Estudo histológico e imunohistoquímico da degeneração da região central da cartilagem de Meckel na mandíbula em desenvolvimento de ratos / Histological and immunohistochemical study of the degeneration of the central region of Meckel's cartilage in the developing mandible of rats

A cartilagem de Meckel é uma estrutura transitória embrionária presente durante os estágios iniciais da formação da mandíbula, localizada em toda sua extensão e dividida em três porções, anterior, intermediária e posterior. O enfoque deste trabalho foi direcionado à elucidação do destino final da porção intermediária por meio de um estudo temporal sequenciado. Por isso, foi investigado a presença de células de reabsorção e a presença de fibras colágenas, bem como da proteína óssea osteopontina (OPN) na cartilagem de Meckel na região do germe do 1º molar inferior e no seu entorno. Foram utilizados fetos de ratos Wistar em períodos gestacionais pré-estabelecidos, G18 a G21 (grupos de dias intrauterinos), bem como P0 e P1 (recém-nascidos) para remoção das cabeças. Em sequência, os espécimes foram fixados em solução de formaldeído 4% + glutaraldeído 0,1% com tampão fosfato 0,1M, descalcificados em EDTA 4,13%, desidratados em concentrações crescentes de etanol e incluídos em parafina. As amostras foram coradas em hematoxilina e eosina (HE) e tricrômico de Mallory para análise histológica. Adicionalmente, os grupos G19 a P0 foram submetidos à reação histoquímica de TRAP para determinação da presença de células clásticas. Além disso, os grupos G21 e P0 (dia do nascimento) passaram por reações de imunomarcação para análise da expressão de OPN. Foi observado a degeneração gradual da cartilagem com a observação de mudanças estruturais, a justaposição de células clásticas na superfície da cartilagem por reação histoquímica TRAP a partir do G21, o aparecimento de colágeno tipo I nas fases terminais da degeneração, assim como a marcação positiva para a osteopontina na superfície de G21 e em todo o remanescente da cartilagem de Meckel no grupo P0. O estudo apontou um processo de degeneração da cartilagem com evidências de formação de matriz mineralizada de natureza óssea, a qual foi reabsorvida por células clásticas, sugerindo a ossificação da porção intermediária da cartilagem de Meckel.

Sex Determination in the Contemporary Chilean Population by Mandible Analysis in Panoramic Radiographies / Estimación Sexual de la Población Chilena Contemporánea Mediante Análisis de la Mandíbula en Radiografías Panorámicas

SUMMARY: Sex identification of a deceased human individual by means of the mandible is very important for forensic dentistry. The aim of the present study was to determine the sex of Chilean individuals by mandible analysis in panoramic radiographies. Linear and angular parameters of the mandible were analyzed from panoramic radiographies (PR). The study included PR of adult Chilean individuals, of both sexes, with optimum solution and contrast, and which allowed the angles and rami of the mandible to be viewed. Sex was determined by univariate and bivariate discriminant function analysis. The sample consisted of 594 PR of individuals aged between 18 and 84 years. The best sex predictor using univariate discriminant function analysis was the mandibular ramus height (MRH) (74.1 %), followed by the distance from the mental foramen - mandibular base (DMF-MB) (69.1 %) and the bicondylar breadth (BC) (66.7 %). The parameters that presented the lowest sex prediction were the angle of the mandible (AM) with 55.0 % and the distance between mental foramina (DMF) with 53.7 %. The best sex prediction was obtained by the step model of discriminant function analysis (80.2 %), including only three parameters: MRH, BC and DMF-MB. The parameters height of the mandibular ramus, bicondylar breadth and distance from the mental foramen - base of the mandible are good predictors of sex in Chilean individuals when used in conjunction; they are therefore indicated for sex determination in the contemporary Chilean population.

La identificación humana de un individuo fallecido a través de la mandíbula es muy relevante para la odontología forense. El objetivo de este estudio fue estimar el sexo de individuos Chilenos a través del análisis de la mandíbula, utilizando radiografías panorámicas. Fueron analizados parámetros lineales y angulares de la mandíbula, a través de radiografías panorámicas (RP). Se incluyeron RP de individuos chilenos adultos, ambos sexos, con solución y contraste óptimos, y que permitían la visualización de los ángulos y ramas de la mandíbula. Se realizó análisis por función discriminante univariada y bivariada para estimación del sexo. Fueron incluidas 594 RP de individuos entre 18 y 84 años. Para el análisis de función discriminante univariado, la altura de la rama mandibular (ARM) fue el parámetro más predictivo (74,1 %), seguido de la distancia foramen mentoniano - base de la mandíbula (DFM-BM) (69,1 %) y el ancho bicondilar (ABCo) (66,7 %). Los parámetros que presentaron menor predicción sexual fueron el ángulo de la mandíbula (AM) con un 55,0 % y la distancia inter-forámenes mentonianos (DIFM), con el 53.7 %. El análisis por pasos fue el modelo de análisis de función discriminante que presentó la mayor predicción sexual (79,5 %), en el cual fueron incluidos sólo tres parámetros: ARM, ABCo y DFM-BM. Los parámetros altura de la rama de la mandíbula, ancho bicondilar y distancia desde el foramen mentoniano hasta la base de la mandíbula son buenos predictores del sexo en individuos Chilenos cuando utilizados en conjunto y están indicados para estimar el sexo en la población chilena contemporánea.

A relevância da odontologia na Síndrome Treacher Collins: relato de caso / The relevance of dentistry in Treacher Collins Syndrome: case report

Treacher Collins também chamada de disostose mandibulofacial, é uma alteração genética dominante rara caracterizada pela má-formação dos ossos e tecidos da face. É uma síndrome crânio-facial que apresenta alterações bilaterais e simétricas de estruturas originadas do primeiro e segundo arcos branquiais. A maioria dos casos possui transmissão autossômica dominante e expressividade variável. O objetivo do presente estudo é realizar um relato de caso sobre o impacto do tratamento odontológico na qualidade de vida do paciente portador de Treacher Collins. Paciente, 39 anos, sexo feminino compareceu a uma clínica odontológica em Belo Horizonte, com a queixa principal de falhas dentárias e sensibilidade. Durante a anamnese a paciente relatou ter a STC, durante o exame clínico extraoral verificou a presença de hipoplasia malar e mandibular, malformação dos pavilhões auriculares com perda auditiva, obliquidade e coloboma palpebral inferior. Ao exame intraoral observou ser classe II de Angle, ausência dos dentes 11, 12, 13, 21 e 22 e extrusão do dente 41 e recessão gengival e periodontite estágio I grau A. Após exames de periodontograma e complementares foi realizado uma raspagem nas áreas com profundidade de sondagem maior que 3mm, frenectomia labial inferior, aplicação de laser para sensibilidade, enxerto gengival e colocação de prótese parcial removível. A paciente ao final do tratamento relatou ter se sentido realizada e contente com a sua conclusão, ela foi encaminhada ao Sistema único de Saúde para realizar as cirurgias para corrigir as alterações crânio-faciais. O tratamento odontológico deve ser adaptado a cada indivíduo de acordo com sua necessidade, tendo uma abordagem multidisciplinar, possibilitando uma melhora na qualidade de vida e estética do paciente(AU)

Treacher Collins syndrome is a rare dominant genetic disorder characterized by malformation of the bones and tissues of the face. It is a craniofacial syndrome that presents bilateral and symmetrical alterations of structures originating from the first and second branchial arches. The aim of the present study is to perform a case report on the impact of dental treatment on the quality of life of a patient with CTS. Patient, 39 years old, female, attended a dental clinic in Belo Horizonte, with the main complaint of dental flaws and sensitivity. During the anamnesis the patient reported having CTS, during the extraoral clinical examination she verified the presence of malar and mandibular hypoplasia, malformation of the pinnae with hearing loss, obliquity and lower eyelid coloboma. Intraoral examination revealed Angle class II, missing teeth 11, 12, 13, 21 and 22, extrusion of tooth 41, gingival recession and stage I periodontitis grade A. After periodontogram and complementary exams it was performed a scaling in areas with a probing depth greater than 3mm, lower lip frenectomy, laser application for sensitivity, gingival graft and placement of partial removable prosthesis. The patient at the end of treatment reported feeling fulfilled and happy with its completion, she was referred to the Unique Health System to undergo surgery to correct the craniofacial changes. The current treatment aims at functional and aesthetic correction and the need for psychosocial support, having the joint participation of a multidisciplinary team to achieve this goal(AU)

Validity of the Maturation Stage Method in the Individual Assessment of Midpalatal Suture Ossification Before Maxillary Expansion: A Systematic Review / Validez del Método de la Etapa de Maduración en la Evaluación Individual de la Osificación de la Sutura Palatina Mediana Previo a la Expansión Maxilar: Una Revisión Sistemática

In 2013, midpalatal suture maturation stage assessment was proposed for the evaluation of patients before performing maxillary expansion. In this study, we aimed to analyze the association between the midpalatal suture maturation stages assessed by CBCT, according to the method described by Angelieri et al., and other objective methods used to assess skeletal maturation or bone fusion. A computerized database search was conducted using PubMed, Cochrane Library, SciELO, LILACS, Web of Science, and Scopus, without language restriction. Unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Authors were contacted when necessary, and reference lists of the included studies were screened. Search terms included midpalatal suture, maturation, correlation, diagnostic performance, classification, evaluation, assessment, and relationship. Quality assessment was performed using the Observational Cohort and Cross-Sectional Studies tool developed by the National Heart, Lung, and Blood Institute. Eleven studies met the inclusion criteria. Of all the studies included, 81.9% had fair qualit y and 18.1% good quality, respectively. Eight out of eleven studies assessed the correlation between the midpalatal suture maturation method and the skeletal maturity evaluated by CVM method (Spearman's correlation coefficient: 0.244-0.908). Two out of eleven studies evaluated the correlation between midpalatal suture maturation method and the skeletal maturity assessed by HWM method (Spearman's correlation coefficient: 0.904-0.905) Even though midpalatal suture maturation stage assessment needs an exhaustive training and calibration process, it is a valid method to evaluate skeletal maturation or bone fusion. From a clinical perspective, for patients at CS4, CS5 and CS6, an assessment of the midpalatal suture on CBCT is indicated. A similar assessment should be done in patients at SMI 7-9.

En 2013, se propuso un nuevo método para la evaluación del estadio de maduración de la sutura palatina mediana para la evaluación de los pacientes antes de realizar la expansión maxilar. En este estudio, nuestro objetivo fue analizar la asociación entre las etapas de maduración de la sutura palatina mediana evaluada en CBCT, según el método descrito por Angelieri et al., y otros métodos objetivos utilizados para evaluar la maduración esquelética o la fusión ósea. Se realizó una búsqueda en las bases de datos PubMed, Cochrane Library, SciELO, LILACS, Web of Science y Scopus, sin restricción de idioma. Se buscó literatura no publicada en ClinicalTrials.gov, el Registro Nacional de Investigación y la base de datos Pro-Quest Dissertation Abstracts and Thesis. Se estableció contacto con los autores cuando fue necesario y se revisaron las listas de referencias de los estudios incluidos. Los términos de búsqueda incluyeron sutura palatina mediana, maduración, correlación, rendimiento diagnóstico, clasificación, evaluación, valoración y relación. La evaluación de la calidad se realizó mediante la herramienta de Estudios transversales y de cohortes observacionales desarrollada por el Instituto Nacional del Corazón, los Pulmones y la Sangre. Once estudios cumplieron con los criterios de inclusión. Del total de estudios incluidos, el 81.9% tuvo calidad regular y el 18.1% calidad buena, respectivamente. Ocho de once estudios evaluaron la correlación entre el método de maduración de la sutura palatina mediana y la madurez esquelética evaluada por el método CVM (coeficiente de correlación de Spearman: 0.244-0.908). Dos de once estudios evaluaron la correlación entre el método de maduración de la sutura palatina mediana y la madurez esquelética evaluada por el método HWM (coeficiente de correlación de Spearman: 0.904-0.905). Aunque la evaluación del estado de maduración de la sutura palatina mediana necesita un proceso exhaustivo de entrenamiento y calibración, es un método válido para evaluar la maduración esquelética o la fusión ósea. Desde una perspectiva clínica, para pacientes en CS4, CS5 y CS6, está indicada una evaluación de la sutura palatina mediana en CBCT. Se debe realizar una evaluación similar en pacientes con SMI 7-9.

Mechanical Evaluation of Different Stable Internal Fixation Techniques of Sagittal Osteotomy in Mandibular Advance / Evaluación Mecánica de Diferentes Técnicas de Fijación Interna Estable de Osteotomía Sagital en Avance Mandibular

The mandibular advancements performed in orthognathic surgeries can be stabilized with several techniques when using stable internal fixation. This study aims to comparatively evaluate, in vitro, the mechanical strength in a polyurethane mandibular model for four fixation techniques for sagittal split ramus osteotomy mandibular. 60 samples were divided into 4 groups, with 15 units for each group: group A, group B, group C and group D. Advances of 5 mm were made for each subgroup and fixed with 2.0 mm system plates and monocortical screws in the replicas of human hemimandibles in polyurethane resin. The samples were submitted to mechanical tests of linear loading, being evaluated the peak load and peak deformation. Technique B presented higher peak load (Kgf) and techniques A and B presented higher peak strain (p<0.05). Technique D presented lower peak load and lower peak strain (p<0.05). It is concluded that the study based on the development of new techniques for fixation for sagittal osteotomy of the mandibular ramus is of great importance for the advancement of orthognathic surgery, provided by the technical innovation of more favorable plate models.

Los avances mandibulares realizados en cirugías ortognáticas pueden estabilizarse con varias técnicas cuando se utiliza fijación interna estable. Este estudio tuvo como objetivo evaluar comparativamente, in vitro, la resistencia mecánica en un modelo mandibular de poliuretano para cuatro técnicas de fijación para la osteotomía sagital de la rama mandibular. Se dividieron 60 muestras en 4 grupos, con 15 unidades para cada grupo: grupo A, grupo B, grupo C y grupo D. Se realizaron avances de 5 mm para cada subgrupo y se fijaron con placas de sistema de 2,0 mm y tornillos monocorticales en las réplicas de hemimandíbulas humanas en resina de poliuretano. Las muestras fueron sometidas a pruebas mecánicas de carga lineal, siendo evaluadas la carga máxima y la deformación máxima. La técnica B presentó mayor pico de carga (Kgf) y las técnicas A y B presentaron mayor pico de deformación (p<0,05). La técnica D presentó menor carga máxima y menor tensión máxima (p<0,05). Se concluye que el estudio basado en el desarrollo de nuevas técnicas de fijación para la osteotomía sagital de la rama mandibular es de gran importancia para el avance de la cirugía ortognática, proporcionada por la innovación técnica de modelos de placas más favorables.

Fratura idiopática de mandíbula atrófica / Idiopathic fracture of atrophic jaw / Fractura idiopática de mandíbula atrófica

Objetivo: Discorrer sobre o tratamento cirúrgico de uma fratura idiopática de mandíbula atrófica. Relato de caso: Idosa compareceu à emergência de um hospital referência em traumas na Paraíba relatando dificuldade ao se alimentar, impossibilidade de uso da prótese dentaria, sintomatologia dolorosa em região mandibular direita com processo infeccioso ativo, sem histórico de trauma direto em face. Ao exame tomográfico constatou-se fratura em mandíbula atrófica com presença de dente incluso na região. Diante do quadro, optou-se por iniciar antibioticoterapia empírica e planejou-se tratamento cirúrgico de reconstrução mandibular com sistema load-sharing, tendo auxílio de biomodelo para conformação prévia da placa. Conclusão: O correto planejamento e escolha do sistema de fixação são fundamentais para o sucesso do tratamento. O uso de biomodelo com pré modelagem de placa mostrou-se positivo por otimizar o tempo cirúrgico, reduzindo os riscos inerentes ao procedimento nesta faixa etária e a utilização de sistema capaz de suportar a carga sofrida na estrutura óssea comprometida nestes casos é mandatório... (AU)

Objective: to discuss the surgical treatment of an idiopathic fracture of the atrophic mandible. Case report: elderly woman attended the emergency department of the Emergency and Trauma Hospital Dom Luiz Gonzaga Fernandes, in Campina Grande, Brazil. The patient reported pain on eating and inability to use her denture as painful symptoms in the right mandibular region with active fistula, without any records of facial trauma. Tomographic examination revealed an atrophic mandibular fracture with an impacted tooth in the region. The following procedures were performed: antibiotic therapy, surgical fixation using a 2.4mm pre-molded plate, shaped using a biomodel, and fistulectomy. Conclusion: Thus, to plan accordingly aiming to minimize the surgical time and its associate damage and the use of appropriate fixation systems capable of supporting the load on the compromised bone are essential to a successful treatment, specially with elderly patients due their general health condition and preexistent comorbities... (AU)

Objetivo: Discutir sobre el tratamiento quirúrgico de una fractura idiopática de la mandíbula atrófica. Caso clínico: Anciana compareció al servicio de urgencias del Hospital de Emergencia y Trauma de Campina Grande Dom Luiz Gonzaga Fernandes, PB, relatando dificultad para alimentarse, imposibilidad de uso de prótesis dental, sintomatología dolorosa en la región mandibular derecha con fístula activa, sin antecedentes de traumatismo directo en la cara. El examen tomográfico presentó una fractura mandibular atrófica con presencia de un diente incluido en la región. Como resultado se realizó antibioticoterapia, procedimiento de fijación quirúrgica con una placa de 2,4 mm premoldeada en biomodelo y fistulectomía. Conclusión: De esta forma, el correcto planeamiento para minimizar el tiempo quirúrgico y los daños asociados, principalmente en los ancianos por su estado general de salud y comorbilidades preexistentes, la utilización de sistemas de fijación adecuados capaces de soportar la carga sufrida en los huesos comprometidos, es fundamental para el éxito del tratamiento... (AU)

Lesión Fibro-ósea de Mandíbula: Un Hallazgo Radiográfico / Fibro-osseous Lesion of the Mandible: A Radiographic Finding

Las lesiones fibro-óseas son consideradas benignas y componen un grupo de patologías de desórdenes que se caracterizan por el reemplazo de un hueso normal por un tejido compuesto de fibras colágenas, fibroblastos y tejido mineralizado. Presentamos un hallazgo radiográfico obtenido de un paciente de sexo masculino de 41 años de edad que asiste a un centro de radiología para realizarse una radiografía panorámica, el examen revela un interesante hallazgo radiográfico en la hemi mandíbula izquierda, donde se observa una lesión fibro-ósea con expansión ósea a nivel de reborde marginal y cortical basal mandibular, desplazamiento de canal mandibular, desplazamiento dentario, compromiso de cortical alveolar y rizálisis en diferentes niveles en los dientes adyacentes a la lesión. De acuerdo a los antecedentes anteriores se establece una hipótesis diagnóstica de Fibroma Osificante de larga data debido a su radiopacidad. La Organización Mundial de la Salud lo clasifica como una neoplasia ósea benigna con afección al esqueleto craneofacial, de mayor incidencia en mandíbula, se presenta generalmente entre la 3º y 4º década de vida. Concluimos que las lesiones fibro-óseas pueden ser detectadas como un hallazgo radiográfico, esto es relevante para un tratamiento precoz, sin embargo, el diagnóstico debe realizarse complementando los antecedentes clínicos e histopatológicos de la lesión, poniendo especial atención en el diagnóstico diferencial.

Fibro-osseous lesions are considered benign and make up a group of disorder pathologies that are characterized by the replacement of normal bone by tissue composed of collagen fibers, fibroblasts, and mineralized tissue. We present a radiographic finding obtained from a 41-year-old male patient who attended a radiology center for a panoramic radiograph. The examination revealed an interesting radiographic finding in the left hemi-mandible, where a fibro-osseous lesion was observed. with bone expansion at the level of the marginal ridge and basal mandibular cortex, displacement of the mandibular canal, dental displacement, compromise of the alveolar cortex and rizalysis at different levels in the teeth adjacent to the lesion. According to the previous antecedents, a long-standing diagnostic hypothesis of Ossifying Fibroma is established due to its radiopacity. The World Health Organization classifies it as a benign bone neoplasm affecting the craniofacial skeleton, with the highest incidence in the jaw, generally presenting between the 3rd and 4th decade of life. We conclude that fibro-osseous lesions can be detected as a radiographic finding, this is relevant for early treatment, however the diagnosis must be made by complementing the clinical and histopathological history of the lesion, paying special attention to the differential diagnosis.

Biomechanical Behavior Evaluation of a Mandibular Full-Arch Implant-Supported Prosthesis on ZrO2 and TiO2 Monotype Dental Implants / Evaluación del Comportamiento Biomecánico de una Prótesis Implante Soportada de Arcada Completa Mandibular sobre Implantes Dentales Monotipos de ZrO 2 y TiO

This in silico study aimed to evaluate the biomechanical behavior of a full-arch implant-supported prosthesis on titanium and zirconia monotype implants. A 3D mandible containing 1.0 mm thick cortical and cancellous bone was modeled. Four dental implants (3.3 x 10 mm) were inserted into the jaw model in each model. The implants consisted of Titanium (Ti-S group) and Zirconia Monotype/one-piece (Zr-S group). Fixed full-arch implant-supported prostheses were cemented onto the implant. The models were exported to the analysis software and divided into meshes composed of nodes and tetrahedral elements. All materials were considered isotropic, elastic, and homogeneous. Therefore, all contacts were considered bonded, the mandible model was fixed in all directions, applying a static structural axial load of 300 N on the bottom of the fossa of the left mola r teeth. Microstrain and von-Mises stress (MPa) were adopted as failure criteria. Comparable stress and strain values were shown in the peri-implant bone for both groups. However, the Ti-S group presented a lower stress value (1,155.8 MPa) than the Zr-S group (1,334.2 MPa). Regarding bone tissues, the Ti-S group presented 612 µε and the Zr-S group presented 254 µε. The highest strain peak was observed in bone tissues around the implant closer to the load for both groups. Evaluating monotype zirconia and titanium implants, it is suggested that the greater the rigidity of the implant, the greater the concentration of internal stre sses and the less dissipation to the surrounding tissues. Therefore, monotype ceramic implants composed of yttrium-stabilized tetragonal polycrystalline zirconia may be a viable alternative to titanium implants for full-arch prostheses.

El objetivo de este estudio in silico fue evaluar el comportamiento biomecánico de una prótesis implanto soportada de arcada completa sobre implantes monotipo de titanio y zirconia. Se modeló una mandíbula en 3D que contenía tejido óseo cortical y esponjoso de 1,0 mm de espesor. En cada modelo, se insertaron cuatro implantes dentales (3,3 x 10 mm) en el modelo de mandíbula. Los implantes consistieron en Monotipo de Titanio y Zirconia. Sobre el implante se cementaron prótesis implanto soportadas de arcada completa fija. Los modelos se exportaron al software de análisis y se dividieron en mallas compuestas por nodos y elementos tetraédricos. Todos los materiales se consideraron isotrópicos, elásticos y homogéneos. Por lo tanto, todos los contactos se consideraron cementados, el modelo mandibular se fijó en todas las direcciones, aplicando una carga vertical estructural estática de 300 N en el fondo de la fosa de los dientes molares izquierdos. Se seleccionaron la microesfuerzo y la tensión de Von-Mises (MPa) como criterios de falla. Se mostraron valores de tensión y deformación comparables en el hueso periimplantario para ambos grupos. Sin embargo, el grupo Ti-S presentó un valor de estrés menor (1.155,8 MPa) que el grupo Zr-S (1.334,2 MPa). En cuanto a los tejidos óseos, el grupo Ti-S presentó 612 µε y el grupo Zr-S presentó 254 µε. La mayor concentración de deformación en el tejido óseo se observó en los tejidos alrededor del implante más cerca de la carga para ambos grupos. Al evaluar los implantes monotípicos de zirconia y titanio, se sugiere que cuanto mayor sea la rigidez del implante, mayor será la concentración de tensiones internas y menor la disipación a los tejidos circundantes. Por lo tanto, los implantes cerámicos monotipo compuestos de zirconia policristalina tetragonal estabilizada con itrio pueden ser una alternativa viable a los implantes de titanio para prótesis de arcada completa.

Diagnóstico e tratamento de extenso cisto dentígero mandibular em um paciente pediátrico / Diagnosis and treatment of extensive mandibular dentigerous cyst in a pediatric patient

Introdução: lesões gnáticas pediátricas são comumente assintomáticas e diagnosticadas em exames de imagem de rotina. Entretanto, algumas podem cursar com dor, assimetria facial, destruição óssea e rápida evolução, requerendo diagnóstico preciso e precoce. Objetivo: o objetivo desse estudo é reportar o processo de diagnóstico e tratamento de um extenso cisto dentígero (CD) em um paciente pediátrico. Relato do caso: um menino de 5 anos idade apresentou queixa de aumento de volume doloroso na região posterior de mandíbula com tempo de evolução de 4 meses. A tomografia computadorizada demonstrou uma imagem hipodensa, bem delimitada, envolvendo a coroa do dente 37, causando a expansão da cortical vestibular e erosão da cortical lingual, com aproximadamente 3cm. Com as hipóteses diagnósticas de fibroma ameloblástico ou CD, a lesão foi enucleada totalmente. Microscopicamente, observou-se uma lesão cística com revestimento epitelial odontogênico, áreas de hiperplasia e exocitose, além de cápsula de tecido conjuntivo densamente colagenizado, com áreas de hemorragia e infiltrado inflamatório linfoplasmocitário. Resultados: baseado nas características clínicas, imagenológicas e histopatológicas, o diagnóstico final foi de CD inflamado. O paciente continua em acompanhamento clínico e radiográfico, com ausência de recidiva. Conclusão: CD inflamados em pacientes pediátricos podem apresentar comportamento peculiar e mimetizar outras lesões de natureza odontogênica. O diagnóstico precoce permite uma menor morbidade associada aos tratamentos cirúrgicos.

Introduction: pediatric gnathic lesions are commonly asymptomatic and diagnosed in routine imaging exams. However, some of them may cause pain, facial asymmetry, bone destruction and rapid evolution, requiring accurate and early diagnosis. Objective: the aim of this study is to report the diagnosis and treatment of an extensive dentigerous cyst (DC) in a pediatric patient. Case report: a 5-year-old boy complained of painful swelling in the posterior region of the mandible with an evolution time of 4 months. Computed tomography showed a hypodense, well-delimited image involving the crown of tooth 37, causing buccal cortical expansion and lingual cortical erosion, measuring approximately 3cm. With the diagnostic hypotheses of ameloblastic fibroma or DC, the lesion was completely enucleated. Microscopically, a cystic lesion with an odontogenic epithelial lining with areas of hyperplasia and exocytosis was observed, in addition to a densely collagenous connective tissue capsule, with areas of hemorrhage and lymphoplasmacytic inflammatory infiltrate. Results: based on clinical, imaging and histopathological characteristics, the final diagnosis was inflamed DC. The patient remains under clinical and radiographic follow-up, with no recurrence. Conclusion: inflamed DC in pediatric patients may show a peculiar behavior and mimic other odontogenic lesions. Early diagnosis allows for lower morbidity associated with surgical treatments.

The groove configuration of mandibular molars of malaysians of mongoloid ancestry / Configuración del surco de los molares mandibulares de los malayos de ascendencia mongoloide

Aim: Variation in dental structures is widely accepted as a combination of multiple factors such as gender, environmental effects and genetics. However, the characterization of similarities and differences in dental morphology has been lacking in relation to the factors mentioned. This study aims to assess and compare the variations in traits in mandibular molars and the influence of gender and ethnicity in affecting these traits amongst the Malaysian population of Mongoloid ancestry. Materials and Methods: Our study population was 180 dental casts of patients, from 15 to 40 years old, comprising 56 Malays and 124 Chinese; 60 were males and 120 were females. Traits like groove pattern, number of cusps, protostylids and deflecting wrinkles were observed, scored, and recorded. Results: This study revealed that the most common mandibular first molar (M1) was characterized by 5 cusps and displayed 'Y' groove pattern, while the most common mandibular second molar (M2) had 4 cusps and exhibited a groove pattern that resembled a '+'. Notably, all the traits studied were bilaterally symmetrical, except for the groove pattern of M1, while sexual dimorphism was observed in groove patterns of M2. Conclusions: This study found that M1 had a preponderance of 5 cusps with 'Y' groove pattern, while M2 were typically 4-cusped with '+' groove pattern.

Objetivo: La variación en las estructuras dentales es ampliamente aceptada como el resultado de una combinación de múltiples factores como el género, los efectos ambientales y la genética. Sin embargo, ha faltado la caracterización de similitudes y diferencias en la morfología dental en relación a los factores mencionados. Este estudio tiene como objetivo evaluar y comparar las variaciones en los rasgos de los molares mandibulares y la influencia del género y la etnia al afectar estos rasgos entre la población malaya de ascendencia mongoloide. Materiales y Métodos: Nuestra población de estudio fue de 180 modelos dentales de pacientes, de 15 a 40 años,conformados por 56 malayos y 124 chinos; 60 eran hombres y 120 eran mujeres. Se observaron, puntuaron y registraron rasgos como el patrón de surcos, el número de cúspides, los protostílidos y las arrugas desviadas. Resultados: Este estudio reveló que el primer molar mandibular más común (M1) se caracterizaba por 5 cúspides y mostraba un patrón de ranura en 'Y', mientras que el segundo molar mandibular más común (M2) tenía 4 cúspides y exhibía un patrón de ranura que se parecía a un ' +'. En particular, todos los rasgos estudiados eran bilateralmente simétricos, excepto el patrón de surco de M1, mientras que se observó dimorfismo sexual en los patrones de surco de M2. Conclusión: Este estudio encontró que M1 tenía una preponderancia de 5 cúspides con un patrón de ranura en 'Y', mientras que M2 tenía típicamente 4 cúspides con un patrón de ranura '+'.

Cone beam computed tomography-based evaluation of the relationship between the inferior alveolar canal and the cortical plates and the mandibular molar roots in the saudi subpopulation / Evaluación basada en tomografía computarizada de haz cónico de la relación entre el canal alveolar inferior y las placas corticales y las raíces de los molares mandibulares en la subpoblación saudita

Aim: To assess the distance between the inferior alveolar canal and the roots of the mandibular second molar and the mandibula and cortex in a Saudi Arabian subpopulation through existing CBCT images. Materials and Methods: This retrospective study was performed based on 120 patients CBCT images in five age groups.The distances (D1 and D2) between the buccal cortex (BC), lingual cortex (LC), and mandibular molars and the distances (D3) between the root apices and inferior alveolar nerve canal (IANC) were measured for each dental root on the right and left of the mandible with the help of Vision iCAT software. A radiology specialist with a gap of 15 days twice carried out the measurements. Statistical analysis was carried out with the help of SPSS 24. to analyse variability Chi-square analysis was done, and the p value was fixed at > 0.05. To check inter-person variability, Cohen's variability was fixed at 0.8. Results: The distance between the outer surface of the buccal cortical plate and the buccal root surface ranged between 3.8 and 5.7 mm, whereas the distance between the root apices of the mandibular molars and the IANC ranged between 4.8 and 3.5 mm. The distance from the outer surface of the lingual cortical plate to the lingual root surface varied between 1.2 and 2.8 mm. The mean distance between the root apices and IANC increased with age, more so in males than females. Conclusions: Even though this study was conducted on a small sample size, it will help the dental practitioners in planning endodontic procedures, surgical extractions, and implant placements, and it should be repeated with a higher number of images.

Objetivo: Evaluar la distancia entre el canal alveolar inferior y las raíces del segundo molar mandibular, y la mandíbula y la corteza en una subpoblación de Arabia Saudita a través de imágenes CBCT existentes.Materiales y Métodos: Este estudio retrospectivo se realizó con base en imágenes CBCT de 120 pacientes en cinco grupos de edad. Las distancias (D1 y D2) entre la corteza bucal (BC), la corteza lingual (LC) y los molares mandibulares y las distancias (D3) entre los Se midieron los ápices radiculares y el canal del nervio alveolar inferior (IANC) para cada raíz dental a la derecha e izquierda de la mandíbula con la ayuda del software Vision iCAT. Un especialista en radiología, con un intervalo de 15 días, realizó dos veces las mediciones. El análisis estadístico se realizó con la ayuda del SPSS 24. Para analizar la variabilidad se realizó un análisis de Chi-cuadrado y el valor p se fijó en > 0,05. Para comprobar la variabilidad entre personas, la variabilidad de Cohen se fijó en 0,8. Resultados: La distancia entre la superficie exterior de la placa cortical bucal y la superficie de la raíz bucal osciló entre 3,8 y 5,7 mm, mientras que la distancia entre los ápices radiculares de los molares mandibulares y el IANC osciló entre 4,8 y 3,5 mm. La distancia desde la superficie exterior de la placa cortical lingual hasta la superficie de la raíz lingual varió entre 1,2 y 2,8 mm. La distancia media entre los ápices de las raíces y la IANC aumentó con la edad, más en hombres que en mujeres. Conclusión: Aunque este estudio se realizó con un tamaño de muestra pequeño, ayudará a los odontólogos a planificar procedimientos de endodoncia, extracciones quirúrgicas y colocación de implantes, y debe realizarse con más números.

Actualización del análisis de los movimientos mandibulares a través de articulografía electromagnética / Updating the analysis of mandibular movements through electromagnetic articulography

El objetivo de registrar los movimientos mandibulares es obtener parámetros relevantes que permitan evaluar el estado de la articulación temporomandibular (ATM) y de los músculos involucrados en la masticación. El movimiento mandibular se debe a un conjunto complejo de rotaciones y traslaciones tridimensionales realizadas por la ATM, limitado por los ligamentos y las superficies articulares de estas, y por la morfología y la alineación de los dientes, cuando la mandíbula se desplaza sobre estos límites, se llaman movimientos bordeantes mandibulares. El objetivo de este artículo es realizar una descripción actualizada de los movimientos mandibulares a través de articulografía electromagnética. Los movimientos mandibulares bordeantes se clasifican según el plano del espacio en que se muevan, de esta manera tenemos movimientos bordeantes en el plano sagital, en el plano horizontal y el plano frontal, y en cada plano dibujan un polígono distinto, llamados polígonos de Posselt. Estos polígonos pueden ser registrados mediante Articulografía electromagnética, gracias a esta tecnología también se pueden extraer algunos parámetros interesantes, como por ejemplo: la trayectoria total recorrida por la mandíbula al describir cada polígono, rangos de desplazamiento en cada plano, área total de cada polígono de Posselt. La apertura mandibular se mide como la distancia entre los márgenes incisales de los incisivos centrales superiores e inferiores en apertura máxima más la sobremordida. El análisis de esta es una parte importante del examen clínico en odontología, ya que una apertura limitada puede ser resultado de trastornos en la articulación temporomandibular, fibrosis oral submucosa, enfermedad reumática o trauma facial. Las mediciones tridimensionales que se obtienen gracias a la Articulografía electromagnética, son apropiados para determinar los rangos normales de apertura, su exactitud permite la realización de investigaciones en el área, abriendo un amplio campo en el análisis de los movimientos mandibulares.

SUMMARY: The objective of recording mandibular movements is to obtain relevant parameters that allow the evaluation of the state of the temporomandibular joint (TMJ) and of the muscles involved in mastication. Mandibular movement is due to a complex set of three-dimensional rotations and translations performed by the TMJ, limited by the ligaments and their articular surfaces, and by the morphology and alignment of the teeth, when the mandible moves over these limits, they are called mandibular border movements. The aim of this article is to provide an updated description of mandibular movements through electromagnetic articulography. Mandibular border movements are classified according to the plane of space in which they move, thus we have border movements in the sagittal plane, in the horizontal plane and the frontal plane, and in each plane they draw a different polygon, called Posselt polygons. These polygons can be recorded by electromagnetic articulography, thanks to this technology some interesting parameters can also be extracted, such as: the total trajectory covered by the mandible when describing each polygon, displacement ranges in each plane, total area of each polygon of Posselt. Mandibular opening is measured as the distance between the incisal edges of the upper and lower central incisors at maximum opening plus the overbite. The analysis of mandibular opening is an important part of the clinical examination in dentistry as a preliminary evaluation, since limited opening can be the result of temporomandibular joint disorders, submucous oral fibrosis, rheumatic disease or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. Analysis of mandibular opening is an important part of the clinical examination in dentistry, since limited opening can be the result of temporomandibular joint disorders, oral submucous fibrosis, rheumatic disease, or facial trauma. The three-dimensional measurements that are obtained thanks to the electromagnetic Articulography, are appropriate to determine the normal ranges of opening, its accuracy allows the realization of investigations in the area, opening a wide field in the analysis of mandibular movements.

Concordance of the vestibular bone thickness at the level of point a between teleradiography and cone beam computed tomography / Concordancia del espesor óseo vestibular a nivel del punto a entre telerradiografía y tomografía computarizada de haz cónico

Objective: The aim of this study was to determine the concordance of the vestibular bone thickness measured at the level of point A between Teleradiography and Cone Beam Computed Tomography (CBCT). Materials and Methods: This study consisted of a cross-sectional analytical design of concordance that evaluated the teleradiographies and CBCTs of 32 patients. The measurements were performed by three evaluators, specialists in orthodontics. Two of them measured the CBCTs and one evaluated the teleradiographs. The concordance of both tests was determined using the Concordance Correlation Coefficient. Results: When evaluating the value of the vestibular bone thickness at the level of point A between the CBCT and the teleradiography, it was observed that the mean value of the absolute difference between the two was 0.95±0.74, 95%CI [0.68­1.22], being statistically significant (p=0.0027). When the concordance between both tests was analyzed, it was observed that it was poor (CCC=0.204 95%CI [0.014­0.394]), although statistically significant (p<0.00001). Conclusions: It was possible to conclude that there is no concordance in the measurement of the vestibular bone thickness at the level of Point A between the Teleradiography and the CBCT.

Objetivo: El objetivo de este estudio fue determinar la concordancia del espesor óseo vestibular medido a nivel del punto A entre la Telerradiografía y la Tomografía computarizada de haz cónico (CBCT). Materiales y Métodos: Esta investigación presentó un diseño analítico transversal de concordancia en el que se evaluaron las telerradiografías y CBCT de 32 pacientes. Las mediciones fueron realizadas por tres evaluadores especialistas en ortodoncia, dos de ellos midieron los CBCT y uno las telerradiografías. La concordancia de ambos exámenes fue medida mediante Coeficiente de Correlación de Concordancia. Resultados: Al evaluar el valor del grosor óseo vestibular a nivel del punto A entre el CBCT y la telerradiografía, se observó que el valor promedio de diferencia absoluta entre ambos fue de 0,95±0,74 IC95% [0,68­1,22], siendo estadísticamente significativas (p=0,0027). Cuando se analizó la concordancia entre ambos exámenes se observó que esta fue pobre (CCC=0,204 IC95 % [0,014­0,394]), aunque estadísticamente significativa (p<0,00001). Conclusión: Se pudo concluir que no existe concordancia en la medición del espesor óseo vestibular medido a nivel del Punto A entre la Telerradiografía y el CBCT.

Frecuencia de la cavidad ósea de Stafne. Un análisis retrospectivo en radiografías panorámicas / Frequency of Stafne's bone cavity. A retrospective analysis in panoramic radiographs

Introducción: La cavidad ósea de Stafne es una variante anatómica poco frecuente, radiolúcida y bien delimitada, que usualmente se presenta en la región molar cerca del ángulo mandibular y por debajo del canal para el nervio dentario inferior. Es frecuente que sea erróneamente diagnosticada con otras entidades de carácter patológico. Objetivo: Determinar la frecuencia de la cavidad ósea de Stafne en las radiografías panorámicas del Servicio de Radiología Oral y Maxilofacial del Centro Dental Docente "Cayetano Heredia", desde 2015 hasta 2019. Métodos: Se realizó un estudio observacional, descriptivo, transversal y retrospectivo de una muestra de 17875 radiografías panorámicas. Se consideraron las variables demográficas como el sexo, la edad, la localización y la forma, posteriormente se realizaron tablas de contenido para el análisis de los datos. Resultados: Entre los 17875 pacientes, solo 24 (0,13 por ciento) presentaban cavidad ósea de Stafne, incluidos 16 hombres y 8 mujeres. La octava década de vida presentó la mayor cantidad de casos con 6 (0,4 por ciento). La localización posterior derecha contó con 13 (54,17 por ciento), la posterior izquierda con 7 (29,17 por ciento) y la anterior con 4 (16,67 por ciento). La forma ovalada con 23 (95,83 por ciento) y la redonda solo con 1 (4,17 por ciento). Conclusiones: La frecuencia de la cavidad ósea de Stafne fue de 0,13 por ciento con predilección del sexo masculino, la octava década de vida, la localización posterior derecha y la forma ovalada(AU)

Introduction: Stafne's bone cavity is a rare, radiolucent, well-demarcated anatomic variant that usually occurs in the molar region near the mandibular angle and below the canal for the inferior dental nerve. It is frequently misdiagnosed with other pathological entities. Objective: To determine the frequency of Stafne's bone cavity in panoramic radiographs of the Oral and Maxillofacial Radiology Service of the Teaching Dental Care Center "Cayetano Heredia", from 2015 to 2019. Methods: An observational, descriptive, cross-sectional and retrospective study was performed on a sample of 17875 panoramic radiographs. Demographic variables such as gender, age, location and shape were considered; subsequently tables of contents were performed for data analysis. Results: Among the 17875 patients, only 24 (0.13 percent) had Stafne's bone cavity, including 16 males and 8 females. The eighth decade of life presented the highest number of cases with 6 (0.4 percent). The right posterior location accounted for 13 (54.17 percent), the left posterior with 7 (29.17 percent) and the anterior with 4 (16.67 percent). The oval shape with 23 (95.83 percent) and round with only 1 (4.17 percent). Conclusions: The frequency of Stafne's bone cavity was 0.13 percent with male sex predilection, eighth decade of life, right posterior location and oval shape(AU)

Manejo quirúrgico de bad split bilateral en cirugía ortognática / Surgical management of bilateral bad split during orthognathic surgery

El bad split es un término clínico que refiere a una fractura no planificada que ocurre al momento de realizar una osteotomía sagital de rama mandibular (OSRM). Afecta aproximadamente al 2,3% de los pacientes y se han descrito factores de riesgo tales como la presencia de terceros molares mandibulares, edad avanzada al momento de la cirugía, técnica de osteotomía inadecuada, entre otros. Se recomienda efectuar manio-bras preventivas para evitar la aparición de patrones de fractura no deseados al realizar la OSRM. Sin embargo, al momento de pesquisar un bad split, éste debe ser tratado por un equipo capacitado y de manera oportuna para evitar retardo en la consolidación, infecciones y secuestros óseos que puedan comprometer los resultados de la cirugía. En este artículo se presenta el manejo de un caso clínico de bad split bilateral intraoperatorio por el Servicio de Cirugía Maxilofacial del Hospital San José, enfatizando su tratamiento quirúrgico.

Bad Split is a clinical term referring to an unplanned fracture that occurs during the bilateral sagittal split osteotomy (BSSO). It affects approximately 2,3% of the patients undergoing orthognathic surgery and several risk factors have been described such as the presence of mandibular third molars, advanced age at the moment of orthognathic surgery, inadequate osteotomy technique, etc. Preventive maneuvers are recommended in order to avoid the appearance of undesired fracture patterns during BSSO. However, if a bad split is detected it must be managed and treated by a qualified team to avoid further complications such as delayed bone consolidation, bone infection and necrosis. In this article we present the management of a case of bilateral bad split by the Maxillofacial Surgery Service of Hospital San José, emphasizing on its surgical treatment.

Defeito ósseo de Stafne uma depressão lingual na mandíbula: revisão da literatura / Stafne's bone defect a lingual depression in the jaw: literature review

O defeito ósseo de Stafne foi considerado por muito tempo como um cisto ósseo por se apresentar radiograficamente de forma radiolúcida, circunscrita, com bordas delimitadas e em quase todos os casos unilateral. Hoje em dia já se sabe que é uma depressão e/ou cavidade óssea causada pelo alojamento da glândula submandibular ou parte dela e/ou seus tecidos adjacentes na região posterior da mandíbula, ou na região anterior em casos mais raros pelo alojamento da glândula sublingual. Sendo assim, o objetivo deste trabalho é realizar uma breve revisão da literatura acerca das características mais frequentes e suas variações desta anomalia anatômica. As buscas foram realizas em periódicos de artigos científicos publicado nas bases de dados eletrônicas: PubMed, Scielo e Google Acadêmico, contendo artigos científicos dos últimos dez anos nos idiomas inglês e português. Os dados mostram que o defeito ósseo de stafne tem predileção pelo sexo masculino, é assintomática, pois se trata de uma alteração anatômica, não requer tratamento, portanto cabe ao cirurgião dentista ter conhecimento, uma vez que este é encontrado de forma ocasional em radiografias panorâmicas para investigação de outras circunstancias, e que muitas vezes acaba levando o profissional odontólogo a realizar diagnósticos errôneos ou exames mutiladores como a biopsia que são desnecessários nesta situação pelo fato desta variação anatômica ter características muitos semelhantes aos cistos.

Stafne's bone defect was considered for a long time as a bone cyst because it presents radiographically in a radiolucent, circumscribed form, with delimited borders and, in almost all cases, unilateral. Nowadays it is known that it is a depression and / or bone cavity caused by the accommodation of the submandibular gland or part of it and / or its adjacent tissues in the posterior region of the mandible, or in the anterior region in rarer cases by the accommodation of the sublingual gland. Therefore, the objective of this work is to carry out a brief literature review of the more specific characteristics and their variations of this anatomical anomaly. Searches were performed in journals of scientific articles published in electronic databases: PubMed, Scielo and Academic Google, containing scientific articles from the last ten years in English and Portuguese. The data show that the stafne bone defect has a predilection for males, it is asymptomatic, as it is an anatomical alteration, does not require treatment, therefore it is up to the dental surgeon to be aware, once panoramic to investigate other circumstances, and that many Sometimes it ends up leading the dental professional to perform misdiagnosis or mutilating tests such as a biopsy, which are unnecessary in this situation because this anatomical variation has characteristics that are very similar to cysts.

A case of intramandibular epidermoid cyst and literature analysis / 华西口腔医学杂志

Epidermoid cysts are generally benign neoplastic lesions, the etiology of which is unclear and is mainly related to epithelial cells left in the tissues during the embryonic period and traumatically implanted in the tissues. The most common intraosseous sites are the phalanges and the skull. Epidermoid cysts occurring in the jaws are clinically rare. In this paper, we report a case of epidermoid cyst occurring in the mandible with embedded teeth and discuss the etiology, clinical manifestations, diagnosis, and treatment of epidermoid cysts in the jaws in the context of the relevant literature.

Study on the effect of chin morphology on orthodontic treatment / 华西口腔医学杂志

OBJECTIVES@#To investigate the effect of different soft-tissue morphologies on the treatment of skeletal class Ⅰ malocclusion patients by analyzing measurement data before and after treatment.@*METHODS@#Pre- and post-treatment lateral cephalograms of 55 adult female Angle class Ⅰ patients were collected in the Department of Orthodontics, Hospital of Stomatology, Jilin University from January 2012 to December 2020. Chin soft-tissue morphologies in the lateral cranial radiographs were used to divide the patients into an abnormal chin morphology group (flat and retracted chins, n=27) and a normal chin morphology group (rounded and prominent chins, n=28). Relevant soft- and hard-tissue indexes were selected to study in-group varieties and intergroup differences in the varying chin morphologies before and after treatment.@*RESULTS@#The chin-lip angle, mandibular chin angle, mandibular chin vertex angle, PP-MP, LL-E, UL-E, Po-Pos, and B-B' thickness in the abnormal chin morphology group were significantly higher than those in the normal chin morphology group (P<0.05). Furthermore, m∶BMe and n∶B'Mes in the abnormal chin morphology group were signi-ficantly lower than those in the normal chin morphology group (P<0.05). After treatment, the mandibular chin angle, mandibular chin vertex angle, U1-SN, L1-MP, LL-E, UL-E, SNA, SNB, and B-B' thickness of the abnormal chin morphology group significantly decreased (P<0.05), whereas the nasolabial angle, m∶BMe, n∶B' Mes, and Po-Pos significantly increased (P<0.05). In the normal chin morphology group, the U1-SN, L1-MP, LL-E, UL-E, and B-B' thicknesses decreased significantly (P<0.05), whereas the nasolabial angle significantly increased (P<0.05). Among them, m∶BMe and n∶B' Mes were positively correlated.@*CONCLUSIONS@#Chin morphology affects the formulation of treatment plans. Compared with the normal chin morphology group, the abnormal chin morphology group required a larger retraction of incisors. Although the chin of soft-tissue morphology is related to the morphology of bones, the changes in soft tissue chin after treatment cannot be directly predicted according to the bone changes. Soft-tissue chin morphology affects the aesthetic assessment of the soft-tissue lateral profile and the change in soft tissue before and after treatment. The method of predicting the change in soft-tissue chin after treatment should consider the morphology of the soft-tissue chin.

Study of dental arch width in patients with idiopathic condylar resorption / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the relationship between idiopathic condylar resorption （ICR） and arch width disorder. Methods:Thirty-two patients with ICR and twenty patients without condylar resorption were enrolled according to the same inclusion criteria. They were divided into experimental group and control group. The experimental group was divided into unilateral ICR group and bilateral ICR group according to the affected side of condylar resorption, and then experimental group was divided into subgroups ICR Ⅰ, ICRⅡand ICR Ⅲ according to the degree of condylar resorption. Patients with no condylar resorption were used as a control group. The width of anterior, middle and posterior segments of dental arch on cone beam computed tomography（CBCT） was measured and the two groups of measured values were statistically analyzed. Results:Compared with the control group, the width of maxillary anterior, middle and posterior segments in ICR group was significantly reduced, and the difference was statistically significant（P<0.01）. But the width of mandibular segment was not significantly different from that in control group（P>0.05）. There was no significant difference in the width of anterior, middle and posterior dental arch between subgroups（P>0.05）. Conclusion:Almost all patients with ICR have malocclusion of maxillary and mandibular arch width, but there is no significant correlation between the malocclusion width and the severity of condylar resorption.