¿Es el "diente rosado" válido en el contexto forense actual? / Are "pink teeth" relevant to current forensics?

Introducción: El "diente rosado" es un fenómeno post mortem. Se caracteriza por una tonalidad rosa, rojiza y hasta púrpura, que puede observarse en los dientes. Su primera referencia se remite a 1829, cuando Thomas Bell lo describió, y genera polémica desde hace casi dos siglos. La temática plantea varias interrogantes: ¿sería más lógico nombrarlo "red teeth" o "purple teeth"?, ¿qué provoca esa tonalidad más intensa?, ¿la coloración rosada indica determinada causa de muerte?, ¿queda para siempre o puede desaparecer por diversos factores? Objetivo: Describir los indicadores de que el "diente rosado" o "pink teeth" pueda aún ser considerado un elemento importante para la investigación forense actual. Comentarios principales: Luego de la experiencia acumulada con los casos trabajados durante los últimos 20 años y la revisión bibliográfica realizada, se evidencia que el fenómeno aparece sobre todo en las piezas dentales anteriores y premolares monorradiculares. Además, puede verse tanto ante mortem como post mortem. Por causas diferentes el post mortem necesita de varios días para instaurarse y es un evento tafonómico, evidenciable tanto en muertes violentas como naturales, aunque la variación en su tonalidad depende de diversos factores. Consideraciones globales: Teniendo en cuenta la experiencia obtenida por los autores, y lo referido en la bibliografía sobre el tema, se evidencia que este signo, fenómeno o hallazgo (al aclararse las interrogantes planteadas) aún puede ser muy significativo y orientador en el contexto forense actual(AU)

Introduction: "Pink teeth" are a post-mortem phenomenon characterized by a rose, reddish and even purple shade of color which may be observed in teeth. Their first reference dates back to 1829, when Thomas Bell described them. They have been a topic of debate for almost two centuries. The subject poses several questions: Would it be more logical to name them "red teeth" or "purple teeth"? What causes the increase in color intensity? Does the pink shade signal a specific cause of death? Does it remain forever or may it disappear for a variety of reasons? Objective: Describe the indicators that "pink teeth" may still be considered an important element in current forensic research. Main remarks: Based on the experience gathered from the cases analyzed in the last 20 years and the bibliographic review conducted, it is evident that the phenomenon appears mainly in anterior teeth and single-rooted premolars. On the other hand, pink teeth may be observed ante mortem as well as post mortem. For a number of reasons, post mortem pink teeth take several days to form, and they are a taphonomic phenomenon, present in violent as well as natural deaths, though their change in tone depends on various factors. General considerations: Founded on the experience obtained by the authors and the bibliography about the topic, it is evident that this sign, phenomenon or finding (upon clarification of the questions posed) may still be very significant and enlightening in the current forensic context(AU)

Dientes fósiles de Carcharocles megalodon: la colección del Museo Universitario de Chieti (Italia). Parte II: análisis paleopatológico / Fossil teeth of Carcharocles megalodon: the collection of the University Museum of Chieti (Italy). Part II: paleopathological analysis

La paleopatología es la ciencia que estudia el origen y la evolución de las enfermedades del pasado. El interés por esta disciplina deriva del hecho de que la frecuencia y la distribución de las patologías que han afectado a las especies extintas se correlacionan con su ecología y etología. Esta suposición también es válida en el caso de Carcharocles megalodon, el tiburón más grande jamás existido, situado en lo alto de la cadena alimenticia y que vivió en los mares templados desde el Mioceno medio hasta el Plioceno (15,9-2,6 Ma). En el presente artículo presentamos las alteraciones patológicas de los dientes de Carcharocles megalodon que se conservan en el Museo Universitario de Chieti (Italia). La colección se compone de nueve dientes de la arcada superior, todos ellos con presencia de alteraciones patológicas correspondientes a defectos del desarrollo y traumas de la corona. Un diente en particular (espécimen #165), presenta una aposición anómala del esmalte sobre la superficie labial, que corresponde a una condición no descrita en la literatura. La colección del Museo Universitario de Chieti enriquece el registro paleopatológico relativamente pobre existente, contribuyendo a completar el conocimiento sobre la paleobiología de Carcharocles megalodon.

Paleopathology is the science that studies the origin and evolution of diseases. The interest in this discipline derives from the fact that the frequency and distribution of the pathologies that have affected the extinct species, correlate with their ecology and ethology. This assumption is also valid in the case of Carcharocles megalodon, the largest shark that ever existed, located at the top of the food chain and that lived in temperate seas from the middle Miocene to the Pliocene periods (15.9-2.6 My). In the present article we present the pathological alterations of the teeth of Carcharocles megalodon housed in the University Museum of Chieti (Italy). The collection consists of nine teeth of the upper arch, all of them with pathological alterations corresponding to developmental defects and crown trauma. A particular tooth (specimen #165) presents an anomalous apposition of the enamel on the labial surface, a condition not yet described in the literature. The collection of the University Museum of Chieti enriches the existing relatively poor paleopathological record, and could improve the knowledge of the paleobiology of Carcharocles megalodon.

Mandibular anterior crowding: normal or pathological?

ABSTRACT The teeth become very close to each other when they are crowded, but their structures remain individualized and, in this situation, the role of the epithelial rests of Malassez is fundamental to release the EGF. The concept of tensegrity is fundamental to understand the responses of tissues submitted to forces in body movements, including teeth and their stability in this process. The factors of tooth position stability in the arch - or dental tensegrity - should be considered when one plans and perform an orthodontic treatment. The direct causes of the mandibular anterior crowding are decisive to decide about the correct retainer indication: Should they be applied and indicated throughout life? Should they really be permanently used for lifetime? These aspects of the mandibular anterior crowding and their implication at the orthodontic practice will be discussed here to induct reflections and insights for new researches, as well as advances in knowledge and technology on this subject.

RESUMO Os dentes ficam muito próximos quando estão apinhados, mas suas estruturas permanecem individualizadas e, nessa situação, o papel dos restos epiteliais de Malassez é fundamental para liberar o EGF. A tensigridade é um conceito chave para compreender as respostas dos tecidos submetidos às forças nos movimentos corporais, incluindo os dentes e sua estabilidade nesse processo. Os fatores da estabilidade de posição de um dente na arcada dentária — ou tensigridade dentária — devem ser considerados quando se planeja e finaliza um caso na prática clínica ortodôntica. As causas diretas do apinhamento dentário anteroinferior são determinantes para se refletir se a contenção deve ser mesmo indicada e aplicada por toda a vida e se, necessariamente, deve ser usada de forma permanente. Esses aspectos do apinhamento dentário anteroinferior e suas implicações na prática clínica serão aqui abordados para induzir reflexões e insights de novas pesquisas, bem como avanços no conhecimento e tecnologia sobre esse assunto.

Orthodontic management of multiple dilacerations

Orthodontic alignment of un-erupted dilacerated teeth is challenging, as the bent roots resist forces applied to move them through the bone. Various treatment options are now available to treat this condition including providing prosthesis after extractions and apicectomies. However, to maintain alveolar bone in the area of the un-erupted tooth, especially if the involved tooth is in the anterior segment, the ideal treatment would be to try and bring the tooth in the arch orthodontically. Treatment requires increased time duration, compliance of the patient, and consistent force mechanics. This case report is of a 9-year boy with un-erupted and dilacerated teeth. Orthodontic treatment of prolonged duration was provided to bring these teeth into the arch, improving the esthetics and function

Alteraciones morfológicas en dientes sometidos a altas temperaturas con interés forense / Morphological changes in teeth exposed to high temperatures with forensic purposes

Los dientes son los elementos más resistentes del esqueleto humano y son utilizados en muchas ocasiones en la rutina de los laboratorios forenses. El objetivo de este estudio fue describir los cambios dentarios estructurales, morfológicos y del color que se producen tras la incineración, para ayudar en el manejo adecuado de las muestras en un escenario forense. Setenta dientes fueron expuestos a intervalos de temperatura de 100 °C a 1200 °C, durante 60 min. Un grupo control de 10 dientes no fue expuesto al choque térmico. Después de la incineración, los dientes fueron fotografiados y radiografiados para evaluar visualmente los cambios morfológicos. La medida del cambio de color fue realizada mediante un espectrofotómetro. Los resultados mostraron cambios estructurales y del color, así como alteraciones radiológicas, que se relacionaron con el intervalo de temperatura a la que fueron incinerados los dientes. En conclusión, es posible informar sobre la temperatura aproximada de calcinación de los dientes basándose en los cambios fotográficos, radiográficos y del color.

Teeth are the most resistant elements of the human skeleton and are thus often used in routine forensic research laboratories. The objective of this study was to describe structural, morphological and color changes that occur post heating the teeth to aid in proper handling of samples in a forensic scenario based on their condition. Seventy teeth were exposed to different temperature intervals, ranging from 100 °C to 1 200 °C for 60 min using a laboratory oven. Ten unheated teeth were used as controls for the study. After incineration, the teeth were photographed and radiographed to visually assess morphological changes. The measure of color change was performed with a spectrophotometer. The results showed structural and color changes as well as radiographic abnormalities, which were associated to the temperature interval at which the teeth were cremated. In conclusion, it is possible to inform about incineration tooth temperature based on photographic, radiographic and color changes.

Changes in lower dental arch dimensions and tooth alignment in young adults without orthodontic treatment

OBJECTIVE: The aim of this longitudinal study, comprising young adults without orthodontic treatment, was to assess spontaneous changes in lower dental arch alignment and dimensions. METHODS: Twenty pairs of dental casts of the lower arch, obtained at different time intervals, were compared. Dental casts obtained at T1 (mean age = 20.25) and T2 (mean age = 31.2) were compared by means of paired t-test (p < 0.05). RESULTS: There was significant reduction in arch dimensions: 0.43 mm for intercanine (p = 0.0089) and intermolar (p = 0.022) widths, and 1.28 mm for diagonal arch length (p < 0.001). There was a mild increase of approximately 1 mm in the irregularity index used to assess anterior alignment (p < 0.001). However, regression analysis showed that changes in the irregularity index revealed no statistically significant association with changes in the dental arch dimensions (p > 0.05). Furthermore, incisors irregularity at T2 could not be predicted due to the severity of this variable at T1 (p = 0.5051). CONCLUSION: Findings suggest that post-growth maturation of the lower dental arch leads to a reduction of dental arch dimensions as well as to a mild, yet significant, increase in dental crowding, even in individuals without orthodontic treatment. Furthermore, dental alignment in the third decade of life cannot be predicted based on the severity of dental crowding at the end of the second decade of life. .

OBJETIVO: o objetivo deste trabalho foi avaliar, por meio de um estudo longitudinal em adultos jovens, sem tratamento ortodôntico, as alterações espontâneas do alinhamento da arcada dentária inferior e de suas dimensões. MÉTODOS: vinte pares de modelos de gesso da arcada inferior foram obtidos em dois tempos. No primeiro exame (T1), os indivíduos tinham, em média, 20,25 anos; enquanto no segundo exame (T2) a média de idade foi de 31,2 anos. Comparações entre os tempos T1 e T2 foram realizadas usando o teste t pareado (p < 0,05). RESULTADOS: houve uma redução significativa nas dimensões da arcada - de 0,43mm nas larguras intercaninos (p = 0,0089) e intermolares (p = 0,022) e de 1,28mm para o comprimento diagonal da arcada (p < 0,001). Foi observado um aumento suave, de aproximadamente 1mm, no índice de irregularidade anterior (p < 0,001). Entretanto, a análise de regressão mostrou que as mudanças no índice de irregularidade não revelaram uma associação estatisticamente significativa com as mudanças na arcada dentária (p > 0,05). Além disso, o índice de irregularidade dos incisivos em T2 não pode ser estimado, devido à severidade dessa variável em T1 (p = 0,5051). CONCLUSÃO: esses achados sugerem que a maturação da arcada dentária inferior, pós-crescimento, leva a uma redução das dimensões da arcada e um aumento suave, porém significativo, do apinhamento dentário, mesmo em indivíduos sem tratamento ortodôntico. Assim, o alinhamento dentário na terceira década de vida não pode ser previsto tendo como base a severidade do apinhamento dentário ao final da segunda década de vida. .

Dentoalveolar mandibular changes with self-ligating versus conventional bracket systems: A CBCT and dental cast study

OBJECTIVE: The aim of the present study was to compare dentoalveolar changes in mandibular arch, regarding transversal measures and buccal bone thickness, in patients undergoing the initial phase of orthodontic treatment with self-ligating or conventional bracket systems. METHODS: A sample of 25 patients requiring orthodontic treatment was assessed based on the bracket type. Group 1 comprised 13 patients bonded with 0.022-in self-ligating brackets (SLB). Group 2 included 12 patients bonded with 0.022-in conventional brackets (CLB). Cone-beam computed tomography (CBCT) scans and a 3D program (Dolphin) assessed changes in transversal width of buccal bone (TWBB) and buccal bone thickness (BBT) before (T1) and 7 months after treatment onset (T2). Measurements on dental casts were performed using a digital caliper. Differences between and within groups were analyzed by Student's t-test; Pearson correlation coefficient was also calculated. RESULTS: Significant mandibular expansion was observed for both groups; however, no significant differences were found between groups. There was significant decrease in mandibular buccal bone thickness and transversal width of buccal bone in both groups. There was no significant correlation between buccal bone thickness and dental arch expansion. CONCLUSIONS: There were no significant differences between self-ligating brackets and conventional brackets systems regarding mandibular arch expansion and changes in buccal bone thickness or transversal width of buccal bone. .

OBJETIVO: o objetivo do presente estudo foi comparar as alterações dentoalveolares transversais e a espessura óssea da arcada inferior em pacientes submetidos ao tratamento ortodôntico utilizando sistemas de braquetes autoligáveis ou convencionais. MÉTODOS: uma amostra de 25 pacientes requerendo tratamento ortodôntico foi recrutada com base no tipo de braquete. No Grupo 1, 13 pacientes foram tratados com braquetes autoligáveis (SLB, slot 0,022"); o Grupo 2 incluiu 12 pacientes, nos quais foram colados braquetes convencionais (CLB, slot 0,022"). Utilizou-se tomografia computadorizada de feixe cônico e um programa 3D (Dolphin) para avaliar as alterações pré-tratamento (T1) e 7 meses após o início desse (T2). As medições em modelos de gesso foram realizadas com o auxílio de um paquímetro digital. As diferenças intergrupos, bem como intragrupo, foram analisadas por meio de teste t de Student. Além disso, o coeficiente de correlação de Pearson foi utilizado. RESULTADOS: alterações dentoalveolares significativas foram observadas em ambos os grupos. Entretanto, não houve diferenças significativas entre os grupos. Houve uma diminuição da espessura óssea na região posterior e das medidas transversais em ambos os grupos. Não houve uma correlação significativa entre a espessura óssea posterior e a expansão da arcada dentária, em nenhum dos dois sistemas de braquetes utilizados. CONCLUSÕES: comparando-se o uso dos aparelhos autoligáveis e convencionais, concluiu-se que não houve diferenças dentoalveolares significativas quanto à expansão da arcada inferior e quanto à espessura óssea posterior. .

Association between Bolton discrepancy and Angle malocclusions

This study aimed to assess and compare the overall and anterior ratios of tooth size discrepancies in all Angle malocclusion groups. The following null hypothesis (H0) was tested: no difference between tooth size discrepancies (overall and anterior) would be observed among Angle malocclusion groups. The sample comprised of 711 pre-orthodontic treatment study casts of Brazilian patients with a mean age of 17.42 years selected from private practices in Brazil. The casts were divided into 3 groups according to the type of malocclusion: Class I (n = 321), Class II (n = 324), and Class III patients (n = 66). The measurement of the greatest mesiodistal width of the teeth was performed using a centesimal precision digital caliper directly on the study casts, from the distal surface of the left first molar to the distal surface of the right first molar. The overall and anterior ratios between the maxillary and mandibular teeth were evaluated using Bolton’s method. The following statistical tests were applied: chi-square, independent t-test, and one-way ANOVA. Results showed that all Angle malocclusions groups exhibited a ratio compatible with those recommended by Bolton. With respect to the overall and anterior ratios among the malocclusion groups, no statistically significant differences were found. The null hypothesis was accepted because the results showed no differences in the overall and anterior ratios of tooth size discrepancies among different Angle malocclusion groups.

Treatment of dental and skeletal bimaxillary protrusion in patient with Angle Class I malocclusion

In the orthodontic clinic, skeletal and dental bimaxillary protrusion is presented frequently as one of the factors leading patients to seek orthodontic treatment, mainly due to the esthetic involvement it has. The patient of this article illustrates this situation, being deeply uncomfortable with her esthetic appearance, due to the excessive upper incisors exposure and problems with lip sealing. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), as part of the requisites to become a BBO Diplomate.

Na clínica ortodôntica, a biprotrusão esquelética e dentária, rotineiramente, aparece como um dos fatores que levam os pacientes a buscarem o tratamento ortodôntico, principalmente pelo envolvimento estético que provoca. A paciente apresentada neste artigo ilustra essa situação, pois estava bastante insatisfeita com sua estética, devido à exposição excessiva dos incisivos superiores e dificuldade em selar os lábios. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Discrepancia dentaria de Bolton y finalización de ortodoncia: consideraciones clínicas / Bolton tooth size discrepancy and orthodontics finalization: clinical considerations

Las discrepancias entre el tamaño mesiodistal de los dientes superiores e inferiores, así como sus efectos sobre la oclusión han sido reportadas desde mediados del siglo XX. El objetivo de este estudio fue determinar la importancia de la aplicación del análisis de discrepancias dentaria de Bolton con finalidad ortodontica. Fueron seleccionados casos de pacientes de raza blanca de ambos sexos, con edades comprendidas entre 12 y 25 años. El análisis de las discrepancias dentarias fue realizado en la fase previa al tratamiento y posterior a la contención. Como criterio básico para la inclusión en la muestra de pacientes en el pre-tratamiento deberían presentar todos los dientes permanentes (de primeros molares a primeros molares del lado opuesto, en ambos arcos). Fueron eliminados los casos que presentaron dientes con grandes destrucciones, restauraciones inadecuadas y dientes mal posicionados donde no fue posible la medición adecuada entre los puntos de contacto. La medición del tamaño mesiodistal de los dientes se realizó con un caliper (Odin, Alemania), precisión de 0,01 mm, por un solo examinador, previamente calibrado para realizar este procedimiento. Se midió el diámetro mesiodistal mayor de todos los dientes. Las relaciones totales y anteriores fueron calculadas por las fórmulas respectivas, según lo propuesto por Bolton (1958). Al finalizar, los casos mostraron que una discrepancia dentaria de Bolton maxilar o mandibular por exceso o falta dentaria, puede ser compensada por la alteración en la forma del arco, dimensión vestibulolingual y por la inclinación axial de los dientes anteriores, utilizadas en conjunto o aisladamente en la arcada, sin perjuicio estético y funcional.

Discrepancies of the mesiodistal dimensions between upper and lower teeth as well as their effects on occlusion have been reported since the middle of the twentieth century. The aim of this study was to elucidate the importance of the applicability of the analysis of the Bolton tooth size discrepancy in the orthodontic finalizing. Cases involving Caucasian male and female patients aged between 12 and 25 years were selected for study. Analyses of the dental discrepancies were carried out before orthodontic treatment and after contention. Basically, only patients having all permanent teeth before treatment (with first molars in both arches) were included. Those cases of severely mutilated teeth, inadequate restorations, and tooth malalignment were ruled out because accurate measurement of the contacting points could not be performed. Measurement of the mesiodistal tooth dimension was performed by only one operator using a digital calliper of a resolution of 0.001 mm (Odin, Germany) which had been previously calibrated for such procedures. It was measured the largest mesiodistal diameter. Both previous and total relationships were calculated through their respective formulas according to Bolton (1958). The orthodontic finalisation showed that Bolton tooth size discrepancies involving either crowded dentition or lack of teeth can be compensated by mandibular or maxillary arch shape, buccal-lingual dimension, and axial inclination of the anterior teeth with no aesthetic or functional impairment.

Effect of drying on the reproducibility of DIAGNOdent to detect caries-like lesions

The aim of this study was to verify the drying effect on the reproducibility of DIAGNOdent (Dd) devices to detect caries-like lesions. Three areas were created in each of the 34 bovine incisors: sound (S), demineralized (DE) and remineralized (RE). One examiner measured each area with two Dd devices (denominated X and Y), twice under humid, and twice under dry condition. Intra-rater agreement according each device and inter-device agreement were estimated by kappa statistics (k). Intra-rater agreement for device Y was substantial under humid (k DE=0.68 and k RE+S=0.68) and dry condition (k DE=0.64 and k RE+S=0.67). For device X, it was substantial under humid condition (k DE=0.57 and k RE+S=0.49), and it was almost perfect after air drying (k DE=1.0 and kRE+S=1.0). Inter-device agreement was slight (k =0.17) under humid condition, and it was substantial under dry condition (k =0.62). As reproducibility increased under dry condition, drying is advised to detect caries-like lesions on free smooth surfaces when different devices are used.

Este estudo verificou o efeito da secagem sobre o resultado de reprodutibilidade de aparelhos laser DIAGNOdent (Dd) no diagnóstico de cárie artificial. Três áreas foram produzidas em cada um dos 34 incisivos bovinos: hígida (S), desmineralizada (DE) e remineralizada (RE). Um examinador mediu cada área com dois aparelhos Dd (denominados X e Y), sendo duas vezes sob a condição úmida e duas vezes sob a condição seca. A concordância intra-examinador segundo cada aparelho, e a concordância entre aparelhos foram estimadas por meio da estatística kappa (k). A reprodutibilidade intra para o aparelho Y foi substancial sob a condição úmida (kDE=0,68 e k RE+S=0,68) e seca (k DE=0,64 e k RE+S=0,67). Para o aparelho X, a concordância foi substancial sob a condição úmida (kDE=0,57 e k RE+S=0,49) e foi quase perfeita após a secagem (kDE=1,0 e k RE+S+1,0). A concordância entre aparelhos foi fraca (k=0,17) na condição úmida, porém foi substancial na condição seca (k=0,62). Como a reprodutibilidade foi melhor sob a condição seca, a secagem da superfície dentária é aconselhada para se detectar lesões de cárie incipientes em superfícies lisas livres, quando mais de um aparelho é utilizado no diagnóstico.

Amelogenesis Imperfecta, hypoplastic type associated with some dental abnormalities: a case report

Amelogenesis imperfecta (AI) is a hereditary disorder expressing a group of conditions that cause developmental alterations in the structure of enamel. AI is a serious problem that reduces oral health-related quality of life and causes some physiological problems. The treatment of patients with AI may upgrade the quality of life and reinforce their self-esteem. Among the treatment options for AI, full-mouth metal reinforced porcelain restoration constitutes an important alternative because of its properties. This paper presents a case of AI of the hypoplastic rough type associated with a group of dental anomalies, and describes the prosthetic management of the patient. A 26-year-old female patient presented with a chief complaint of discolored teeth. Clinical and radiographic examination of the patient confirmed the diagnosis of rough pattern hypoplastic AI. The patient was treated with full-mouth metal reinforced porcelain fixed bridge. The adaptation of the temporomandibular joints and masticatory muscles was carefully observed periodically during 4 months and, after this period, the patient tolerated well her new vertical dimension. The patient received instructions on cleansing of the subpontic and interproximal areas. Follow-up visits were scheduled at 3 months and then at 6 months. No esthetic or functional problems were seen after the follow up period.

Amelogenesis imperfecta (AI) é uma desordem hereditária que expressa um grupo de condições que causam alterações de desenvolvimento na estrutura do esmalte. A AI é um problema grave que compromete a qualidade de vida relacionada à saúde bucal e causa alguns problemas psicológicos. O tratamento de pacientes com AI pode melhorar sua qualidade de vida e reforçar sua auto-estima. Dentre as opções de tratamento para AI, a restauração de toda a boca com porcelana reforçada com metal representa uma alternativa importante devido a suas propriedades. Este artigo apresenta um caso de AI do tipo hipoplásica rugosa associada a um grupo de anomalias dentais, e descreve o tratamento protético da paciente. Uma paciente de 26 anos apresentou-se com queixa principal de dentes manchados. O exame clínico e radiográfico da paciente confirmou o diagnóstico de AI hipoplásica rugosa. A paciente foi tratada com a construção de próteses fixas de porcelana reforçada com metal em toda a boca. A adaptação das articulações temporomandibulares e dos músculos mastigatórios foi cuidadosamente observada periodicamente durante 4 meses e, após este período, a paciente mostrou tolerar bem sua nova dimensão vertical. A paciente recebeu instruções sobre limpeza das áreas sob o pôntico e áreas interproximais. As visitas de acompanhamento foram agendadas a cada 3 meses e subseqüentemente a cada 6 meses. Não foram observados problemas estéticos ou funcionais após o período de acompanhamento.

Aspectos microbiológicos, histopatológicos e clínicos da cárie radicular / Microbiology, histopathology and clinical aspects of human root caries

O avanço científico da Odontologia e um maior acesso ao tratamento odontológico fizeram com que o número de pacientes com idade avançada, ainda portadores de dentições naturais, aumentasse. Assim, aumentou também a quantidade de superfícies radiculares expostas, seja por processos fisiológicos, patológicos ou terapêuticos, tornando estas superfícies mais susceptíveis e vulneráveis ao processo de cárie. Este estudo teve como objetivo revisar as características microbiológicas, histopatológicas e clínicas das lesões de cárie radicular. Os estudos revisados apontaram que, dentre os fatores etiológicos dessa patologia, destaca-se a ação do Streptococcus mutans. Contudo, o microrganismo não é o único responsável pelo aparecimento das lesões. A falta de higiene oral, assim como a presença de dieta rica em carboidratos fermentáveis contribui para o desenvolvimento e progressão das cáries de raiz. O tratamento destas lesões é realizado de acordo com a severidade destas, variando desde aplicação de flúor em cáries incipientes, até em restaurações estéticas nos casos mais avançados. Novos estudos, clínicos e laboratoriais, são necessários para se avaliar a longevidade dos tratamentos propostos, principalmente o restaurador.

This study reviewed the microbiological, histopathological and clinical aspects of root caries. Dental caries is one of the most significant health problems facing older adults. More than half of the elderly who are dentate are affected with either coronal or root caries, and caries is the primary cause of tooth loss in this population. However, age per se is not considered to be the main reason for caries development on root surfaces. The same main factors as for coronal caries, ie, cariogenic microorganisms, diet and saliva seem to play important roles in root caries development. Due to different anatomy, histology, and chemical composition of the tissues, there may be a higher risk of caries development on root surfaces than on coronal surfaces. In treatment of root surface caries, a causative treatment strategy should be determined. Prevention should focus on oral hygiene, fluoride exposure, and restriction of intake frequency of foods containing sugars or other easily fermentable carbohydrates. When a more invasive treatment is necessary, caries are removed and the cavities are restored with glass ionomer cement or with flowable composites, where aesthetics procedures become indispensable. New materials and techniques are emerging to help with geriatric preventive and restorative needs.

Dental Findings in Cornelia De Lange Syndrome

Cornelia de Lange syndrome is a congenital disease, basically characterized by psychomotor retardation associated with a series of malformations, including mainly skeletal, craniofacial deformities together with gastrointestinal and cardiac malformations. There is no definitive biochemical or chromosomal marker for the prenatal diagnosis of this syndrome. We actually want to present the case of a 10-year-old patient, who was admitted to our clinic for dental pain. The patient had the symptoms of Cornelia de Lange syndrome. During the oral examination of this patient, the patient was found to have the typical symptoms of Cornelia de Lange syndrome, such as micrognathia and delayed eruption in conjunction with the symptoms of the Hutchinson's syndrome, which had never been reported before.

Clinical evaluation of various medication methods on the incidence of post-treatment endodontic pain in necrotic teeth

The pain after root canal treatment is one of the main problems for patient and dentist. Various drugs were studied for alleviating the pain after treatment. The purpose of this study was evaluation of various medication methods on the incidence of posttreatment endodontic pain in necrotic teeth. In this controlled double blind clinical trial, 120 patients with single canal teeth and necrotic pulps were selected. The patients were divided into six groups and randomly received drugs in one of the following ways: Group A, 2gr Amoxicillin one hour before treatment. Group B, 2gr Amoxicillin plus 4mg Betamethasone one hour before treatment. In group C, 2gr placebo [control group] one hour before treatment. Group D, 500 mg Amoxicillin immediately after treatment and continued every 8 hours for 4 days. Group E, the same treatment as group D was performed expect that, 4mg Betamethasone was added to Amoxicillin. Group F, the same treatment as group D was performed, but placebo were used instead of Amoxicillin. Root canal therapy was accomplished with step back technique and lateral condensation method. Evaluation of incidence of pain was recorded 6, 12, 24, 48 and 72 hours after treatment. Data were analyzed by Kruskall-wallis and Mann-whitney tests. The results of this study in various intervals showed that there was no significant difference in the incidence of posttreatment endodontic pain between those patients who received Amoxicillin or Betamethasone [A, B, D, E, F] and those who used placebo [control group C, F]. Most of patients that had severe pain received placebo [C and F groups]. Oral administration of corticosteroids plus antibiotic in cases with necrotic pulp did not significantly reduce posttreatment endodontic pain

Is there relationship between pink teeth phenomenon and cause of death? / 法医学杂志

OBJECTIVE@#To explore the relationship between the pink teeth phenomenon and the cause of death as well as its significance in forensic medicine.@*METHODS@#Inspection method was adopted to observe the pink teeth phenomenon in different causes of death. Ten rats were selected for every experimental groups, which were then divided into two groups: Eight in fresh group with teeth pulled immediately, and two in decayed group with body decayed in water firstly. The teeth pulled from rats were immersed in 75% alcohol and observed at different immersion time.@*RESULTS@#In every fresh groups, pink teeth phenomenon was not observed when they were pulled immediately, whereas it emerged gradually after the teeth immersed in 75% alcohol, and the color showed distinct and constant four hours later. In decayed groups, Pink teeth phenomenon was observed immediately when teeth pulled, it became distinct and constant after one hour's immersion in alcohol. So it was more distinctive in the decayed groups than that in the fresh groups.@*CONCLUSION@#There is no significant connection between the pink teeth phenomenon and the cause of death, thus it may not be subject to forensic identification.

Tooth size in cleft lip and or palate patients in comparison with normal individuals in Shiraz

The most common major defect of the lip and palate is clefting. Clefting occurs due to failure of fusion between embryologic structures. Tooth size abnormalities are common in these patients. This study was performed to determine the tooth size in cleft lip and or patients and compare with normal individual. This study was carried out on 51 pretreatment orthodontic records of the cleft lip and or palate patients and compared with 276 normal individuals. These subjects were in acceptable age for determination of the mesiodistal width of the teeth. The greatest mesiodistal width of all permanent teeth on each model was obtained except the second and third molars. The measuring was done by digital calliper with 0.01 mm accuracy. The collected data were analyzed by SPSS software and t. test. This study showed that there was no asymmetry in tooth size between cleft and normal sides of the maxillary arch. The upper teeth in cleft patients were smaller than the upper teeth in normal patients and there was a significant difference. The lateral incisor and first premolar in females and the central incisor, second premolar and first molar in males were smaller in the cleft patients than normal groups in the mandibular arch. We concluded that: 1] tooth size of the maxillary arch in cleft patients was smaller than non-cleft subjects. 2] There was no significant difference between cleft and non-cleft sides in tooth size. 3] Tooth size in mandibular arch of cleft patients was affected less than maxillary arch

Estudos macro e microscópico da morfologia do terço dentário apical na hipercementose: implicaçöes clínicas e etiopatogênicas / Macro and microscopical studies of apical dental portion morphology in the hypercementosis: clinical and etiopathogenic implications

Cento e sessenta dentes com e sem hipercementose foram analisados macroscopicamente, ao estereomicroscópio sem e com diafanizaçäo e na microscopia óptica de luz, com a finalidade de estudar a anatomia externa e interna do terço apical. Verificou-se que: 1) A hipercementose aumenta consideravelmente o número de canais secundários, canais acessórios e deltas apicais. 2) As modificaçöes na morfologia interna do terço apical dos dentes comprometidos näo säo passíveis de visualizaçäo e identificaçäo radiográfica. 3) O canal principal na grande maioria dos dentes com hipercementose apresenta-se constricto no terço apical associado à mudança da trajetória original ou a canais secundários, acessórios e deltas apicais. 4) O tipo morfológico mais comum de hipercementose dá à raiz a forma de clava. A forma localizada de hipercementose apresenta-se com considerável menor frequência. A forma de boca de manga de camisa encontra-se apenas eventualmente. 5) O padräo morfológico e aposicional do cemento constituinte da hipercementose assemelha-se ao cemento em dentes normais quando observado na microscopia óptica de luz, assim como sua superfície externa. Após estas verificaçöes, concluiu-se que na hipercementose o clínico de várias especialidades, como o cirurgiäo, o ortodontista e especialmente o endodontista, deve considerar a modificaçäo anatômica externa e interna a que foi submetido o dente portador, pois sua forma radicular tende a ser retentiva, o corpo radicular mais espesso e o terço apical mais rico em canalículos e deltas apicais associado à constricçäo e mudança direcional do canal principal