Relationship Between the Initial Position of Palatally Displaced Canines and Treatment Duration / Relación entre la posición incial de caninos desplazados palatalmente y la duración del tratamiento

Abstract This prospective study aimed to assess the positional features of palatally displaced maxillary canines (PDCs), their relationship with both cephalometric and dental cast measurements and treatment duration. Pretreatment panoramic and lateral cephalometric radiographs and dental casts of 46 patients (23 patients with uni/bilateral PDC and 23 patients with Class I malocclusion) were collected. The mesial inclination of the permanent canine to the midline (α angle), the distance from the cusp tip of the permanent canine to the occlusal line (d distance), and the mesial position of the crown of the displaced canine (sector) were measured on the panoramic radiographs. SNA°, SNB°, ANB°, SN-GoGn°, SN-PP°, and PP-MP° angles and sagittal inclinations of the PDCs' (C-PP°) were measured on cephalometric radiographs. Arch length discrepancies and transversal arch measurements were also performed. The Student's t-test, Mann-Whitney U test and Kruskal-Wallis test were used to compare variables that were not normally distributed while ANOVA was used for the normally distributed data. The arch widths were similar between the groups while crowding was significantly greater in the PDC group. A negative correlation was found between the α angle and vertical plane angle (SN-GoGn°). Treatment duration was positively correlated with α angle and d distance but there was no relationship with the sagittal angulation of the PDC to the palatal plane (C-PP°) and the treatment duration. Treatment duration can be expected to be longer with every increase in the angle of the PDC to the midline and distance from the occlusal plane.

Resumen El objetivo de este estudio prospectivo fue evaluar las características de los caninos mailares desplazados palatalmente (CDPs), su relación con las radiografías cefalométricas, las medidas en los modelos de yeso y el tiempo de duración del tratamiento. Se recolectaron radiografías panorámicas, laterales cefalométricas y modelos dentales de 46 pacientes (23 pacientes con CDPs uni/bi laterales y 23 pacientes con maloclusión de Clase I). Se midieron la inclinación mesial de los caninos permanentes con respecto a la línea media (ángulo α), la distancia de la punta de la cúspide del canino permanente a la línea oclusal (distancia d) y la posición mesial de la corona del canino desplazado (sector) en la radiografía panorámica. En las radiografías cefalométricas se midieron los ángulos SNA°, SNB°, ANB°, SN-GoGn°, SN-PP° y PP-MP° y las inclinaciones sagitales de los CDPs (C-PP°). También se realizaron las medidas de las discrepancias de la longitud de arco y las medidas de arco transversal. La prueba de t de student, prueba Mann-Whitney U y la prueba Kruskal-Wallis se usaron para comparar las variables que no se comportaron con una distribución normal, mientras que se utilizó la ANOVA para los datos de distribución normal. El ancho de los arcos fue similar entre grupos mientras el apiñamiento fue significativamente mayor en el grupo de CDPs. Se encontró una correlación negativa entre el ángulo α y el ángulo del plano vertical (SN-GoGn°). La duración del tratamiento fue positivamente correlacionado con el ángulo α y la distancia d peron o se encontró relación entre la angulación sagital del CDP con el plano palatal (C-PP°) y la duración del tratamiento. Se puede esperar que la duración del tratamiento sea mayor con el aumento del ángulo entre el CDP a la línea media y la distancia desde el plano oclusal.

Diagnosis of alveolodental ankylosis in unerupted canines: one of the answers to why the canine does not come

ABSTRACT Introduction: Teeth frequently fail to erupt and situations arise that prevent the canines from reaching the occlusal plane. Objective: Discourse about the three situations in which the canine does not reach the occlusal plane, and remains unerupted; and at the same time, point how to make a safe diagnosis of alveolodental ankylosis - one of the three causes -, based on tomography. Conclusions: Ankylosis occurs in impacted teeth by atrophy of the periodontal ligament, including the epithelial rests of Malassez. The tomographic signs of alveolodental ankylosis in unerupted canines are the interruption of hypodense periodontal space, discontinuity of the lamina dura and its continuity with the root surface, which gradually loses its regular shape.

RESUMO Introdução: Muitas vezes, a erupção falha, e ocorrem situações que impedem que os caninos cheguem até o plano oclusal. Objetivos: Discorrer sobre quais as três situações nas quais o canino não chega até o plano oclusal, permanecendo não irrompido e, ao mesmo tempo, destacar como se diagnosticar com segurança uma dessas três causas, a anquilose alveolodentária, a partir da tomografia. Conclusões: A anquilose em dentes não irrompidos ocorre pela atrofia do ligamento periodontal, incluindo os Restos Epiteliais de Malassez. Os sinais tomográficos de uma anquilose alveolodentária em caninos não irrompidos são a interrupção do espaço periodontal hipodenso, a descontinuidade da lâmina dura e a sua continuidade com a superfície radicular, que, gradativamente, perde sua regularidade.

Impaction of mandibular canine associated with a dentigerous cyst: a 2. 5 - year follow-up report

Introduction: Dentigerous cyst is an odontogenic cyst lesion surrounding the crown of an unerupted or impacted tooth in the jaw. Objective: The aim of this case report is to describe the treatment planning and follow-up of a dentigerous cyst associated with the impaction of the permanent mandibular right canine tooth in an 11-year-old female. Case report: Radiographic assessment revealed a radiolucent unilocular round-shaped lesion localized in the mandibular symphysis. Enucleation was performed and the affected tooth was removed under general anesthesia. The patient is under follow-up due to orthodontic treatment. The affected area healed without complications. Conclusion: Two and a half years after the enucleation, the cyst had totally disappeared, and no recurrences were observed. Bone remodeling and neoformation were noticed.

Introdução: O cisto dentígero é uma lesão odontogênica ao redor da coroa de um dente não irrompido ou impactado na mandíbula. Objetivo: O objetivo deste relato de caso é descrever o plano do tratamento e o acompanhamento de um cisto dentígero associado à impactação do canino permanente inferior direito em uma criança do gênero feminino de 11 anos de idade. Relato do caso: A avaliação radiográfica revelou lesão unilocular radiolúcida de forma arredondada, localizada na sínfise mandibular. A enucleação foi realizada e o dente afetado foi removido sob anestesia geral. A paciente encontra-se em acompanhamento devido o tratamento ortodôntico. A área afetada curou sem complicações. Conclusão: Dois anos e meio após a enucleação, o cisto desapareceu totalmente e não houve recidivas. Remodelação óssea e neoformação foram observadas.

Age estimation in Brazilian adults by Kvaals and Camerieres methods

Abstract The aim of this study was to verify the precision and applicability of two methods of age estimation, Kvaal's and Cameriere's methods, among Brazilian adults. A sample composed of periapical radiographs of canine teeth belonging to 320 Brazilian adults was analyzed, divided into groups according to sex (male and female) and age group (20-29 years, 30-39 years, 40-49 years and 50-59 years). Kvaal's method presented better results when compared to the results of Cameriere's method in the general evaluation of each canine tooth, except for the upper left canine (tooth 23), which presented a mean error (ME) with no statistically significant difference between the methods (Kvaal: ME = 7.43, p = 0.4991, Cameriere: ME = 7.55, p = 0.6982). In the evaluation by age groups, Kvaal's method presented a lower variation between the real age and estimated age when applied to the age groups of 20-29 years and 30-39 years compared to the results provided by Cameriere's method. With respect to the groups aged 40 to 49 years and 50 to 59 years, Cameriere's method presented better performance than the results provided by Kvaal's method. The methods of estimating age proposed by Kvaal and Cameriere are simple and nondestructive and have demonstrated reproducibility and reliability. The Kvaal method was more accurate for the age groups of 20-29 and 30-39 years, and for those over 40 years, the Cameriere method was the most accurate.

Bilateral canine space infection secondary to odontogenic origin: a rare case report

Odontogenic infections (OI) are a major reason for consultation in dental practice. They affect people of all ages, and most of them respond well to current medical and surgical treatments. The aim of this paper is to emphasize different and rare etiological factors that can play a role in odontogenic abscesses, which can lead to complications. A 54-year-old man complaints of pain and swelling on the upper front-side of his face. Physical examination of the face showed enlargement and swelling in the upper front region. Panoramic radiograph images showed a ra-diolucent appearance of the canine region. Based on the results of the clinical and radiographic examinations, the patient was diagnosed with a bilateral canine space infection. The treatment performed was FNAC (Fine neddle aspiration cytology) from canine region followed by intraoral drainage incision at the most prominent part of swelling (Modified Hiltons method), 5 ml of pus was removed, postoperative dressing was applied and regular follow-up was done with continued antibiotic therapy. Bilateral canine space abscess is a rare odontogenic infection that can cause life-threatening complications. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management. To per-form treatment of odontogenic infections, the Oral & Maxillofacial Surgeon should understand the terminology regarding infectious diseases and pathophysiology. The success of treatment requires early recognition, determination of etiological factors, and appropriate medical and surgical management.

Estimación de la edad dental en adultos mediante análisis de relación de área pulpa/diente en premolares y caninos mandi bulares mediante ortopantomografías, en una muestra chilena / Dental age estimation in adults by pulp/tooth ratio in lower premolars and canines by orthopantomographs, in a Chilean sample

La estimación de la edad es uno de los procedimientos más importantes para la identificación humana. Cameriere et al. propusieron un método para estimación de edad evaluando la relación área pulpa/diente utilizando radiografías dentales, basado en la aposición de dentina secundaria. El objetivo de este estudio, fue desarrollar modelos de regresión lineal para la estimación de la edad, mediante la relación de área pulpa/diente en caninos y premolares mandibulares utilizando ortopantomografías (OPGs) en una población chilena de individuos adultos de edad y sexo conocidos. Se analizaron 162 OPGs digitales (67 hombres y 95 mujeres) mediante el programa ImageJ, con el fin de medir las áreas señaladas. Mediante análisis de regresión, se estudiaron las posibles interacciones entre la edad, sexo y relación de área pulpa/diente. Esta relación disminuyó regularmente con la edad y varió de 0,03 a 0,6 para premolares y 0,04 a 0,6 para caninos respectivamente. El mejor modelo de estimación de edad fue para la relación del canino inferior izquierdo obteniendo un coeficiente de determinación de R2=8,7 %. La media de error absoluto, con un intervalo de confianza del 95 %, osciló entre 5,6 y 5,72 años. El análisis de ANCOVA no mostró diferencias significativas entre hombres y mujeres para la estimación de edad, al igual que para ambos lados de la cavidad oral. Según los resultados obtenidos, la relación de área pulpa/diente es una metodología fiable para la estimación de la edad en adultos. Sin embargo, los resultados demuestran que, en casos reales, es necesario contar con métodos adicionales de estimación ya que, al menos en la muestra analizada, el ajuste indicado por los coeficientes de determinación demostró falta de certeza en las estimaciones etarias producidas por los modelos de regresión lineal.

Age estimation is one of the most important procedures for human identification. Cameriere et al. proposed a method for age estimation based on the analysis of the pulp/tooth ratio by using dental x-rays, based on the apposition of secondary dentine. The objective of this study was to develop linear regression models for age estimation, by means of the pulp/tooth ratio of mandibular canines and premolars using orthopantomographies (OPGs) in a Chilean population of adults of known age and sex. We analyzed 162 digital OPGs (67 men and 95 women) through ImageJ software, in order to measure these areas. By means of regression analysis, the possible interactions between age, sex and pulp / tooth ratio were studied. This relationship decreased regularly with age and ranged from 0.03 to 0.6 for premolars and 0.04 to 0.6 for canines, respectively. The best model of age estimation was for the relation of the lower left canine, obtaining a coefficient of determination of R2=8.7 %. The mean absolute error, with a confidence interval of 95 %, ranged between 5.6 and 5.72 years. The ANCOVA analysis showed no significant differences between men and women for age estimation, as well as for both sides of the oral cavity. According to the results, the pulp/tooth ratio is a reliable methodology for estimating age in adults. However, the results showed that, in actual cases, it is necessary to use additional estimation methods since, at least in the sample analyzed, the adjustment indicated by coefficients of determination showed uncertainty in age estimation produced by the linear regression models.

Abordagem cirúrgica de canino impactado em região de mento / Canine surgical approach impacted in mento region

Os caninos maxilares e mandibulares são dentes importantes dos pontos de vista estético e funcional. Esses dentes são frequentemente mal posicionados, no entanto, a falha da irrupção do canino mandibular é pouco comum, sendo mais frequente a inclusão de caninos maxilares. Fatores como posicionamento dentário, anquiloses, cistos, idade do paciente, saúde periodontal, formação radicular, entre outros, direcionam o tratamento. Objetivo: reportar um caso clínico de um jovem com impactação dentária de um canino inferior direito, enfatizando e discutindo a técnica cirúrgica e o planejamento realizado. Relato de caso: paciente de 15 anos de idade, do gênero masculino, com a não erupção do canino inferior direito, ao exame clínico, apresentou ausência clínica do dente 43, persistência do dente 83. Foi solicitada uma tomografia computadorizada de feixe cônico (cone beam) da região, na qual se diagnosticou a presença do elemento dentário 43 em posição horizontal localizado no mento. O plano de tratamento proposto foi remoção cirúrgica do dente não irrompido. Considerações finais: a opção de tratamento de dentes não erupcionados dependente de fatores como rizogênese incompleta, idade do paciente e grau de inclusão, e as manobras referentes aos dentes envolvidos devem ser realizadas no momento mais oportuno e com adequado planejamento, evitando lesões nas estruturas nobres e permitindo, assim, um processo de reparo adequado.(AU)

Introduction: Maxillary and mandibular canines are important teeth from the aesthetic and functional points of view. These teeth are often poorly positioned but the eruption failure of the mandibular canine is uncommon, and the inclusion of maxillary canines occurs more frequently. Factors such as dental positioning, ankyloses, cysts, patient age, periodontal health, root formation, among others guide the treatment. Objective: To report a clinical case of a young man with tooth impaction of a right lower canine, emphasizing and discussing the surgical technique and planning performed. Case report: A 15-year-old male patient, with non-eruption of the right lower canine on the clinical examination, presented a clinical absence of tooth 43 and persistence of tooth 83. A cone-beam computed tomography was requested for the region in which the presence of dental element 43 was diagnosed, in the horizontal position located in the chin. The treatment plan proposed was surgical removal of the non-erupted tooth. Final considerations: The treatment option of non-erupted teeth depends on factors such as incomplete rhizogenesis, patient age, and degree of inclusion, and the teeth involved should be managed at the optimal time and with adequate planning, preventing injuries to noble structures, thus allowing an adequate repair process.(AU)

Age estimation by pulp/tooth area ratio in anterior teeth using cone-beam computed tomography: comparison of four teeth

Abstract Objectives Age estimation is one of the most important factors in forensic medicine. Measuring secondary dentin deposition using cone-beam computed tomography images is an easy and noninvasive method. The aim of this study was to evaluate cone-beam computed tomography images as a reliable method to estimate chronological age by pulp/teeth ratio in anterior teeth in Iranian population. Methodology A total of 649 CBCT images from 377 Iranian patients aged between 20 and 69 years were evaluated. Pulp/teeth ratio (PTR) in maxillary and mandibular canine and central incisor teeth was measured in the axial and sagittal sections using OnDemand 3D Dental software. The Pearson correlation coefficient was determined to evaluate the correlation between the variables. Linear regression analysis, as well as age estimation formula, was used for each tooth separately. Results The regression analyses indicated that maxillary central incisors were more reliable for age estimation (R2=0.586 and standard error of estimate=7.045) compared with the other anterior teeth studied. Maxillary canine teeth had the lowest predictive power (R2=0.392 and standard error of estimate=8.387). Also, comparison of the axial and sagittal sections showed that the axial sections had a higher predictive power. (R2=0.48 for axial plans and R2=0.328 for sagittal plans) Conclusion The use of cone-beam computed tomography in age estimation by pulp/teeth ratio of anterior teeth is useful and a reliable method for age estimation in Iranian population.

Tomografia computadorizada multidetectores de baixa dose de radiação para avaliação de canino incluso / Low-dose multidetector computed tomography for impacted canine evaluation

Objetivo: avaliar caninos inclusos em tomografias computadorizadas multidetectores (TCMD) realizadas no Hospital Universitário de Santa Maria. Materiais e mé¬todo: foi realizado um estudo observacional transversal com imagens de um banco de dados de TCMD de baixa dose de radiação, solicitadas por indicações clínicas odontológicas. Os exames em formato digital imaging and communications in medicine foram avaliados por um examinador treinado, no software Weasis Medical Viewer. A avaliação dos exames compreendeu a observação das seguintes características: impactação do canino (uni ou bilateral), localização do canino (maxila ou mandíbula), localização da coroa do canino (vesti¬bular ou lingual/palatal), eixo de erupção, espessura do folículo pericoronário, presença de lesões associadas, presença de reabsorção nos dentes adjacentes e presença de agenesias dentárias ou de supranumerários. Os resultados foram avaliados de maneira descritiva, por meio de prevalência dos achados. Resultados: foram encontrados 21 caninos inclusos em 837 tomografias avaliadas (1,9%). Foi observado um predomínio de indivíduos do sexo feminino (71,4%), e a retenção do canino foi mais frequente na maxila (71,4%) e com impactação unilateral (61,9%). Quatro caninos apre¬sentaram folículo pericoronário, com espessura maior que 2 mm; 19% dos exames apresentaram reabsorção radicular externa em algum incisivo lateral. Apenas um canino apresentava lesão associada, sugerindo esclero-se óssea. Além dos caninos inclusos, foi possível avaliar alterações relacionadas às demais regiões e estruturas dentomaxilofaciais. Conclusão: apesar da amostra limitada de imagens, o presente estudo demonstrou a aplicabilidade clínica da TCMD com protocolo de baixa dose de radiação, para a avaliação dos caninos inclusos e características relacionadas a esses dentes, bem como de dentes e regiões adjacentes. (AU)

Objective: to evaluate impacted canines by tomographic exams performed at the University Hospital of Santa Maria. Materials and method: a cross-sectional observational study was performed with selected images from a database of low dose computed tomography (CT) scans requested by several dental indications. The DICOM files were evaluated by a trained examiner, using Weasis Medical Viewer software. The evaluation of each exam included the following characteristics: canine impaction (uni or bilateral), location of the canine (maxilla or mandible), location of the canine crown (buccal or lingual / palatal), shaft of canine eruption, thickness of the pericoronal follicle, presence of associated lesions, presence of external root resorption in adjacent teeth and presence of dental agenesis or supernumerary tooth. The results were evaluated in a descriptive way, through prevalence of the findings. Results: a total of 21 impacted canines were found in 837 CT scans evaluated (1,9%). A predominance of female patients was observed (71,4%); canine impaction was more frequent in the maxilla (71,4%), and unilateral (61,9%). In 19% of the exams, external root resorption occurred in some lateral incisor. Four dental elements presented pericoronal follicles thicker than 2 mm. In the evaluated sample, only one canine presented an associated lesion, suggesting bone sclerosis. Beyond the canine-related, other dental and maxillofacial changes were also evaluated. Conclusion: in spite of the limited sample, the present study demonstrated the clinical applicability of low dose CT for the evaluation of impacted canines, and characteristics related to these teeth, as well as to the adjacent teeth and regions. (AU)

Morphology and volume of maxillary canine pulp cavity for individual age estimation in forensic dentistry / Morfología y volumen de la cavidad de pulpa del canino maxilar para la estimación de la edad individual en odontología forense

Age estimation plays a very important role in individual recognition in forensic dentistry. Morphological data of 3D pulp cavity of maxillary canines were acquired by oral and craniofacial CT scans. In accordance with inclusion criteria, CT data of 103 patients (51 males and 52 females) were collected at the Department of Radiology, Stomatological Hospital, Shanxi Medical University, China from September 2015 to August 2016. Mimics 17.0 software was used to measure pulp volume of maxillary canines and tooth volume, and to calculate the ratio of pulp volume/tooth volume. SPSS 16.0 software was utilized to analyze and establish database. Linear regression analysis was applied to process data and to establish a linear regression equation for individual age: Y=69.137-621.200 (pulp volume/tooth volume), R=0.544. Subjects were grouped according to gender, deriving the inferred function of male age: Y=64.333-468.811 (pulp volume/tooth volume), R=0.435; the inferred function of female age: Y=76.445-843.186 (pulp volume/tooth volume), R=0.691. The ratio of pulp volume to tooth volume can be used to infer individual age, and can provide a new method and pathway for individual recognition in forensic dentistry.

La estimación de la edad juega un papel importante en el reconocimiento individual en la odontología forense. Los datos morfológicos de la cavidad pulpar tridimensional de los caninos maxilares fueron adquiridos por tomografía computarizada oral y craneofacial. De acuerdo con los criterios de inclusión, se recolectaron datos de 103 pacientes (51 hombres y 52 mujeres) en el Departamento de Radiología del Hospital de Estomatología de la Universidad de Medicina de Shanxi, desde septiembre de 2015 hasta agosto de 2016. Se utilizó el software Mimics 17.0 para medir el volumen de pulpa de los caninos maxilares y el volumen del diente, además, se calculó la relación entre el volumen de la pulpa y el volumen del diente. Se utilizó el software SPSS 16.0 para analizar y establecer las bases de datos. El análisis de regresión lineal se aplicó a los datos del proceso y para establecer la edad individual se aplicó una ecuación de regresión lineal: Y = 69.137-621.200 (volumen de la pulpa / volumen del diente), R = 0.544. Los sujetos se agruparon según el sexo, derivando la función inferida de la edad masculina: Y = 64.333-468.811 (volumen de la pulpa / volumen del diente), R = 0.435; La función inferida de la edad de la mujer: Y = 76.445-843.186 (volumen de la pulpa / volumen del diente), R = 0.691. La relación entre el volumen de la pulpa y el volumen del diente puede usarse para inferir la edad individual y puede proporcionar un nuevo método y forma para el reconocimiento individual en la odontología forense.

Transmigrated canines associated to odontomas / Caninos transmigrados asociados a odontomas

We present the case of a 13-year-old patient with bilateral transmigration of mandibular canine associated with multiple composite odontoma. Impacted canines are very uncommon, with a 0.1 % to 3.6 % prevalence of appearance. The presence in the mandible is less frequent. The odontoma development is often associated with the impacted canines. The etiology is unknown but is associated with traumatic, infectious, hereditary or genetic factors. This pathology is asymptomatic and associated with eruption disorders in temporal and permanent dentition.

Presentamos el caso de un paciente de 13 años de edad con trasmigración bilateral de canino mandibular asociado a múltiples odontomas compuestos. Los caninos impactados son muy poco frecuentes, con una prevalencia de aparición de 0,1 % a 3,6 %. La presencia en la mandíbula es menos frecuente. El desarrollo de odontomas se asocia a menudo con los caninos impactados. La etiología es desconocida pero está asociada con factores traumáticos, infecciosos, hereditarios o genéticos. Esta patología es asintomática y está asociada a trastornos de erupción en dentición temporal y permanente.

Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation

Abstract Objective The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. Material and Methods Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). Results There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. Conclusions Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.

Risk of developing palatally displaced canines in patients with early detectable dental anomalies: a retrospective cohort study

ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.

Multidetector computed tomography dental scan analysis of root canal morphology of maxillary canine.

Aim: The aims of this in vitro study were to see potential applications of multidetector computed tomography (MDCT) in the analysis of root canal morphology. Materials and Methods: In this in vitro study measurement of root and canal diameters, root and canal diameter ratios, and radicular wall thickness at different levels in maxillary canines with long oval root canals. A total of 40 human maxillary canines, with single long oval canals were selected for this study. The specimens were analyzed with MDCT (16 slice) through dentascan software. The cross‑sections corresponding to 625 mm slice thickness from the radiologic apex were analyzed to measure the mesiodistal (MD) and buccolingual (BL) diameters of the canals and the thickness of the root and the walls. The BL/MD ratios of the canal (ΔC) and the root (ΔR) diameters were calculated, as was as the mean taper in both a BL and an MD dimension. Results: A high correlation was established between the shape of the root canal and the corresponding root. Conclusion: Clinical Implications of these techniques is useful to clinician and it can also be applied to improve preclinical training and analysis of fundamental procedures in endodontic and restorative treatment.

Transmigration of the Mandibular Canine: A Report of Two Rare Cases.

When the tooth, instead of erupting in its normal position, remains impacted and crosses midline and is seen on the opposite side of the jaw, it is termed as Transmigration; e.g., right side tooth is seen on the left side and vice-versa. This phenomenon occurs without any pathology intervening cause. Canines are commonly seen unerupted and remain impacted, but rarely seen crossing the midline and migrating to the opposite side. They are usually symptomless. Here, we present two such rare cases of transmigration of the mandibular canine, one from the right side to the left side and appearing piercing the lower border of the mandible and producing a hard bulge on the left side of the lower jaw, but without any pain. The other case is of transmigration of mandibular left canine toward the right side well below the inferior alveolar canal beyond mental foramen facing toward posterior region of the mandible and causing pain symptoms in the jaw due to its close proximity to inferior alveolar canal. It is very essential to have panoramic radiograph to detect such abnormalities at an early stage to plan treatment and avoid future complications. Cone beam computed tomography images also play an important role.

Caracterización morfométrica del reborde anterior de la maxila mediante tomografía computarizada cone-beam / Morphometric characterization of anterior maxillary alveolar ridge by cone-beam computed tomography

Las imágenes obtenidas por Tomografía Computarizada Cone-Beam (TCCB) permiten determinar las relaciones de estructuras anatómicas tridimensionalmente y superar limitaciones de la radiografía convencional. El objetivo de este estudio fue describir las características morfométricas de la zona anterior del maxilar y su relación con los dientes canino y premolares mediante exámenes de TCCB. Se realizó un estudio descriptivo sobre 50 imágenes de TCCB siguiendo una sistemática de observación tridimensional se ubicaron puntos anatómicos entre dientes y paredes del seno maxilar, y se trazaron tangentes para su medición. Se calculo la Media y DE para cada parámetro, y la normalidad de la distribución se comprobó mediante la prueba de Kolmogorov-Smirnov. Los datos fueron comparados con la prueba ANOVA, con una valor p < 0,05 como significativo. El análisis de la relación entre los dientes y la pared anterior del seno maxilar, mostró que en un 80% de los casos se relacionó con el canino y 20% con el primer premolar. La menor altura entre el reborde alveolar y la pared inferior del seno maxilar se observó a nivel del segundo premolar con 13,54±0,30 mm en el lado derecho y 14,65± 0,30 mm en el izquierdo. Se registraron diferencias significativas en relación a las mediciones morfométricas y la variable rango etáreo. Los datos obtenidos en este estudio complementan las características morfométricas de la zona anterior del maxilar, lo que permite ejecutar tratamientos de implantes bajo una base morfológica científica y minimizando al máximo los riesgos de fracaso o daño a las estructuras anatómicas relacionadas.

The images obtained by Cone -Beam Computed Tomography (CBCT) allow the determination of three-dimensional relationships of anatomical structures and overcome limitations of conventional radiography. The aim of this study was to describe the morphometric characteristics of the anterior maxilla and its relation to canine and premolars by CBCT exams. A descriptive study on 50 CBCT images was made, following a systematic observation of three-dimensional anatomical points between teeth and maxillary sinus walls, they were located and plotted tangent for measurement. The Mean and SD was calculated for each parameter, and the normality of distribution was tested by Kolmogorov -Smirnov test. Data were compared by ANOVA test, with a p value <0.05 as significant. The analysis of the relationship between the teeth and the anterior wall of the maxillary sinus, showed that in 80% of cases are associated with the canine and in 20% to first molar. The lower height between the alveolar ridge and the inferior wall of the maxillary sinus was observed at the second premolar with 13.54±0.30 mm on the right side and 14.65±0.30 mm on the left. Significant differences were recorded in relation to morphometric measurements and age range variable. The data obtained in this study complement the morphometric characteristics of the anterior maxilla, allowing implant treatments in a scientific morphological basis and minimizing the level of risk of failure or damage to the anatomical structures related.

Canino mandibular con dos raíces / Mandibular canine with two roots

El canino inferior es un diente con raíz larga y ancha que le permite una adecuada implantación en el arco dentario. Es considerado un pilar valioso en muchos tratamientos rehabilitadores. Con la finalidad de mantener este elemento dentario es necesario realizar un correcto diagnóstico, para lo que se tendrá en cuenta el conocimiento de las variaciones anatómicas. El objetivo del artículo es presentar un caso de canino mandibular con dos raíces con sus respectivos canales radiculares .Paciente femenina de 21 años, que acudió a la Clínica de Radiología de la Facultad de Odontología de Piracicaba con indicación de una radiografía panorámica para valorar cirugía de terceros molares. Llamó la atención una configuración inusual de las raíces de los caninos mandibulares. En el examen de tomografía computarizada de haz cónico se observó que el canino mandibular del lado derecho presentaba dos raíces separadas, cada una con sus respectivos canales radiculares. Se concluyó que a pesar de la baja prevalencia de las variaciones anatómicas, estas pueden ocurrir en el número de raíces y canales de los caninos mandibulares, tal como se presenta en este reporte de caso(AU)

The mandibular canine is a robust and long tooth which allows an adequate implantation in the dental arch. It is considered a valuable pillar in many rehabilitating treatments. In order to maintain this important dental element, it is necessary to make a correct diagnosis, for which the knowledge of the different anatomic variations should be kept in mind. The objective of this article is to present a case of a mandibular canine with two roots with their respective root canals. A 21-year-old female patient went to the Radiology Clinic at the Faculty of Odontology of Piracicaba with the indication of a panoramic radiography for preoperative third molars surgery. An unusual root configuration of the mandibular canines was observed. In the cone beam CT, it was observed that the right mandibular canine presented two separate roots, each one with their respective radicular canals. It was concluded that, despite of the low prevalence of anatomical variations, these can occur in the root system of the mandibular canines, as presented in this case report(AU)

Evaluation of an innovative radiographic technique - parallel profile radiography - to determine the dimensions of dentogingival unit.

Background: Maintenance of gingival health is a key factor for longevity of the teeth as well as of restorations. The physiologic dentogingival unit (DGU), which is composed of the epithelial and connective tissue attachments of the gingiva, functions as a barrier against microbial entry into the periodontium. Invasion of this space triggers inflammation and causes periodontal destruction. Despite the clinical relevance of the determination of the length and width of the DGU, there is no standardized technique. The length of the DGU can be either determined by histologic preparations or by transgingival probing. Although width can also be assessed by transgingival probing or with an ultrasound device, they are either invasive or expensive Aims: This study sought to evaluate an innovative radiographic exploration technique - parallel profile radiography - for measuring the dimensions of the DGU on the labial surfaces of anterior teeth. Materials and Methods: Two radiographs were made using the long-cone parallel technique in ten individuals, one in frontal projection, while the second radiograph was a parallel profile radiograph obtained from a lateral position. The length and width of the DGU was measured using computer software. Transgingival probing (trans-sulcular) was done for these same patients and length of the DGU was measured. The values obtained by the two methods were compared. Pearson product correlation coefficient was calculated to examine the agreement between the values obtained by PPRx and transgingival probing. Results: The mean biologic width by the parallel profile radiography (PPRx) technique was 1.72 mm (range 0.94-2.11 mm), while the mean thickness of the gingiva was 1.38 mm (range 0.92-1.77 mm). The mean biologic width by trans-gingival probing was 1.6 mm (range 0.8-2.2mm). Pearson product correlation coefficient (r) for the above values was 0.914; thus, a high degree of agreement exists between the PPRx and TGP techniques. Conclusions: We conclude that the biologic width of the DGU in humans can be measured with the PPRx technique. The values obtained agree with the values obtained by transgingival probing, a technique considered standard so far. Thus, the PPRx technique offers a simple, concise, noninvasive, and reproducible method that can be used in the clinical setup to measure both the length and thickness of the DGU with accuracy.