Factors Affecting Length of Impacted Maxillary Central Incisors after Surgical-Orthodontic Treatment / 대한소아치과학회지

The purpose of this study is to identify the factors affecting the treatment outcome after surgical-orthodontic treatment of the maxillary impacted incisors using multiple regression analysis. The study enrolled 83 patients who had surgical-orthodontic treatment in impacted maxillary central incisor between January 2005 and December 2015. Possible explanatory variables related to the prognosis of impacted incisor were age, gender, tooth developmental stage, height, position and angle of the teeth.The results of multiple regression analysis showed that as the height of the stem cell from apical papilla (SCAP) increased, the tooth length ratio increased by 0.345 units (p < 0.01). There was no statistically significant difference in gender, tooth development stage, distance and angle between the center line and the tooth, and the height of incisal tip of the tooth. In conclusion, the height of the SCAP of the impacted central incisor is factor affecting the tooth length after orthodontic traction.

Platelet rich fibrin in the management of established dry socket

OBJECTIVES: Dry socket may occur secondary to the removal of any tooth. However, most dry socket cases develop in the third molar region. Dry socket is multifactorial in nature and has been treated using various modalities with varying success rates. This study assessed the efficacy of platelet rich fibrin (PRF) in established dry socket. MATERIALS AND METHODS: Ten patients of either sex aged from 41 to 64 years with established dry socket according to established criteria were treated using PRF. Evaluation was performed by observing the reduction of pain using visual analogue scale, analgesic tablet use over the follow-up period, and healing parameters. RESULTS: Pain was reduced on the first day in all patients with decreased analgesic use. Pain was drastically reduced during follow-up on the first, second, third, and seventh days with a fall in pain score of 0 to 1 after the first day alone. The pain scores of all patients decreased to 1 by the first day except in one patient, and the scores decreased to 0 in all patients after 48 hours. Total analgesic intake ranged from 2 to 6 tablets (aceclofenac 100 mg per tablet) over the follow-up period of 7 days. Healing was satisfactory in all patients by the end of the seventh day. CONCLUSION: PRF showed early pain reduction in established dry socket with minimal analgesic intake. No patients had allergic reactions to PRF as it is derived from the patient's own blood. PRF showed good wound healing. Our study suggests that PRF should be considered as a treatment modality for established dry socket.

Long-term survival of retained deciduous mandibular second molars and maxillary canine incorporated into final occlusion / 대한치과교정학회지

Orthodontic treatment of a complex case that involves retained deciduous mandibular second molars with missing permanent successors is challenging. Usually, congenitally missing teeth are manifested with other dental anomalies that further complicate orthodontic treatment, such as retained deciduous teeth, impactions, transpositions and peg-shaped lateral incisors. Even though the long term prognosis of the retained deciduous tooth is not fully predictable, if the teeth are in good condition, the patient and clinician may incline towards a decision to preserve the deciduous teeth as long as possible. This case report demonstrates that deciduous teeth, in this case the mandibular second molars and maxillary canine, can be incorporated into final occlusion with clinically stable long-term results.

Interdental alveolar bone density in bruxers, mild bruxers, and non-bruxers affected by orthodontia and impaction as influencing factors / Densidad ósea alveolar interdental en bruxómanos, bruxómanos leves y no bruxómanos influenciada por ortodoncia e impactación dentaria

Abstract: aim: to assess the interdental alveolar bone density within specific regions of interest in the mandible of bruxers, mild bruxers and non-bruxers in absence or presence of influencing factors, such as orthodontia and impaction. Materials and methods: The study consisted of 104 subjects (64 bruxers and 40 controls) from the female students in the Faculty of Dentistry. Students were classified into bruxers, non-bruxers, and mild bruxers. The presence of modifying factors, such as impacted mandibular third molars and/or current or recent orthodontic treatment were identified. Panoramic radiographs were obtained, and the mean bone density values of interdental alveolar bone were measured using ImageJ software. Results: Nonbruxers had the highest mean bone density in all measured regions. The mesial aspect of the second premolar was an area of higher mean bone density in bruxers and in mild bruxers, compared to non bruxers. In the presence of orthodontic treatment, the mean bone density in non-bruxers surpassed that of bruxers and mild bruxers. Conclusion: Bruxism, whether mild or severe decreased the interdental mean bone density in the studied regions of interest. The presence of influencing factors affected the interdental mean bone density.

Resumen: evaluar la densidad ósea alveolar interdental en áreas de interés de la mandíbula de bruxómanos, bruxómanos leves y no bruxómanos en ausencia o presencia de factores como ortodoncia e impactación dentaria. Material y métodos: El estudio consistió de 104 (64 bruxómanos y 40 controles) estudiantes de odontología. Los estudiantes fueron clasificados en bruxómanos, bruxómanos leves y no bruxómanos. Se identificó la presencia de factores modificadores: terceros molares mandibulares y/o tratamiento de ortodoncia actual o reciente. Se obtuvieron radiografías panorámicas, y los valores medios de densidad ósea del hueso alveolar interdental se midieron utilizando el software ImageJ. Resultados: Los no bruxómanos tuvieron la mayor densidad ósea media en todas las áreas de interés. La cara mesial del segundo premolar fue un área de mayor densidad ósea media en bruxómanos y en bruxómanos leves, en comparación con los no bruxómanos. En presencia de un tratamiento de ortodoncia, la densidad ósea media en los no bruxómanos superó a la de bruxómanos y bruxómanos leves. Conclusión: El bruxismo, ya sea leve o grave, disminuye la densidad ósea interdental promedio en las regiones de interés estudiadas. La presencia ortodoncia e impactación dentaria influye en la densidad ósea interdental promedio.

The efficacy of an elevated concentration of lidocaine HCl in impacted lower third molar surgery

BACKGROUND: There have been few studies on the effect of an elevated concentration of lidocaine hydrochloride in the surgical removal of an impacted lower third molar. This study aimed to examine the efficacy of 4% lidocaine along with 1:100,000 epinephrine compared to 2% lidocaine along with 1:100,000 epinephrine as inferior alveolar nerve block for the removal of an impacted lower third molar. METHODS: This single-blind study involved 31 healthy patients (mean age: 23 y; range: 19-33 y) with symmetrically impacted lower third molars as observed on panoramic radiographs. Volunteers required 2 surgical interventions by the same surgeon with a 3-week washout period. The volunteers were assigned either 4% lidocaine with 1:100,000 epinephrine or 2% lidocaine with 1:100,000 epinephrine as local anesthetic during each operation. RESULTS: We recorded the time of administration, need for additional anesthetic administration, total volume of anesthetic used. We found that the patient's preference for either of the 2 types of local anesthetic were significantly different (P < 0.05). However, the extent of pulpal anesthesia, surgical duration, and duration of soft tissue anesthesia were not significantly different. CONCLUSIONS: Our study suggested that inferior alveolar nerve block using 4% lidocaine HCl with 1:100,000 epinephrine as a local anesthetic was clinically more effective than that using 2% lidocaine HCl with 1:100,000 epinephrine; the surgical duration was not affected, and no clinically adverse effects were encountered.

Orthodontic and surgical management of cleidocranial dysplasia / 대한치과교정학회지

Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, is mainly caused by mutations in Runx2, a gene required for osteoblastic differentiation. It is generally characterized by hypoplastic clavicles, narrow thorax, and delayed or absent fontanel closure. Importantly, its orofacial manifestations, including midfacial hypoplasia, retained primary teeth, and impacted permanent and supernumerary teeth, severely impede the well-being of affected individuals. Successful treatment of the orofacial problems requires the combined efforts of dental specialists. However, only a few successfully treated cases have been reported because of the rarity of CCD and complexity of the treatment. This article presents the University of California, San Francisco (UCSF) treatment protocol for the dentofacial manifestations of CCD based on two treated and 17 diagnosed cases. The records of two patients with CCD who had been treated at the UCSF School of Dentistry and the treatment options reported in the literature were reviewed. The UCSF treatment protocol produced a successful case and a partially successful one (inadequate oral hygiene in the retention stage resulted in decay and loss of teeth). It provides general guidelines for successfully treating the orofacial manifestations of CCD.

Aspects and clinical procedures of eruptive changes of permanent upper canines

INTRODUCTION: Even though the upper canine is the tooth that presents most eruption anomalies, after the third molars, canine retention prevalence in the population is quite low. Local, physiologic and pathologic factors can provide difficulties for the tooth eruptive process. The correct diagnosis in trying to prevent upper canine retention with ectopic eruption is fundamental to choose the ideal treatment, which can be performed by various methods. OBJECTIVE: The present paper has the purpose of approaching aspects related to impacted upper permanent canines by a literature review, including localization and treatment conducts.

First case of bimaxillary transmigration of impactedcanines: report of a rare case and review of literature / Primeiro caso de transmigração bimaxilar de caninosimpactados: relato de um caso raro e revisão da literatura

Objective: To present a rare case of bimaxillary transmigration of impacted canines. Discussion: Preeruptivemigration of a tooth across the midline is termed transmigration. Transmigration typically affectsthe mandibular canines, but occurs rarely in maxillary canines as well. Transmigration of mandibular canineacross the midline is rare. An even less common finding is transmigration of maxillary canine acrossthe midline. The least common finding is bimaxillary occurrence of canines transmigration. Conclusion:Migration of both upper and lower canine teeth on the same side across the midline is called bimaxillarytransmigration, which is a very rare phenomenon of oral and maxillofacial complex, often undetected inroutine dental examination, neither clinical, nor periapical radiographic examination.

Objetivo: Apresentar um caso raro de transmigração bimaxilar de caninos impactados. Discussão: A migraçãopré-eruptiva de um dente através da linha média é denominado transmigração. A transmigraçãotipicamente afeta os caninos inferiores, mas pode ocorrer raramente em caninos superiores também. Transmigraçãode canino inferior através da linha média é rara, porém um achado ainda menos comum é a ocorrênciade transmigração bimaxilar de caninos. Conclusão: A migração de caninos superiores e inferiores nomesmo lado e cruzando a linha média é chamada de transmigração bimaxilar, um fenômeno raro de sistema bucal e maxilofacial, frequentemente diagnosticado em exame clínico odontológico de rotina ou exame radiográficoperiapical.

Distalização de segundo molar inferior impactado através da utilização de ancoragem esquelética com miniplaca: relato de caso / Distalization of impacted mandibular second molar using miniplates for skeletal anchorage: case report

O presente estudo consiste no relato de um caso onde a distalização do segundo molar inferior impactado do lado direito foi obtida através da ancoragem esquelética com o uso de miniplaca. A verticalização dos segundos molares inferiores impactados, durante muito tempo, colocou-se como um grande desafio para ortodontistas e cirurgiões bucais devido à escassez de recursos de ancoragem destinados para esse fim. A utilização da ancoragem esquelética foi iniciada na clínica ortodôntica em meados dos anos 80 e, desde então, diversas modalidades têm sido desenvolvidas para esse princípio, como a utilização de mini-implantes, implantes dentários e, finalmente, miniplacas, que foram testadas e apresentaram resultados animadores. O assunto é relevante para ortodontistas e cirurgiões bucais, uma vez que o uso das miniplacas pode influir de forma significativa no tratamento de molares inferiores impactados.

This study describes a case with an impacted right mandibular second molar which was distalized using miniplates for skeletal anchorage. Uprighting impacted mandibular second molars has been a great challenge for orthodontists and oral surgeons because of the scarcity of anchorage options. Skeletal anchorage was first used in clinical orthodontics in the middle of the 1980s. Since then, several devices have been developed for that purpose, such as mini-screws, tooth implants and, lately, miniplates, which have been tested and showed encouraging results. This topic is relevant for orthodontists and oral surgeons because the use of miniplates may significantly change the treatment of impacted mandibular molars.

A study on the prevalence of dental anomalies in Korean dental-patients / 대한치과교정학회지

OBJECTIVE: The purpose of this study was to investigate the prevalence of dental anomalies in outpatient clinics. METHODS: The subjects of this study were 3,133 patients who visited the clinic between January 2009 and June 2011. The dental records and panoramic films of the patients and detection of supernumerary, missing, and impacted teeth, transposition, and peg lateralis were reviewed. The results were analyzed according to gender and types and locations of dental anomalies. RESULTS: Among the patients, 362 had dental anomalies, with a prevalence rate of 11.55%. Congenital missing teeth (5.71%) ranked first in the categories, and impacted teeth (3.09%) ranked second. The percentage of patients having supernumerary teeth, peg lateralis, and dislocated teeth were 1.79%, 1.66%, and 0.45%, respectively. CONCLUSIONS: Congenital missing teeth and impacted teeth are, respectively, the first and second most common dental anomalies in Korean dental patients.

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

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

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

Effect of Bio-Oss grafts on tooth eruption: an experimental study in a canine model

INTRODUCTION: There are few reports on tooth eruption through Bio-Oss grafts. To our knowledge, there are no reports on whether teeth can erupt normally through the grafts. The aim of this study was to examine the effect of Bio-Oss grafts on tooth eruption in a canine model. MATERIALS AND METHODS: In five 10-week-old dogs, the deciduous third mandibular molars in one jaw quadrant of each animal were extracted and the fresh extraction sockets were then filled with Bio-Oss particles (experimental side). No such treatments were performed on the contralateral side (control side). A clinical and radiological evaluation was carried out every other week to evaluate the eruption level of the permanent third mandibular premolars and compare the eruption levels between the two sides. RESULTS: At week 4 after the experiment, the permanent third premolars began to erupt on both sides. At week 12, the crown of the permanent third premolar emerged from the gingiva on both sides. At week 20, the permanent third premolars on both sides erupted enough to occlude the opposing teeth. No significant differences were found between the control and experimental sides in terms of the eruption speed of the permanent third molars. CONCLUSION: These findings demonstrate that the grafting of Bio-Oss particles into the alveolar bone defects does not affect tooth eruption.

Má oclusão de Classe I de Angle, com ausência congênita e impacção de dentes permanentes / Angle Class I malocclusion with congenitally absence and impaction of permanent teeth

Este artigo relata o tratamento ortodôntico de um paciente com 14 anos e 6 meses de idade, portador de má oclusão de Classe I de Angle, que apresentava ectopia e impacção do dente 45 e ausência congênita do dente 35. O caso foi tratado com extração do dente 45 e fechamento dos espaços inferiores. Documentações inicial, final e pós-tratamento serão apresentadas e discutidas. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 7, livre escolha, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

This article reports the orthodontic treatment of a 14 year and 6 months old patient that had a Angle Class I malocclusion with an ectopic position and impaction of the tooth 45 and congenitally absence of tooth 35. This case was treated with the extraction of the tooth 45 and space closure in the lower arch. Initial, final and post-treatment orthodontic records will be presented and discussed. This case was presented to the Brazilian Board of Orthodontics and Facial Orthopedics (BBO), representing the category 7, free choice, as part of the requirements for achieving the title of BBO diplomate.