ABSTRACT
The crown lengthening is indicated for aesthetic purposes, exposure of subgingival caries, crown fractures or a combination of these, which can be characterized as aesthetic or functional, related to restorative indications, and restoration of biological width. Several factors need to be evaluated in the aesthetic planning for optimizing the smile, with the inclusion of an increase in the clinical crown, emphasizing the quality of the thin or thick periodontal phenotype, an adequate band of keratinized tissue and the size of the biological width. A correct diagnosis of the gummy smile etiology, as well as an assessment of clinical characteristics and anatomical dimensions, is of fundamental importance prior to the patient's approach. It determines and guide decisions regarding the possibilities of treatment and prognosis of cases. The aim of this study was to report two cases of cosmetic periodontal surgery with techniques commonly used for this purpose: gingivectomy and flap surgery with osteotomy.
El alargamiento clínico de corona está indicado con fines estéticos, exposición de caries subgingivales, fracturas coronarias o alguna combinación de estas, y puede caracterizarse como estético o funcional, relacionado con indicaciones restaurativas y restauración del espacio biológico. Varios factores deben ser evaluados en la planificación estética para optimizar la sonrisa, con la inclusión del aumento clínico de coronas, destacando la calidad del fenotipo periodontal delgado o grueso, la gama adecuada de tejido queratinizado y la dimensión del espacio biológico. Un diagnóstico correcto de las causas asociadas a la sonrisa gingival, así como una valoración de las características clínicas y dimensiones anatómicas, son de fundamental importancia antes de abordar al paciente, para determinar y orientar decisiones respecto a las posibilidades de tratamiento y pronóstico de los casos. El objetivo de este estudio fue reportar dos casos de cirugía periodontal estética con técnicas comúnmente utilizadas para este fin: gingivectomía y cirugía de colgajo con osteotomía.
Subject(s)
Humans , Male , Female , Adult , Crown Lengthening/methods , Dental Porcelain , Crowns , Gingivectomy/methods , IncisorABSTRACT
Objetivo: describir el impacto de la agenesia no sindrómica de incisivos laterales maxilares permanentes en la oclusión. Material y método: se realizó una búsqueda de la evidencia disponible de manera electrónica en las bases de datos PubMed, Cochrane Library, EBSCOhost, SciELO y Epistemonikos, con filtro de búsqueda de artículos publicados entre los años 2005 y 2022, y con disponibilidad de texto completo. Resultados: se seleccionaron 9 estudios publicados entre los años 2010 y 2021; 3 estudios genéticos, 4 estudios transversales y 2 revisiones sistemáticas. Conclusión: la agenesia no sindrómica de incisivos laterales maxilares permanentes se relaciona con alteraciones esqueléticas y dentales que inciden en la oclusión dental. Un diagnóstico temprano y un tratamiento oportuno, según las necesidades de cada paciente, son importantes por las repercusiones funcionales y estéticas que genera esta alteración.
Objective: to describe the impact of non-syndromic agenesis of permanent maxillary lateral incisors on occlusion. Material and method: a search of the electronically available evidence was carried out in the PubMed, Cochrane Library, EBSCOhost, SciELO and Epistemonikos databases, with a search filter for articles published between 2005 and 2022, and with full text availability. Results: 9 studies were selected, published between 2010 and 2021: 3 genetic studies, 4 cross-sectional studies and 2 systematic reviews. Conclusion: Non-syndromic agenesis of permanent maxillary lateral incisors is related to skeletal and dental abnormalities that affect dental occlusion. Because of the functional and aesthetic repercussions of this alteration, early diagnosis and timely treatment, according to the needs of each patient, are essential.
Subject(s)
Humans , Dental Occlusion , Incisor/abnormalities , Anodontia , Maxilla , Anodontia/etiology , Anodontia/therapy , Anodontia/epidemiologyABSTRACT
El tratamiento endodóntico requiere detallados conocimientos sobre la morfología radicular. En premolares maxilares, se ha reportado variabilidad en el número de raíces y morfología del sistema de canales radiculares (SCR). La causa más frecuente de fracaso endodóntico son los conductos no tratados. Por lo tanto, una mejor compresión de la morfología del SCR y sus variaciones es crucial para el tratamiento endodóntico. El objetivo de esta investigación fue describir la frecuencia del número de raíces y morfología del SCR en premolares maxilares, mediante exámenes de tomografía computarizada Cone Beam (CBCT) en una población chilena. Se realizó un estudio observacional descriptivo de corte transversal donde se observó la morfología del sistema de canales radiculares de primeros y segundos premolares maxilares a través de exámenes CBCT, agrupándolos de acuerdo con la Clasificación de Vertucci. Se observaron 228 exámenes CBCT, donde se incluyeron 268 primeros premolares superiores y 233 segundos premolares maxilares. Se determinó que en primeros premolares maxilares un 56,3 % presentó una raíz, un 43,3 %, siendo más frecuente una morfología del SCR tipo IV. En los segundos premolares maxilares, se determinó la presencia de una raíz en el 95,7 % de los casos, siendo más frecuente una morfología del SCR tipo I. Estos resultados pueden ser de interés para endodoncistas, ya que conocer la morfología del SCR de premolares maxilares permite mejorar la planificación de la terapia endodóntica realizada en estos dientes.
Endodontic treatment requires detailed knowledge of root morphology. In maxillary premolars, variability in root number and root canal system (RCS) morphology has been reported. The most frequent cause of endodontic failure is non treated canals. Therefore, a better understanding of RCS morphology and its variations is crucial for endodontic treatment. The aim of this research was to describe the frequency of root number and SCR morphology in maxillary premolars, by means of Cone Beam Computed Tomography (CBCT) examinations in a Chilean population. A cross-sectional descriptive observational study was carried out in which the morphology of the root canal system of maxillary first and second premolars was observed through CBCT examinations, grouping them according to the Vertucci Classification. A total of 228 CBCT examinations were observed, which included 268 upper first premolars and 233 maxillary second premolars. It was determined that in maxillary first premolars 56.3 % presented one root, 43.3 %, being more frequent a SCR type IV morphology. In maxillary second premolars, the presence of one root was determined in 95.7 % of the cases, being more frequent a SCR type I morphology. These results may be of interest to endodontists, since knowing the morphology of the RCS of maxillary premolars allows improving the planning of endodontic therapy performed on these teeth.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Tooth Root/diagnostic imaging , Bicuspid/diagnostic imaging , Incisor/diagnostic imaging , Tooth Root/anatomy & histology , Bicuspid/anatomy & histology , Dental Pulp Cavity/anatomy & histology , Dental Pulp Cavity/diagnostic imaging , Cone-Beam Computed Tomography , Mandible/anatomy & histology , Mandible/diagnostic imaging , Maxilla/anatomy & histology , Maxilla/diagnostic imagingABSTRACT
Objetivo: revisar a literatura acerca da presença de anomalias dentárias por meio de radiografias panorâmicas de pacientes com fissura labiopalatina. Métodos: a busca foi realizada utilizando-se os descritores DECs/MeSH "Radiography, panoramic", "Cleft palate" e "Tooth Abnormalities", submetidos às bases de dados LILACS, SciELO, PubMed e Portal de Periódicos da Capes. Foram aceitos artigos observacionais e de caso-controle, publicados entre 2018 e 2022, em português, inglês ou espanhol. Resultados: trinta e dois artigos foram encontrados a partir dos critérios de inclusão. Dentre eles, foram excluídos artigos de revisão, relatos de caso e livros, além daqueles que não se enquadraram nos objetivos do estudo ou que estivessem publicados exclusivamente em outras línguas. Por fim, 5 artigos compuseram esta revisão. Entre as anomalias dentárias identificadas, a agenesia foi a mais prevalente, acometendo, majoritariamente, o incisivo lateral superior. Outras anomalias encontradas também foram relatadas, como hiperdontia, impactações, dilacerações radiculares, giroversões, geminações e fusões, e distúrbios na erupção. Conclusão: é possível considerar a radiografia panorâmica como recurso auxiliar no diagnóstico dessas anomalias com maior precisão.
Objective: the aim of this study is to review the literature on the presence of dental anomalies identified through panoramic radiographs of patients with cleft lip and palate. Methods: the search was carried out using the DECs/MeSH descriptors "Radiography, panoramic", "Cleft palate", and "Tooth Abnormalities", which were submitted to the LILACS, SciELO, PubMed, and Portal de Periódicos da Capes databases. Observational and case-control articles published between 2018 and 2022 in English, Portuguese, and Spanish were accepted. Results: thirty-two (32) articles were accepted according to the inclusion criteria. Among them, review articles, case reports and books were excluded, as well as articles that did not fit the objectives of this study or that were published only in other languages. Finally, five (5) articles were considered to compose this review. Among the identified dental anomalies, dental agenesis was the most prevalent, especially affecting the upper lateral incisor. Other anomalies found were also reported, such as hyperdontia, impaction, root laceration, rotation, twinning, and fusion, in addition to eruption disorders. Conclusion: It's possible to consider panoramic radiography as an important resource in the diagnosis of these anomalies with more precision.
Subject(s)
Tooth Abnormalities , Cleft Palate , Palate , Radiography, Panoramic , Cleft Lip , Health Resources , IncisorABSTRACT
Objetivo: Apresentar um caso clínico em que o tracionamento ortodôntico dos incisivos impactados promoveu correção da oclusão, melhoria estética, funcional e aumento da autoestima. Relato de caso: Uma paciente de 13 anos, insatisfeita com o seu sorriso pela ausência dos incisivos centrais superiores, apresentava 5dentes supranumerários, mordida cruzada posterior dentária, relação molar de Classe III e relação de caninos de Classe I. O tratamento consistiu na extração dos dentes supranumerários, tracionamento ortodôntico dos incisivos centrais superiores, ajuste transversal interarcos e a correção sagital com elásticos intermaxilares de Classe III. Ao final de 5 anos de tratamento, obteve-se aspectos de uma oclusão ideial com relação de molares e de caninos de Classe I, linhas médias coincidentes, sobremordida e sobressaliência adequadas e oclusão bilateral mutuamente protegida. Discussão: Mesmo havendo outro plano de tratamento possível para este caso, o tracionamento foi escolhido devido à possibilidade de ele sanar as queixas oclusais e estéticas da paciente e deforma mais imediata. Conclusão: O tratamento ortodôntico com tracionamento dos incisivos impactados promoveu oclusão satisfatória, melhoria significante da estética do sorriso e da autoestima.
Aim: To present a case report of orthodontic traction of impacted incisors that promoted occlusion correction, aesthetic and functional improvement and self-esteem increase. Case report:A 13-year-old patient, dissatisfied with her smile due to the absence of upper central incisors, presented 5 supernumerary teeth, posterior dental crossbite, Class III molar relationship and Class I canine relationship. The treatment consisted of extracting the supernumerary teeth, orthodontic traction of the upper central incisors, transverse interarch adjustment and sagittal correction with Class III intermaxillary elastics. After 5 years, there was an ideal occlusion pattern with Class I molar and canine relationships, coincident midlines, satisfactory overbite, and overjet, and mutually protected bilateral occlusion. Discussion:Even though there is another possible treatment plan for this case, the orthodontic traction was chosen due to the possibilityof solving more immediately the patient's occlusal and aesthetic complaints. Conclusion:Orthodontic treatment with traction of impacted incisors promoted satisfactory occlusion, significant improvement in the smile aesthetics and in her self-esteem.
Subject(s)
Adolescent , Esthetics, Dental , Malocclusion , IncisorABSTRACT
Introdução: a perda prematura e destruição severa de dentes decíduos devido à cárie em crianças menores de 6 anos é conhecida como Cárie na Primeira Infância (CPI), devido a pouca idade e grandes destruições dentárias torna-se desafiador o tratamento. Objetivo: demonstrar técnicas de reabilitação estética de um paciente com CPI atendido na Clínica de Odontopediatria do Instituto de Odontologia das Américas (IOA) Belém, Brasil. Relato do caso: o paciente gênero masculino, com 4 anos de idade apresentava todos os dentes decíduos com lesões de carie, com severa destruição dos incisivos superiores e inferiores, perda de estrutura dentária nos molares inferiores. O tratamento foi iniciado com instruções de higiene oral, dieta e o uso de fluoretos. Foram confeccionadas restaurações indiretas com resina composta confeccionadas em laboratório para os dentes posteriores, e cimentadas com resina flow nos dentes; reconstrução dos incisivos inferiores com auxílio de enceramento e confecção de mockup para restauração direta em resina composta e no arco superior exodontia dos incisivos e instalação do Arco de Nance modificado. O tratamento durou o período de 60 dias, foi realizada intervenção clínica, cirúrgica e protética para reabilitação total e satisfatória do paciente. Conclusão: constatou-se que a pouca idade do paciente trouxe grandes dificuldades, no entanto, a proposta das restaurações indiretas e o Arco de Nance modificado permitiu a reabilitação de forma satisfatória, mas para manter a longevidade do tratamento, os hábitos de higiene e alimentar devem ser modificados.
Introduction: the premature loss and severe destruction of primary teeth due to caries in children under 6 years of age is known as Early Childhood Caries (ECC), due to young age and large dental destruction making treatment challenging. Objective: To demonstrate aesthetic rehabilitation techniques for a patient with ECC treated at the Pediatric Dentistry Clinic of the Institute of Dentistry of the Americas (IOA) Belém, Brazil. Case report: the 4-year-old male patient presented all of his primary teeth with carious lesions, with severe destruction of the upper and lower incisors, loss of tooth structure in the lower molars. Treatment began with instructions on oral hygiene, diet and use of fluorides. Indirect restorations were made with composite resin made in the laboratory for the posterior teeth, and cemented with flow resin on the teeth; removal of the lower incisors with the aid of closing and manufacture of a model for direct restoration in composite resin and in the upper arch, extraction of the incisors and installation of the modified Nance Arch. Results: the treatment lasted a period of 60 days, clinical, surgical and prosthetic intervention was carried out for total rehabilitation and patient safety. Conclusion: it was found that the patient's young age brought great difficulties, however, the proposal of indirect restorations and the modified Nance Arch allowed rehabilitation in a safe way, but to maintain the longevity of the treatment, hygiene and eating habits suitable to be modified.
Subject(s)
Male , Child, Preschool , Tooth, Deciduous , Dental Caries , Tooth Loss , Esthetics, Dental , Incisor , Mouth RehabilitationABSTRACT
Objective: To evaluate the degree of perception among lay people of different age groups about black spaces between lower incisors. Methodology: digital changes were performed in a frontal photograph of a smiling 30 year-old patient, simulating different dimensions of black spaces. The images were printed on photographic paper and applied with a questionnaire in order to evaluate the attractiveness using as tool a visual analogue scale (VAS). The participants were divided into 6 groups, considering race (Caucasian and Negroid) and age (15-19 years, 35-44 years and 65-74 years old). The differences between the examiners were checked by the Mann-Whitney test and the significance level was 5% (α = 0.05) for all analyzes. Results: The photographs that did not have black spaces were better graded and the ones that had larger black spaces scored worse. The older age group and the Negroid race group graded better the photograph with the largest black spaces, compared to the younger age groups and the group of Caucasians. Conclusion: black spaces between lower incisors are esthetically unattractive and their perception decreases with aging, besides being less relevant to older and Negroid people.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Racial Groups/psychology , Esthetics, Dental/psychology , Incisor , Age Groups , Perception , Smiling/psychology , Ethnicity , Surveys and Questionnaires , Visual Analog ScaleABSTRACT
Objetivo: avaliar e discutir a relação entre alteração de cor na coroa e necrose pulpar em dentes decíduos, baseado em dois relatos de casos. Relato dos casos: em ambos os casos os pacientes do gênero feminino, 4 anos de idade, compareceram a um centro de referência de traumatismos dentários com escurecimento nos incisivos decíduos. O caso 1 trata-se de um traumatismo classificado como subluxação ocorrido há mais de dois anos. No exame clínico foi observada alteração de cor nos elementos 51 e 61 e no exame radiográfico não foi verificada imagem sugestiva de lesão periapical. No caso 2, diagnosticado como concussão, clinicamente foi observada alteração de cor e no exame radiográfico verificou-se uma reabsorção radicular associada à lesão periapical no elemento 61. Conclusão: o escurecimento de um dente decíduo após um traumatismo dentário nem sempre é indicativo de necrose pulpar. Sugere-se o acompanhamento periódico da presença de outros fatores, como fístula, abscesso ou lesão apical que irão auxiliar em um correto diagnóstico. Cada caso deve ser averiguado de forma independente tendo em vista que o sucesso do tratamento está vinculado ao acompanhamento periódico e ao diagnóstico de sinais radiográficos e clínicos de alterações decorrentes do episódio traumático.
Objective: the aim of this study was to evaluate and discuss the relationship between color change in the crown and pulp necrosis in deciduous teeth, based on two case reports. Case Report: both cases were female patients, 4 years old, who came to a reference center for dental trauma with complaints of darkening of the deciduous incisors. The case 1 was a trauma classified as subluxation that occurred more than two years ago. In the clinical examination a color change was observed in element 51 and 61, and in the radiographic examination no image suggestive of periapical lesion was seen. In case 2, diagnosed as concussion, clinically the color change was observed, and radiographic examination showed root resorption associated with periapical lesion in element 61. Conclusion: thus, according to the literature, we conclude that the darkening of a deciduous tooth after dental trauma is not always indicative of pulp necrosis. Periodic monitoring for the presence of other factors, such as fistula, abscess or apical lesion that will help in a correct diagnosis is suggested. Each case must be evaluated independently, since treatment success is linked to periodic monitoring and diagnosis of radiographic and clinical signs of changes resulting from the traumatic episode.
Subject(s)
Female , Child, Preschool , Tooth, Deciduous , Color , Dental Pulp Necrosis , Tooth Injuries , IncisorABSTRACT
RESUMO - Introdução: a Hipomineralização Molar-Incisivo (HMI) é considerada uma condição clínica ainda sem etiologia definida, que acomete os primeiros molares permanentes e, frequentemente, os incisivos permanentes, causando grandes impactos desde o acometimento da estética até a perda dental. Objetivo: este estudo buscou avaliar o nível de conhecimento dos acadêmicos do curso de graduação em Odontologia sobre a HMI. Materiais e Métodos: a pesquisa foi realizada com os acadêmicos matriculados da primeira a décima fase do curso de Odontologia de um centro Universitário de Santa Catarina. Os dados foram obtidos através de um questionário semiestruturado e imagens de dentes com defeitos de formação em esmalte. Resultados: pode-se observar que os acadêmicos de períodos finais (27,1%) apresentaram maior confiança em realizar o diagnóstico de HMI quando comparados aos acadêmicos de períodos iniciais (14,5%) (p<0,041). A maioria dos participantes acertou a resposta quanto à prevalência da HMI (p<0,001). Em relação ao diagnóstico clínico da HMI, observou- se que 69% dos acadêmicos que tinham o conhecimento soube identificar através da imagem clínica. Entretanto, 77,6% dos acadêmicos que não tinham conhecimento sobre a HMI responderam incorretamente (p<0,001). Conclusão: há uma parcela significante de acadêmicos do curso de Odontologia que ainda não possui conhecimento suficiente sobre a HMI. Desta forma, a formação acadêmica deve melhorar a abordagem e suprir essa dificuldade.
ABSTRACT - Introduction: molar-Incisor Hypomineralization (MIH) is considered a clinical condition with no defined etiology yet, which affects the first permanent molars and, frequently, the permanent incisors, causing major impacts ranging from aesthetic impairment to tooth loss. Objective: this study evaluated the level of knowledge of undergraduate Dentistry students about HMI. Materials and Methods: the research was carried out with students enrolled in the first to tenth period of the Dentistry course at a university center in Santa Catarina. Data were obtained through a semi-structured questionnaire and images of clinical cases were used for diagnosis. Results: it can be observed that students in final periods (27.1%) were more confident in carrying out the MIH diagnosis when compared to students in initial periods (14.5%) (p<0.041). Most participants answered correctly regarding the prevalence of MIH (p<0.001). Furthermore, 69% of students who had knowledge about MIH correctly diagnosed the image of teeth compromised by MIH. However, 77.6% of students who had no knowledge about HMI answered incorrectly (p<0.001). Conclusion: there is a significant portion of Dentistry students who still do not have sufficient knowledge about HMI. Therefore, academic training must improve the approach and overcome this difficulty.
Subject(s)
Molar Hypomineralization , Students, Dental , Incisor , MolarABSTRACT
Uno de los principales problemas durante la dentición mixta es la determinación de la futura discrepancia entre tamaño dentario y el espacio disponible. Para predecir el ancho mesiodistal de los dientes permanentes no erupcionados se han introducido diferentes métodos de análisis. Objetivo: El propósito de este estudio fue comparar el método Tanaka-Johnston con una nueva ecuación de regresión para predecir el ancho mesiodistal de caninos y premolares permanentes no erupcionados en una población de la región de Valparaíso, Chile. Material y método: Este estudio fue realizado en la Facultad de Odontología de la Universidad de Valparaíso, desde octubre de 2022 a junio de 2023 (8 meses), la muestra estuvo compuesta por 202 modelos de estudio del departamento de ortodoncia (91 hombres y 111 mujeres) en el rango de edad de 11 -20 años. Resultados: Se demostró que el método elaborado por Lara-Sandoval presenta mayor fiabilidad respecto a las medidas mesiodistales reales de los pacientes (ICC 0,773 para maxilar y 0,762 para mandíbula), en comparación con el método de Tanaka-Johnston (ICC 0,665 para maxilar y 0,623 para mandíbula). No existen diferencias significativas entre los valores reales y el método de Lara-Sandoval. Conclusión: El método de Lara-Sandoval es mejor que el propuesto por Tanaka-Johnston para determinar el ancho mesiodistal de caninos y premolares para esta muestra. Es necesario validar este método en otras regiones del país para ser utilizado con mayor seguridad que el ya existente como método estándar nacional.
One of the main orthodontic problems in mixed dentition is the determination of future tooth and size arch discrepancy. In order to predict the mesiodistal widths of unerupted permanent teeth different methods of analyses have been introduced. The aim of this study is to compare the Tanaka-Johnston analysis with a new regressive equation to predict the mesiodistal width of unerupted permanent canines and premolars in a Chilean population sample, from Valparaíso region. This study was conducted at the Universidad de Valparaíso Dental Faculty, from october 2022 to june 2023 (8 months), and the sample comprised historical dental casts from 202 patients (91 boys and 111 girls) in the age range of 11-20 from the orthodontics department. All the patients are from the Valparaíso region, Chile. The results show that the predictions of the new regressive equation method are closer to the actual mesiodistal measurements of the patients (ICC 0,773 for maxilla and 0,762 for mandible), compared to the Tanaka- Johnston method (ICC 0,665 for maxilla and 0,623 for mandible). There are no significant differences between the real values and the Lara-Sandoval method. Lara-Sandoval method is better than the one proposed by Tanaka-Johnston to determine the mesiodistal width of canines and premolars in this sample population. It is necessary to validate this method in other regions of the country to be used with greater security than the ones that already exists as a national standard method.
Subject(s)
Humans , Tooth, Unerupted/anatomy & histology , Tooth Crown/anatomy & histology , Tooth Eruption/physiology , Bicuspid/anatomy & histology , Chile , Cuspid/anatomy & histology , Dentition, Mixed , Incisor/anatomy & histology , Mandible , Maxilla , Molar/anatomy & histology , Odontometry/statistics & numerical dataABSTRACT
Introdução: O traumatismo dentário é uma ocorrência frequente durante a infância e adolescência. Geralmente, o diagnóstico acontece de forma tardia, devido à falta de conhecimento da população. Cada tipo de trauma necessita de uma conduta única e especializada. Nos casos de comprometimento pulpar, é necessário cuidado quanto à escolha da técnica a ser empregada, bem como a seleção da medicação intracanal que, por sua vez, apresenta grande interferência no sucesso do tratamento. Não obstante o avanço das técnicas de instrumentação, a troca da medicação entre as sessões nesses casos é mandatória. Relato de caso: Um paciente, sexo masculino, em idade escolar (15 anos) apresentou-se ao serviço de saúde bucal com relato de escurecimento e dores na mastigação após trauma dentário durante a infância. Os testes de vitalidade pulpar revelaram necrose pulpar, com resultado negativo no teste térmico e positivo na percussão. O exame radiológico evidenciou uma lesão apical, juntamente com reabsorção externa no elemento 21, confirmado em tomografia. O paciente foi submetido a um tratamento endodôntico. Resultado: Após o tratamento, foi solicitado novo exame tomográfico, em que se evidenciou um processo de cicatrização óssea no periápice e reabsorção por substituição na lesão cervical. Conclusão: A partir deste caso clínico, pôde-se evidenciar a importância do diagnóstico adequado, do manejo e da técnica endodôntica eficaz na resolução de problemas decorrentes de traumas dentários em pacientes jovens.
Introduction: Dental trauma is a frequent occurrence during childhood and adolescence. Generally, diagnosis happens late, due to lack of knowledge among the population. Each type of trauma requires a unique and specialized approach. In cases of pulp involvement, care must be taken when choosing the technique to be used, as well as the selection of intracanal medication, which, in turn, has a major impact on the success of the treatment. Despite advances in instrumentation techniques, changing medication between sessions in these cases is mandatory. Case report: A male patient of school age (15 years old) presented to the oral health service with reports of darkening and pain when chewing following dental trauma during childhood. Pulp vitality tests revealed pulp necrosis, with a negative result in the thermal test and positive in percussion. The radiological examination showed an apical lesion, together with external resorption in element 21, confirmed on tomography. The patient underwent endodontic treatment. Result: After treatment, a new tomographic examination was requested, which showed a process of bone healing in the periapex and resorption by replacement in the cervical lesion. Conclusion: From this clinical case, it was possible to highlight the importance of adequate diagnosis, management, and effective endodontic technique in solving problems arising from dental trauma in young patients.
Subject(s)
Humans , Male , Adolescent , Tooth Injuries/therapy , Incisor/injuries , Incisor/diagnostic imaging , Radiography, Panoramic , Treatment Outcome , Cone-Beam Computed TomographyABSTRACT
Introducción: la sínfisis mentoniana es la articulación cartilaginosa medial de los huesos mandibulares, su posición se relaciona con los diferentes biotipos y puede influir en la posición del incisivo inferior. Objetivo: determinar si existen variaciones en la posición del incisivo inferior, en pacientes clase II con diferentes biotipos. Materiales y métodos: se evaluaron la totalidad de tomografías de pacientes clase I y II esquelética que asistieron entre 2014 y 2020 a una clínica privada, teniendo una muestra total de 74 pacientes, caracterizándolos por sexo y edad. Se determinó biotipo facial, Incisor Mandibular Plane Angle, distancias a la sínfisis como el ACV-ACL y altura desde el ápice. Para el análisis se utilizó I-CAT Visión Q, para las medidas de las tomografías digitales y para el análisis estadístico Stata 17. Resultados: se en- contró un Incisor Mandibular Plane Angle mayor en pacientes clase II en los tres biotipos; los dolicofaciales clase II mostraron menor valor en corticales ACV-ACL, los pacientes mostraron mayor proinclinación en la clase II. La posición del incisivo en pacientes clase II presenta una proinclinación significativa en braquifaciales (p = 0.04). Conclusión: se encontraron variaciones entre los tres biotipos faciales en las diversas mediciones en pacientes clase I y II, el sexo femenino evidenció diferencias significativas en las clases en las medidas del Incisor Mandibular Plane Angle y la altura de la sínfisis a nivel del ápice; estos hallazgos son relevantes en el momento de realizar un tratamiento ortodóntico ya que puede limitar el movimiento de los incisivos inferiores.
Introduction: the mental symphysis is the medial cartilaginous joint of the mandibular bones, its position is related with the different biotypes and can influence the position of the lower incisor. Objective: to determine if there are variations in the position of the lower incisor, in class II patients with different biotypes. Materials and methods: all the tomography of skeletal class I and II patients who attended a private clinic between 2014 and 2020 were evaluated, having a total sample of 74 participants, characterizing the patients by sex and age. Facial biotype, Incisor Mandibular Plane Angle, distances to the symphysis such as the ACV-ACL and height from the apex were determined. For the analysis, I-CAT Vision Q was used for the measurements of the digital tomography and for the statistical analysis Stata 17. Results: a greater Incisor Mandibular Plane Angle in class II patients in the three biotypes was evident; class II dolichofacials showed a lower value in both cortical ACV-ACL, with the narrowest and longest measurement of the symphysis, the patients showed proclination in class II for both sexes, being higher for the male. The position of the incisor within the symphysis in class II patients presents a significant proclination in brachyfacial patients (p=0.04), despite presenting greater proclination, it maintains its apices centered within the symphysis. Conclusion: variations were found between the three facial biotypes in class I and II patients, it is relevant when performing orthodontic treatment since it can limit the movement of the lower incisors.
Subject(s)
Humans , Incisor , Malocclusion , Colombia , Facial AsymmetryABSTRACT
La transposición es el intercambio de la posición de dos dientes adyacentes durante los primeros años de la dentición mixta. El objetivo de la investigación fue evaluar los cambios clínicos de un caso con transposición parcial bilateral de incisivos laterales mandibulares. Se atendió una paciente de 8 años de edad, femenina, de raza blanca, síndrome de Clase II división 1, con transposición de los incisivos laterales con caninos inferiores. Fue tratada con un arco lingual de cierre horizontal, de alambre 0,032 y dos muelles de NiTi comprimidos desde el cierre horizontal del arco hasta una armella soldada a la banda que se colocó en ambos incisivos laterales. Se recuperó el espacio necesario para la erupción de los caninos inferiores y así mejoró la estética dental y facial de la paciente.
Transposition is the exchange of the position of two adjacent teeth during the first years of the mixed dentition. The objective of this research is to evaluate the clinical changes of a case with partial bilateral transposition of mandibular lateral incisors. We present an 8-year-old white female patient with Class II Division 1 malocclusion and transposition of the lateral incisors with lower canines. She was treated with a 0.032 wire horizontal closure lingual arch and two NiTi springs compressed from the horizontal closure of the arch to an eyebolt welded to the band that was placed on both lateral incisors. The necessary space for the eruption of the lower canines was recovered, thus improving her dental and facial aesthetics.
Subject(s)
Esthetics, Dental , Incisor , Mouth AbnormalitiesABSTRACT
To determine the accuracy of the Kvaal method in the estimation of dental age through the analysis of digital panoramic radiographs of patients between 20 and 47 years of age who attended the stomatological clinic of the Universidad Científica del Sur, (2018 to 2019), Lima-Perú. 289 digital panoramic radiographs belonging to individuals of both sexes, aged 20 to 47 years were analyzed. Length and width measurements were obtained in the dental and pulp chamber in the upper central incisors. These data were subsequently evaluated by calculating the proportions between the pulp and root length of the upper central incisor by applying the formula of the method of Kvaal et al. to obtain the accuracy of the method in estimating dental age. Applying the formula of Kvaal et al. indicates that the relationship between the width of the pulp and the length of the root has a higher level of significance in relation to others proportions: M mean value of all ratios except T (-0.659) and W-L difference between W and L (-0.643). The coefficient of determination (r²) and standard error of estimation (SEE) using the original Kvaal formula is r²: 0.70, SEE: 4.90 years, then a modified Kvaal formula was proposed for the Peruvian population. The Method of Kvaal et al. has an accuracy of 1.24 in estimating the dental age of individuals, using the upper central incisor in digital panoramic radiographs.
Determinar la precisión del método de Kvaal en la estimación de la edad dental mediante el análisis de radiografías panorámicas digitales de pacientes entre 20 a 47 años atendidos en la clínica estomatológica de la Universidad Científica del Sur, (2018 a 2019), Lima-Perú. Se analizaron 289 radiografías panorámicas digitales pertenecientes a individuos de ambos sexos, de 20 a 47 años. Se obtuvo medidas de longitud y anchura en la cámara dental y pulpar en los incisivos centrales superiores. Estos datos se valoraron posteriormente al calcular las proporciones entre la pulpa y longitud de la raíz del incisivo central superior aplicando la fórmula del método de Kvaal et al. para obtener la precisión del método en la estimación de la edad dental. Al aplicar la fórmula de Kvaal et al. indica que la relación entre la anchura de pulpa y la longitud de la raíz presentan un nivel de significancia mayor en relación a otras proporciones: M valor medio de todas las proporciones excepto T (-0.659) y W-L: diferencia entre los valores de W y L (-0.643). El coeficiente de determinación (r²) y el error estándar de la estimación (SEE) utilizando la fórmula original de Kvaal es de r²: 0.70, SEE: 4.90 años, después se propuso una fórmula modificada de Kvaal para la población peruana. El Método de Kvaal et al. tiene una precisión del 1.24 en la estimación de la edad dental de los individuos, utilizando el incisivo central superior en radiografías panorámicas digitales.
Subject(s)
Humans , Adult , Age Determination by Teeth/methods , Peru , Radiography, Panoramic , IncisorABSTRACT
Objetivo: determinar si existe asociación entre la inclinación del incisivo central superior y el ángulo naso-labial de Legan. Materiales y métodos: se utilizaron las telerradiografías laterales de cráneo de 20 pacientes entre 18 y 39 años, obtenidas al inicio y final de su tratamiento ortodóncico, para un análisis cefalométrico. El total de medidas obtenidas se ordenó en dos tiempos. Tiempo 1 (T1) incluyó la medición del ángulo plano biespinal-eje mayor del incisivo superior (AiT1) y del ángulo naso-labial (AnlT1) en las radiografías tomadas previo al tratamiento y tiempo 2 (T2) incluyó la medición de los mismos ángulos en las radiografías tomadas al finalizar el tratamiento (AiT2 y AnlT2 respectivamente). Los datos obtenidos fueron tabulados y analizados estadísticamente. Resultados: la muestra presentó distribución normal, por lo que se aplicó el test de correlación de Pearson, para determinar si existía asociación entre ambas variables (Ai y Anl) en T1 y T2, obteniendo como resultado un valor de R=0,5. Conclusión: no existe asociación estadística entre la variación en la inclinación del incisivo central superior y el Ángulo naso-labial de Legan.
Aim: to determine if there is an association between the inclination of the upper central incisor and the nasolabial Legan angle. Materials and methods: lateral head radiographs of 20 patients between 18 and 39 years old, obtained at the beginning and end of their orthodontic treatment, were used for a cephalometric analysis. The total of measurements obtained was ordered in two times. Time 1 (T1) included the measurement of the bispinal plane angle-major axis of the upper incisor (AiT1) and the nasolabial angle (AnlT1) in the radiographs taken before treatment and time 2 (T2) included the measurement of the same angles, in the radiographs taken at the end of the treatment (AiT2 and AnlT2 respectively). The data obtained were tabulated and statistically analyzed. Results: the sample presented a normal distribution. So, the Pearson correlation test was applied to determine if there was an association between both variables (Ai and Anl) in T1 and T2, obtaining a value of R=0.5 as a result. Conclusion: there is no statistical association between the variation in the inclination of the upper central incisor and the nasolabial Angle of Legan.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Nose/diagnostic imaging , Incisor/diagnostic imaging , Lip/diagnostic imaging , Radiography , Normal Distribution , Nose/anatomy & histology , Cephalometry , Incisor/anatomy & histology , Lip/anatomy & histologyABSTRACT
Aim: Determination of the most common shade of anterior teeth in Malaysian students of different ethnicities. Materials and Methods: A total of 120 subjects, 40 each from different ethnicities (Malay, Chinese, and Indian) aged 18-22 years were evaluated for tooth shade using the VITA Classical shade guide. The subject was asked to sit in an up-right position with teeth at the clinician's eye level and the subject was instructed to remove makeup or tinted eyewear which may affect the result. The procedure was done in natural daylight. The shade tabs were positioned adjacent to the maxillary central incisor and the middle 1/3rd of the facial surface was assessed by experts to determine the correct tooth shade. The data was statistically analysed. Results: The differences in tooth shade were seen among the subjects of different ethnicities. The Malay ethnicity has B1 (37%) as the most common tooth shade whereas Chinese has C1 (27%) and Indian C1 (40%). Conclusions: Under the limitation of the study, it was found that there is a relationship between tooth color and ethnic background. Malay students tend to have brighter teeth as compared to Chinese and Indian students.
Objetivo: Determinar el tono más común de los dientes anteriores en estudiantes malasios de diferentes etnias. Materiales y Métodos: Se evaluó el color de los dientes de un total de 120 sujetos, 40 de diferentes etnias (malayos, chinos e indios) de edades comprendidas entre 18 y 22 años, utilizando la guía de colores VITA Classical. Se pidió al sujeto que se sentara en posición vertical con los dientes al nivel de los ojos del médico y se le indicó que se quitara el maquillaje o las gafas teñidas, lo que podría afectar el resultado. El procedimiento se realizó con luz natural. Las pestañas de color se colocaron adyacentes al incisivo central superior y expertos evaluaron el tercio medio de la superficie facial para determinar el tono correcto del diente. Los datos fueron analizados estadísticamente. Resultados: Se observaron diferencias en el color de los dientes entre los sujetos de diferentes etnias. La etnia malaya tiene el B1 (37%) como el color de dientes más común, mientras que los chinos tienen el C1 (27%) y los indios C1 (40%). Conclusión: Bajo las limitaciones del estudio, se encontró que existe una relación entre el color de los dientes y el origen étnico. Los estudiantes malayos tienden a tener dientes más brillantes en comparación con los estudiantes chinos e indios.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Ethnicity , Colorimetry , Incisor/anatomy & histology , Malaysia/ethnologyABSTRACT
As lesões dentárias traumáticas são um problema de saúde pública mundial, dentre as quais a fratura dentária é a de maior ocorrência, envolvendo principalmente os dentes anteriores. A abordagem de grandes fraturas anteriores é um desafio para cirurgiões dentistas de qualquer nível pois, além da função, afetam diretamente a estética do paciente, fazendo-se necessário um planejamento que envolva diferentes especialidades na odontologia. Objetivo: Relatar um caso clínico de reabilitação funcional e estética de fratura dentária nos incisivos centrais superiores envolvendo tratamento endodôntico, instalação de pino de fibra de vidro e restauração direta em resina composta. Relato de Caso: O paciente de 17 anos sofreu fratura nos incisivos centrais superiores causada por uma queda de bicicleta. Devido à busca tardia por tratamento o elemento 21 foi diagnosticado com necrose pulpar e, portanto, foi submetido à tratamento endodôntico pela Técnica Crown Down e reabilitação com pino de fibra de vidro Splendor-SAP. Posteriormente, os elementos 11 e 21 foram restaurados com facetas diretas em resina composta pela técnica incremental. Conclusão: A reabilitação com instalação de pino de fibra de vidro associada à técnica de estratificação incremental em resina composta se mostra como uma boa opção para reabilitação estética pois permite dar forma anatômica ao dente com riqueza de detalhes na estratificação da dentina e esmalte, além de máxima preservação da estrutura dental. Os resultados obtidos reforçam o sucesso estético e funcional com significativo impacto na qualidade de vida do paciente(AU)
Traumatic dental injuries are a worldwide public health problem, among which dental fractures are the most frequent, mainly involving the anterior teeth. The approach of large anterior fractures is a challenge for dental surgeons of any level because, in addition to function, they directly affect the patient's esthetics, requiring a plan that involves different specialties in dentistry. Objective: Report a clinical case of functional and aesthetic rehabilitation of dental fractures in maxillary central incisors involving endodontic treatment, installation of a fiberglass post and direct restoration in composite resin. Case Report: The 17-year-old patient suffered a fracture in the upper central incisors caused by a fall from a bicycle. Due to the late search for treatment, element 21 was diagnosed with pulp necrosis and, therefore, underwent endodontic treatment using the Crown Down Technique and rehabilitation with a Splendor-SAP fiberglass pin. Later, elements 11 and 21 were restored with direct veneers in composite resin using the incremental technique. Conclusion: Rehabilitation with the installation of a fiberglass post associated with the incremental layering technique in composite resin is a good option for aesthetic rehabilitation as it allows the anatomical shape of the tooth with rich details in the layering of dentin and enamel, in addition to maximum preservation of the tooth structure. The results obtained reinforce the aesthetic and functional success with a significant impact on the patient's quality of life(AU)
Subject(s)
Humans , Male , Adolescent , Tooth Injuries , Composite Resins , Dental Restoration, Permanent , Esthetics, Dental , Quality of Life , Root Canal Therapy , Dental Pulp Necrosis , Dental Veneers , IncisorABSTRACT
In 1995 Gebeck & Merrifield studied a successful and unsuccessful treated Class I and Class II's samples; they found a -1.33 mm intrusion in the former and a 0.80 mm extrusion in the latter. The purpose of this article was to perform a cephalometric evaluation of maxillary incisors torque and vertical changes. We studied a sample of 129 patients, 30 males and 99 females, taken from The Charles H. Tweed Foundation Long Term Study, at pretreatment mean age 12.93 years, posttreatment mean age 16.19 years and follow up post retention mean age 29.83 years, a 13.88 years interval. The records were collected from private practitioners across the North American continent who used Standard Edgewise Mechanics and were members of the Charles H. Tweed Foundation. All patients were Class I and II American whites treated with the extraction of 4 premolars. We found an Upper anterior incisal edge to PP vertical linear measurement 28.7 and 29.2 mm, +0.53 mm (p<0.019) from pretreatment to posttreatment. The average Upper 1 to SN angle was 103.2 ° at pretreatment and 100.1° at posttreatment, -3.2° (p<0.000), Upper 1 to PP 111.0° and 108.9°, -2.2° (p<0.000), the three of them statistically significant. Conversely, Upper 1 to commissure was not. The four measurements were also statistically significant posttreatment to follow up, upper anteriors kept losing torque after posttreatment, and less upper anteriors surface was below the commissure. Some torque loss and vertical extrusion can be expected while treating patients with extractions of four premolars, therefore, upper incisor inclination increase and vertical change by itself cannot determine the success of treatment.
En 1995, Gebeck y Merrifield estudiaron muestras de Clase I y Clase II tratadas con éxito y sin éxito; encontraron una intrusión de -1,33 mm en el primero y una extrusión de 0,80 mm en el segundo. El propósito de este artículo fue realizar una evaluación cefalométrica del torque y los cambios verticales de los incisivos maxilares. Estudiamos una muestra de 129 pacientes, 30 hombres y 99 mujeres, tomados del estudio a largo plazo de la Fundación Charles H. Tweed, con una edad media previa al tratamiento de 12,93 años, una edad media posterior al tratamiento de 16,19 años y una edad media de seguimiento posterior a la retención de 29,83 años, con un intervalo de de 13,88 años. Los registros se recopilaron de médicos privados en todo el continente norteamericano que utilizaron Standard Edgewise Mechanics y eran miembros de la Fundación Charles H. Tweed. Todos los pacientes eran blancos americanos Clase I y II tratados con extracción de 4 premolares. Encontramos una medida lineal vertical del borde incisal anterior superior a PP de 28,7 y 29,2 mm, +0,53 mm (p<0,019) desde el pretratamiento hasta el postratamiento. El promedio del ángulo Superior 1 a SN fue de 103,2° en el pretratamiento y 100,1° en el postratamiento, -3,2° (p<0,000), Superior 1 a PP 111,0° y 108,9°, -2,2° (p<0,000), los tres estadísticamente significante. Por el contrario, Superior 1 a la comisura no lo era. Las cuatro mediciones también fueron estadísticamente significativas para el seguimiento después del tratamiento, los dientes anteriores superiores siguieron perdiendo torsión después del tratamiento y se observó menor superficie de los dientes anteriores superiores debajo de la comisura. Se puede esperar cierta pérdida de torque y extrusión vertical al tratar a pacientes con extracciones de cuatro premolares, por lo tanto, el aumento de la inclinación del incisivo superior y el cambio vertical por sí mismos no pueden determinar el éxito del tratamiento.
Subject(s)
Humans , Malocclusion , Malocclusion, Angle Class II , Orthodontics/methods , Cephalometry , Incisor , Mandible , MaxillaABSTRACT
The anatomical variations of teeth are directly related to the esthetics achieved in orthodontic treatment. These variations include the dental axes, such as the long crown axis and the long root axis. For this reason, these axes and the angle formed by their intersection, or crown-root angle, have been studied using several methodologies, mainly in central incisors. This study aimed to propose the visual- spatial processing as a method to determine the long crown axis and the long root axis, and thus measure the angle between these axes (crown-root angle) in the permanent upper and lower central incisors. The study had a quantitative, descriptive, observational and cross- sectional approach. The study sample consisted of 100 Cone-beam computed tomography (CBCT) images: 50 of permanent upper central incisors and 50 of permanent lower central incisors. The crown-root angle was measured considering the long crown axis and the long root axis. The mean crown root angle in the upper central incisors was 21.34 °, with a standard deviation (SD) of 4.41º; for the lower central incisors, the mean value was 20.05º with a SD of 4.18º. This study suggests that the visual-spatial processing can be a valid method to determine the long crown axis and the long root axis, also with the advantage of not requiring specific instruments and anatomical reference points, which simplifies the tracing of axes and thus measurement of the crown-root angle.
Las variaciones anatómicas de los dientes tienen directa relación con la estética lograda en el tratamiento de ortodoncia. Dentro de estas variaciones se encuentran los ejes dentarios, como el eje mayor de la corona y el eje mayor radicular. Por esta razón, se ha estudiado mediante diversas metodologías estos ejes y el ángulo formado por dicha intersección o ángulo corono radicular, principalmente en los incisivos centrales. El objetivo del presente estudio es plantear la percepción viso espacial como método para determinar el eje mayor de la corona y el eje mayor radicular, y así medir el ángulo entre estos ejes (ángulo corono radicular) en los incisivos centrales superiores e inferiores definitivos. La investigación es de enfoque cuan- titativo, descriptivo, observacional y transversal. La muestra del estudio fueron 100 imágenes de CBCT: 50 de incisivos centrales superiores definitivos y 50 de incisivos centrales inferiores definitivos. Se midió el ángulo corono radicular considerando el eje mayor de la corona y el eje mayor radicular. El promedio del ángulo corono radicular en los incisivos centrales superiores fue de 21.34° con desviación estándar (DS) de 4. 41º y para los incisivos centrales inferiores se obtuvo como valor promedio 20.05º con DS de 4.18º. Este estudio plantea que la percepción viso espacial puede ser válido como método para determinar el eje mayor de la corona y el eje mayor radicular, teniendo además la ventaja de prescindir de instrumentos específicos y de puntos anatómicos de referencia, lo cual simplifica el trazado de los ejes y por ende la medición del ángulo corono radicular.
Subject(s)
Humans , Incisor/diagnostic imaging , Malocclusion , Tooth Root/diagnostic imaging , Epidemiology, Descriptive , Cross-Sectional Studies , Crowns , Cone-Beam Computed Tomography/methods , Spiral Cone-Beam Computed Tomography , Maxilla/diagnostic imagingABSTRACT
La odontología basada en evidencias es una metodología que busca que las decisiones clínicas diarias que toman los profesionales en estomatología se encuentren fundamentadas en la evidencia científica, en ella se integran las experiencias clínicas, las necesidades, las preferencias del paciente y la evidencia clínicamente relevante más actual analizada por pares. Estos pilares son parte del proceso en la toma de decisiones para la atención al paciente. La odontología basada en evidencias surge de las exitosas experiencias obtenidas con el desarrollo e implementación de la medicina fundamentada en pruebas, al aplicar el método científico en la evaluación, planificación y toma de decisiones de las prestaciones sanitarias, sobre todo a través de los estudios controlados. En general, toda la práctica odontológica ha tenido grandes avances basados en evidencias, con hechos verídicos comprobados, pero los conceptos fundamentales de oclusión no han tenido una mejora cimentada en el conocimiento científico, prueba de ello es que se siguen ocupando teorías y conceptos de las filosofías de oclusión en la rehabilitación de muchos pacientes, seguimos creyendo en mitos y sofismas que no han podido ser demostrados. En esta revisión, demostramos los grandes avances en los conceptos de oclusión e invitamos a todos los odontólogos a romper los paradigmas de la oclusión antigua sin evidencias científicas y a utilizar las herramientas del método científico en la práctica clínica odontológica (AU)
Evidence-based dentistry is a strategy that seeks to ensure that the daily clinical decisions made by the dental professional are based on scientific evidence. It integrates the clinical experience of the dentist, the needs and preferences of the patient, and the most current relevant clinical evidence. All three are part of the decision-making process for patient care. Evidence-based dentistry arises from the successful experiences obtained with the development and implementation of evidence-based medicine, applying the scientific method in the evaluation, planning and decision-making of health benefits, especially through controlled studies. In general, all dental practice has had great advances based on evidence, with proven true facts, but the fundamental concepts of occlusion have not had an improvement based on scientific knowledge, proof of this is that theories and concepts continue to be used. of the philosophies of occlusion in patient rehabilitation, we follow myths and sophisms that have not been demonstrated, in this review, we demonstrate the great advances in the concepts of occlusion and we know all dentists to break the paradigms of the old occlusion without scientific evidence (AU)