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1.
Rev. ADM ; 77(6): 329-336, nov.-dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1151749

ABSTRACT

La mediastinitis se define como una inflamación aguda severa de los tejidos conectivos ubicados en la cavidad torácica media, en la que 20% de los casos puede implicar una infección difusa y polimicrobiana del mediastino denominada mediastinitis necrotizante descendente (MND), secundaria a la propagación de una infección grave desde los tejidos bucofaríngeos o cervicales tales como infecciones odontogénicas (de 36 a 47%), faríngeas (de 33 a 45%), cervicales (15%) y otras infecciones de cabeza y cuello (5%). Clínicamente, los pacientes presentan aumento de volumen, temblores, trismus, odinofagia con disnea, disfagia, hipotensión, dolor de cuerpo y del ángulo de la mandíbula. Puede observarse signo de Hamman (crepitación mediastinal con el latido cardiaco) y enfisema subcutáneo. El manejo quirúrgico de las infecciones odontogénicas, sin importar su severidad, consta de dos principios: eliminar el foco etiológico y el vaciamiento quirúrgico de los espacios anatómicos comprometidos con la instalación de un drenaje adecuado. Se presenta el caso de un masculino de 60 años con diagnóstico de mediastinitis necrotizante descendente de origen dental (AU)


Mediastinitis is defined as a severe acute inflammation of the connective tissues affected in the middle thoracic cavity, in which 20% of cases may involve a diffuse and polymicrobial infection of the mediastinum, descending necrotizing mediastinitis (MND), secondary to the spread of a serious infection from the oropharyngeal or cervical tissues, stories such as odontogenic infections (36 to 47%), pharyngeal (33 to 45%), cervical (15%) and other head and neck infections (5%). Clinically, patients present with increased volume, tremors, trismus, odynophagia with dyspnea, dysphagia, hypotension, pain in the body and in the angle of the jaw. Hamman sign (mediastinal crepitus with heartbeat) and subcutaneous emphysema may be observed. The surgical management of odontogenic infections, regardless of their severity, consists of two principles: eliminate the etiological focus and the surgical emptying of the anatomical spaces compromised with the installation of adequate drainage. We present the case of a 60-year-old man diagnosed with descending necrotizing (AU)


Subject(s)
Humans , Male , Middle Aged , Focal Infection, Dental/complications , Mediastinitis , Postoperative Complications , Subcutaneous Emphysema , Tooth Extraction , Thoracic Cavity , Mandible , Mexico , Molar/pathology
3.
J. oral res. (Impresa) ; 8(3): 254-262, jul. 31, 2019. ilus, tab
Article in English | LILACS | ID: biblio-1145344

ABSTRACT

To identify the prevalence and diagnostic criteria of Molar-Incisor Hipomineralization (MIH) in the scientific literature. Materials and Methods: This is a bibliographical research conducted through the analysis of indexed articles until October 2017 in the PubMed, Web of Science and Scopus databases. The Medical Subject Headings (MESH) used were "Dental Enamel Hypoplasia" and "Molar Incisor Hypomineralization". The analysis of articles was carried out by two reviewers, who collected information independently. The following information was collected: author, year of publication, place of work (continent and country), sample calculation, sample number, age of participants, type of study, prevalence of molar-incisor hypomineralization and criteria used for diagnosis. Data were tabulated using Microsoft Excel for Windows and presented using descriptive statistics. Results: A total of 484 articles were found and 57 were included in the study. Most of the studies were conducted in Europe (35%), and 31.6% of the studies mentioned using a probability sampling. The number of study participants ranged from 99 for a study in Brazil to 3,591 in Kenya. The most frequent age was 8 years, while the predominant type of study was cross-sectional (91.2%). The prevalence varied from 0.4% to 37.3% and most studies (73.6%) employed the European Academy of Pediatric Dentistry criteria for the diagnosis of MIH. Conclusion: There is great variability in prevalence in different countries, probably due to the use of different diagnostic criteria being used, and due to different age groups and geographical variation.


Objetivo: Identificar la prevalencia y los criterios diagnósticos de la hipomineralización de incisivos molares (HIM) en la literatura científica. Materiales y métodos: Investigación bibliográfica realizada a través del análisis de artículos indexados hasta octubre de 2017 en las bases de datos PubMed, Web of Science y Scopus. Los Medical Subject Headings (MESH) utilizados fueron "Dental Enamel Hypoplasia" y "Molar Incisor Hypomineralization". El análisis de los artículos fue llevado a cabo por dos revisores, quienes recolectaron información de manera independiente. Se recopiló la siguiente información: autor, año de publicación, lugar de trabajo (continente y país), cálculo y número de muestra, edad de los participantes, tipo de estudio, prevalencia de hipomineralización molar-incisiva y criterios utilizados para el diagnóstico. Los datos se tabularon con Microsoft Excel para Windows y se presentaron con estadísticas descriptivas. Resultados: Se encontraron un total de 484 artículos y 57 se incluyeron en el estudio. La mayoría de los estudios se llevaron a cabo en Europa (35%), y el 31,6% de los estudios mencionados utilizaron una muestra probabilística. El número de participantes en el estudio varió de 99 en un estudio en Brasil a 3.591 en un estudio desde Kenia. La edad más frecuente fue de 8 años, mientras que el tipo de estudio predominante fue transversal (91,2%). La prevalencia varió de 0,4% a 37,3% y la mayoría de los estudios (73,6%) emplearon los criterios de la Academia Europea de Odontología Pediátrica para el diagnóstico de HIM. Conclusión: Existe una gran variabilidad en la prevalencia de HIM en diferentes Países, probablemente debido al uso de diferentes criterios de diagnóstico, al utilizar diferentes grupos de etarios y a la variación geográfica.


Subject(s)
Humans , Dental Enamel Hypoplasia , Incisor/pathology , Molar/pathology , Prevalence , Databases, Bibliographic
4.
J. oral res. (Impresa) ; 8(2): 166-172, abr. 30, 2019. graf, tab
Article in English | LILACS | ID: biblio-1145331

ABSTRACT

Introduction: The first permanent molars are the most affected due to age of eruption and their anatomical characteristics. Objective: to determine the prevalence of caries and premature loss of the first permanent molar in a group of grade school children 6 - 12 years of age, and to determine the level of prevention knowledge of the parents, in Vargas state, Venezuela. Materials and Methods: observational study with 182 children between 6 and 12 years old who underwent a clinical evaluation. The parents were asked about their knowledge regarding caries, methods of prevention and chronology of eruption of the child's first permanent molar. Study was approved by the Bioethics Committee of the Faculty of Dentistry at Universidad Santa María. Results: 6.60% of children presented caries in tooth 16, 6.08% in tooth 26, 24.85% in the tooth 36 and 15.62% in tooth 46. Regarding premature loss, 0.55% had lost tooth 26, 4.95% tooth 36 and 4.40% tooth 46. None presented loss of tooth 16. It was observed that 90.11% of parents had knowledge about dental caries and 44.51% knew how to prevent them. However, only 12.09% knew the age of eruption of the first molar and only 7.69% knew that it has no predecessor. Conclusions: The highest percentage of caries was in tooth 36. The lower molars were the most commonly extracted. The majority of parents demonstrated to have little knowledge about caries and permanent first molars.


Introducción: Los primeros molares permanentes son los más afectados debido a la edad de erupción y a sus características anatómicas. Objetivo: determinar la prevalencia de caries y pérdida prematura del primer molar permanente en un grupo escolares de 6 ­ 12 años y el nivel de conocimiento en prevención de los padres, Estado Vargas, Venezuela. Materiales y Métodos: estudio observacional con 182 niños entre 6 y 12 años a los que se les realizó una evaluación clínica. Se interrogó a los padres sobre el nivel de conocimiento de la caries, métodos de prevención y cronología de erupción del primer molar permanente. Se contó con el aval de Bioética de la Facultad de Odontología de la Universidad Santa María. Resultados: El 6,60% presentó caries en la UD 16, el 6,08% en la UD26, el 24,85% en la UD 36 y el 15,62% en la UD 46. Respecto a la pérdida prematura, el 0,55% había perdido la UD 26, el 4,95% la UD 36 y el 4,40% la UD 46. Ninguno presentó pérdida de la UD 16. Se observó que el 90,11% de los padres tenía conocimiento sobre la caries dental y el 44,51% conocía los medios para prevenirlas. Sin embargo, solo el 12,09% conocía la edad de erupción del primer molar y únicamente el 7,69% sabía que no tiene antecesor. Conclusiones: El mayor porcentaje de caries lo tuvo UD-36. Los molares inferiores fueron los más extraídos. La mayoría de los padres demostró poseer escasos conocimientos sobre caries y primeros molares permanentes.


Subject(s)
Humans , Male , Female , Child , Tooth Eruption , Tooth Loss , Dental Caries/pathology , Molar/pathology , Venezuela , Prevalence , Dentition, Permanent
5.
Braz. oral res. (Online) ; 33: e048, 2019. tab
Article in English | LILACS | ID: biblio-1019601

ABSTRACT

Abstract This cross-sectional study aimed to assess the prevalence of molar incisor hypomineralization (MIH) and its relationship with the number of primary teeth with developmental defects of enamel (DDE). A representative population-based sample of 731 schoolchildren was randomly selected from the public school system in Curitiba, Brazil. Schoolchildren aged 8 years with fully erupted permanent first molars and incisors were eligible for the study. MIH and DDE were classified by four calibrated examiners (kappa > 0.75) according to EAPD criteria and to the FDI-modified DDE index. Clinical data were collected in a school environment. Socioeconomic information was collected through a self-administered semistructured questionnaire applied to the children's caregivers. Statistical analyses were carried out using Poisson multiple regression with robust variance (α = 0.05). MIH prevalence was 12.1% (95%CI: 10-15), and opacities were the most prevalent defect. Socioeconomic factors were not associated with MIH. Children with demarcated opacity in primary teeth presented a higher prevalence of MIH than those without DDE in primary teeth. In the multiple analysis, the increase of one primary tooth affected by demarcated opacity increased the prevalence of MIH by 33% (PR = 1.33, 95%CI: 1.15-1.53, p < 0.001). Asian children had a higher prevalence of MIH (PR = 2.91, 95%CI: 1.08-8.09 p = 0.035) than did Caucasian children.Conclusion: Based on these findings, the prevalence of MIH in Curitiba was 12.1%. Demarcated opacity in primary teeth could be considered a predictor of MIH.


Subject(s)
Humans , Male , Female , Child , Dental Enamel Hypoplasia/epidemiology , Socioeconomic Factors , Tooth, Deciduous , Severity of Illness Index , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Regression Analysis , Risk Factors , Dental Enamel Hypoplasia/pathology , Self Report , Incisor/pathology , Molar/pathology
6.
J. oral res. (Impresa) ; 7(8): 382-386, nov. 30, 2018. ilus
Article in English | LILACS | ID: biblio-1121119

ABSTRACT

Chronic pulpal inflammation and infection are the main predisposing factors for internal and external root resorption (IRR & ERR); however, merging of IRR and ERR is a rare lesion which rigorously alters the anatomy of root canals. this study reports a case of merged IRR and ERR in an asymptomatic maxillary left central incisor in a 33-year old caucasian woman that was managed by one-visit root canal therapy (RCT) using calcium-enriched mixture (CEM) cement. radiographic examination showed a short root with under-filled root canal obturation associated with ERR/IRR and an apical lesion. after thorough chemo-mechanical preparation, the root canal was obturated with CEM cement; one week later, the access cavity was permanently restored. clinical/radiographic examinations at 1-year follow-up revealed uneventful healing, reestablishment of lamina dura and stabilization of the resorptive defects. the treatment outcome demonstrates that one-visit RCT using CEM cement may be a viable treatment option in cases with merged external/internal root resorption. further clinical trials with a larger number of cases are suggested to document a higher level of evidence.


Subject(s)
Humans , Female , Adult , Periapical Diseases/therapy , Root Canal Filling Materials/therapeutic use , Root Canal Therapy/methods , Root Canal Obturation/methods , Biocompatible Materials/therapeutic use , Calcium/therapeutic use , Dental Pulp Necrosis , Molar/pathology
7.
Braz. dent. j ; 29(2): 159-165, Mar.-Apr. 2018. graf
Article in English | LILACS | ID: biblio-951525

ABSTRACT

Abstract The aim of this study was to evaluate the clinical, radiographic and histological outcomes of the dentin-pulp complex from primary molars after pulpotomy with mineral trioxide aggregate (MTA) and 15.5% ferric sulfate (FS). Thirty-one primary molars were randomly allocated into MTA or FS groups. Clinical and radiographic evaluations were recorded at 3-, 6-, 12- and 18-month follow-up. Teeth at the regular exfoliation period were extracted and processed for histological analysis. Clinical and radiographic data were tested by statistical analysis (p≤0.01). Histological outcomes were analyzed descriptively. All of the treated teeth presented clinical success over the experimental periods. Both groups exhibited 100% of radiographic success at 3, 6 and 12 months. At the 18-month follow-up, one tooth from FS group presented inter-radicular radiolucency (p>0.01). Histologically, the treated teeth presented pulp vitality and absence of inflammatory infiltrate into the connective tissue. Only MTA group showed hard tissue barrier surrounded by odontoblasts over the pulp stumps. Both MTA and 15.5% FS are effective for pulpotomies of primary teeth. Although MTA is considered the first-choice material, FS may be a suitable alternative when treatment cost is an issue.


Resumo O objetivo deste estudo foi avaliar os resultados clínicos, radiográficos e histológicos do complexo dentino-pulpar de molares decíduos após pulpotomia com agregado trióxido mineral (MTA) e sulfato férrico (SF) 15,5%. Trinta e um molares decíduos foram alocados aleatoriamente nos grupos MTA ou SF. As avaliações clínicas e radiográficas foram realizadas aos 3, 6, 12 e 18 meses de acompanhamento. Os dentes no período regular de esfoliação foram extraídos e processados ​​para análise histológica. Os dados clínicos e radiográficos foram analisados estatisticamente (p≤0,01). O resultados histológicos foram analisados ​​descritivamente. Todos os dentes tratados apresentaram sucesso clínico ao longo dos períodos experimentais. Ambos os grupos exibiram 100% de sucesso radiográfico aos 3, 6 e 12 meses. Aos 18 meses de acompanhamento, um dente do grupo SF apresentou radiolucidez interradicular (p>0,01). Histologicamente, os dentes tratados apresentaram vitalidade pulpar e ausência de infiltrado inflamatório no tecido conjuntivo. Somente o grupo MTA mostrou barreira de tecido duro rodeada por odontoblastos sobre os cotos pulpares. MTA e SF 15,5% são eficazes para pulpotomias de dentes decíduos. Embora o MTA seja considerado o material de primeira escolha, o SF pode ser uma alternativa adequada quando o custo do tratamento é um problema.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Oxides/administration & dosage , Pulpectomy/methods , Ferric Compounds/administration & dosage , Calcium Compounds/administration & dosage , Aluminum Compounds/administration & dosage , Pulp Capping and Pulpectomy Agents , Tooth, Deciduous/surgery , Tooth, Deciduous/pathology , Tooth, Deciduous/diagnostic imaging , Radiography, Dental , Treatment Outcome , Dental Pulp/pathology , Drug Combinations , Molar/pathology , Molar/diagnostic imaging
8.
Int. j. odontostomatol. (Print) ; 11(3): 319-325, set. 2017. graf
Article in English | LILACS | ID: biblio-893268

ABSTRACT

ABSTRACT: Ankylosis is an anomaly of tooth eruption characterized by the fusion of cementum and alveolar bone, and may affect from small regions to the entire root surface. Clinical assessment combined with imaging exams can aid diagnosis. Radiographic testing enables assessing only proximal regions of possibly affected roots. Whereas cone beam computed tomography (CBCT) allows a three-dimensional assessment of axial, coronal, and sagittal planes of all dental extension, eliminating thus overlapping images and helping to confirm the correct diagnosis. The present study contains a case report of a male patient with ankylosis in tooth 16 diagnosed by CBCT, aiming at providing information for dentists about this anomaly, its characteristics and situations in which CBCT should be indicated.


RESUMEN: La anquilosis es una anomalía de la erupción del diente caracterizada por la fusión de cemento y hueso alveolar, y puede afectar desde pequeñas regiones hasta toda la superficie de la raíz. La evaluación clínica combinada con los exámenes de imagen puede ayudar a diagnosticar esta anomalía. Las pruebas radiográficas permiten evaluar sólo las regiones proximales de las raíces posiblemente afectadas. La tomografía computarizada de haz de cono (CBCT) permite una evaluación tridimensional de los planos axial, coronal y sagital de toda la extensión dental, eliminando así las imágenes superpuestas y ayudando a confirmar el diagnóstico correcto. En el presente estudio se presenta un reporte de caso de un paciente con anquilosis en el diente 16 diagnosticado por CBCT, con el objetivo de proporcionar información para los dentistas sobre esta anomalía, sus características y situaciones en las que debe indicarse la CBCT.


Subject(s)
Humans , Male , Adolescent , Tooth Eruption, Ectopic/complications , Tooth Ankylosis/complications , Tooth Ankylosis/diagnosis , Anodontia/complications , Molar/pathology , Tooth, Deciduous/pathology , Bicuspid/physiopathology , Imaging, Three-Dimensional , Cone-Beam Computed Tomography/methods , Molar/physiopathology
9.
Dental press j. orthod. (Impr.) ; 22(2): 106-117, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-840222

ABSTRACT

ABSTRACT The present study reports the treatment carried out in a patient with mandibular second premolar agenesis associated with early loss of a deciduous second molar, deep overbite, severe overjet and dentoalveolar bimaxillary protrusion, which led to lip incompetence and a convex facial profile. The main objectives of this treatment were: to eliminate the spaces in mandibular arch, correct overbite, as well as eliminate bimaxillary protrusion and lip incompetence, thus leading to a balanced profile. The case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as part of the requirements to obtain the title of BBO diplomate.


RESUMO O presente caso clínico relata o tratamento de uma paciente com agenesia de segundo pré-molar inferior associada à perda precoce do segundo molar decíduo, sobremordida profunda, sobressaliência exagerada e biprotrusão dentoalveolar, que causavam incompetência labial e perfil facial convexo. Os objetivos do tratamento foram eliminar os espaços presentes na arcada inferior, corrigir a sobremordida, eliminar a biprotrusão e a incompetência labial, harmonizando o perfil. Esse caso foi apresentado ao Board Brasileiro de Ortodontia e Ortopedia Facial (BBO) como parte dos requisitos para obtenção do título de Diplomado pelo BBO.


Subject(s)
Humans , Female , Child , Tooth, Deciduous/abnormalities , Bicuspid/pathology , Overbite/therapy , Malocclusion/therapy , Mandible/pathology , Anodontia/therapy , Brazil , Radiography, Panoramic , Cephalometry/methods , Orthodontic Brackets , Orthodontic Appliance Design , Malocclusion/diagnostic imaging , Malocclusion, Angle Class I/therapy , Malocclusion, Angle Class I/diagnostic imaging , Malocclusion, Angle Class II/therapy , Malocclusion, Angle Class II/diagnostic imaging , Maxilla/pathology , Maxilla/diagnostic imaging , Anodontia/diagnostic imaging , Molar/pathology , Molar/diagnostic imaging
10.
Actas odontol ; 13(1): 4-14, jul.2016.
Article in Spanish | LILACS | ID: lil-796671

ABSTRACT

Los segundos molares superiores e inferiores con frecuencia erupcionan mesioinclinados o quedan retenidos con esta inclinación debidoa terapias ortodoncicas tempranas como la colocación de arcos linguales, previas a la erupción de estas piezas. De acuerdo al grado deinclinación que presenten se pueden implementar diversas mecßnicas ortodoncicas. En este caso clínico se utilizaron varias de estasmecßnicas y se aprovecha la ocasión para explicar otras mßs disponibles...


Upper and lower second molars frecuently erupt with a mesioinclination fashion or eventually get included due to early orthodontictherapies such as lingual arches placed prior to the eruption of these teeth. According to the inclination degree, different mechanics canbe used. In this case report these mechanics are explained wether they were used in the solution or not...


Subject(s)
Humans , Adolescent , Female , Tooth, Impacted/therapy , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods , Molar/pathology , Malocclusion, Angle Class I , Orthodontic Anchorage Procedures/instrumentation , Patient Care Planning
11.
Bol. Asoc. Argent. Odontol. Niños ; 44(3): 12-17, ene.-abr. 2016. ilus, tab
Article in Spanish | LILACS | ID: lil-794307

ABSTRACT

Estimar la frecuencia de éxito clínico-radiográfico del tratamiento endodóntico no instrumentado con pasta 3Mix-MP en molares primarios con diagnóstico de necrosis pulpar. Materiales y métodos: estudio experimental, prospectivo y longitudinal, realizado en la Cátedra de Odontología Integral Niños de la FOUBA (agosto 2014 - agosto 2015). Formaron parte de la investigación 44 molares primarios con diagnóstico de necrosis pulpar, de 36 niños (6,07 +/- 1,63 años), sin compromiso inmunológico ni metabólico y que junto con sus responsables legales brindaron el consentimiento informado. Se realizó el tratamiento endodóntico no instrumentado con pasta 3Mix-MP (metronidazol, minociclina, ciprofloxacina 1:1:1 y vehículos macrogol, propilenglicol 1:1) y restauración definitiva con corona de acero. Los molares fueron evaluados por dos examinadores al mes, 3, 6 y 12 meses. Se calcularon porcentajes con sus intervalos de confianza del 95 por ciento. Resultados: al mes, la tasa de éxito clínico fue de 97.72 por ciento (87.96-99.97) y la de éxito radiográfico de 93.18 por ciento (81.31-98.61). Fue posible el seguimiento del 65.85 por ciento de la muestra a los 3 meses, del 34.14 por ciento a los 6 meses y del 24.39 por ciento a los 12 meses, revelando un 100 por ciento de éxito clínico-radiográfico en los tratamientos evaluados. Conclusión: en los casos y períodos estudiados, esta terapéutica mostró un buen comportamiento clínico y radiográfico. Son necesarios estudios con mayor tamaño muestral y mayor período de seguimiento para proponerla como alternativa de tratamento...


Subject(s)
Humans , Male , Female , Child , Tooth, Nonvital/drug therapy , Tooth, Deciduous/pathology , Root Canal Filling Materials/therapeutic use , Molar/pathology , Dental Pulp Necrosis/drug therapy , Crowns , Schools, Dental , Follow-Up Studies , Longitudinal Studies , Prospective Studies , Data Interpretation, Statistical
12.
Actas odontol ; 12(2): 24-31, dic. 2015.
Article in Spanish | LILACS | ID: lil-790153

ABSTRACT

La caries dental es la causa principal por la que se realizan tratamientos de conducto, sin embargo existen procedimientos de protección pulpar para el manejo de lesiones cariosas profundas, que ayudan en la recuperación del tejido pulpar. Uno de los procedimientos es el tratamiento expectante, éste va a ser efectivo en preservar la pulpa que podría ser expuesta durante la remoción de caries profunda donde no hay signos clínicos que indiquen pulpitis irreversible. El tratamiento expectante, al ser en dos etapas tiene como objetivo detener el avance de la lesión cariosa, minimizar la dentina cariada retenida y permitirle a la pulpa recuperarse generando dentina reparativa para evitar cualquier exposición pulpar en una segunda sesión. Se describe el manejo de lesiones cariosas profundas en molar permanente joven mediante el tratamiento expectante a través de un reporte de caso. Paciente femenino de 15 años presenta dolor provocado a los cambios térmicos en el segundo molar inferior izquierdo. Las radiografías revelaron lesión cariosa profunda, clasificación R4 de Pitts, ausencia de radiolucidez apical y espacio del ligamento periodontal normal. A la prueba objetiva de diagnóstico con frío, se observó respuesta positiva, diagnosticándose Pulpitis Reversible. Basado en estos hallazgos se decide mantener la vitalidad pulpar y realizar el tratamiento expectante. El tratamiento expectante constó de dos fases, en la primera se retiró el tejido cariado de paredes y piso, dejándose dentina afectada y se colocó hidróxido de calcio seguido de una restauración temporal. En la segunda fase, 6 meses después, tras confirmar el mantenimiento de la vitalidad pulpar y formación de puente dentinario, se reabrió la cavidad y se colocó la restauración definitiva con resina compuesta. Se realizaron dos controles posteriores, el primero 12 meses después de iniciado el tratamiento y el segundo 60 meses después...


Dental caries is one of the main reasons to perform root canal treatments; however there are procedures to protect the pulp in case of deep caries lesions. During caries removal pulp tissue could be exposed, so stepwise excavation is one procedure which will be effective in pulp preservation. Stepwise excavation consists of two stages, its purpose is stop caries progression, change cariogenic environment and allow the pulp recover generating reparative dentine to avoid pulp exposure in a second visit. Below we describe the management of deep carious lesions in a young permanent molar treated with stepwise excavation. A 15-year-old female patient with cause pain due to thermal changes in second inferior left molar, X-Rays revealed deep caries lesion, R4 Pitts ́s classification, no signs of apical radiolucency or widening of the periodontal ligament space. Presents positive response to sensibility test with cold so Reversible Pulpitis is diagnosed, because of these findings it was decided to keep pulp vitality and perform stepwise excavation. This procedure consists in two phases: the first one is taking out the caries lesion from walls and floor, leaving affected dentin and placed calcium hidroxyde paste over, followed by a temporal restoration with glass ionomer. The second phase is six months later, once pulp vitality is confirmed and dentinal bridge is formed, so the cavity is reopened and definitive restoration is placed with composite resin.Two subsequent check-ups were carried out, the first one 12 months after stepwise excavation had been performed and the second control was 60 months later, clinical and radiographic controls were performed in both controls and no pathology was found considering the treatment as effective.


Subject(s)
Humans , Adolescent , Female , Dental Caries/therapy , Molar/pathology , Dental Cavity Preparation/methods , Dental Pulp Capping/methods , Follow-Up Studies
13.
Dental press j. orthod. (Impr.) ; 20(3): 64-68, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-751410

ABSTRACT

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. .


Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Tooth/pathology , Dental Arch/pathology , Mandible/pathology , Cephalometry/methods , Longitudinal Studies , Cuspid/pathology , Incisor/pathology , Molar/pathology , Odontometry/methods
14.
Dental press j. orthod. (Impr.) ; 20(2): 110-118, Mar-Apr/2015. tab, graf
Article in English | LILACS | ID: lil-745860

ABSTRACT

This clinical case reports the treatment of an Angle Class II malocclusion in a young woman with a balanced face affected by agenesis of second and third mandibular molars and subsequent extrusion of second maxillary molars. The atypical and peculiar occlusal anomaly led to individualized treatment proposed in order to normalize dental malpositions, with subsequent rehabilitation of edentulous areas by means of a multidisciplinary approach. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) in partial fulfillment of the requirements for obtaining the title of certified by the BBO.


O presente caso clínico relata o tratamento de uma má oclusão de Classe II de Angle, em uma jovem com face harmoniosa, porém agravada por agenesias de segundos e terceiros molares inferiores e consequente extrusão dos segundos molares superiores. A anomalia oclusal atípica e peculiar levou a uma proposta de tratamento individualizada, visando normalizar os maus posicionamentos dentários e uma posterior reabilitação das áreas edêntulas, por meio de uma abordagem multidisciplinar. O presente 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.


Subject(s)
Adolescent , Female , Humans , Anodontia/therapy , Malocclusion, Angle Class II/therapy , Molar, Third/abnormalities , Molar/abnormalities , Cephalometry/methods , Diastema/therapy , Mandible/pathology , Maxilla/pathology , Molar/pathology , Orthodontic Appliance Design , Orthodontic Appliances, Removable , Orthodontic Brackets , Orthodontic Wires , Overbite/therapy , Patient Care Planning , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods
15.
Bauru; s.n; 2015. 75 p. ilus, tab.
Thesis in Portuguese | LILACS | ID: lil-794223

ABSTRACT

O seio maxilar apresenta formato distinto e volume variável entre as pessoas e seu assoalho pode ser encontrado em íntimo contato com as raízes dos dentes posteriores, podendo haver protrusão dessas raízes em seu interior. Tal proximidade é de grande relevância frente aos casos de comunicação bucossinusal em potencial ou pela possibilidade de desenvolvimento de um quadro infeccioso de origem odontogênica, em que esse pode vir a se estender para o interior do seio maxilar. Existe uma ausência de trabalhos na literatura acerca da relação estabelecida entre dentes posteriores e o seio maxilar em pessoas com fissura labiopalatina. O objetivo do presente estudo foi identificar e comparar a relação entre o assoalho do seio maxilar e os ápices radiculares dos dentes posteriores em imagens de tomografia computadorizada de feixe cônico em pessoas sem fissura labiopalatina e com fissura transforame incisivo unilateral e bilateral. Foram avaliados 100 indivíduos sem anomalias craniofaciais e 112 com fissura transforame incisivo unilateral ou bilateral, não sindrômicos, utilizando o programa i-CAT® Vision, onde a relação estabelecida pelas estruturas foi convencionada sendo, tipo 0 ou ausência de contato entre as estruturas, tipo 1 ou relação de íntimo contato entre as estruturas sem protrusão radicular no interior do seio maxilar e tipo 2 ou relação de íntimo contato entre as estruturas com protrusão radicular no interior do seio maxilar. Foi utilizado o teste do qui-quadrado para comparar os achados entre os grupos estudados, considerando valor estatisticamente significante quando p≤ 0,05. Foi avaliada a relação do assoalho do seio maxilar com 1679 dentes, totalizando 3664 raízes onde 1883 (51,3%) foram classificadas como tipo 0, 1456 (39,7%) tipo 1 e 325 (8,8%) do tipo 2. Houve diferença estatisticamente significante para a raiz palatina do dente 18 entre os grupos com fissura unilateral e bilateral (p = 0,011), para a raiz mesiovestibular do dente 18...


The maxillary sinus has a remarkable feature and a variable volume among people where the inferior wall may be found in an intimate relation with the posterior teeth roots protruding or not inside the antrum. This proximity is of great relevance considering a potential oroantral communication or the spreading of an odontogenic infection into the maxillary sinus. There is a lack of evidence into the literature regarding the relationship between posterior teeth roots and the maxillary sinus in non-syndromic complete cleft lip and palate patients. This study aimed to evaluate and compare cone beam computed tomography images regarding the relationship between the posterior teeth roots and the maxillary sinus floor in non-cleft lip and palate patients and non-syndromic complete unilateral and bilateral cleft lip and palate patients. Images were interpreted using the i-CAT® Vision software including 100 noncleft patients and 112 presenting non-syndromic complete unilateral and bilateral cleft lip and palate. The relationship between teeth roots and the maxillary sinus floor was established as type 0 or no contact between these structures, type 1 or close contact without root protrusion into the sinus and type 2 or close contact with root protrusion into the sinus. The chi-square test, considering a statistically significant value where p≤0,05, was used to compare data between different groups. The sample included 1679 teeth and 3664 roots where 1883 (51,3%) were classified as type 0, 1456 (39,7%) as type 1 and 325 (8,8%) as type 2. There were statistically significant differences for tooth 18 palatine root between both complete cleft lip and palate groups (p = 0,011), for tooth 18 mesiobuccal root between noncleft and the bilateral groups (p = 0,046) and between both complete cleft lip and palate groups (p = 0,016) and for tooth 24 buccal root between non-cleft and the bilateral group (p = 0,001). Complete unilateral and bilateral cleft lip and palate...


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Molar/pathology , Cleft Lip/pathology , Cleft Palate/pathology , Tooth Root/pathology , Maxillary Sinus/pathology , Mouth Floor/pathology , Case-Control Studies , Reference Values , Sex Factors , Cone-Beam Computed Tomography/methods
16.
Rev. Ateneo Argent. Odontol ; 54(2): 9-14, 2015. ilus
Article in Spanish | LILACS | ID: lil-776099

ABSTRACT

La hipoplasia del esmalte es una anomalía estructural originada por la formación incompleta o defectuosa de la matriz del esmalte dentario. Se manifiesta como defectos macroscópicos que varían desde línas tenues hasta cavidades de diferentes tamaños. Las propuestas terapéuticas son variadas y abarcan desde la remineralización de la lesión hasta la exodoncia de la pieza afectada. Frente a los reiterados fracasos de las restauraciones en molares hipoplásicos debido al pobre patrón de grabado que presentan, el objetivo de este trabajo es mostrar una alternativa para el tratamiento restaurador de estas piezas dentarias, mejorando la adhesión.


Subject(s)
Humans , Female , Child , Collagen , Dentin , Acid Etching, Dental/methods , Dental Enamel Hypoplasia/therapy , Molar/pathology , Phosphoric Acids/chemistry , Fluorides, Topical/therapeutic use , Oral Hygiene/education , Sodium Hypochlorite/chemistry , Patient Care Planning , Dental Enamel Proteins/physiology , Dental Bonding/methods , Dental Restoration, Permanent/methods
17.
Dental press j. orthod. (Impr.) ; 19(6): 99-104, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732427

ABSTRACT

INTRODUCTION: Although lip bumpers (LBs) provide significant clinical gain of mandibular arch perimeter in mixed-dentition patients, orthodontists are reluctant to use them due to the possibility of permanent second molar eruptive disturbances. OBJECTIVE: The present study was conducted to assess second molar impaction associated with the use of LBs, and to investigate how they can be solved. MATERIAL AND METHODS: Lateral and panoramic radiographs of 67 patients (34 females and 33 males) were assessed prior (T1) and post-LB treatment (T2). LB therapy lasted for approximately 1.8 ± 0.9 years. Concomitant rapid palatal expansion (RPE) was performed in the maxilla at LB treatment onset. Impaction of mandibular second molars was assessed by means of panoramic radiographs in relation to the position of first mandibular molars. Horizontal and vertical movements of first and second molars were assessed cephalometrically on lateral cephalometric radiographs based on mandibular superimpositions. RESULTS: Eight (11.9%) patients had impacted second molars at the end of LB therapy. Two patients required surgical correction, whereas five required spacers and one patient was self-corrected. Mandibular first molar tip and apex migrated forward 1.3 mm and 2.3 mm, respectively. Second molar tip showed no statistically significant horizontal movement. CONCLUSION: Although LB therapy increased the risk of second molar impaction, impactions were, in most instances, easily solved. .


INTRODUÇÃO: embora placas labioativas (PLAs) promovam um ganho clínico significativo no perímetro da arcada inferior em pacientes com dentição mista, ortodontistas são relutantes em usá-las devido a possibilidade de problemas eruptivos dos segundos molares. OBJETIVO: o presente estudo avaliou a impacção dos segundos molares associada ao uso das PLAs e como a impacção pôde ser resolvida. MÉTODOS: radiografias cefalométricas lateral e panorâmica de 67 pacientes (34 do sexo feminino e 33 do masculino) foram avaliadas antes (T1) e após (T2) o tratamento com PLAs, que durou aproximadamente 1,8 ± 0,9 anos. Expansão rápida do palato (ERP) foi usada na maxila no início do uso da PLA. Usando as radiografias panorâmicas, a impacção dos segundos molares inferiores foi avaliada relativamente à posição dos primeiros molares mandibulares. Os movimentos horizontais e verticais dos primeiros e segundos molares inferiores foram avaliados com base em sobreposições de estruturas estáveis da arcada inferior por meio das radiografias laterais. RESULTADOS: oito (11,9%) pacientes apresentaram impacção dos segundos molares mandibulares ao final do tratamento com PLA; dois pacientes tiveram de recorrer à intervenção cirúrgica para a correção da impacção, cinco tiveram a correção da impacção usando apenas espaçadores e um apresentou autocorreção da impacção. A coroa e o ápice do primeiro molar inferior migraram 1.3mm e 2,.3mm, respectivamente, para mesial. O segundo molar não mostrou movimento horizontal significativo. ...


Subject(s)
Child , Female , Humans , Male , Molar/pathology , Orthodontic Appliance Design , Orthodontic Appliances/adverse effects , Tooth, Impacted/etiology , Cephalometry/methods , Follow-Up Studies , Incisor/pathology , Longitudinal Studies , Mandible/pathology , Palatal Expansion Technique/instrumentation , Radiography, Panoramic , Retrospective Studies , Tooth Eruption/physiology , Tooth Movement Techniques/instrumentation
18.
Dental press j. orthod. (Impr.) ; 19(6): 93-98, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732433

ABSTRACT

OBJECTIVE: This study aimed to assess tissue changes during orthodontic movement after binge-pattern ethanol 20% exposure. METHODS: Male Wistar rats (n = 54) were divided into two groups. The control group (CG) received 0.9% saline solution, while the experimental group (EG) received 20% ethanol in 0.9% saline solution (3 g/kg/day). On the 30th day, a force of 25 cN was applied with a nickel-titanium closed coil spring to move the maxillary right first molar mesially. The groups were further divided into three subgroups (2, 14 and 28 days). Tartrate-resistant acid phosphatase and picrosirius were used to assess bone resorption and neoformation, respectively. Data were compared by two-way ANOVA, Tukey's HSD, Games-Howell and chi-square test. Significance level was set at 5%. RESULTS: There was a decrease in the number of osteoclasts in EG at day 28. The percentage of collagen showed no interaction between group and time. CONCLUSION: Binge-pattern 20% ethanol promoted less bone resorption at the end of tooth movement, thereby suggesting delay in tooth movement. .


OBJETIVO: objetivou-se avaliar as alterações teciduais decorrentes da administração de etanol a 20% no padrão binge, durante o movimento ortodôntico. MÉTODOS: foram utilizados ratos Wistar machos (n = 54), divididos em dois grupos, sendo Grupo Controle (GC), com administração de soro fisiológico a 0,9%; e Grupo e Experimental (GE), com administração de etanol a 20% em soro fisiológico a 0,9%, no volume de 3g/kg/dia. Após o 30º dia de administração, foi aplicada força de 25cN com mola fechada de níquel-titânio para mover o primeiro molar superior direito para mesial. Os grupos foram subdivididos nos subgrupos 2, 14 e 28 dias, correspondendo ao número de dias de movimentação dentária. Utilizou-se as colorações de fosfatase ácida-tartarato resistente e picrosírius para avaliar reabsorção óssea e neoformação óssea, respectivamente. Os dados foram comparados por ANOVA a dois critérios, Tukey HSD e Games-Howell, ao nível de significância de 5%. RESULTADOS: verificou-se diminuição no número de osteoclastos no GE II no 28º dia. A percentagem de colágeno não demonstrou alteração na interação grupo x tempo. CONCLUSÕES: o etanol no padrão binge a 20% promoveu menor reabsorção óssea no final da movimentação dentária, sugerindo atraso na movimentação dentária. .


Subject(s)
Animals , Male , Rats , Binge Drinking/complications , Tooth Movement Techniques/methods , Azo Compounds , Acid Phosphatase/analysis , Alveolar Process/pathology , Bone Resorption/pathology , Bone Resorption/physiopathology , Cell Count , Coloring Agents , Collagen Type I/analysis , Dental Alloys/chemistry , Isoenzymes/analysis , Molar/pathology , Nickel/chemistry , Orthodontic Wires , Osteoclasts/pathology , Osteogenesis/physiology , Periodontal Ligament/pathology , Random Allocation , Rats, Wistar , Time Factors , Titanium/chemistry , Tooth Movement Techniques/instrumentation
19.
Dental press j. orthod. (Impr.) ; 19(6): 78-85, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-732436

ABSTRACT

OBJECTIVE: The aim of this study is to assess dentoskeletal symmetry in cone-beam computed tomography (CBCT) scans of Brazilian individuals with Angle Class I malocclusion. MATERIAL: A total of 47 patients (22 females and 25 males) aged between 11 and 16 years old (14 years) seen in a private radiology service (CIRO, Goiânia, GO, Brazil) were assessed. All CBCT scans were obtained from January, 2009 to December, 2010. Cephalometric measurements were taken by multiplanar reconstruction (axial, coronal and sagittal) using Vista Dent3DPro 2.0 (Dentsply GAC, New York, USA). Minimum, maximum, mean and standard deviation values were arranged in tables, and Student t-test was used to determine statistical significance (P < 0.05). RESULTS: Data were homogeneous, and differences between the right and left sides were not significant. CONCLUSIONS: Cephalometric measurements of Brazilian individuals with Angle Class I malocclusion can be used to establish facial symmetry and three-dimensional standard references which might be useful for orthodontic and surgical planning. .


OBJETIVO: o objetivo deste estudo é avaliar a simetria dentoesqueléticas em imagens de tomografia computadorizada de feixe cônico (TCFC) de indivíduos brasileiros com má oclusão Classe I de Angle. MÉTODOS: quarenta e sete pacientes (22 meninas e 25 meninos), com idades entre 11 e 16 anos (14 anos, em média), foram atendidos em um serviço de radiologia privado. Todas as imagens de TCFC foram adquiridas a partir de janeiro de 2009 a dezembro de 2010. Medições cefalométricas foram realizadas por reconstruções multiplanares (axial, coronal e sagital) usando o VistaDent 3D Pro 2.0 ( Dentsply GAC, Nova Iorque, EUA). O desvio-padrão mínimo, máximo e a média foram descritos em tabelas, e o teste t de Student foi utilizado para definir significância estatística (p < 0,05). RESULTADOS: os dados foram homogêneos e as diferenças entre os lados direito e esquerdo não foram significativas. CONCLUSÕES: as medidas cefalométricas de indivíduos brasileiros com má oclusão Classe I de Angle podem ser usadas para definir a simetria facial e referências de padrão tridimensional, que podem ser úteis para o planejamento ortodôntico e cirúrgico. .


Subject(s)
Adolescent , Child , Female , Humans , Male , Cephalometry/methods , Imaging, Three-Dimensional/methods , Malocclusion, Angle Class I/pathology , Anatomic Landmarks/pathology , Anatomic Landmarks , Chin/pathology , Chin , Cone-Beam Computed Tomography/methods , Ear Canal/pathology , Ear Canal , Face/pathology , Face , Facial Asymmetry/pathology , Facial Asymmetry , Facial Bones/pathology , Facial Bones , Image Processing, Computer-Assisted/methods , Malocclusion, Angle Class I , Mandible/pathology , Mandible , Mandibular Condyle/pathology , Mandibular Condyle , Maxilla/pathology , Maxilla , Molar/pathology , Molar , Nasal Bone/pathology , Nasal Bone , Orbit/pathology , Orbit , Photography/methods
20.
Dental press j. orthod. (Impr.) ; 19(6): 70-77, Nov-Dec/2014. tab
Article in English | LILACS | ID: lil-732438

ABSTRACT

OBJECTIVE: The aim of this retrospective study was to compare the longitudinal stability of two types of posterior crossbite correction: rapid maxillary expansion (RME) and slow maxillary expansion (SME). METHODS: Study casts of 90 adolescent patients were assessed for interdental width changes at three different periods: pretreatment (T1), post-treatment (T2) and at least, five years post-retention (T3). Three groups of 30 patients were established according to the treatment received to correct posterior crossbite: Group A (RME), group B (SME) and group C (control- Edgewise therapy only). After crossbite correction, all patients received fixed edgewise orthodontic appliances. Paired t-tests and one-way ANOVA were used to identify significant intra and intergroup changes, respectively (P < 0.05). RESULTS: Except for intercanine distance, all widths increased in groups A and B from T1 to T2. In the long-term, the amount of relapse was not different for groups A and B, except for 3-3 widths which showed greater decrease in group A. However, the percentage of clinically relapsed cases of posterior crossbite was similar for rapid and slow maxillary expansion. CONCLUSION: Rapid and slow maxillary expansion showed similar stability in the long-term. .


OBJETIVO: o objetivo desse estudo retrospectivo foi comparar a estabilidade em longo prazo em dois tipos de correção da mordida cruzada posterior, sendo a expansão rápida (ERM) e a expansão lenta da maxila (ELM). MÉTODOS: modelos de estudos de 90 pacientes adolescentes foram avaliados quanto às alterações na largura interdentária em três diferentes tempos: pré-tratamento (T1), pós-tratamento (T2) e pelo menos cinco anos pós-contenção (T3). Três grupos de 30 pacientes foram definidos de acordo com o tratamento realizado para a correção da mordida cruzada posterior: Grupo A (ERM), grupo B (ELM) e grupo C (controle - apenas tratamento com técnica Edgewise). Após correção da mordida cruzada, todos pacientes receberam aparelhos ortodônticos fixos corretivos Edgewise. Teste t pareado e análise de variância a um critério (ANOVA) foram realizados para identificar alterações significantes intra- e intergrupos, respectivamente (p < 0,05). RESULTADOS: exceto para a distância intercaninos, todas as larguras aumentaram nos grupos A e B de T1 para T2. Em longo prazo, a quantidade de recidiva não foi diferente para os grupos A e B, exceto para a largura 3-3, que apresentou uma maior diminuição no grupo A. Clinicamente, entretanto, a porcentagem de casos com recidivas da mordida cruzada posterior foi semelhante para expansões rápida e lenta da maxila. CONCLUSÃO: Expansões rápida e lenta da maxila apresentaram estabilidades semelhantes em longo prazo. .


Subject(s)
Adolescent , Child , Female , Humans , Male , Palatal Expansion Technique , Bicuspid/pathology , Bicuspid/surgery , Cohort Studies , Cephalometry/methods , Cuspid/pathology , Dental Arch/pathology , Longitudinal Studies , Malocclusion/therapy , Maxilla/pathology , Molar/pathology , Orthodontic Appliance Design , Orthodontic Retainers , Palatal Expansion Technique/instrumentation , Recurrence , Retrospective Studies , Tooth Extraction , Tooth Movement Techniques/instrumentation , Tooth Movement Techniques/methods
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