ABSTRACT
Objetivo: este artigo tem como objetivo demonstrar a abordagem de um trauma alveolar dentário no qual o reimplante dentário foi realizado no Sistema Único de Saúde (SUS) e encaminhado para acompanhamento a longo prazo em uma Clínica Odontológica da Universidade do Nordeste do Brasil. Relato de caso: paciente do sexo masculino, 7 anos, encaminhado à Clínica Odontológica da Universidade Tiradentes para acompanhamento em longo prazo de um reimplante dentário do elemento 11. Durante o exame clínico, observa-se um grau severo de mobilidade dentária, além da presença de fístula na linha do muco gengival do dente. Radiograficamente, observou-se espessamento do ligamento periodontal e áreas de extensa reabsorção externa. O acompanhamento do caso durou aproximadamente 1 ano. Conclusão: portanto, é essencial que o profissional cirurgião-dentista tenha conhecimento para o correto diagnóstico e agilidade neste tratamento urgente, a fim de preservar o órgão dentário na cavidade oral por mais tempo
Introduction: dental trauma is an injury that mainly affects children and adolescents. Tooth avulsion is one of the most common causes of trauma, which is the expulsion of the alveolar tooth. The prognosis is due to pulp and support tissue repair, however, it is associated with complications such as functional, aesthetic and psychological problems, and is doubtful and dependent on rapid behavior. Objective: this article aims to demonstrate the approach of a dental alveolar trauma in which dental reimplantation was performed in the Unified Health System (SUS) and referred for long-term follow-up in a University Dental Clinic of Northeast Brazil. Case report: a 7-year-old male patient, referred to the Dental Clinic of Universidade Tiradentes for long-term follow-up of a dental reimplantation of element 11. During the clinical examination, a severe degree of tooth mobility can be observed, in addition to presence of fistula in the gingival mucus line of the tooth. Radiographically, thickening of the periodontal ligament and areas of extensive external resorption were observed. The follow-up of the case lasted approximately 1 year. Conclusion: thus, it is essential that the dental surgeon professional has knowledge for the correct diagnosis and agility in this urgent treatment, in order to preserve the dental organ in the oral cavity for a longer time.
Subject(s)
Humans , Child , Tooth Avulsion , Tooth Mobility , Tooth Replantation , Tooth InjuriesABSTRACT
Objective:To investigate the relationship between the removal time of 0.2 mm occlusal in-terference and the recovery of masticatory muscle mechanical hyperalgesia in rats.Methods:Forty male Sprague-Dawley rats (200-220 g)were randomly assigned to eight groups,with five rats in each group:(1 )nave group:these rats were anesthetized and their mouths were forced open for about 5 min (the same duration as the other groups),but restorations were not applied;(2 )sham-occlusal interference control group:bands were bonded to the right maxillary first molars which did not interfere with occlu-sion;(3 )occlusal interference group:0.2 mm thick crowns were bonded to the right maxillary first molars;(4)2,3,4,5,and 6 d removal of occlusal interference groups:0.2 mm thick crowns were bonded to the right maxillary first molars and removed on days 2,3,4,5,and 6.The nave group and sham-occlusal interference control group were control groups.The other groups were experimental groups. Bilateral masticatory muscle mechanical withdrawal thresholds were tested on pre-application days 1 ,2, and 3,and on post-application days 1 ,3,5,7,1 0,1 4,21 and 28.The rats were weighed on pre-application day 1 and on post-application days 1 ,2,3,4,5,6,and 7.Results:Between the nave group and the sham-occlusal interference control group,there was no significant difference in the mastica-tory muscle mechanical withdrawal threshold of bilateral temporalis and masseters at each time point.No significant difference was detected between the contralateral side and ipsilateral side in experimental groups (P>0.05 ).In the 2,3,4,and 5 d removal of occlusal interference groups,the masticatory muscle mechanical withdrawal thresholds decreased after occlusal interference and increased after removal of the crowns and recovered to the baseline on days 7,1 0,1 4,and 1 4,respectively [the masticatory muscle mechanical withdrawal thresholds of right masseter muscle were (1 37.46 ±2.08)g,(1 39.02 ± 2.1 1 )g,(1 40.40 ±0.98)g,(1 38.95 ±0.98)g,respectively].In the 6 d removal of occlusal inter-ference group,the masticatory muscle mechanical withdrawal threshold increased after removal of the crowns and became stable since day 1 4.There was a significant difference between the 6 d removal of oc-clusal interference group and the sham-occlusal interference group on day 28(P<0.05),the masticatory muscle mechanical withdrawal thresholds of right masseter muscle were (1 31 .24 ±0.76 ) g and (1 41 .34 ±1 .43)g,respectively.Conclusion:After removal of the 0.2 mm thick crown within 5 days, the mechanical hyperalgesia of the rats could reverse completely.The mechanical hyperalgesia of the rats could only be relieved,but not reverse completely after removal of the 0.2 mm thick crown on day 6.As the time went on,even minor occlusal interference could cause irreversible mechanical hyperalgesia of masticatory muscles.This study suggested that occlusal interference caused by dental treatment should be eliminated as soon as possible,to avoid irreversible orofacial pain.
ABSTRACT
Los traumas dentarios en niños y niñas son frecuentes, razón por la cual el estomatólogo debe estar capacitado para darles solución. En el presente trabajo se expone el diagnóstico, tratamiento y evolución del caso de un niño con resalte de 12 mm, hábito de respiración bucal y cierre bilabial incompetente, que sufrió trauma severo en el diente 11, lo que le causó movilidad de este. Se aplicó una férula al diente afectado y posteriormente se realizó tratamiento pulporadicular, todo ello con una evolución satisfactoria. Aunque estos traumas son comunes, la presentación de este caso es de interés, por su utilidad en el contexto docente.
Dental traumas in children are common; therefore the dentist should be trained to solve them. This paper presents the diagnosis, treatment and outcome of a child with a 12 mm overjet, mouth breathing habit and bilabial incompetence who suffered a severe trauma to tooth number 11, causing its mobility. A splint was applied to the affected tooth and subsequently, a root canal filling was performed, all with a satisfactory outcome. Although these traumas are common, the presentation of this case is important due to its use in the teaching context.
ABSTRACT
O trauma oclusal é uma injúria ao aparato de inserção como resultado de força oclusal excessiva, e sua interação com a doença periodontal/peri-implantar permanece um tema muito discutido na literatura. O objetivo neste artigo foi realizar uma revisão de literatura acerca da relação entre trauma oclusal e doença periodontal/peri-implantar, por meio de uma análise de estudos experimentais em humanos e animais, bem como de revisões sistemáticas que discutiram o papel do fator oclusal como etiológico ou agravante da doença periodontal/peri-implantar. Concluiu-se que apesar de não ser considerado fator etiológico para o desenvolvimento de periodontite e peri-implantite, o trauma oclusal pode agravar a perda óssea ao redor de dentes ou implantes. Além disso, a diversidade das metodologias nos estudos sobre o assunto pode contribuir para os resultados conflitantes disponíveis, destacando-se a importância da padronização e maior detalhamento dos critérios de pesquisa.
The occlusal trauma is an injury to the insertion apparatus as a result of excessive occlusal force, and its interaction with periodontal/peri-implant disease remains controversial topic in the literature. The aim of this study was to review the literature about the relationship between occlusal trauma and periodontal/peri-implant disease, through an analysis of experimental studies in humans and animals, as well as systematic reviews that discussed the role of occlusal factor as etiological or aggravating periodontal/periplant disease. It was concluded that, although not considered a cause for the development of periodontitis and periimplantitis, occlusal trauma may exacerbate bone loss around the teeth or implants. Moreover, the diversity of methodologies in studies on the subject might contribute to the conflicting results available, highlighting the importance of standardization and more detailed research criteria.
Subject(s)
Humans , Animals , Dental Implants , Dental Occlusion, Traumatic , Periodontal DiseasesABSTRACT
A distribuição correta de forças oclusais deve ser uma preocupação constante para os profissionais da odontologia, isto para que propicie a manutenção do equilíbrio entre os elementos do sistema estomatognático. Quando as forças oclusais excedem o limite fisiológico dos tecidos, pode ocorrer injúria nos tecidos periodontais decorrente do trauma oclusal. A paciente MLC, branca do sexo feminino 53 anos compareceu à pesquisa de oclusão e dor orofacial da Faculdade de Odontologia da UFG com quadro clínico de mobilidade no primeiro pré-molar inferior esquerdo, hipersensibilidade ao toque no mesmo e reabsorção óssea na região face mesial. Ao exame clínico observou-se desvio da mandíbula para a esquerda, devido a interferência na vertente mesial da cúspide mésio palatina do primeiro molar superior esquerdo, a referida interferência projetava a mandíbula para anterior e para a esquerda resultando em trauma oclusal no segundo pré-molar inferior esquerdo. O dente sob trauma não apresentava bolsa periodontal e respondeu positivamente ao teste de vitalidade pulpar. Observou-se que a dor e a mobilidade foram causadas pela interferência, caracterizando trauma oclusal primário. Para eliminar o contato prematuro, o tratamento indicado foi o ajuste oclusal por desgaste seletivo, num total de cinco sessões. Após quatro meses de acompanhamento verificou-se ao exame radiográfico neoformação óssea na região mesial do referido dente, com desaparecimento da mobilidade e de toda sintomatologia associada. Concluindo, assim, o ajuste oclusal por desgaste seletivo pode ser indicado em casos de trauma oclusal, desde que este seja o fator tiológico.
The correct distribution of occlusal forces should be a constant concern for dental professionals, to ensure that conducive to maintaining the equilibrium between the elements of the stomatognathic system. When occlusal forces exceed the physiological limit tissue, injury can occur in periodontal tissues resulting from occlusal trauma. The patient MLC, white female 53 years old attended the search occlusion and orofacial pain, School of Dentistry of UFG with clinical mobility in the first premolar left, hypersensitivity to touch and even bone reabsorption in the mesial region. On clinical examination there was deviation of the jaw to the left, because interference in mesial aspect mesial palatal cusp of the maxillary first molar left, the interference projected the mandibular anterior and to the left resulting in injury in the second premolar left . The tooth under trauma showed no periodontal pocket and responded positively to the test pulp vitality. It was observed that the pain and mobility were caused by interference, characterizing primary occlusal trauma. To eliminate premature contact, the indicated treatment was occlusal adjustment by selective grinding. After four months of follow-up was found to radiographic bone formation in the region of the mesial said tooth, with disappearance of mobility and all associated symptoms. In conclusion, therefore, occlusal adjustment by selective grinding can be used in cases of occlusal trauma, since this is the etiologic factor.