da anatomia e fisiologia bucal, assim como por razões patológicas - optar pela extração dos dentes do siso, pelos várias motivos que serão descritos no presente trabalho.

Tratamento de correção de biprotrusão com extrações de quatro primeiros molares permanentes / Treatment for the correction of biprotrusion with fourfirst permanent molars extractions

Apresentação de caso clínico de uma paciente feoderma portadora de biprotrusão, tratada com extrações dos quatro primeiros molares permanentes.

Clinical case report of patient Brazilian African-Caucasian descendent with biprotrusion treated with four first molars extractions.

Comparison of the dental arch changes in patients with different malocclusions.

Aims and Objectives: To evaluate the pre-treatment and post-treatment dental arch changes in both upper and lower arches in orthodontic patients treated with extraction of first premolar teeth. Subjects and Methods: Measurements were made on casts of 50 post treated cases in the age group of 12-30 years for individual tooth measurements, width of the arches (inter-incisal, inter-canine, inter-premolar and inter-molar) arch length (both right and left sides, anterior segment, posterior segment and total arch length for both for the maxillary and mandibular dental casts. Statistical Analysis Used: Kolmogorov-Smirnov test for Normality, Regression Analysis was done as variables were tested and proved to follow normality. Statistical software  Statistical Package for the Social Sciences version 18 (SPSS Inc.; Chicago, Illinois, USA) was used for data analysis. Descriptive statistics and paired t-tests were used to compare the changes in the Class I and Class II div 1 groups. Results: There was a significant increase in the inter-incisor and inter-canine width post-treatment in the Class I and Class II div 1 subjects in the upper arch but no significant change in inter-incisor width in the lower arch in class I subjects. A significant decline in the inter-molar arch width in both the groups were seen. The inter-premolar arch width declined significantly in Class I cases while it increased significantly in Class II div 1 subjects. There was a significant increase in anterior arch length and a significant decrease in posterior arch length in all subjects. Conclusions: The findings of this original clinical research should significantly help the orthodontists in orthodontic treatment planning in patients requiring extractions of premolars.

Treatment needs for Dental Caries, Restorative Care Index, and Index of Extractions in adolescents 12 and 15 years old / Necesidades de tratamiento para Caries Dental, Indice de Cuidados Restauradores, e Índice de Extracciones en adolescentes de 12 y 15 años de edad

OBJECTIVE: To determine the Treatment Needs Index (TNI) for dental caries, the restorative Care Index (CI), and to introduce a Tooth Extractions Index (TEI) to estimate past and current treatment needs among Mexican adolescents. SUBJECT AND METHODS: A descriptive cross-sectional study was carried out on 1538 adolescents aged 12 and 15 years in the state of Hidalgo, Mexico, to collect decayed, missing, filled teeth (DMFT) data to describe TNI, CI and TEI indices. RESULTS: Higher TNI was identified in younger male teenagers who had always lived in the same community, without dental visits in the last year, and who had poorer socio-economic markers. Higher CI was found in older, female subjects who had moved in their lifetimes to a new community in the area, with dental visits in the last year and who had better socio-economic markers. Higher TEI was found in older, female teenagers who had moved in their lifetimes to a new community in the area, without dental visits in the last year, and who had worse socio-economic markers. CONCLUSIONS: We observed high rates of treatment needs for dental caries and little experience of restorative treatment. While dental extractions due to advanced caries should ideally be zero, relatively few adolescents had this treatment experience. Despite the fact that the overall background of these adolescents is rather homogeneous, it was still possible to find that treatment needs'indices (past and present needs) appeared to be modified by sociodemographic and socio-economic variables.

OBJETIVO: Determinar las necesidades de tratamiento para caries dental (INT), el índice de cuidados restauradores (IC) así como proponer un índice que haga referencia a las extracciones dentales (IE), para estimar necesidades de tratamiento actual y pasada en adolescentes mexicanos. MATERIAL Y MÉTODOS: Se realizó un estudio transversal descriptivo en 1538 adolescentes de 12 y 15 años en el Estado de Hidalgo, México. Empleando el índice CPOD se calcularon los índices TNI e IC; asimismo se propone un IE a las que ha estado expuesta la población. RESULTADOS: El INT fue mayor en los de 12 años, hombres, los que vivieron siempre en la misma comunidad, que no tuvieron visita al dentista en el último año, y con marcado nivel socioeconómico bajo. El IC fue mayor en los sujetos de 15 años, las mujeres, con migración interna, que si tuvieron visita al dentista en el último año, y con mejor nivel socioeconómico. El IE fue mayor en los de 15 años, mujeres, con migración interna, que no tuvieron visita al dentista en el último año, y con peores condiciones socioeconómicas. CONCLUSIONES: Se observaron altas necesidades insatisfechas de tratamiento para caries dental y poca experiencia de tratamiento restaurador. Las extracciones se observaron en pocos adolescentes, considerando cero como ideal. A pesar de que los antecedentes de estos adolescentes es bastante homogéneo, fue posible encontrar que los índices de necesidades de tratamiento (necesidades presentes y pasadas) parecen ser modificados por variables socio-demográficas y socioeconómicas.

Soft tissue profile changes in class II patients treated with first bicuspid extraction / Alterações do perfil mole em pacientes portadores de classe II tratados com extrações de primeiros pré-molares

Objetivo: Avaliar mudanças nos tecidos moles da área labial decorrentes do tratamento ortodôntico com extrações de primeiros pré-molares em 20 indivíduos classe II de Angle. Material e métodos: Foram utilizadas 40 telerradiografias de perfil escaneadas, sendo 20 radiografias iniciais e 20 radiografias pós-tratamento. Dezoito pontos foram digitalizados sobre as telerradiografias e analisados utilizando o programa Radiocef 4.0 (Radio Memory Ltda.). Foram utilizadas medidas lineares e angulares para medir a variação da posição dos lábios dos indivíduos. Foi realizado cálculo de erro do método. Valores pré e pós-tratamento foram comparados entre si utilizando o teste t de Student para dados pareados. Resultados: A retrusão média dos lábios superior e inferior foi de 2 mm. Foi observado um aumento significativo do ângulo nasolabial de 5,36°, o que resultou em uma diminuição da convexidade facial. O ângulo do lábio superior (ULA) diminuiu 4,74°. Conclusão: Pode-se concluir que planejamentos envolvendo extração de primeiros prémolares em pacientes com maloclusão classe II resultam em uma pequena alteração da convexidade do perfil facial (aumento do ângulo nasolabial e diminuição do ângulo do lábio superior).

Objective: To assess soft tissue changes in the lip area after orthodontic treatment with first bicuspid extraction in 20 Angle class II patients. Methods: A total of 40 profile cephalograms were digitized and measured: 20 obtained at baseline and 20 after treatment. Eighteen landmarks were marked on the cephalograms and analyzed using the Radiocef software version 4.0 (Radio Memory Ltda.). Linear and angular measurements were used to analyze changes in upper and lower lip position. Statistical analysis included calculation of error. Pre- and post-treatment measurements were compared using the Student t test for paired samples. Results: Upper and lower lips showed a mean retrusion of 2 mm. There was a significant increase in the nasolabial angle, of 5.36°, leading to a decreased facial convexity. The upper lip angle (ULA) retruded -4.74°. Conclusions: Our findings suggest that treatment of class II patients including first bicuspid extraction result in small changes in the patients' facial profile (increased nasolabial angle and decreased upper lip angle).

Transplante dentário: Atualização da literatura e relato de caso / Dental Transplantation: Literature Update and Case Report

Apesar dos grandes avanços da odontologia, com consequente diminuição das indicações de exodontia por doença periodontal e cárie, a prática da remoção de dentes que podem ser tratados de forma conservadora ainda é rotineira em locais onde a condição sócio-econômica é desfavorável. As terapêuticas possíveis frente a um dente perdido são geralmente por reabilitação protética, implantes e ortodontia, todavia são tratamentos que geralmente dependem de condição financeira. Desse modo, o transplante dental surge como uma opção de tratamento a todas as camadas sociais, sendo denominado por alguns pesquisadores de "prótese biológica". As principais indicações para a transferência de um dente natural do seu alvéolo para outro sítio estão relacionadas a cáries extensas, reabsorção radicular, doença periodontal, fratura coronorradicular, agenesia e aplasia de dentes, dentes inclusos. A técnica cirúrgica deve ser minimamente traumática para melhor prognóstico do dente a ser transplantado, uma vez que o ligamento periodontal não deve ser manipulado, por ser necessário à reparação dos tecidos periodontais.

Despite major advances in dentistry, with consequent reduction of the indications for extraction for periodontal disease and tooth decay, the practice of removing teeth may be treated conservatively is still routinely used in places where the socio-economic status is unfavorable. The therapeutic potential against a missing tooth are usually for prosthetic rehabilitation, implants and orthodontics, however, are treatments that often depend on financial condition. Thus, the dental transplant comes as a treatment option to all social strata, being called by some researchers "bioprosthetic". The main indications for the transfer of a natural tooth in its socket to another site is related to extensive caries, root resorption, periodontal disease, fractured coronorradicular, agenesis and aplasia of teeth, impacted teeth. The surgical procedure should be minimally traumatic to better prognosis of the tooth to be transplanted, since the periodontal ligament should not be manipulated by the need of periodontal tissue repair.

Reparação pós-exodôntica em pacientes com diabetes tipo 2 / Post-extraction wound healing in patients with type 2 diabetes

A hiperglicemia, bem como o diabetes, é reconhecida como fator de risco para infecções pós-cirúrgicas, assim manter o controle glicêmico perioperatório tem sido padrão de cuidado em saúde. Entretanto há poucos estudos sobre o impacto do controle glicêmico no processo de reparação de cirurgias de extração dentária. Apesar da escassez de estudos e de evidências clínicas e científicas que investiguem o risco de infecções pós-exodônticas em pessoas com diabetes, existem livros, artigos e guias que recomendam aos dentistas o uso de antibióticos profiláticos nesses indivíduos, especialmente para aqueles descompensados. O objetivo deste estudo foi avaliar clinicamente a cicatrização pós-exodôntica, em relação à cronologia dos eventos reparacionais e em relação à ocorrência de complicações pós-operatórias, em indivíduos com diabetes tipo 2 comparados a um grupo controle. Além disso, procuramos relacionar os eventos pós-cirúrgicos com o controle metabólico e com o perfil imunológico dos pacientes. Este estudo prospectivo longitudinal caso controle incluiu 53 indivíduos com diabetes tipo 2 (grupo de estudo=GE) e 29 indivíduos sem diabetes (grupo controle=GC). Foi aplicado questionário sobre a história médica, realizados exames clínicos intraoral e extraoral e exames laboratoriais para conhecimento do controle glicêmico e do perfil imunológico do indivíduo, tais como, hemograma completo, hemoglobina glicada (A1C), glicemia de jejum, IgA, IgG, IgM, C3, C4, linfócitos T CD3+, CD4+, CD8+, quimiotaxia de neutrófilos, oxidação de neutrófilos, fagocitose de neutrófilos e monócitos. Todos os participantes foram submetidos a extrações padronizadas de dentes erupcionados...

Hyperglycemia and diabetes are recognized as a risk factor for postoperative infections. Thus, maintaining perioperative glucose control has become the standard of care. However, there are scarce data on the appropriate glucose control during minor dental surgery. Despite the paucity of studies investigating the risk of postsurgical oral infections in persons with diabetes, there are text books, papers and guidelines recommending to dentists the use of prophylactic antibiotics for patients with poorly controlled diabetes undergoing invasive oral procedures. The aim of this study was to clinically evaluate the post extraction healing regarding to the chronology and to the occurrence of postoperative complications in patients with type 2 diabetes compared to a control group. Additionally, we associated the postoperative events with metabolic control and the immunological profile of the participants. This prospective case-control study included 53 subjects with type 2 diabetes (SG) and 29 controls without diabetes (CG). A questionnaire on medical history was applied, intraoral and extraoral clinical examinations were conducted and laboratory tests for glycemic control and immunological profile of the individual, such as complete blood count, glycated hemoglobin (A1C), fasting glucose, IgA, IgG, IgM, C3, C4, lymphocytes T CD3+, CD4+, CD8+, neutrophil chemotaxis, oxidation of neutrophil phagocytosis by neutrophils and monocytes, were obtained at the time of the extraction. All participants underwent standardized extractions of erupted teeth and clinical assessments were performed 3, 7, 21 and 60 days after surgery...

Relación entre la dimensión vertical dentoalveolar posterior y clasificación esquelética en pacientes tratados ortodóncicamente con extracciones y sin extracciones de primeros bicúspides / Relationship between posterior dentoalveolar vertical dimension and skeletal

Introducción: el objetivo del estudio fue determinar y comparar cefalométricamente la variación de la dimensión vertical dentoalveolar posterior en pacientes tratados ortodóncicamente con y sin extracciones de primeros bicúspides en maloclusiones clases I y II y establecer su relación con el indicador de displasia anteroposterior (APDI). Métodos: 76 pacientes de la Fundación CIEO, entre 22 y 45 años, con TeleRx lateral de cráneo pre- (T1) y postratamiento (T2) de ortodoncia, clasificados esqueléticamente (APDI) y tipo de tratamiento hecho, independientemente del sexo, conformando cuatro grupos: clase I con exodoncias y sin exodoncias, clase II conexodoncias y sin exodoncias. La dimensión vertical dentoalveolar posterior se midió linealmente y se analizó estadísticamente su variaciónentre las maloclusiones, así como la correlación múltiple entre las alturas dentoalveolares y APDI en T1 y T2. Resultados: el análisis intragrupo, evidenció el aumento significativo entre la dimensión vertical dentoalveolar posterior en clases I y II con extracciones en T1 y T2, a nivel del segundo premolar inferior (5i) y segundo molar superior (7s), respectivamente. El análisis intergrupo, mostró aumento significativo al comparar la dimensión vertical dentoalveolar posterior, según la clasificación esquelética en tratamientos con extracciones a nivel del segundo premolar (5s), primer molar (6s) y segundo molar (7s) superiores y primer molar (6i) inferior. Conclusiones: se encontró aumento en la dimensión vertical dentoalveolar posterior en todos los grupos en T1 y T2, siendo significativo en los grupos clases I y IIcon exodoncias de primeros bicúspides pero sin evidenciar cambios en la clasificación esquelética (APDI).

Introduction: the purpose of this study was to determine and to cephalometrically compare the variation of posterior dentoalveolar vertical dimension in orthodontic patients treated with and without extraction of first premolars in Class I and Class IImalocclusions and to establish its correlation by means of the Anteroposterior Dysplasia Indicator (APDI). Mehods: pre (T1) and post(T2) treatment lateral cephalograms of 76 patients from Fundación CIEO, aged 22 to 45 years, were skeletally classified according to APDI and the type of treatment received, regardless of gender, forming four groups: Class I with and without extractions, and Class II with and without extractions. The posterior dentoalveolar vertical dimension was calculated with linear measurements and its variationamong the malocclusion groups was statistically analyzed; also, a multiple correlation analysis between dentoalveolar heights and APDIwas performed at T1 and T2. Results: the intragroup analysis showed a significant increase of posterior dentoalveolar vertical dimensionat T1 and T2 in both Class I and Class II groups with first premolar extractions at the lower second premolar (5i) and upper second molar (7s), respectively. The intergroup analysis showed a significant increase in posterior dentoalveolar vertical dimension, according to skeletal malocclusion class, in treatments with first premolar extractions, at the upper second premolar (5s), upper first molar (6s), upper second molar (7s), and lower first molar (6i). Conclusions: there was an increase of posterior dentoalveolar vertical dimension at T1 and T2 inall the groups, being statistically significant in Class I and Class II patients treated with first premolar extractions without altering theskeletal classification (APDI).

Extraccion del primer molar permanente como una alternativa en el tratamiento de ortodoncia / Extractions of first permanent molars as a choice of the orthodontic treatment

La extracción de primeros molares permanentes es una alternativa de tratamiento en algunos casosde ortodoncia como aquellos que presentan apiñamiento moderado, biprotrusión, mordidas abiertas,clase II y III en casos en los cuales es necesario realizar exodoncias y en donde los primeros molaresestán en mal estado por caries extensas u otras alteraciones en su formación, lo que los hace maselegibles para ser extraidos evitando restauraciones extensas futuras o la necesidad de colocar implantespara remplazarlos . Este articulo describe tres casos con diferentes tipos de maloclusiones en los cualeslos primeros molares superiores y/o inferiores fueron elegidos para ser extraídos y así poder obtenerresultados clínicos óptimos tanto faciales como oclusales.

Extraction of First permanent molars is a treatment alternative in patients with moderate crowding, bimaxillaryprotrusion, open bites, class III, Class II, in cases of extensive caries or other developmental problems or to prevent the placement of implants to replace them. This article describes three different clinical cases in which first, upper and lower permanent molars were chosen to be extracted in order toobtain clinical, facial and oclusal good results.