Brote dentario precoz. Un acercamiento a la realidad

Introducción: Las tendencias seglares influyen en el crecimiento y desarrollo general del individuo. El brote dentario no escapa a esta realidad. Existen variables que pueden retardarlo o acelerarlo, dentro de las que se encuentran el sexo y el color de la piel. Objetivos: Determinar la cronología y el orden de brote de los dientes permanentes en niños y adolescentes. Métodos: Se realizó un estudio transversal descriptivo desde mayo de 2017 a noviembre de 2020. El universo constituido por 21383 niños y adolescentes entre 5 y 13 años de edad, de la provincia Holguín, Cuba, que no presentaban pérdida prematura de dientes temporales o extracciones de dientes permanentes, ni enfermedades sistémicas que influyen en el crecimiento y desarrollo. En el procesamiento estadístico se utilizaron las medidas de resúmenes para las variables cuantitativas y el test de comparación de las medias. Resultados: La edad de brote de todos los dientes permanentes resultó adelantada en comparación con las tablas para su valoración clínica. El primer diente en brotar fue el primer molar superior, entre los 5,66 años, y el último el segundo molar maxilar, entre los 10,38 años. Al comparar las medias de brote de los dientes permanentes según el sexo, hubo diferencias altamente significativas en la arcada superior: primer premolar (p = 0,000), arcada inferior: canino (p = 0,009), primer premolar (p = 0,000) y segundo molar (p = 0,012). Se encontraron diferencias altamente significativas entre las medias de brote para el color de la piel en el maxilar: incisivo central (p = 0,004), incisivo lateral (p = 0,000), canino (p = 0,002), mandíbula: incisivo central (p = 0,000), incisivo lateral (p = 0,000) y segundo premolar (p = 0,000). Conclusiones: La cronología de brote de todos los dientes permanentes resultó adelantada. Los dientes permanentes siguieron la secuencia de brote, tal como describe Mayoral. Se encontraron diferencias al comparar las medias de brote según el sexo y color de la piel.

Introduction: Secular tendencies influence the overall growth and development of the individual. Tooth eruption does not escape this reality. There are variables that can delay or accelerate it, among which are sex and skin color. Objectives: To determine the chronology and order of eruption of permanent teeth in children and adolescents. Methods: A descriptive cross-sectional study was conducted from May 2017 to November 2020. The universe constituted by 21383 children and adolescents between 5 and 13 years of age, from Holguín province, Cuba, who did not present premature loss of primary teeth or extractions of permanent teeth, nor systemic diseases that influence growth and development. Statistical processing used summary measures for quantitative variables and the comparison test of the average values. Results: The age of teething of all permanent teeth was advanced in comparison with the tables for clinical assessment. The first tooth was the upper first molar at 5.66 years of age and the last tooth was the maxillary second molar at 10.38 years of age. When comparing the teething averages of the permanent teeth according to gender, there were highly significant differences in the upper arch: first premolar (p = 0.000), lower arch: canine (p = 0.009), first premolar (p = 0.000) and second molar (p = 0.012). Highly significant differences were found between bud means for skin color in maxilla: central incisor (p = 0.004), lateral incisor (p = 0.000), canine (p = 0.002), mandible: central incisor (p = 0.000), lateral incisor (p = 0.000) and second premolar (p = 0.000). Conclusions: The teething chronology of all permanent teeth resulted advanced. The permanent teeth followed the teething sequence as described by Mayoral. Differences were found when comparing the teething averages according to gender and skin color.

Asociación entre apiñamiento anteroinferior y tercer molar en pacientes de 20 años de edad

Introducción: El apiñamiento dentario anteroinferior es una maloclusión frecuente en el ser humano. Entre sus causas se cita al tercer molar inferior, sin embargo, no existe suficientes estudios que avalen una dependencia estadística entre el apiñamiento y el tercer molar. Objetivo: Determinar la asociación entre el apiñamiento anteroinferior y el tercer molar inferior. Métodos: Se realizó un estudio descriptivo transversal, en el que participaron 68 estudiantes de 20 años de la facultad de Estomatología de la provincia Camagüey, durante el período de noviembre de 2019 a febrero de 2020. Se determinó presencia del tercer molar y de apiñamiento; así como, posición del tercer molar y espacio para su ubicación en el arco. Resultados: Hubo supremacía en la existencia del tercer molar inferior en pacientes estudiados, donde se presentó en su mayoría el apiñamiento anteroinferior. La posición no adecuada predominó en ambos molares inferiores, lo que coincide con una mayor prevalencia de apiñamiento. El espacio para el molar 48 fue en su generalidad suficiente, mientras para el diente 38 fue el no existe; el apiñamiento se diagnosticó tanto donde hubo el espacio suficiente como en los que estuvo o no existió. Se encontró asociación estadística entre el apiñamiento anteroinferior y el tercer molar inferior con posición no adecuada. Conclusiones: Se constató que los terceros molares inferiores estuvieron presentes en la mayoría de los casos estudiados lo que coincide con la mayor parte de los pacientes con apiñamiento anteroinferior.

Introduction: Lower anterior dental crowding is a common malocclusion in humans. Among its causes, the lower third molar is cited; however there are not enough studies to support a statistical dependence between crowding and the third molar. Objective: To determine the association between lower anterior crowding and the lower third molar. Methods: A cross-sectional descriptive study was carried out, in which 68 20-year-old students from the Dentistry Faculty of Camagüey province participated, during the period from November 2019 to February 2020. The presence of the third molar and crowding was determined; as well as, position of the third molar and space for its location in the arch. Results: There was supremacy in the presence of the lower third molar in the patients studied where there was mostly the presence of lower anterior crowding. The inadequate position prevailed in both lower molars, which coincides with a higher prevalence of crowding. The space for molar 48 was generally sufficient, while for tooth 38 it was non-existent; crowding was present where there was sufficient space as well as where space was doubtful or non-existent. There was a statistical association between lower anterior crowding and the lower third molar with improper position. Conclusions: It was found that the lower third molars were present in most of the patients studied, coinciding with the majority of patients with lower anterior crowding.

Surgery traction canine of impacted in the maxillary: a case report / Cirurgia de tracionamento de canino impactado em maxila: relato de caso

ABSTRACT Permanent canines are essential for the preservation of the stomatognathic system, as they are part of the occlusal and aesthetic function and balance. During the normal development of occlusion, canines follow a long and complex trajectory until their eruption, that is, they are more likely to suffer disturbances during this process. Removal of the permanent canine should only be considered in extreme cases, where the canine itself is not susceptible to orthodontic traction. Orthodontic traction is the most indicated treatment due to the high morphofunctional and aesthetic value of the permanent canine. The aim of this study is to report a clinical case of traction surgery of the superior permanent canine included in the maxilla. A 13-year-old female patient attended the dental clinic at the Nilton Lins University accompanied by her guardian, referred by an orthodontistfor canine traction surgery. during the examIn the clinical analysis, tooth 13 was absent from the dental arch. The patient had a computed tomography scan, where it was possible to verify the actual position of the toothimpacted with the partially erupted crown on the alveolar ridge. After planning, surgery was performed to install an orthodontic button and adapt the ligature with a 0.30 mm wire. After the 10-month follow-up period, the presence of the tooth in arch, completely erupted, was observed, showing effectiveness in the proposed treatment. Therefore, the procedure for bonding the orthodontic device was performed satisfactorily without complications or intercurrences, making it possible to continue the orthodontic treatment. The patient remains under follow-up.

RESUMO Os caninos permanentes são essenciais para a preservação do sistema estomatognático, visto que, fazem parte da função e equilíbrio oclusal e estético. Durante o desenvolvimento normal da oclusão, os caninos seguem uma longa e complexa trajetória até seu irrompimento, ou seja, estão mais propensos a sofrerem distúrbios no decorrer desse processo. A extração do canino permanente só deve ser considerada em casos extremos, onde o próprio não se encontra suscetível à tração ortodôntica. O tracionamento ortodôntico é o tratamento mais indicado devido ao alto valor morfofuncional e estético do canino permanente. Sendo assim, o objetivo deste estudo é relatar um caso clínico de cirurgia de tracionamento de canino permanente superior incluso em maxila. Paciente de 13 anos, gênero feminino, compareceu a clínica odontológica da Universidade Nilton Lins acompanhado de seu responsável, encaminhada por um ortodontista para cirurgia de tracionamento de canino. Durante o exame clínico observou-se ausência do dente 13 na arcada dentária. A paciente apresentou a tomografia computadorizada, onde foi possível verificar o real posicionamento do dente impactado com a coroa parcialmente irrompida no rebordo alveolar. Após o planejamento, realizou-se a cirurgia destinada a instalação de botão ortodôntico e adaptação da amarrilha com fio 0,30 mm. Posteriormente ao período de acompanhamento de 10 meses, observou-se a presença do dente em arco, totalmente erupcionado, mostrando efetividade no tratamento proposto. Portando, o procedimento de colagem de dispositivo ortodôntico ocorreu de forma satisfatória sem complicações ou intercorrências, tornando possível a continuidade do tratamento ortodôntico. A paciente permanece em acompanhamento.

Are Premature Birth and Low Birth Weight Associated with Delay on the Eruption of Deciduous Teeth? A Systematic Review and Meta-analysis

ABSTRACT Objective: To investigate whether children with premature birth (PB) and/or with low birth weight (LBW) have different tooth eruption patterns than those born at term or with normal weight. Material and Methods: Searches were performed in the PubMed, Cochrane Library, Sc1opus, Web of Science, LILACS, and BBO databases as well as the grey literature. Three independent reviewers were involved in study selection, data extraction, and bias assessment. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. Meta-analysis was conducted to compute the mean difference (MD) in mean chronological or adjusted age at the eruption of the first deciduous tooth between preterm children and those born at full term. The GRADE approach was used. Results: Among a total of 316 articles identified, 21 were eligible for inclusion and three were included in the meta-analysis. PB was associated with the delay in the first tooth deciduous eruption when chronological age was considered (MD: 1.36; 95%CI: 1.02-1.69) but not when considering adjusted age (MD: -0.30; 95%CI: -0.67-0.07). The evidence was graded as having very low quality. Conclusion: Based on a low certainty of evidence the PB is associated with the delayed eruption of the first deciduous tooth when considering chronological age but not when adjusted age is considered.

Single Nucleotides Polymorphisms in COX2 Gene and their Association with Signs and Symptoms of Teething - A Pilot Study

ABSTRACT Objective: To investigate the association between single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) and local and systemic signs and symptoms of teething. Material and Methods: Forty-four pairs of mothers-babies/toddlers were included. Erupted primary teeth were evaluated during clinical examination. Local and systemic signs and symptoms of teething were obtained from mothers' reporting via anamnesis. Samples of buccal cells were retrieved for DNA genotyping using real-time PCR. The T-test, Chi-square test, logistic regression, and haplotype analyses were applied. Results: Almost all mothers (95.5%) reported at least one local or systemic sign and symptom of teething. The most common was increased salivation (79.5%), diarrhea (72.3 %), and fever (70.5 %). The mean number of signs and symptoms per child was higher in boys than girls (mean = 5.1; SD= 1.5; p=0.008). Sleep disturbance (p=0.03) and loss of appetite (p=0.05) were more reported in boys. The rs689466 and rs5275 were not associated with signs and symptoms of teething (p>0.05). Conclusion: The single nucleotide polymorphisms in the COX2 gene (rs689466 and rs5275) were not associated with local and systemic signs and symptoms of teething.

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.

Effect of extraction timing of mesiodens on orthodontic treatment duration for abnormal eruption of permanent teeth in children / 口腔疾病防治

Objective@# To discuss the correlation between the extraction timing of mesiodens and the orthodontic treatment duration of its eruption-related complications in children to provide a reference for the clinic.@*Methods @#The mesiodentes of 187 children were classified as eruption type (typeⅠ), dental crown impacted type (type Ⅱ), interdental impacted type (type Ⅲ), and dental root impacted type (type Ⅳ). According to the timing of extraction, mesiodentes in typeⅠ, type Ⅲ, and type Ⅳ were divided into Groups A: before the eruption of the adjacent central incisor and B: after the eruption of the adjacent central incisor. Mesiodentes in type Ⅱ were divided into Group A: before the eruption of the contralateral central incisor and B: after the eruption of the contralateral central incisor. Eruption-related complications and orthodontic treatment durations caused by mesiodens were statistically analyzed. @*Results @# There were 106 cases of displacement, 28 cases of failed eruption, 27 cases of tooth rotation, and 26 cases of individual cross-bite among the eruption-related complications caused by mesiodens. The mean orthodontic treatment cycle in Group A of type Ⅰ (7.07 ± 2.45 month), Group A of type Ⅱ (6.57 ± 1.12 month), and Group A of type Ⅲ (6.95 ± 2.52 month) were lower than that in Group B of type Ⅰ (9.67 ± 3.04 month), Group B of type Ⅱ (10.25 ± 1.29 month), and Group B of type Ⅲ (9.33 ± 3.26 month), and the differences were statistically significant (P<0.01). Meanwhile, there was no significant difference in the mean orthodontic treatment duration between Groups A (6.00 ± 0.94 month) and B (6.33 ± 0.80 month) of type Ⅳ (P>0.05).@*Conclusion@# In most cases, the mesiodens are removed before the eruption of the adjacent central incisor, which can reduce the duration of orthodontic treatment for eruption-related complications in children.

Number of erupted teeth at the age of 12 and 24 months: a maternal report validation study

Aim: To verify the validity of maternal reports on the number of deciduous teeth erupted in their children. Methods: This cross-sectional study was performed with children enrolled in a Birth Cohort at the age of 12 months in the first stage and 24 months in the second stage. At both stages, children were clinically examined, and mothers reported the number of teeth of their children. Comparison between groups was performed using the Mann-Whitney non-paired Wilcoxon test. Level of agreement between two methods were estimated by the Observed Agreement, Weighted Kappa and Intraclass Correlation coefficients. Results: A total of 125 children were examined in the first stage, with mean number of reported teeth of 6.2. In the second stage, 149 children were examined, with mean number of reported teeth of 15.9. High level of agreement, kappa values and intraclass correlation coefficients were observed for both arches in both periods (p<0.001). Conclusions: Maternal report on the number of teeth erupted in children was reliable and valid. Thus, it seems to be a useful instrument for collecting data in population-based epidemiological studies targeting young children

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)

Association between body mass index with premature eruption of second permanent molars in children aged 9-12 in Bengbu City / 中国学校卫生

Objective@#To investigate the epidemiological characteristics of premature eruption of permanent molars and its aasociation with body mass index (BMI), to provide a reference for childhood oral health promotion.@*Methods@#A total of 861 children aged 9 to 12 years from two primary schools in Bengbu City were selected by cluster sampling method. Parental questionnaire was administered to collect socio demographic information. The eruption of second permanent molars were examined. Data was analyzed by multivariate Logistic regression model and margins command.@*Results@#The detection rate of premature eruption of second permanent molars was 26.5%(228), 27.5% in boys and 24.9% in girls( χ 2=0.73, P =0.39). Early detection rate of second permanent molars (39.0%) was significantly higher in obese group than normal weight group (21.5%)( χ 2=21.85, P <0.01). Logistic regression analysis showed that obesity was positively correlated with the risk of premature eruption of second permanent molars( OR= 3.55 , 95%CI=2.14-5.87, P <0.01). Overweight was not associated with higher risk of premature eruption of second permanent molars( OR=1.64, 95%CI=0.95-2.81, P =0.07). Being female was associated with higher risk of premature eruption of second permanent molars compared to age matched peers( OR=2.19, 95%CI=1.42-3.39, P <0.01).@*Conclusion@#Childhood obesity is associated with higher risk for premature eruption of second permanent molars. Girls are more likely to have second permanent molar erupted in advance compared to age matched boys.

Cronología de la erupción dentaria en adolescentes de 13 años del municipio Sancti Spíritus

Introducción: La erupción dentaria es un proceso fisiológico que puede ser alterado por múltiples causas congénitas o ambientales. Objetivo: Determinar la cronología de la erupción dentaria permanente y su relación con factores influyentes en adolescentes de 13 años del municipio Sancti Spíritus. Métodos: Se realizó un estudio descriptivo, transversal en el municipio Sancti Spíritus entre septiembre 2017 y junio de 2019. La población estuvo constituida por 1 355 adolescentes de 13 años pertenecientes a todas las escuelas secundarias básicas urbanas de este municipio y por muestreo estratificado en dos etapas se seleccionó una muestra de 406 adolescentes. Se utilizaron métodos del nivel teórico, empírico y estadístico-matemático. Resultados: Se constató que el 22,9 % de los adolescentes presentaron la cronología de la erupción dentaria atrasada respecto a las medidas de Mayoral con predominio del sexo masculino (57 %) y el grupo étnico europoide (83,9 %). Los factores que más influyeron fueron la retención de dientes temporales con 72 %, el sexo con 57 % y los antecedentes hereditarios con 49,5 %, los tres con gran significación estadística. Conclusiones: Casi la cuarta parte de los adolescentes de 13 años estudiados del municipio Sancti Spíritus presentan atraso en la cronología de la erupción dentaria permanente respecto a los valores de Mayoral. Los del sexo masculino presentaron el doble de riesgo para una cronología atrasada y no existieron diferencias en cuanto al grupo étnico. Los factores que más influyeron fueron la herencia, el sexo y la retención de dientes temporales.

Introduction: Tooth eruption is a physiological process that can be altered by multiple congenital or environmental causes. Objective: To determine the chronology of permanent dental eruption and its relationship with influencing factors in 13-year-old adolescents from the Sancti Spíritus municipality. Methods: A cross-sectional descriptive study was carried out in the Sancti Spíritus municipality from September 2017 to June 2019. The population consisted of 1 355 13-year-old adolescents belonging to all the urban basic secondary schools of this municipality and by stratified sampling in two stages. A sample of 406 adolescents was selected. Theoretical, empirical and statistical-mathematical level methods were used. Results: It was found that 22.9% of the adolescents presented delayed dental eruption chronology with respect to the Mayoral measures, with a predominance of males (57%) and the Europoid ethnic group (83.9%). The factors that most influenced were the retention of temporary teeth with 72%, sex with 57% and hereditary history with 49.5%, the three variables with great statistical significance. Conclusions: Almost a quarter of the 13-year-old adolescents studied in the municipality of Sancti Spíritus presents a delay in the chronology of permanent dental eruption with respect to the Mayoral values. Those of the masculine sex presented double the risk for a delayed chronology and there were no differences regarding the ethnic group. The factors that most influenced were heredity, sex and retention of temporary teeth.

Efficacy of fluoride gel in arresting active non-cavitated caries lesions: a randomized clinical trial

Abstract: This study evaluated the efficacy of fluoride gel in arresting active non-cavitated caries lesions in permanent teeth. This randomized, triple-blind, placebo-controlled clinical trial randomized 100 schoolchildren aged 10.7 ± 2.2 years to test treatment (1.23% acidulated phosphate fluoride [APF] gel) or control treatment (placebo gel) for 4-6 applications at weekly intervals. Data collection included the visible plaque index, gingival bleeding index, visible plaque accumulation on the occlusal surfaces, eruption stage, and dental caries. The association between group and lesion arrestment was assessed using logistic regression, and estimates were adjusted for plaque accumulation over the lesion at baseline, surface type, and tooth type. Models were fitted using generalized estimating equations for accounting for the clustering of data (i.e., the same individual contributed > 1 lesion). Ninety-eight children completed the study (48 fluoride and 50 placebo). When all dental surfaces were analyzed, the likelihood of lesion arrestment was similar between both groups (p > 0.05). A secondary analysis including only the occlusal lesions in molars showed that for teeth under eruption, lesions receiving the 1.23% APF gel were about 3-fold more likely to become arrested than lesions receiving the placebo gel (OR = 2.85; 95%CI = 1.23-6.61; p = 0.01). No significant difference was detected for molars with complete eruption (p > 0.05). The benefit of fluoride gel for arresting non-cavitated caries lesions could not be identified by clinical assessment in this short-term trial. Notwithstanding, when the cariogenic challenge was greater (as on the occlusal surfaces of erupting molars), 1.23% APF gel treatment was an important tool for caries control.

Efficacy of treatments used to relieve signs and symptoms associated with teething: a systematic review

Abstract: The purpose of this review was to systematically evaluate all the existing literature on the efficacy of treatments used to relieve the signs and symptoms associated with teething. A systematic search up to February 2021, without restrictions on language or date of publication, was carried out in MEDLINE/PubMed, SCOPUS, Web of Science, The Cochrane Library, EMBASE, LILACS, BBO, OpenGrey, Google Scholar, Portal de Periódicos da CAPES, clinicaltrials.gov, and the references of the included studies. Clinical studies that evaluated the effect of any intervention to alleviate the signs and symptoms associated with teething in babies and children were included. The risk of bias was assessed using the ROB-2 and ROBINS-I tools. The characteristics and results of the individual studies were extracted and synthesized narratively. The GRADE approach was followed to rate the certainty of the evidence. Three randomized and two non-randomized clinical trials were included. The outcomes of these five articles were classified as high or serious risk of bias. Three studies using homeopathy reported improvement in appetite disorders, gum discomfort, and excess salivation. One study showed a new gel with hyaluronic acid was more effective than an anesthetic gel in improving signs and symptoms such as pain, gingival redness, and poor sleep quality. Another study applied non-pharmacological treatments, which were more effective, especially against excess salivation. Although the present systematic review suggests some therapies could have a favorable effect on signs and symptoms related to teething, definitive conclusions on their efficacy cannot be drawn because of the very low certainty of the evidence. The existing literature on the subject is scarce and heterogeneous and has methodological flaws; therefore, further high-quality investigations are necessary.

Systemic Manifestations, Tooth Eruption and Enamel Defects in Children with Congenital Zika Virus Syndrome: 36-Month Follow-up Case Series

Abstract Objective: To describe systemic manifestations, the characteristics related to tooth eruption, and the occurrence of enamel defects in children with Congenital Zika Virus Syndrome (CZS). Material and Methods: Prospective case series based on nine children with confirmed CZS diagnosis assisted at a reference center in a municipality in the Northeast Region of Brazil. Through a structured interview directed to mothers, information related to prenatal, delivery, and postpartum periods was collected. Tooth eruption was monitored through clinical examinations for 36 months. The modified developmental defect of enamel index (DDE) was used to identify opacities and hypoplasia. Data were presented using descriptive statistics. Results: A high proportion (77.8%) had microcephaly, and 55.5% had low birth weight. Musculoskeletal disorders, swallowing difficulty, and self-injury practices were present in all children. Among the systemic findings, visual impairment (77.8%) and seizures (77.8%) were widely reported. Concerning disorders related to the stomatognathic system, bruxism (66.7%) and difficulty in sucking (33.3%) were present. For most children (77.8%), the deciduous right lower central incisor was the first tooth to erupt (minimum 8 months and maximum 17 months). Enamel defects were diagnosed in only two children (22.2%). Conclusion: A wide range of systemic manifestations was observed in children with CZS, including visual impairment and musculoskeletal disorders. Delayed eruption of the first deciduous tooth was also observed. Enamel defects were present in a small proportion of children.

Odontomas: un reto para el tratamiento interdisciplinario del paciente de ortodoncia / Odontomas: a challenge for the interdisciplinary treatment of the orthodontic patient

El objetivo del presente trabajo es describir las técnicas para el diagnóstico y tratamiento de 3 casos clínicos de odontoma en pacientes ortodóncicos. En el caso 1, se trató a un paciente masculino de 17 años, que acudió para interconsulta con el servicio de ortodoncia, ya que no había erupcionado el canino superior izquierdo y el primer premolar superior izquierdo. El estudio anatomopatológico reveló odontoma complejo con áreas pindborgoides y acumulación de células fantasma. En al caso 2 se trató a un paciente femenino de 15 años. El estudio anatomopatológico reveló odontoma complejo. En el caso 3, se trató a un paciente masculino de 28 años que acudió a rehabilitación integral de su boca, y fue derivado a la cátedra de ortodoncia. En la radiografía panorámica se observó una imagen compatible con odontoma. Se remitió una muestra a anatomía patológica que confirmó el diagnóstico de odontoma. Conclusión: el conocimiento adecuado de las características clínicas, radiológicas y patológicas es necesario para un correcto diagnóstico y tratamiento. Es importante el trabajo interdisciplinario ortodoncista - cirujano para tratar estos casos (AU)

The objective of this work is to describe the techniques for the diagnosis and treatment of 3 clinical cases of odontoma in orthodontic patients. In case 1, a 17-year-old male patient was treated who came for consultation with the orthodontic service, since the upper left canine and the upper left first premolar had not erupted. Pathological study revealed complex odontoma with pindborgoid areas and accumulation of ghost cells. In case 2, a 15-year-old female patient was treated. The anatomopathological study revealed a complex odontoma. In case 3, a 28-year-old male patient was treated who attended comprehensive rehabilitation of his mouth and was referred to the orthodontic department. In the panoramic radiography, an image compatible with odontoma was observed. A sample was sent to pathological anatomy, which confirmed the diagnosis of odontoma. Conclusion: Adequate knowledge of the clinical, radiological and pathological characteristics is necessary for a correct diagnosis and treatment. Interdisciplinary orthodontist-surgeon work is important to treat these cases (AU)

Misconceptions and traditional practices toward infant teething symptoms among mothers in eastern Sudan: a cross-sectional study

There is no much published data on the mothers' false beliefs about signs and symptoms associated with teething in Sudan. Aim: This cross-sectional hospital-based study was conducted to assess mothers` knowledge about infant teething process and to evaluate mothers' practices used to alleviate teething disturbances in Gadarif city, eastern Sudan. Methods: Questionnaires were used to collect data. Multivariate logistics regression models were performed and adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. Results/Conclusion: Of a total of 384 participating mothers, 126 (32.8%) had good knowledge about infant teething. The mothers' knowledge was associated with a higher number of children in the family (adjusted odds ratio [AOR] = 1.14) and with having a job (AOR = 2.22). Mothers residing in rural areas (AOR = 0.40) and mothers with lower than secondary education (AOR = 0.43) were less likely to have good knowledge about teething. Diarrhea (88.5%), fever (86.5%), an urge to bite (76.6%), and poor appetite (71.9%) were the signs and symptoms most attributed to teething by mothers. Only the mother's knowledge about teething was associated with reporting fever as a sign. A considerable number (317; 82.6%) of mothers reported performing "Dokhan" (acacia wood smoke), 313 (81.5%) preferred to administer paracetamol or other systemic analgesics, 262 (68.2%) agreed that a child with tooth eruption should be taken to a hospital or health center, and 216 (56.3%) believed that antibiotics relieved symptoms related to teething

Validación de un modelo cefalométrico de predicción para el brote de los terceros molares / Validation of a cephalometric prediction model for third molar eruption

Introducción: La intervención temprana en el brote anormal de los terceros molares podría reducir la proporción de pacientes con las molestias asociadas y la aparición de alteraciones producto a la retención dentaria. Objetivo: Validar el modelo cefalométrico predictivo para el brote de los terceros molares desarrollado González Espangler. Métodos: Se realizó un estudio longitudinal, descriptivo, de corte transversal, en adolescentes del Instituto Preuniversitario "Rafael María de Mendive" de Santiago de Cuba durante el periodo comprendido entre enero del 2017 y marzo del 2020. Fueron empleadas dos muestras aleatorias de 21 estudiantes de 15-18 años y 29 profesionales de las ciencias de la salud. Se estudiaron variables como el sexo, color de la piel, localización, etapa de formación, espacio óseo posterior, angulación, diámetro mesiodistal, factores predictivos y tipo de brote de los terceros molares. Resultados: Predominó el tipo de brote anormal: 19,0 por ciento para la localización 1.8; 17,9 por ciento para la 2.8; 21,4 por ciento en la 3.8 y 20,2 por ciento en la posición 4.8. No existieron diferencias significativas entre las medidas promedios del espacio óseo posterior, angulación y diámetro mesiodistal con el estudio de referencia. La validación de modelo por criterio de expertos obtuvo una calificación global de concordancia entre ellos del 100 por ciento. Conclusiones: El modelo cefalométrico predictivo validado es viable en el proceso de predicción del brote de los terceros molares en la población(AU)

Introduction: Early intervention in the abnormal eruption of third molars could reduce the number of patients with associated discomfort and the appearance of alterations caused by dental retention. Objective: Validate the cephalometric prediction model for third molar eruption developed by González Espangler. Methods: A cross-sectional longitudinal descriptive study was conducted of adolescents from Rafael María de Mendive Senior High School in Santiago de Cuba from January 2017 to March 2020. The two random samples examined consisted of 21 students aged 15-18 years and 29 health sciences professionals. The variables considered were sex, skin color, location, training stage, posterior bony space, angulation, mesiodistal diameter, predictive factors and type of third molar eruption. Results: Abnormal eruption prevailed: 19.0 percent in location 1.8; 17.9 percent in 2.8; 21.4 percent in 3.8 and 20.2 percent in 4.8. Significant differences were not observed between average values for posterior bony space, angulation and mesiodistal diameter, and the study reference. Validation of the model by expert criteria obtained a global agreement score of 100 percent. Conclusions: The cephalometric prediction model validated in the study is viable for the prediction of third molar eruptions in the population(AU)

Lack of association between delayed tooth emergence and single nucleotide polymorphisms in estrogen receptors

Abstract The purpose of the study was to investigate the association between single nucleotide polymorphisms (SNPs) in genes encoding estrogen receptors (ESR1 and ESR2, respectively) and delayed tooth emergence (DTE). This cross-sectional study was composed of biological unrelated children of both sexes, age ranging from 11 to 13 years old. DTE was defined when the successor primary tooth was still present in the oral cavity after its exfoliation time or the absence of the permanent tooth emergence into the oral cavity. Children were diagnosed with DTE when they had at least one delayed permanent tooth, according to age of exfoliation of each tooth proposed by The American Dental Association. Genomic DNA from saliva was used to evaluate the SNPs in ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938) using Real-Time PCR. Chi-square or Fisher exact tests and Logistic Regression adjusted by age and gender were performed. SNP-SNP interaction was accessed by multifactor dimensionality reduction (MDR) analysis also adjusted by gender and age. The established alpha of this study was 5%. Among 537 included children, 296 (55%) were in the "DTE" group and the 241 (45%) were in the "Control" group. Age and gender were not statistically different among the groups (p>0.05). Genotype distribution of the SNPs rs9340799, rs2234693, rs1256049 and rs4986938 were not associated with DTE (p> 0.05). The models elected by MDR were not statistically significant either. Conclusions: The studied SNPs in ESR1 and ESR2 were not associated with permanent DTE.

RESUMO O objetivo do presente estudo foi investigar a associação entre polimorfismos de nucleotídeo único (SNPs) em genes que codificam receptores de estrógeno (ESR1 e ESR2, respectivamente) e o retardo na emergência dentária (DTE). Este estudo transversal foi composto por crianças biológicas não relacionadas de ambos os sexos, com idades entre 11 e 13 anos. O DTE foi definido pela presença do dente decíduo na cavidade bucal após seu tempo e também, quando as crianças apresentaram pelo menos um dente permanente com atraso. O DNA genômico foi usado para avaliar os SNPs em ESR1 (rs9340799 e rs2234693) e ESR2 (rs1256049 e rs4986938) usando PCR em tempo real. Foram realizados testes Qui-quadrado ou exato de Fisher e Regressão Logística ajustados por idade e sexo. A interação SNP-SNP foi acessada pela análise de redução de dimensionalidade multifatorial (MDR), também ajustada por sexo e idade. O alfa de 5% foi estabelecido. Entre 537 crianças incluídas, 296 (55%) estavam no grupo "DTE" e 241 (45%) estavam no grupo "Controle". A idade e o sexo não foram estatisticamente diferentes entre os grupos (p> 0,05). A distribuição de genótipos dos SNPs rs9340799, rs2234693, rs1256049 e rs4986938 não foi associada ao DTE (p> 0,05). Os modelos eleitos pelo MDR também não foram estatisticamente significativos. Conclusões: Os SNPs estudados na ESR1 e ESR2 não foram associados ao DTE na dentição permanente.

Corrective Treatment of Ectopic Eruption of Permanent First Molars: Case Report / Tratamiento correctivo de erupción ectópica de primeros molares permanentes: Reporte de casos

ABSTRACT: Ectopic eruption of a tooth is the process in which a tooth emerges in an abnormal position. The first permanent molar is the tooth that most frequently presents ectopic eruption, mostly because it is retained below the distal contour of the second temporary molar. The ectopic eruption may be reversible or irreversible, the latter of which requires corrective treatment to achieve correct eruption of the permanent molar in the arch. Treatments can be minimally invasive, such as the use of interproximal wedging, or more invasive orthodontic devices, such as brass wire, k-loops, Halterman devices, or wedging springs. The aim of this case report is to present two clinical cases where the ectopic eruption of permanent first molars is corrected using elastic separators. Conclusion:The elastic separators could be used successfully in cases of moderate or severe ectopic eruptions, not only in mild cases, as reported in most of the literature. The use of this technique does not require great cooperation from the patient, and it is low in cost.

RESUMEN: La erupción ectópica de un diente es el proceso por el cual el diente emerge en una posición anormal. La primera molar permanente es el diente que más frecuentemente presenta erupción ectópica, ya que, en su proceso de erupción, queda retenida debajo del contorno distal de la segunda molar temporal. La erupción ectópica puede ser reversible o irreversible, si es irreversible requiere tratamiento correctivo para lograr que la molar permanente erupciones correctamente en el arco. Los tratamientos pueden ser poco invasivos como el uso de separados elásticos o más invasivos con aparatos ortodóncicos tales como brass wire, k-loop, Halterman o wedging spring. El objetivo del presente artículo es presentar dos casos clínicos donde se corrige la erupción ectópica de primeros molares permanentes utilizando separadores elásticos. Conclusión: los separadores elásticos pueden usarse con éxito en casos de erupciones ectópicas moderadas o severas, no sólo en casos leves como reporta la mayoría de la literatura. El uso de esta técnica no requiere gran cooperación por parte del paciente y es de bajo costo económico.

Hexavalent chromium exposure alters bone remodeling in the developing tooth alveolus and delays tooth eruption / La exposición a cromo hexavalente altera la remodelación ósea del alvéolo dental en desarrollo y retarda la erupción dentaria

ABSTRACT Although it has been demonstrated that exposure of lactating rats to CrVI delays tooth eruption, the effects of CrVI exposure on bone remodeling in the developing alveolus during tooth eruption remain unknown. Our purpose was to analyze the effect of CrVI in the alveolus of the first lower molar of rats. Thirty-two suckling Wistar rats were divided into two groups. The experimental group received 12.5 mg/kg body weight/day of potassium dichromate dissolved in saline solution by oral gavage as of day 4 of the experiment; the control group received an equal dose of saline solution. Each group was divided into two sub-sets and euthanized at the ages of 9 and 15 days, respectively. Histochemical and histomorphometric studies of the bone surfaces of the developing tooth alveolus were performed. The percentage of bone formation surfaces was lower in experimental animals than in age-matched controls. The percentage of bone resorption surfaces was significantly lower in 9-day-old experimental rats than in controls and significantly higher in 15-day-old experimental rats than in controls. Exposure to CrVI during lactation alters the sequence of bone resorption and formation in the walls of the developing alveolus, both of which are necessary for tooth eruption, thus causing a delay.

RESUMEN Si bien ya ha sido demostrado que la exposición a CrVI de ratas lactantes retrasa la erupción dentaria, aún se desconocen los efectos de la exposición a CrVI que se producen sobre la modelación y remodelación de las paredes del alvéolo en formación que ocurren en los diferentes estadios de la erupción dentaria. Por tal motivo, el propósito de este trabajo fue estudiar el efecto del CrVI sobre la formación y la reabsorción óseas del alvéolo del primer molar inferior en desarrollo en ratas, a los 9 y a los 15 días de edad, que corresponden a los estadios intraóseo y de penetración mucosa de la erupción dentaria, respectivamente. El grupo experimental recibió una dosis diaria de 12,5 mg/kg de peso corporal de dicromato de potasio disuelto en solución salina por sonda bucal a partir del 4° día; mientras que el grupo control, un volumen equivalente de solución salina. Cada grupo fue dividido en 2 subgrupos de acuerdo al tiempo experimental en el que se llevó a cabo la eutanasia: 9 y 15 días de edad. Se llevaron a cabo estudios histoquímicos e histomorfométricos de las superficies óseas de los alveólos dentarios en formación. Los datos fueron analizados estadísticamente utilizando la prueba t de Student; estableciéndose un valor de p<0,05 como estadísticamente significativo. El porcentaje de superficies en formación fue menor en los animales experimentales de 9 y de 15 días de edad que en los respectivos controles. El porcentaje de superficies en reabsorción en los animales experimentales de 9 días de edad fue significativamente menor y en los animales de 15 días de edad fue significativamente mayor con respecto a sus controles. La exposición al cromo hexavalente durante la lactancia altera la secuencia de la reabsorción y la formación ósea de las paredes del alvéolo en desarrollo necesarias para que la pieza dentaria erupcione, causando su retraso. Los hallazgos obtenidos muestran la importancia del control de sustancias tóxicas en el agua potable, ya que sus efectos pueden alterar la remodelación ósea y por ende, el crecimiento y el desarrollo de los individuos que fueron expuestos durante la infancia temprana.