X-linked hypohidrotic ectodermal dysplasia management with removable prosthesis in a pediatric patient: case report / Manejo de displasia ectodérmica hipohidrótica ligada al cromosoma X con prótesis removible en un paciente pediátrico: reporte de caso

Introduction: Ectodermal dysplasia is a rare genetic disorder that affects structures derived from ectoderm such as teeth, hair, nails, and sweat glands. Oligodontia is a common finding that affects the chewing, smiling and self- esteem of these pediatric patients. Case Report: We present a case report of a 7-years-old pediatric patient who consulted with his mother, showing the same condition. The intervention consisted of a removable prosthesis with satisfactory results. Conclusion: The X-linked hypohidrotic ectodermal dysplasia represents a challenge for a pediatric dentist who offers rehabilitation to the patient according to craniofacial development, age, socioeconomic status, and the number of missing teeth.

Introducción: La oligodoncia es un hallazgo común que afecta la masticación, la sonrisa y la autoestima de estos pacientes pediátricos. Case Report: Presentamos un reporte de caso de un paciente pediátrico de 7 años que consultó con su madre presentando la misma condición. La intervención consistió en una prótesis de remoción con resultados satisfactorios. Conclusión: La displasia ectodérmica hipohidrótica ligada al cromosoma X representa un desafío para un odontopediatra que ofrece rehabilitación al paciente de acuerdo con el desarrollo craneofacial, la edad, el nivel socioeconómico y el número de dientes faltantes.

Anomalías dentales en personas con discapacidad / Dental Anomalies in People with Disabilities

RESUMEN Introducción: Durante la odontogénesis se pueden producir malformaciones congénitas que afectan la forma, el número, el tamaño, la estructura, la posición, el color y la erupción de los dientes. En las personas con discapacidades como parálisis cerebral, trastorno del desarrollo intelectual, síndrome de Down y trastorno del espectro autista, pueden presentarse variedad de anomalías dentales. Objetivo: Describir las anomalías dentales en las condiciones de discapacidad de parálisis cerebral, trastorno del desarrollo intelectual, síndrome de Down y trastorno del espectro autista. Métodos: Se realizó una búsqueda bibliográfica en las bases de datos Clinical Key, Medline, Dialnet y SciELO. Se aplicó la lista de comprobación PRISMA. Análisis e integración de la información: Posterior al proceso de lectura y análisis de la información, se recuperaron 800 artículos de las bases de datos, se eliminaron 590 por encontrarse repetidos. Luego de la discriminación, quedaron para revisar 210, a estos restantes se hizo la revisión de texto completo. Se eliminaron 193 no hacían referencia a anomalías dentales y/o a los trastornos o síndromes. De los 17 restantes, solo 15 cumplieron con los criterios de inclusión. Conclusiones: No se encontraron diferencias para afirmar que algunas de las anomalías y alteraciones presentadas correspondan de manera individual a cada tipo de discapacidad. Sin embargo, el síndrome de Down presenta anomalías dentales relacionadas al estado del paciente. La parálisis cerebral reporta otros hallazgos como bruxismo, debido al deficiente desarrollo muscular, lo que afecta la cavidad bucal y sus estructuras(AU)

ABSTRACT Introduction: During odontogenesis, congenital malformations can occur that affect teeth shape, number, size, structure, position, color and eruption. In people with disabilities such as cerebral palsy, intellectual development disorder, Down syndrome, and autism spectrum disorder, a variety of dental abnormalities can occur. Objective: To describe dental anomalies in such disability conditions as cerebral palsy, intellectual development disorder, Down syndrome and autism spectrum disorder. Methods: A bibliographic search was performed in the databases Clinical Key, Medline, Dialnet and SciELO. The PRISMA checklist was applied. Information analysis and integration: After reading and analyzing the information, 800 articles were retrieved from the databases, of which 590 were deleted because they were repeated. After the discrimination, 210 were pending to review; the remaining ones were reviewed full-text. 193 were deleted because they did not do any reference to dental anomalies and/or disorders or syndromes. Of the remaining 17, only 15 met the inclusion criteria. Conclusions: No differences were found to affirm that some of the anomalies and alterations presented correspond individually to each type of disability. However, Down syndrome has dental abnormalities related to patient condition. Cerebral palsy coincides with other findings such as bruxism, due to poor muscle development, which affects the oral cavity and its structures(AU)

Disostosis cleidocraneal a tres años de tratamiento ortopédico / Cleidocraneal dysostosis at three years of orthopedic treatment

Introducción: La disostosis cleidocraneal es un trastorno genético raro con patrón hereditario. Sus rasgos patognomónicos son la aplasia clavicular, fontanelas y suturas abiertas, múltiples anomalías dentales. Su origen se relaciona con alteraciones en el gen RUNX2, importante para la síntesis de CBFA1, que a su vez funciona como un conformador óseo y un diferenciador de osteoblastos. Caso clínico: Paciente de 11 años con características clínicas de CCD, se corroboran los antecedentes genéticos hereditarios y alteraciones dentales relacionados con disostosis cleidocraneal. Resultado: A tres años de tratamiento se observa mejor definición facial, la erupción de piezas permanentes retenidas y mejor función masticatoria. Conclusión: Mejorar la calidad de vida del paciente con tratamientos interceptivos y el conocimiento de las alteraciones causadas por el síndrome, así como el trabajo interdisciplinario (AU)

Introduction: Cleidocranial dysostosis is a rare genetic disorder with a hereditary pattern. Its pathognomonic features are clavicular aplasia, fontanelles and open sutures, multiple dental anomalies. Its origin is related to alterations in the RUNX2 gene, important for the synthesis of CBFA1, which in turn functions as a bone conformer and an osteoblast differentiator. Clinical case: Patient with eleven years old with clinical characteristics of CCD, hereditary genetic background, and dental alterations related to cleidocranial dysostosis are corroborated. Result: After three years of treatment, the facial definition is better, the eruption of permanent pieces retained and better chewing function. Conclusion: Improve the quality of life of the patient with interceptive treatments and the knowledge of the alterations caused by the syndrome, as well as the interdisciplinary work (AU)

Reabilitação com coroas metal free em dentes anteriores traumatizados e com rizogênese incompleta: relato de caso / Rehabilitation with metal free crowns in traumatized anterior teeth with incomplete rhizogenesis: case report

Objetivo: rizogênese incompleta refere-se a dentes permanentes em que não houve a formação completa do ápice radicular, ocasionando perda da vitalidade pulpar e, consequentemente, incapacidade da bainha epitelial de Hertwig para induzir a formação completa da raiz. Devido ao traumatismo e escurecimento dental, se faz necessário em certos casos a confecção de coroas em porcelana pura para reabilitar a paciente em estética e função. O presente trabalho tem como objetivo demonstrar um caso de reabilitação estética e funcional em dente com rizogênese incompleta, onde se consideraram as perdas estruturais e alteração de cor, para que seja possível estabelecer o tratamento mais adequado. Relato de caso: paciente de 16 anos, gênero feminino, atendida na Clínica de Odontologia de uma instituição privada, insatisfeita com a estética do seu dente devido ao escurecimento do elemento 21, pois quando tinha 5 anos o dente foi traumatizado juntamente com o elemento 11. O plano de tratamento adotado para ambos os elementos foi a confecção de peças protéticas em porcelana e cimentação. Considerações finais: esse caso demonstrou que a confecção de coroas estéticas em porcelana é considerada uma boa conduta na rotina clínica em casos de escurecimento dental, devolvendo estética e função para o paciente.(AU)

Objective: incomplete rhizogenesis refers to permanent teeth with incomplete formation of the root apex, causing loss of pulp vitality and the consequent inability of the Hertwig epithelial sheath to induce complete root formation. Due to dental trauma and darkening, some cases require the production of pure porcelain crowns to rehabilitate the aesthetics and function of patients. The present study aims to show a case of aesthetic and functional rehabilitation in a tooth with incomplete rhizogenesis, in which structural losses and color change were considered to establish the most appropriate treatment. Case report: a 16-year-old female patient treated at the Dental Clinic of a private institution. The patient was not satisfied with the aesthetics of her tooth due to the darkening of element 21, because at 5 years old the tooth was traumatized along with element 11. The treatment used for both elements was the production of prosthetic porcelain crowns and cementation. Final considerations: this case showed that the production of aesthetic porcelain crowns is considered a good conduct in the clinical routine in cases of tooth darkening, returning aesthetics and function to the patient.(AU)

Manejo clínico del talón cuspídeo en bebés: reporte de un caso / Clinical management of talon cusp in babies: report of a case

El talón cuspídeo es considerado como una rara anomalía de desarrollo de los dientes anteriores. Si bien afecta a ambas denticiones, suele darse con mayor frecuencia en la permanente. Esta anomalía de desarrollo puede causar problemas estéticos, dificultad en la higiene con el consecuente riesgo de caries y gingivitis, interferencias oclusales, entre otros. Por lo que el diagnóstico temprano y su tratamiento oportuno resultan de fundamental importancia. Se reporta un caso donde se describe el manejo clínico de un bebé de 16 meses de vida con talón cuspídeo sobre la superficie palatina de los incisivos centrales superiores y caries (AU)

Talon cusp is a rare developmental dental anomaly of the anterior teeth. While it may affect both dentitions, talon cusp occurs more frequently in permanent than in primary dentition. This developmental anomaly may cause esthetic problems, difficulties of oral hygiene hence favoring the development of caries and gingivitis, occlusal interferences, among others. Therefore, early diagnosis and prompt treatment are of the utmost importance. The present case report describes the clinical management of a 16-month old baby with talon cusp on the palatine surface of maxillary central incisors together with carious lesion (AU)

Talón cuspídeo en incisivo central superior y tratamiento endodóntico integral: informe de caso clínico / Talon cusp in maxillary central incisor and comprehensive endodontic treatment: report of a case

Objetivo: describir el tratamiento endodóntico integral de un incisivo central superior con una anomalía inusual de talón cuspídeo y su posterior rehabilitación. Caso clínico: se presenta un incisivo central superior con talón cuspídeo, fracturado por un odontólogo en un intento de extracción, al ser confundido con un diente supernumerario en la cara palatina, con sintomatología dolorosa. Al análisis con cone beam, se observan dos conductos radiculares, uno de ellos perteneciente a la cúspide anómala y con tejido necrótico en su interior y la pulpa del conducto principal inflamada. Se realiza tratamiento endodóntico con sistema WaveOne Gold de cada conducto radicular y obturación con técnica híbrida. Posteriormente, se hacen los desgastes selectivos de acuerdo a la oclusión del paciente y la reconstrucción con resinas, con inicio de terapia ortodóntica, para su rehabilitación. Conclusiones: en un tratamiento endodóntico, siempre deben considerarse las diversas anomalías anatómicas de los dientes.

Dental anomalies in an orthodontic patient population with maxillary lateral incisor agenesis

ABSTRACT Introduction: The purpose of this study was to evaluate the prevalence of dental anomalies in a subpopulation of orthodontic patients with agenesis of maxillary lateral incisors (MLI). Methods: The material of the present study included the records of the 1964 orthodontic patients. Panoramic radiographs and dental casts were used to analyze other associated eight dental anomalies, including agenesis of other teeth, dens invaginatus, dens evaginatus, peg shaped MLI, taurodontism, pulp stone, root dilaceration and maxillary canine impaction. Results: Out of the 1964 patients examined, 90 were found to have agenesis of MLI, representing a prevalence of 4.6%. The most commonly found associated-anomalies were agenesis of other teeth (23.3%), peg-shaped MLIs (15.6%), taurodontism (42.2%), and dilacerated teeth (18.9%). Conclusion: Permanent tooth agenesis, taurodontism, peg-shaped maxillary lateral incisor, and root dilacerations are frequently associated with maxillary lateral incisor agenesis.

RESUMO Objetivo: o objetivo do presente estudo foi avaliar a prevalência de anomalias dentárias em uma subpopulação de pacientes ortodônticos com agenesia de incisivos laterais superiores (ILS). Material e Métodos: o material do presente estudo incluiu os registros de 1964 pacientes ortodônticos. Radiografias panorâmicas e modelos de estudo foram usados para analisar outras anomalias dentárias associadas, incluindo a agenesia de outros dentes, dens invaginatus, dens evaginatus, ILS conoides, taurodontismo, calcificação pulpar, dilaceração radicular e impacção do canino superior. Resultados: dos 1964 pacientes examinados, constatou-se que 90 tinham agenesia do ILS, o que representa uma prevalência de 4,6%. As anomalias associadas mais comumente encontradas foram a agenesia de outros dentes (23,3%), ILS conoides (15,6%), taurodontismo (42,2%) e dentes com dilaceração (18,9%). Conclusão: a agenesia de dentes permanentes, o taurodontismo, incisivos laterais superiores conoides e dilaceração radicular estão frequentemente associados à agenesia de incisivos laterais superiores.

Oral Findings and Dental Treatment in a Child with Williams-Beuren Syndrome

Williams-Beuren syndrome (WBS), also known as Williams syndrome, is a rare congenital disorder involving cardiovascular problems, mental retardation, distinctive facial features and tooth anomalies. It is caused by the submicroscopic deletion of 1.5 to 1.8 Mb on chromosome 7q11.23. This paper reports the dental care to a 7-year-old child with WBS syndrome. The interview also revealed visual impairment, sensorineural hearing loss, hyperacusis, photophobia and hoarse voice. The intraoral clinical examination showed anterior open bite, tongue thrusting, excessive interdental spacing, enamel hypomineralization of the incisors, hypoplasia and caries lesions. The dental treatment included: modulating sessions to control aversion to noises, the photophobia, and the dental fear and anxiety because of his reduced visual acuity; oral hygiene instructions, dietary and daily use of a 0.05% sodium fluoride mouthwash; the permanent mandibular left first molar was treated endodontically, and maxillary and mandibular first molars were restored with amalgam. Due to the patient's heart defect, a prophylactic antibiotic regimen was prescribed prior to the dental procedures. This patient has been followed up for 4 years and this case report underscores the importance of early dental evaluation and counseling for parents of WBS patients.

A Síndrome de Williams-Beuren (SWB), também conhecida como síndrome de Williams, consiste em uma desordem congêntica rara a qual apresenta problemas cardiovasculares, retardo mental, alterações faciais e anomalias dentárias. É causada pela microdeleção de 1,5 a 1,8 Mb no cromossomo 7q11.23. Este trabalho relata o tratamento odontológico de uma criança de 7 anos com a síndrome. Durante a anamnese constatou-se deficiência visual, perda auditiva neurossensorial, hiperacusia, fotofobia e voz rouca. O exame clínico intra-oral revelou mordida aberta anterior, deglutição atípica, espaçamento interdental excessivo, hipomineralização dos incisivos, hipoplasia e lesões de cárie. O tratamento dentário incluiu: sessões de condicionamento comportamental afim de controlar a aversão a ruídos, a fotofobia e o medo e a ansiedade frente ao tratamento odontológico, provocadas principalmente por sua reduzida acuidade visual; instruções de higiene oral, dieta e uso diário de bochechos de fluoreto de sódio a 0,05%; endodontia do primeiro molar permanente inferior esquerdo e restaurações de amálgama nos primeiros molares superiores e inferiores. Devido ao defeito cardíaco do paciente, antibioticoterapia profilática foi realizada antes dos atendimentos odontológicos. Este paciente está em acompanhamento há 4 anos e este relato ressalta a importância da avaliação odontológica precoce e do aconselhamento aos pais dos pacientes com SWB.

Peg Shaped Mandibular Lateral Incisor in a Hypodontia Patient: A Case Report.

Congenitally missing teeth are not rare. However, their association with other dental anomalies has always been a topic of interest in the profession. Occurrence of peg-shaped incisors in the mandibular arch is a rare finding. Strong association has been suggested between hypodontia and microdontia. Treatment approach has to be case specific and depends on the condition of primary predecessor, number of missing teeth, status of occlusion/occlusal condition and patient/parent’s preferences. This paper reports an unusual case of bilateral agenesis of permanent mandibular canines and unilateral agenesis of mandibular incisors, in association with a rare finding of peg-shaped mandibular lateral incisor in a 7-year-old Indian female.

Carillas de composite como alternativa a carillas cerámicas en el tratamiento de anomalías dentarias: reporte de un caso / Composite veneers as an alternative to ceramic veneers in the treatment of dental anomalies: case report

Las anomalías dentarias de forma y tamaño son alteraciones anatómicas frecuentes que comprometen la estética del sector anterior. Existen distintos abordajes para tratar esta alteración morfológica. El procedimiento con mayor demanda es la restauración con carillas estéticas, cuyos materiales de elección son la cerámica en el caso de restauraciones indirectas y resinas compuestas en el caso de las restauraciones directas. La cerámica conserva propiedades físicas y estéticas que la convierten en la primera opción; sin embargo, las resinas compuestas se convirtieron en una alternativa confiable. Se presenta a consulta paciente con inconformidad estética. Al examen intraoral se observan órganos dentarios 12 y 22 en forma de espiga, se observan diastemas en el maxilar superior, sector anterior. Se propuso como plan de tratamiento la restauración estética del sector anterosuperior con carillas en resina compuesta empleando preformas plásticas. El objetivo del presente caso es la descripción del tratamiento restaurador estético realizado con resinas compuestas, empleando cofias preformadas.

The tooth anomalies of size and shape are common anatomical alterations involving the aesthetics of the anterior sector. There are different approaches to address this morphological alteration. The procedure most in demand is restoration with veneers, with the materials of choice in this case being indirect ceramic restorations and direct composite resin restorations. The ceramic preserves physical and aesthetic properties that make it the first choice, but composite resins are becoming a reliable alternative. The case of a patient is presented who consulted with aesthetic anomalies. In the intraoral examination 2 pin-shaped dental organs 12 and 22 are observed, as well as diastemas in the maxilla, in the anterior sector. A proposed treatment plan was cosmetic restoration of anterior-superior sector with composite resin veneers using plastic preforms. The aim of the present case is to describe the aesthetic restorative treatment performed using composite resin copings.

Manejo clínico de la mancha negra en odontología / Clinical Management of black stains in dentistry

El propósito del presente artículo es realizar una revisión bibliográfica y presentación de casos de una entidad clínica poco conocida que se presenta con mucha frecuencia en la práctica clínica odontopediátrica llamada mancha negra. La mancha negra es un tipo de tinción cromógena que se observa en la cavidad oral como pigmentaciones negras sobre los dientes, causando una gran preocupación en los pacientes y en los padres de família. Estas pigmentaciones son de origen extrínseco, cuya causa se debe a la presencia de bacterias cromógenas en la saliva del sujeto y son eliminadas mediante una limpieza profesional; luego de ser eliminadas de las superfícies de los dientes estas manchas vuelven a reaparecer. Así mismo presentamos 2 casos clínicos de pacientes con mancha negra donde se puede observar la secuencia cómo estas manchas, después de un período de tiempo tienden reaparecer.

The purpose of this article is to conduct a literature review of a little known clinical entity that occurs frequently in the clinical practice of pediatric dentistry called black stain. The black stain is a type of chromogenic staining observed in the oral cavity as black pigmentation on the teeth, causing great concern for patients and parents. These pigmentations are of extrinsic origin, the cause is due to the presence of chromogenic bacteria in the saliva of the subject and can be removed by a professional cleaning, which after being removed from the surfaces of these teeth stains reappear. We present 2 cases of patients with black stains where you can see the sequence of how these stains after being removed after a period of time tend to reappear.

Double root anatomical variations in a single patient: endodontic treatment and rehabilitation of a three-rooted first premolar: case report / Variaciones anatómicas de raíces dobles en un solo paciente: tratamiento endodóntico y rehabilitación de un primer premolar trirradicular: reporte de caso

Abnormal interaction between oral epithelium and underlying mesenchematic tissue during odontogenesis could result in teeth with an anatomical variation. First maxilar premolar has such variable root canal morphology. However, (0.2-6% of cases) a three-rooted premolar is particularly uncommon. First mandibular premolar frequently has one root and one single canal (75% of cases), however, a tooth with two canals and two separate roots could be found (19.5-22.5%). Execution of an accurate diagnosis of root canal system is essential to perform a successful endodontic treatment and tooth rehabilitation. This article describes diagnosis, endodontic treatment and rehabilitation (means single crown) of a maxillary three-rooted and three-canal first premolar, and a non-endodontically treated mandibular first premolar with two canals and two independent roots in a single patient.

La interacción anormal entre el epitelio oral y el tejido mesenquimático subyacente durante la odontogénesis puede resultar en la formación de un diente con una variación anatómica. El primer premolar maxilar posee una anatomía relativamente variable, sin embargo, es especialmente poco frecuente (0,2% a 6% de los casos) la presencia de este diente con tres raíces y tres canales radiculares. El primer premolar mandibular posee frecuentemente una raíz y un canal radicular (75% de los casos) y es bastante más infrecuente encontrar este diente con dos raíces y dos canales radiculares (19.5 a 22.5%). Un diagnóstico acabado y preciso de es fundamental para lograr un exitoso tratamiento de endodoncia y posterior rehabilitación. Este artículo describe el diagnóstico, tratamiento de endodoncia y rehabilitación (mediante prótesis fija singular) de un primer premolar maxilar con tres raíces y tres canales radiculares, además el reporte de un caso de un primer premolar mandibular biradicular con dos canales radiculares. Ambos se presentan en un mismo paciente.

Tratamiento endodóntico en dientes geminados o fusionados: reporte de caso / Root canal treatment in geminated or fused teeth: case report

El tratamiento endodóntico en dientes anteriores superiores e inferiores por lo general es un desafío para el endodoncista por la complejidad del sistema de conductos y todas las variaciones encontradas, tanto del propio sistema de conductos como istmos, conductos laterales, deltas apicales o propias del dientes así como también las anomalías dentarias tales como: fusión, geminación, concrescencia, dens in dens etc. Por lo que es necesario al momento de realizar un tratamiento de conducto un análisis propio de cada caso, para plantear una alternativa de tratamiento adecuado y disminuir la tasas de accidentes y fracasos inherentes del tratamiento aun cuando la mayor parte de los casos son relativamente sencillos y pueden ser tratados sin complicaciones. El especialista debe estar al tanto de estas variaciones, modificar los procedimientos de tratamiento como corresponda, e informar al paciente de estas posibles causas de fracaso del tratamiento. El fracaso de un tratamiento endodóntico tiene múltiples factores asociados y no solo del tratamiento del sistema de conducto como tal, también por la estrecha relación que encontramos entre el diente y los tejidos de soporte dental, un foco infeccioso a nivel periodontal puede llevar al fracaso de la terapéutica endodóntica por la relación endo-periodontal

Endodontic treatment in upper and lower anterior teeth are usually a challenge to the endodontist due up to the complexity of the conduct system and all the variations found, both from within the conduct system as isthmus, lateral canals, apical deltas or own the teeth as Dental abnormalities such as fusion, gemination, concrescence, in dens etc. Therefore it is necessary when performing a root canal own analysis of each case to raise an appropriate treatment option and reduce accident rates and the inherent failures of treatment even though most cases are relatively simple and can be treated without complications. The specialist should be aware of these changes, modifying the treatment procedures as appropriate, and inform patients of these possible causes of treatment failure. The failure of endodontic treatment has multiple associated factors and treatment not only through system as such also by the strong relationship we found between the tooth and dental supporting tissues, an infectious periodontal level can lead to failure endodontic therapy for endo-periodontal relationship

Dilaceración de diente primario asociado a un mesiodens en niño de 4 años / Dilaceration temporary tooth associated with a mesidens in 4 year old

Dilaceración es un término utilizado para describir la distorsión que ocurre en la raíz durante el desarrollo dentario, el cual se manifiesta alterando la normal relación axial entre la corona y la raíz dentaria. La dilaceración radicular es una angulación o curvatura de la raíz dentaria. Esta alteración es frecuentemente observada en dientes permanentes como consecuencia de un traumatismo de su correspondiente temporario, con una incidencia de 3 %. En la literatura hay solamente cinco casos de dilaceración que involucran a incisivos temporarios. El propósito de este artículo fue hacer una revisión y presentar un caso clínico que fue un hallazgo radiográfico

Dilaceration is a term used to describe the distortion that occurs in the root during tooth development, which manifests itself by altering the normal axial relationship between the crown and the dental root. The root is dilaceration, angulation or curvature of the tooth root. This alteration is frequently observed in permanent teeth as a result of trauma to the corresponding temporary, with an incidence of 3%. In the literature there are only five cases involving dilaceration temporary incisors. The purpose of this article was to review and present a clinical case was a radiographic finding

Evaluation of facial asymmetry using soft-tissue thickness for forensic purposes / Evaluación de la asimetría facial mediante el grosor de tejidos blandos para propósitos forenses

Facial reconstruction for forensic sculpture aims to reproduce the face of an individual for identification. This technique is based on the knowledge of the facial soft-tissue thickness, which differs in terms of sexual dimorphism. However, in terms of asymmetry, the real significance of the soft-tissue thickness on both sides of the face is not considered to make an approximation of the morphofacial characteristics of an individual. This study analyzed the facial tissue thickness of 32 adult Spanish corpses of both sexes in six bilateral cephalometric landmarks through the needle puncture technique, comparing the measurements of right and left sides. No significant differences were found when comparing the soft-tissue thickness on the right and left sides in the total sample (p <0.05), or when comparing the values in men and women (p<0.05). The facial morphology is created by internal and external forces exerted on the soft tissue and influenced by their evolutionary development in vivo, where asymmetry parameters have a genetic and muscular determination, which in normal individuals do not represent a significant difference in the process of reconstruction of forensic sculpture, and can reliably standardize the entire information of facial thickness to the right or left side of the face.

La reconstrucción facial por escultura forense tiene por finalidad reproducir el rostro de un individuo para su identificación. Esta técnica se sustenta en el conocimiento del grosor del tejido blando facial; el cual presenta diferencias en términos de dimorfismo sexual. Sin embargo, en términos de asimetría, no se ha considerado la real significancia del espesor de tejido blando a ambos lados del rostro al realizar una aproximación de las características morfofaciales de un individuo. En este estudio se analizaron los grosores tisulares faciales de 32 cadáveres españoles adultos de ambos sexos en 6 puntos cefalométricos paramedianos bilateralmente mediante el método de punción por agujas, comparando las mediciones del lado derecho e izquierdo. No se encontraron diferencias significativas al comparar el espesor del tejido facial en el lado derecho e izquierdo en el total de la muestra (p<0,05), así como al comparar los valores en hombres y mujeres (p<0,05). La morfología facial es creada in vivo por fuerzas internas y externas ejercidas sobre el tejido blando e influenciada por su desarrollo evolutivo, donde parámetros de asimetría tienen una determinación genética y muscular, que en individuos normales no representan una diferencia significativa para el proceso de reconstrucción por escultura forense, pudiendo homologar de manera confiable la totalidad de la información del grosor facial del lado derecho o izquierdo del rostro.

Concommitant occurance of dens invaginatus and talon cusp: A case report / Ocorrência simultânea de dens invaginatus e cúspide talon: relato de caso

PURPOSE: Morphological dental anomalies of the maxillary lateral incisors are relatively common. However, their simultaneous occurrence is a relatively rare event. We report a case of dens invaginatus and talon cusp concurrently affecting maxillary lateral incisors. The etiology, pathophysiology, association with other dental anomalies, as well as various treatment modalities of these anomalies are discussed. CASE DESCRIPTION: An 18-year-old male patient reported with a complaint of crowding of maxillary front teeth. On intraoral examination, permanent dentition with Class I malocclusion with anterior crowding was observed. Tooth 12 showed a radiopaque invagination from a lingual pit but confined to the crown of the tooth. This invagination was approximately circular with a central core of radiolucency, which was consistent with the diagnosis of a dens invaginatus type I. Tooth 22 showed the talon cusp as a typical inverted cone with enamel and dentine layers and a pulp horn extending only into the base of the cusp. Talon cusp was treated by prophylactic enameloplasty to avoid plaque accumulation, the deep lingual pit was sealed using composite resin and regular clinical and radiographic follow-up was advised. Patient was scheduled for orthodontic treatment to correct crowding of maxillary anterior teeth. CONCLUSION: We emphasize the fact that detailed clinical and radiographic examination of the maxillary lateral incisors is vital in avoiding complications.

OBJETIVO: Anomalias morfológicas dentárias dos incisivos laterais superiores são relativamente comuns. No entanto, a sua ocorrência simultânea é um evento relativamente raro. Relatamos um caso de dens invaginatus e cúspide talon simultaneamente afetando incisivos laterais superiores. A etiologia, fisiopatologia, associação com outras anomalias dentárias, bem como várias modalidades de tratamento destas anomalias são discutidas. DESCRIÇÃO DO CASO: Um paciente de 18 anos, sexo masculino, relatou com queixa de apinhamento dos dentes anteriores superiores. Ao exame intraoral observou-se dentição permanente com má oclusão Classe I com apinhamento anterior. O dente 12 mostrou uma invaginação radiopaca lingual, confinada à coroa do dente. Esta invaginação era aproximadamente circular, com um núcleo central de radioluscência, que foi compatível com o diagnóstico de dens invaginatus tipo I. O dente 22 apresentou uma cúspide talon como um cone invertido típico com esmalte e dentina em camadas. A cúspide talon foi tratada por ameloplastia profilática para evitar acúmulo de placa, a fissura lingual foi selada com resina composta e foram aconselhados controles clínicos e radiográficos. O paciente foi encaminhado para tratamento ortodôntico para corrigir o apinhamento dos dentes anteriores superiores. CONCLUSÃO: Enfatizamos o fato de que o exame clínico e radiográfico detalhado dos incisivos laterais superiores é vital para evitar complicações.

Dens invaginatus: aetiology, classification, prevalence, diagnosis and treatment considerations

Dens invaginatus is a developmental malformation of teeth.Affected teeth show a deep infolding of enamel and dentine starting from the foramen caecum or even the tip of the cusps and which may extend deep into the root. Teeth most affected are maxillary lateral incisors. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of complex anatomy of teeth. Aetiology, classification, prevalence, diagnosis and treatment considerations are reviewed

Bilateral transmigration of impacted mandibular canines: report of two cases and review / Transmigração bilateral de caninos inclusos mandibulares: relato de dois casos e revisão

Objective: To present and discuss a rare case of transmigration of bilateral mandibular canines. To review the literature and to discuss treatment. Discussion: Transmigration of the canine tooth is an uncommonphenomenon, often undetected in routine dental examinations. The less common finding is type 5 (the canine is positioned vertically in the midline with the long axis of the tooth crossing the midline)and the least common phenomenon is bilateral occurrence of type 5. There is no known etiology for its occurrence. Conclusion: Transmigration of mandibular canines across the midline is a rare condition. An even less common finding is bilateral transmigration of canines across the midline.

Objetivo: Apresentar e discutir um caso raro de transmigração bilateral de caninos mandibulares; revisar a literatura; e discutir tratamentos. Discussão: A transmigração de caninos é um fenômeno incomum que frequentemente não édetectado no exame clínico de rotina. O achado menos comum é o tipo 5 (canino posicionado verticalmente com o seulongo eixo cruzando a linha média) e o fenômeno menos comum é a ocorrência bilateral do tipo 5 de transmigração. A sua etiologia é desconhecida. Conclusão: A transmigração de caninos mandibulares cruzando a linha média é rara e um achado ainda menos comum é a transmigração bilateral de caninos cruzando a linha média.

Variações anatômicas internas em dentes submetidos ao tratamento endodôntico: caso clínico / Internal anatomical variations in teeth submited at the endodontic treatmente: case report

Um dos motivos que pode levar ao fracasso da terapia endodôntica é o desconhecimento da anatomia interna dos dentes, inviabilizando o acesso, a instrumentação e a obturação do sistema de canais radiculares. Relatar casos clínicos de dentes com alterações do número de canais radiculares submetidos ao tratamento endodôntico e enfatizar a necessidade do conhecimento das variações anatômicas pelo profissional que intervirá no endodonto. Descrição de casos clínicos. O desconhecimento das variações na anatomia interna dos dentes pelo profissional poderá comprometer o sucesso do tratamento endodôntico.

One of the reasons which may lead to failure of endodontic therapy is the lack ok knowledge of teeth internal anatomy, not allowing access, instrumentation and filling the root canal system. Report on clinical cases of teeth with changes in the number of root canals submitted to endodontic treatment and emphasize the need for knowledge of anatomic variations by endodontist. Description of clinical cases. The lack of knowledge of the variations in internal anatomy of the teeth by the endodontist may compromise the success of endodontic treatment.