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1.
Rev. Ateneo Argent. Odontol ; 66(1): 21-25, 2022. ilus
Article in Spanish | LILACS | ID: biblio-1380065

ABSTRACT

Se presenta un caso clínico de quiste dentígero, asociado a un tercer molar inferior izquierdo retenido, que concurre a la Cátedra de Diagnóstico por Imáge- nes de la Facultad de Odontología de la Universidad de Buenos Aires. El paciente, de 53 años de edad, es de sexo femenino. Se utiliza la tomografía de haz cónico para diagnosticar presuntivamente dicha patolo- gía. Posteriormente, se realiza biopsia para obtener una muestra y ser enviada para realizar los estudios anatomopatológicos, que corroboran el presuntivo diagnóstico. Basado en lo expuesto, se analiza al quis- te dentígero según ubicación, sexo, edad y maxilar; habiendo realizado una revisión de la literatura (AU)


A clinical case of a dentigerous cyst associated with a retained lower left third molar is presented. The 53-year-old patient is female. Cone beam tomography is used to presumptively diagnose said pathology. Subsequently, a biopsy is performed to obtain a sample and be sent to perform pathological studies that corroborate the presumptive diagnosis. Based on the above, the dentigerous cyst is analyzed according to location, sex, age and maxilla; having carried out a review of the literature (AU)


Subject(s)
Humans , Female , Middle Aged , Dentigerous Cyst/diagnostic imaging , Cone-Beam Computed Tomography , Argentina , Schools, Dental , Tooth, Impacted/complications , Biopsy/methods , Age and Sex Distribution , Molar, Third/pathology
2.
Braz. dent. sci ; 25(2): 1-7, 2022. tab
Article in English | LILACS, BBO | ID: biblio-1368112

ABSTRACT

Objective: Impacted tooth develops when the tooth fails to erupt into its anatomical functional position. The aim of this prospective study was to find out common clinical effects of impacted lower molar on adjacent tissues and to evaluate the relationship between signs and symptoms of impacted tooth as regards gender and age respectively. Material and Methods: Data for this study were obtained using a well-structured questionnaire at the Teem Dental Hospital Warri, Nigeria. The data included age, sex, and clinical features of patients with confirmed diagnosis of impacted lower third molar following clinical examination and radiographic investigation. Data were analysed and chi-square was employed. Results: A total of 131 patients were examined, 57 (44.5%) were males and 74 (56.5%) were females within the ages of 10-40 years. Patients within the ages of 21-25 years had the highest frequency (32.1%) of impacted lower third molar. It was observed that impacted tooth had a gender predilection towards females than males. Inflamed gingivae around lower 3rd molar 60(45.8%) and pain on the lower third molar 72(55.0%) were most predominantly associated with impacted third molar teeth. No significant association was observed between age (0.909) and gender (0.461) against symptoms of impacted tooth but significant association (0.001) between age and sign was observed. Conclusion: The most commonly associated effect of impacted third molar is inflammation of the adjacent gingivae alongside pain around the lower third molar. Prevalence of impacted molar tooth was gender based with age being a predilection factor in its signs of presentation. (AU)


Objetivo: O dente impactado se desenvolve quando o dente não consegue irromper em sua posição anatômica funcional. O objetivo deste estudo prospectivo foi identificar os efeitos clínicos comuns do molar inferior impactado nos tecidos adjacentes e avaliar a relação entre os sinais e sintomas do dente impactado em relação ao sexo e idade, respectivamente. Material e Métodos: Os dados para este estudo foram obtidos por meio de um questionário bem estruturado no Teem Dental Hospital Warri, Nigéria. Os dados incluíram idade, sexo e características clínicas de pacientes com diagnóstico confirmado de terceiro molar inferior impactado após exame clínico e investigação radiográfica. Os dados foram analisados e o teste qui-quadrado foi empregado. Resultados: Foram examinados 131 pacientes, 57 (44,5%) do sexo masculino e 74 (56,5%) do sexo feminino na faixa etária de 10 a 40 anos. Pacientes com idades entre 21 a 25 anos tiveram a maior frequência (32,1%) de terceiros molares inferiores impactados. Observou-se que o dente impactado teve uma predileção de gênero para o sexo feminino em relação ao masculino. Gengiva inflamada ao redor do 3º molar inferior 60 (45,8%) e dor no terceiro molar inferior 72 (55,0%) foram predominantemente associadas a terceiros molares impactados. Não foi observada associação significativa entre idade (0,909) e sexo (0,461) diante sintomas de dente impactado, mas foi observada associação significativa (0,001) entre idade e sinal. Conclusão: O efeito mais comumente associado ao terceiro molar impactado é a inflamação da gengiva adjacente associada à dor ao redor do terceiro molar inferior. A prevalência de dente molar impactado foi baseada no gênero, sendo a idade um fator de predileção em seus sinais de apresentação.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Pain , Tooth, Impacted , Gingiva , Molar, Third
3.
Rev. Asoc. Odontol. Argent ; 109(2): 119-123, ago. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1348424

ABSTRACT

Objetivo: Presentar el caso de una patología poco común como es el fibro-odontoma ameloblástico (FOA), su manejo interdisciplinario y su resolución quirúrgica. Caso clínico: En este reporte de caso describimos un FOA en una paciente de 10 años, ubicado en el cuerpo mandibular derecho, asociado a las raíces de molares temporales que generó la retención de premolares. Se realizó la enucleación completa de la lesión, exodoncia de los temporales asociados y se decidió mantener los dientes definitivos y esperar su erupción espontánea. Es importante considerar la posibilidad de mantener el diente retenido si este no dificulta la exéresis de la lesión, ya sea para su erupción espontánea o rescate ortodóntico, lo cual es posible observar en este caso en el que se aprecia una evolución intraósea favorable. Con respecto al seguimiento, se recomienda el control a largo plazo con el fin de controlar la erupción del órgano dentario o la aparición de posibles recidivas (AU)


Aim: To present a clinical case of a rare pathology, the ameloblastic fibro odontoma (AFO), its interdisciplinary management and its surgical resolution. Clinical case: In this case report we describe an AFO in a 10-years-old patient, localized in the right hand side of the body of the mandible, associated with the roots of temporary molars that generated the retention of the premolars. Complete enucleation of the lesion and the extraction of the associated temporary molars were performed. It was decided to keep the permanent teeth and to wait for their spontaneous eruption. It is important to consider the possibility of keeping the retained teeth if it does not hinder the excision of the lesion, either for its spontaneous eruption or orthodontic rescue, which is possible to see in this case, in which a favorable intraosseous evolution is appreciated. With regard to follow-up, long-term monitoring is recommended in order to control the eruption of the dental organ or the appearance of possible recurrences (AU)


Subject(s)
Humans , Female , Child , Odontogenic Tumors , Odontoma/surgery , Schools, Dental , Tooth Extraction , Tooth, Impacted , Bicuspid , Biopsy , Chile , Histological Techniques , Oral Surgical Procedures , Molar
4.
Odontol. Clín.-Cient ; 20(1): 62-67, jan.-mar. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1367867

ABSTRACT

It is necessary to use criteria based on the scientific literature, in order to obtain correct indications for cone beam computed tomography (CBCT). Therefore, the objective of this work is to analyze, through a bibilographic review, the applications of CBCT in oral surgery, mainly addressing surgery for included / impacted teeth. A bibliographic survey was performed in the PubMed database, selecting the keywords impacted teeth AND preoperative planning AND cone beam computed tomography. Twelve studies related to the topic were analyzed, some related to the use of CBCT and conventional radiographs in surgeries of included teeth, seeking to evaluate the influence of CBCT on the diagnosis and planning of cases and on the incidence of postoperative complications such as sensorineural disorders. It has been observed that CBCT is a good indication for surgery of included / impacted teeth when one wants to obtain a precise location of the dental element within the bone structure and its relationship with the adjacent structures, resulting in a better diagnosis and planning of cases, bringing more security and predictability during procedures... (AU)


É necessária a utilização de critérios baseados na literatura científica, para se obter indicações corretas da tomografia computadorizada de feixe cônico (TCFC). Sendo assim, o objetivo deste trabalho é analisar, por meio de revisão bibilográfica, as aplicações da TCFC em cirurgia oral, abordando principalmente a cirurgia de dentes inclusos/impactados. Realizou-se um levantamento bibliográfico no banco de dados PubMed, selecionado os descritores impacted teeth AND preoperative planning AND cone beam computed tomography. Foram analisados 9 estudos relacionados ao tema, alguns relacionaram o uso da TCFC e de radiografias convencionais nas cirurgias de dentes inclusos buscando avaliar a influência da TCFC no diagnóstico e planejamento dos casos e na incidência de complicações pós operatórias como distúrbios neurossensoriais. Foi observado que a TCFC é uma boa indicação na cirurgia de dentes inclusos/impactados quando se quer obter uma localização precisa do elemento dental dentro da estrutura óssea e sua relação com as estruturas adjacentes, resultando em um melhor diagnóstico e planejamento dos casos, trazendo mais segurança e previsibilidade durante os procedimentos... (AU)


Subject(s)
Humans , Tooth, Impacted , Tooth, Unerupted , Cone-Beam Computed Tomography
5.
Medisan ; 25(2)mar.-abr. 2021. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1250350

ABSTRACT

Se describe el caso clínico de una paciente de 18 años de edad, quien acudió a la Clínica Estomatológica Provincial Docente Mártires del Moncada de Santiago de Cuba, por presentar persistencia de caninos temporales. Para el diagnóstico y tratamiento exitoso fue necesaria la participación de un equipo multidisciplinario integrado por especialistas en: ortodoncia, imagenología, prótesis y cirugía maxilofacial, quienes corroboraron la retención de caninos superiores. Mediante el tratamiento conjunto de ortodoncia y prótesis, se logró la rehabilitación estética y funcional de la paciente.


The case report of an 18 years patient is described. She went to Mártires del Moncada Teaching Provincial Stomatologic Clinic in Santiago de Cuba, due to persistence of temporary canine teeth. The participation of a multidisciplinary team integrated by specialists in: orthodontics, imaging, prosthesis and maxillofacial surgery was necessary for the successful diagnosis and treatment. They corroborated the retention of upper canine teeth. By means of the combined treatment of orthodontics and prosthesis, the patient cosmetic and functional rehabilitation was achieved.


Subject(s)
Surgery, Oral/rehabilitation , Tooth, Impacted/diagnostic imaging , Cuspid/growth & development , Patient Care Team , Diastema/surgery
6.
Article in English | LILACS, BBO | ID: biblio-1250445

ABSTRACT

ABSTRACT Objective: To compare and assess the primary and secondary closure techniques following extraction of impacted third molars for post-operative complications. Material and Methods: In total, 30 patients ranging between 18-30 years of age and of either sex who had bilaterally impacted mandibular third molars were randomly selected. Split mouth study method was used so that the participants served as their own control. Group 1 consisted of primary closure of left mandibular impacted third molars and Group 2 consisted of secondary closure of right mandibular impacted third molars. Basement evaluations were recorded for each patient along with subjective and objective evaluations for postoperative 7 days. Data analysis was carried out by SPSS 17.0 software using Mann-Whitney U test, Wilcoxon matched-pairs test and t-test. A p-value ≤ 0.05 was assigned as statistically significant. Results: When compared to group 1, group 2 revealed statistically less pain and swelling following the secondary closure of wound from day 1 to 7. There was a significant improvement in mouth opening in Group 2 at day 1 (p=0.0005) and at day 7 (p=0.00001). Conclusion: Secondary wound closure after disimpaction of mandibular third molar results in better postoperative recovery than primary closure.


Subject(s)
Humans , Male , Female , Adult , Postoperative Complications , Surgery, Oral , Trismus/pathology , Wound Closure Techniques/instrumentation , Molar, Third/anatomy & histology , Tooth Extraction , Tooth, Impacted , Wound Healing , Data Interpretation, Statistical , Suture Techniques/instrumentation , Statistics, Nonparametric , Diagnosis, Oral , India
7.
Article in English | LILACS, BBO | ID: biblio-1250441

ABSTRACT

ABSTRACT Objective: To assess the relationship of ɑ and ß angles of maxillary impacted canines with maxillary lateral incisor root resorption. Material and Methods: For this, 40 patients (between 11 and 45 years) with impacted maxillary canines presenting to a private orthodontic clinic were evaluated.20% of the cases were male and 80% were female. The ɑ and ß angles were measured on panoramic radiographs to determine the angulation of impacted canine. CBCT scans had been taken by ProMax 3D CBCT system were used to examine lateral root reorption. The relationship between the size of ɑ and ß angles of impacted maxillary canines and root resorption in the adjacent maxillary lateral incisor was analyzed using SPSS version 22. Results: The mean size of ɑ and ß angles had no significant correlation with the presence/absence, location, or severity of root resorption in the adjacent lateral incisor or the buccolingual position of impacted canine. The ɑ and ß angles in impacted maxillary canines cannot be used to determine the incidence or severity of root resorption in the adjacent lateral incisor. Conclusion: No significant association between ɑ and ß angles and incidence or severity of root resorption in the adjacent lateral incisor was found.


Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Orthodontics, Interceptive , Root Resorption , Tooth, Impacted/diagnosis , Cone-Beam Computed Tomography/instrumentation , Incisor , Tooth, Unerupted , Radiography, Panoramic/instrumentation , Chi-Square Distribution , Cross-Sectional Studies/methods , Data Interpretation, Statistical , Statistics, Nonparametric , Cuspid , Iran
8.
Article in English | WPRIM | ID: wpr-921381

ABSTRACT

OBJECTIVES@#This study aims to analyze the effectiveness of platelet-rich fibrin (PRF) in mandibular third molar extraction and provide suggestions for alleviating postoperative complications.@*METHODS@#Pubmed, EMBASE, Web of Science, and SinoMed were searched electronically on February 2020. Randomized controlled trials focusing on PRF usage in mandibular third molar extraction were included. Reviewers assessed the risk of bias in the included literature and extracted data independently using the criteria recommended by the Cochrane Collaboration. Meta-analysis was performed using RevMan 5.3 and STATA 13.0.@*RESULTS@#Twenty-one studies were included, comprising 991 patients who had mandibular third molar extraction. The topical application of PRF effectively reduced pain after extraction [MD=-12.06, 95%CI (-21.42, -2.71), @*CONCLUSIONS@#Limited clinical evidence indicates that applying PRF after mandibular third molar extraction could reduce pain, swelling, trismus and the occurrence of dry socket and promote soft tissue healing. However, the effect of PRF on bone healing requires further large-scale randomized controlled trials and unified measurement criteria.


Subject(s)
Humans , Mandible , Molar, Third/surgery , Platelet-Rich Fibrin , Tooth Extraction , Tooth, Impacted
9.
Article in English | WPRIM | ID: wpr-921380

ABSTRACT

OBJECTIVES@#This prospective study was performed to evaluate whether the distal-triangular flap was a practical alternative surgical approach for extracting mandibular third molars.@*METHODS@#Sixty participants with impacted mandibular third molars were randomly divided into three groups: group A, distal-triangular flap; group B, Szmyd flap; and group C, envelope flap. The impacted third molars were extracted by the corresponding flapping method. During a three-month follow-up observation after the extraction, the postoperative pain, swelling, mouth opening, and periodontal status were recorded and analyzed by ANOVA and chi-square tests.@*RESULTS@#The 60 participants had successful extraction and 3-month follow-up observation. No participant suffered from postoperative infections, lower lip disorder, or tongue sensory disorders. No statistical differences were found in the postoperative symptoms and signs of the three flap designs, such as postoperative pain, swelling, mouth opening, and periodontal status (@*CONCLUSIONS@#The distal-triangular flap was as safe and reliable as the Szmyd and envelope flaps but more advantageous because of its convenient operative field exposure and low requirement for the patient's mouth opening. Thus, the distal-triangular flap is one of the alternative flap options for extracting impacted mandibular third molars.


Subject(s)
Humans , Mandible/surgery , Molar, Third/surgery , Prospective Studies , Tooth Extraction , Tooth, Impacted/surgery
10.
Article in English | WPRIM | ID: wpr-878456

ABSTRACT

With a case of mesial impaction of maxillary first and second molar, the mechanical analysis and clinical applications of a self-made helical spring for the uprighting treatment of mesial impacted molars was introduced.


Subject(s)
Humans , Mandible , Maxilla , Molar , Molar, Third , Tooth Movement Techniques , Tooth, Impacted
11.
J. appl. oral sci ; 29: e20200932, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250188

ABSTRACT

Abstract Third molar removal surgery usually comes accompanied by postoperative discomfort, which could be influenced by the surgical approach chosen. This scoping systematic review aimed at compiling the available evidence focused on the influence of flap design, including envelope flap (EF), triangular flap (TF), and modified triangular flap (MTF), on postoperative pain, swelling, and trismus, as primary outcome measures, and any result mentioning healing promotion or delay, as secondary outcome measure, after mandibular third molar extraction surgery. An electronic search, complemented by a manual search, of articles published from 1999 to 2020 was conducted in the Medline (PubMed), EMBASE and Web of Science databases including human randomized controlled trials, prospective, and retrospective studies with at least 15 patients. The risk of bias of the included studies was assessed either with the Cochrane's Risk of Bias tool or with the Newcastle-Ottawa scale. Every step of the review was performed independently and in duplicate. The initial electronic search recovered 2102 articles. After applying the inclusion criteria, 12 articles were included. For patient's perceived postoperative pain, TF and MTF frequently reported better results than EF. For swelling, the literature is divided, despite a trend favoring EF. For trismus, data showed that its occurrence is mostly associated with the duration of the surgery rather than with the chosen flap. For healing, the limited data is inconclusive. Finally, randomized studies showed a high risk of bias, whereas nonrandomized studies were mostly of good quality and low risk of bias. Although there was no clear consensus regarding the influence of different flap designs for third mandibular molar extraction on postoperative clinical morbidities; the surgeon's experience, estimated surgical difficulty, molar position and orientation, and surg ery duration should be considered when choosing among the different flap designs.


Subject(s)
Humans , Tooth, Impacted/surgery , Trismus/etiology , Pain, Postoperative/etiology , Postoperative Complications , Tooth Extraction/adverse effects , Prospective Studies , Retrospective Studies , Edema , Mandible , Molar , Molar, Third/surgery
12.
Dental press j. orthod. (Impr.) ; 25(6): 19-25, Nov.-Dec. 2020. graf
Article in English | LILACS, BBO | ID: biblio-1154054

ABSTRACT

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


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


Subject(s)
Humans , Tooth, Impacted , Tooth Ankylosis , Cuspid/diagnostic imaging , Periodontal Ligament , Tooth, Impacted/diagnostic imaging , Tomography, X-Ray Computed , Tooth Ankylosis/diagnostic imaging
13.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 39-43, jul.-set. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253321

ABSTRACT

Introdução: A Odontectomia Parcial Intencional ou Coronectomia é uma abordagem cirúrgica que consiste na remoção da porção coronária de molares mandibulares impactados e a manutenção das suas raízes no alvéolo dentário. Esta técnica é indicada quando há íntima relação entre o dente e o canal mandibular e tem por principal objetivo evitar lesões ao nervo alveolar inferior. Relato de Caso: Paciente do sexo masculino, 24 anos, ASA I, compareceu a Clínica Escola de Cirurgia de uma universidade pública para exodontia de terceiro molar inferior impactado (48). Ao exame clínico o dente apresentava-se semi-incluso e ao exame radiográfico (panorâmica e tomografia computadorizada), observou-se íntima relação da raiz do dente com o canal mandibular. Diante disto, foi realizada Odontectomia Parcial Intencional, com o intuito de preservação de feixe vásculo-nervoso adjacente. Paciente evoluiu satisfatoriamente sem sinais de infecção ou alteração sensorial de nervo alveolar inferior. Considerações finais: A Odontectomia Parcial Intencional é uma técnica segura, eficaz e de previsibilidade significativa, sendo uma alternativa que pode ser empregada em exodontias de molares mandibulares inclusos próximos ao canal mandibular, minimizando os riscos de lesões nervosas para os pacientes... (AU)


Introduction: Intentional partial odontectomy or coronectomy is a surgical approach that consists of removing the coronary portion of impacted mandibular molars and maintaining their roots in the dental alveolus. This technique is indicated when there is an intimate relationship between the tooth and the mandibular canal and its main objective is prevent injuries to the lower alveolar nerve. Case Report: Male patient, 24 years old, ASA I, compared the Clinical School of Surgery of a public university for extraction of the impacted lower third molar (48). On clinical or dental examination, we present semi impacted wisdom tooth and on radiographic examination (panoramic + computed tomography), an intimate relationship between the root of the tooth and the mandibular canal was observed. Therefore, intentional partial odontectomy was performed in order to preserve the adjacent vascular-nervous bundle. The patient progressed satisfactorily without signs of infection or sensory alteration of lower alveolar nerve. Final considerations: Intentional partial odontectomy is a safe, effective and predictable technique, being an alternative that can be used in extractions of mandibular molars, including those close to the mandibular canal, minimizing the risk of nerve injuries to patients... (AU)


Subject(s)
Humans , Male , Adult , Surgery, Oral , Tooth, Impacted , Mandibular Nerve , Molar , Molar, Third , Tooth , Tomography, X-Ray Computed , Tooth Socket
14.
Dental press j. orthod. (Impr.) ; 25(4): 68-74, July-Aug. 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1133672

ABSTRACT

ABSTRACT Objective: To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. Methods: 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). Results: The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). Conclusions: Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.


RESUMO Objetivo: Avaliar a habilidade de ortodontistas e cirurgiões bucomaxilofaciais (CBMF) em propor um prognóstico para terceiros molares inferiores. Métodos: Foram analisados 22 pacientes tratados ortodonticamente sem extração, cujos terceiros molares inferiores irrompidos espontaneamente (n= 44) foram avaliados por meio de radiografias panorâmicas seriadas. A primeira radiografia foi obtida logo após o tratamento ortodôntico (RX1), entre 13 e 19 anos de idade. A segunda radiografia (RX2) foi avaliada dois anos depois, em média. As radiografias foram analisadas aleatoriamente por 54 especialistas, 27 ortodontistas e 27 CBMFs, para obter sua opinião sobre a abordagem a ser adotada na RX1. Em seguida, outra opinião foi coletada adicionando-se a segunda radiografia seriada (RX1+2). Resultados: A concordância das respostas foi moderada para os CBMFs (Kappa = 0,44; p< 0,0001) e significativa para os ortodontistas (Kappa = 0,39; p< 0,0001). Após analisar apenas a primeira radiografia (RX1) dos molares antes deles irromperem espontaneamente, os CBMFs indicaram extração em 44,5% dos casos; enquanto os ortodontistas, em 42%, sem diferença entre os grupos (p= 0,22). Na análise de RX1+2, os ortodontistas mantiveram o mesmo nível de indicação de extração (45,6%, p= 0,08), enquanto os cirurgiões passaram a indicar mais extrações (63,2%, p< 0,0001). Conclusões: Ortodontistas e CBMFs não foram capazes de predizer a erupção de terceiros molares por meio da análise de uma única radiografia panorâmica, indicando extrações em cerca da metade dos terceiros molares examinados. Uma análise de acompanhamento, incluindo mais uma radiografia, não melhorou a precisão do prognóstico entre os ortodontistas, e piorou entre os CBMFs.


Subject(s)
Humans , Tooth, Impacted/diagnostic imaging , Molar, Third/surgery , Molar, Third/diagnostic imaging , Tooth Eruption , Tooth Extraction , Radiography, Panoramic , Oral and Maxillofacial Surgeons , Orthodontists , Mandible/diagnostic imaging , Molar
15.
Rev. Odontol. Araçatuba (Impr.) ; 41(2): 45-51, maio-ago.2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1102698

ABSTRACT

Dentes impactados são caracterizados pela falha na erupção dentro do tempo cronológico. O termo ''dente invertido'' se refere ao mau posicionamento do dente, caracterizando-se pelo dente na direção contrária à usual. A inversão de dente impactado é considerada um fenômeno raro. Em casos mais complexos de impacção dentária, há a necessidade de um tratamento conservador, específico e procura-se prevenir possíveis danos às estruturas anatômicas adjacentes. Por essa razão, a técnica cirúrgica denominada coronectomia, também conhecida como odontectomia parcial intencional, tem, em alguns casos, indicação de uso, pois realiza-se a exérese da porção coronária do dente, sepultando as suas raízes, quando estas se encontram em contato com estruturas nobres. Dessa forma, este trabalho tem como objetivo apresentar um caso raro da utilização da técnica de coronectomia para um terceiro molar superior invertido em paciente do sexo feminino, 26 anos, que compareceu ao serviço de Cirurgia Buco-Maxilo-Facial apresentando um terceiro molar superior, assintomático, impactado em posição invertida no lado esquerdo. Ao exame tomográfico, apresentou íntimo contato do dente 28 com as raízes do 27. A porção coronária se encontrava em posição superior, em direção a parte posterior do seio maxilar. A técnica da coronectomia foi escolhida como planejamento cirúrgico, a fim de proteger o dente 27 das possíveis consequências traumáticas que a luxação e extração completa do dente 28 poderia ocasionar. O acompanhamento clínico demonstrou que a técnica foi bem indicada, com evolução de neoformação óssea completa na região da coroa removida e o dente adjacente com vitalidade e em função mastigatória(AU)


Impacted teeth are characterized by eruption failure within chronological time. The term 'inverted tooth' refers to the mispositioning of the tooth, characterized by the tooth in the opposite direction to the usual one. Impacted tooth inversion is considered a rare phenomenon. In more complex cases of dental impaction, there is a need for conservative and specific treatment, and attempts are made to prevent possible damage to adjacent anatomical structures. For this reason, the surgical technique called coronectomy, also known as intentional partial odontectomy, has, in some cases, indication of use, where the coronary portion of the tooth is excised, burying its roots when they are in contact with noble structures. Thus, this paper aims to present a rare case of the use of the inverted upper third molar coronectomy technique in a 26-year-old female patient, who attended the Buccomaxillofacial Surgery Service presenting a superior third molar, asymptomatic, impacted in inverted position on the left side. At tomographic examination, the patient presented close contact of tooth #16 with the roots of tooth #15. The coronary portion was in the superior position, towards the posterior part of the maxillary sinus. The coronectomy technique has been chosen as a surgical planning in order to protect tooth #15 from the possible traumatic consequences that dislocation and complete extraction of tooth #16 could cause. Clinical follow-up showed that the technique was successfully indicated, with complete bone neoformation in the removed crown area and the adjacent tooth with vitality and masticatory function(AU)


Subject(s)
Humans , Female , Adult , Tooth, Impacted/surgery , Molar, Third/surgery , Tooth Extraction , Tooth, Impacted , Molar, Third
17.
Rev. medica electron ; 42(3): 1900-1910, mayo.-jun. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1127050

ABSTRACT

RESUMEN La retención dentaria es común encontrarla en la clínica de ortodoncia, los caninos maxilares son los de mayor solicitud de tratamiento por su importancia estética. Sin embargo, no es frecuente la retención de dientes temporales. Su etiología no está bien definida pero se considera de carácter multifactorial. Se presentó una paciente del sexo femenino de 12 años y medio de edad, con ausencia de 15 y 13, presencia de 53 y mesogresión del 16. Al examen radiográfico se observó retención de 55, 15 y 13, este último en transposición incompleta con el 12. Después de un profundo análisis se decidió exéresis del 55 y alineación al arco dentario de 15 y 13, mediante colocación de un dispositivo, con el empleo del sistema de cementado directo en el acto quirúrgico. Se estableció una oclusión funcional y estética aceptable, con particular cuidado de la integridad de los dientes vecinos y sus tejidos blandos. Las retenciones constituyen maloclusiones dentarias complejas y de difícil pronóstico y tratamiento, más aún cuando son múltiples. Se requiere de estudio y tratamiento multidisciplinario (AU).


ABSTRACT It is common to find teeth retention in Orthodontics clinic; maxillary canines, due to their esthetical importance, are the ones the patients ask to be treated more frequently. Nevertheless, temporary teeth retention is not frequent. Its etiology is not clear, but it is considered multifactorial. The authors present the case of a female patient, aged 12 years and a half, without 15 and 13 teeth, presence of 53 and mesogression of 16. At the radiographic examination, the retention of 55, 15 and 13 was found, and also the incomplete transposition of 13 and 12. After deeply analyzing the case, the orthodontists decided the removal of 55 and aligning 15 and 13 to dental arch, placing a device with the system of direct cementing at the moment of the surgery. It was established a functional occlusion and an acceptable esthetics, particularly caring for the neighboring teeth and their soft tissues. Retentions are complex dental malocclusions, of difficult prognosis and treatment, mainly when they are multiple. They require study and multidisciplinary treatment (AU).


Subject(s)
Humans , Female , Child , Tooth, Impacted/diagnosis , Orthodontic Retainers , Malocclusion/diagnosis , Malocclusion/diagnostic imaging , Orthodontics , Surgery, Oral , Tooth, Impacted/therapy , Tooth Movement Techniques , Malocclusion/therapy
18.
Rev. cir. traumatol. buco-maxilo-fac ; 20(1): 18-21, jan.-mar. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253532

ABSTRACT

Introdução: A apicotomia é uma técnica, que vem sendo utilizada em dentes com dilaceração radicular acentuada, com o intuito de liberar a porção do dente impactada e, dessa forma, permitir seu reposicionamento na arcada dentária. Este trabalho tem como objetivo apresentar um relato de caso clínico do manejo ortocirúrgico de tracionamento ortodôntico associado à apicotomia em dente incluso com dilaceração radicular acentuada. Relato de caso: O paciente foi encaminhado para o serviço de bucomaxilofacial para exodontia do elemento incluso após insucesso de tracionamento ortocirúrgico, em que se verificou, ao exame radiográfico periapical, dente incluso com dispositivo ortodôntico e dilaceração radicular importante. Diante disso, realizou-se, sob anestesia local, a apicotomia e instalação do dispositivo ortodôntico. O paciente evoluiu bem, e, após 8 meses, o elemento dentário encontrava-se em posição oclusal e em função mastigatória. Considerações finais: Assim, a técnica da apicotomia mostra-se eficaz como alternativa ao insucesso do tracionamento ortodôntico tradicional, sendo uma técnica mais conservadora que a exodontia, necessitando de conhecimento teórico e domínio técnico do profissional... (AU)


Introduction: Apichotomy is a technique that has been used in teeth with severe root laceration in order to release the impacted tooth portion and thus allow its repositioning of the tooth in the dental arch. The aim of this paper is to present a clinical case report of orthosurgical orthodontic traction management associated with apichotomy in an included tooth with severe root laceration. Case report: The patient was referred to the Oral and Maxillofacial Service for extraction of the included element after ortho-surgical traction failure, which was verified by periapical radiographic examination, tooth included with orthodontic device and significant root laceration. Thus, under local anesthesia, apichotomy and orthodontic device installation were performed. The patient progressed well, and after 8 months the dental element was in occlusal position and in masticatory function. Final considerations: Thus, the apichotomy technique is effective as an alternative to the failure of traditional orthodontic traction, being a more conservative technique than extraction and requiring theoretical knowledge and technical mastery of the Professional... (AU)


Subject(s)
Humans , Male , Female , Adolescent , Orthodontics , Apicoectomy , Surgery, Oral , Tooth, Impacted , Tooth Movement Techniques , Tooth, Unerupted , Dental Arch , Malocclusion
19.
Int. j. med. surg. sci. (Print) ; 7(2): 42-52, jun. 2020. tab
Article in English | LILACS | ID: biblio-1179271

ABSTRACT

Third molars usually erupt within the age of 17 ­ 21years. Usually, due to the evolution of human jaws, the size is decreasing leading to the impacted tooth. An impacted tooth may lead to external resorption of the adjacent tooth, trismus, infection, etc. Many studies have been reported in the literature for evaluating the surgical difficulty and postoperative complications secondary to impacted third molars. This study includes a sample of 100 subjects evaluated for the surgical difficulty and postoperative complications. Various demographic, radiological, and intraoperative factors were evaluated which may lead to postoperative complications. Factors responsible for postoperative sequelae were also evaluated with complications. Postoperative pain after 4 hours and 7 days was assessed to mark the factors commonly responsible. Pain at 7th postoperative day was significant involving factors like fully impacted, horizontal impaction, level C, no/very little retromolar space, and root contact. Postoperative complications were not reported in this study.


Los terceros molares suelen erupcionar entre los 17 y los 21 años de edad. Por lo general, debido a la evolución de las mandíbulas humanas, el tamaño disminuye, lo que conduce al diente impactado. Un diente impactado puede conducir a la reabsorción externa del diente adyacente, trismo, infección, etc. Se han reportado muchos estudios en la literatura para evaluar la dificultad quirúrgica y las complicaciones postoperatorias secundarias a terceros molares impactados. Este estudio incluye una muestra de 100 sujetos evaluados por la dificultad quirúrgica y las complicaciones postoperatorias. Se evaluaron diversos factores demográficos, radiológicos e intraoperatorios que pueden conducir a complicaciones postoperatorias. También se evaluaron los factores responsables de las secuelas postoperatorias con las complicaciones. Se evaluó el dolor postoperatorio después de 4 horas y 7 días para marcar los factores comúnmente responsables. El dolor al séptimo día postoperatorio fue significativo e involucró factores como impacto total, impactación horizontal, nivel C, espacio retromolar nulo o muy pequeño y contacto con la raíz. En este estudio no se informaron complicaciones posoperatorias.


Subject(s)
Humans , Postoperative Complications , Tooth, Impacted/complications , Molar, Third/surgery
20.
Rev. Cient. CRO-RJ (Online) ; 5(2): 61-64, May-Aug. 2020.
Article in English | LILACS, BBO | ID: biblio-1254131

ABSTRACT

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


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


Subject(s)
Humans , Female , Child , Tooth, Impacted/diagnostic imaging , Dentigerous Cyst/diagnostic imaging , Cuspid/diagnostic imaging , Tooth, Impacted/surgery , Dentigerous Cyst/surgery , Follow-Up Studies , Treatment Outcome , Cuspid/surgery
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