Tercer molar heterotópico, etiología y manejo quirúrgico / Heterotopic third molar, etiology and surgical management

Los terceros molares heterotópicos son dientes que se encuentran incluidos en los maxilares y la mandíbula distantes a su sitio de erupción habitual. Su etiología no está bien definida y existen diversas teorías. Estos dientes pueden aparecer en diferentes zonas de las estructuras óseas, teniendo predilección por la mandíbula. Suelen aparecer entre la segunda y la séptima década de la vida, la mayoría de los casos son hallazgos imagenológicos en la consulta odontológica. El tercer molar mandibular es el diente que presenta heterotopía con mayor frecuencia, siendo su localización habitual en rama mandibular y en la región subcondílea. El quiste dentígero es la patología asociada más común. Presentamos un caso de tercer molar heterotópico en rama mandibular derecha de larga evolución, relacionado a un quiste dentígero, el cual se manejó bajo anestesia regional. Se describe la etiología, técnica quirúrgica y consideraciones especiales relacionados con los dientes heterotópicos (AU)

Heterotopic third molars are teeth that are embedded in the maxilla and mandible, remote from their usual eruption site. Its etiology is not well defined and there are various theories at the moment. These teeth can appear in different areas of the bone's structures, having a predilection for the jaw. They usually appear between the second and seventh decade of life, and in most cases are imaging findings. The mandibular third molar is the tooth with the most frequent heterotopia, being its usual location in the mandibular branch and in the subcondylar region. The dentigerous cyst is the most common associated pathology. We present a case of a long evolution heterotopic third molar in the right mandibular branch, related to a dentigerous cyst which was managed under local anesthesia. The etiology, surgical technique and special considerations related to heterotopic teeth are described (AU)

Transposición dentaria. Reporte de un caso / Tooth transposition. Case report

RESUMEN La transposición dentaria se define como una ectopia del germen dentario, es común encontrarla en caninos superiores, pero cuando esta entidad se combina con una transposición se convierte en un dilema para el ortodoncista. Su etiología es multifactorial y no está bien aclarada, es conocido que se produce en el momento de la formación embrionaria por un intercambio en la posición del germen dentario, y con frecuencia, se considera ligado a factores genéticos. Se relaciona con trauma en el área afectada y con interferencias mecánicas. Se presentó un paciente de 14 años de edad, sexo masculino, que solicitó tratamiento por tener los dientes "botados" y un diente "fuera de lugar". Al examen clínico se observó transposición de 23 con 2:4. Se colocó aparatología fija con técnicas de cementado directo y bandas en los primeros molares permanentes superiores, se determinó mesializar el 23 y dejar libre 24, para evitar daño radicular. Una vez colocado 23 en su posición, 24 fue distalado y alineado al arco; para esto se utilizó arcos térmicos de nitinol preformados y secciones con elastómeros. Se logró neutroclusión de molares y caninos sin perjudicar los tejidos de soporte (AU).

ABSTRACT Tooth transposition is defined as an ectopia of the tooth germ, commonly found in upper canines, but when this entity is combined with a transposition, it becomes a dilemma for the orthodontists. Its etiology is multi-factorial and unknown. It takes place at the moment of the embryonic formation due to an interchange in the position of a tooth germ, and it is frequently considered linked to genetic factors. It is related to trauma in the affected area and with mechanic interferences. We present the case of a male patient, aged 14 years, who asked treatment for having buckteeth and a tooth ¨out of place¨. At the clinical examination it was observed the transposition of the 23 with 24. A fixed brace was put with direct cement techniques and bands in the first permanent upper molars. The orthodontist decided to mesialize 23 and let 24 free, to avoid root damage. Once 23 was in its position, 24 was distalized and aligned to the arch using pre-formed thermic nitinol arches and sections with elastomers. The molars and canines neutral occlusion was achieved without damaging the support tissues (AU).

Root length and alveolar bone level of impacted canines and adjacent teeth after orthodontic traction: a long-term evaluation

Abstract Objective The aim of this retrospective study was to evaluate the long-term effects of orthodontic traction on root length and alveolar bone level in impacted canines and adjacent teeth. Material and Methods Sample consisted of 16 patients (nine males and seven females), mean initial age 11 years and 8 months presenting with unilaterally maxillary impacted canines, palatally displaced, treated with the same surgical and orthodontic approach. Teeth from the impacted-canine side were assigned as Group I (GI), and contralateral teeth as control, Group II (GII). The mean age of patients at the end of orthodontic treatment was 14 years and 2 months and the mean post-treatment time was 5 years and 11 months. Both contralateral erupted maxillary canines and adjacent teeth served as control. Root length and alveolar bone level (buccal and palatal) were evaluated on cone-beam computed tomography (CBCT) images. The comparison of root length and alveolar bone level changes between groups were assessed by applying paired t-test, at a significance level of 5% (p<0.05). Results There were no statistically significant differences in root length and buccal and palatal bone levels of canines and adjacent teeth among groups. Conclusions Impacted canine treatment by closed-eruption technique associated with canine crown perforation, has a minimal effect on root length and buccal and palatal alveolar bone level in both canine and adjacent teeth, demonstrating that this treatment protocol has a good long-term prognosis.

Risk of developing palatally displaced canines in patients with early detectable dental anomalies: a retrospective cohort study

ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.

Tratamiento quirúrgico de caninos mandibulares bilaterales transmigrados / Surgical treatment of bilateral mandibular transmigrated canine

La migración de caninos inferiores es un fenómeno poco común. Su incidencia es menor que incluidos maxilares y son frecuentemente encontrados en jóvenes. Solamente caninos, segundos premolares y terceros molares incluidos migran a lugares ectópicos en su desarrollo y dientes incluidos ectópicos son, en la mayoría de los casos, asintomáticos. La etiología es compleja y poco descrita en la literatura. Un canino es considerado un diente migrado cuando, horizontalmente, más de la mitad del diente atraviesa la línea mediana. Este artículo reporta un caso clínico, con tratamiento quirúrgico de exodoncia de caninos bilaterales incluidos, horizontalmente en la región de la sínfisis. Se observó que la exodoncia es la conducta operatoria más frecuente, presentando en este caso buenos resultados.

Migration of canine mandibles is a very uncommon phenomenon. Their incidence is less frequent than maxillary canines and present frequently in young people. Only canines, second bicuspid and third molars can migrate to ectopic areas in their development and ectopic embedded teeth are, for the most part asymptomatic. The etiology is complex and with poor information. A canine is considered a migrating tooth when it penetrates horizontally the middle line of the mandible. This paper reports a case with surgical treatment of dental extraction, including horizontal bilateral canines in the symphysis region. It was observed that dental extraction is a more frequent treatment and presented with good results in this case.

Palatally impacted canine: diagnosis and treatment options: [review]

Canines contribute significantly to the esthetic and chewing functions. Orthodontists should diagnose canine ectopic eruption early, trying to prevent retention of these teeth. Its multifactorial etiology involves general and local factors and the correct diagnosis depends on clinic, radiographic and/or tomographic exams. Several therapeutic procedures depend on factors such as relationship between canine and adjacent structures, possibility of orthodontic movement and patient age. Orthodontic and surgical treatment with canine traction is very much effective, with time of treatment being shorter than in patients under the age of 25.

Diagnóstico y tratamiento temprano de la malposición intralveolar de caninos permanentes / Diagnosis and early treatment of intra-alveolar malposition of permanent canines

El diagnóstico y tratamiento temprano es un procedimiento que cada día toma más fuerza entre los profesionales del área de la salud en general y los odontólogos en particular. Con relación a las alteraciones oclusales, los caninos retenidos son una anomalía de erupción y aunque en nuestro medio no conocemos ninguna estadística, nos vemos enfrentados a ella con mucha frecuencia. El desarrollo del canino es único y su patrón de erupción es el más tortuoso de todos los dientes de la cavidad bucal, por lo cual la vigilancia de este proceso es mandatoria. El diagnóstico de esta alteración debe hacerse desde el momento en que se establece la dentición mixta, utilizando para ello todos los elementos necesarios como signos clínicos duraonte la inespección y palpación y los análisis radiográficos pertinentes

Dientes supernumerarios: reporte de 170 casos y revisión de la literatura / Supernumerary teeth: report of 170 cases and review of the literature

Los dientes formados en exceso del número normal son denominados supernumerarios; tales dientes pueden también ser definidos como suplementarios si ellos recuerdan cercanamente al diente adyacente. Pueden ser simples o múltiples, unilaterales o bilaterales, malformados morfológicamente o normales en tamaño y forma y euprcionados o retenidos. Los dientes supernumerarios pueden causar varias complicaciones como: apiñamiento, retardo en la erupción, diastemas, rotaciones, lesiones quísticas, erupción dentro del piso de la cavidad nasal y reabsorción del diente adyacente. La hiperodoncia es detectada tanto por examen RX de rutina o como resultado de signos clínicos bien conocidos; pueden erupcionar normalmente, permanecer retenidos, aparecer invertidos, asumir una posición ectópica, reabsorberse o desaparecer. La remoción temprana de tales dientes es recomendada si ellos pimpiden la erupción de los dientes permanentes adyacentes. Este documento revisa la literatura previa y presenta los hallazgos de una muestra de 170 casos con 242 dientes supernumerarios para establecer lineamientos respecto al tratamiento y enfatiza en la importancia de un diagnóstico y manejo adecuado, dependiendo de diferentes factores

Hipoplasia maxilar como posible factor etiológico en la retención de caninos superiores: caso clínico / Maxillary hypoplasia as a possible etiologic factor in the impaction of upper canines. A clinical case

Se mencionan una cadena de eventos en el desarrollo de la dentición relacionados a la hipoplasia maxilar. El colapso maxilar de la arcada superior podría afectar el patrón de erupción de los caninos superiores. Especial atención debe prestarse a estos pacientes con hipoplasia maxilar. Se presenta un caso clínico, el cual presenta hipoplasia maxilar y falta de espacio para los caninos superiores permanentes, su clasificación, tratamiento, resultados y comparaciones inicial y final. Se sugiere que los pacientes con hipoplasia maxilar tienen potencial a retener los caninos superiores o erupción ectópica de éstos

Changes in developing succedaneous teeth as a consequence of infected deciduous molars.

The need for dental treatment in paediatric dental patients is immense. The present study was carried out in fifty children in the age group of five to ten years of age with recurrent episodes of dentoalveolar infection. Advanced pulpal infections led to torsion in 54 percent, premature eruption in 46 percent, crater like bone loss in 36 percent, sequestration and dilaceration in 10 percent and 6 percent respectively. Most of the developmental disturbances could have been avoided with timely antibiotics and endodontic intervention.

Erupçäo ectópica de primeiros molares permanentes / Ectopic eruption of the first permanent molars

Tendo em vista a freqüente ocorrência de erupçäo ectópica de primeiros molares permanentes na clínica odontopediátria, o presente trabalho faz uma revisäo da literatura acerca do tema, enfatizando aspectos relacionados à sua prevalência, etiologia, diagnóstico, tratamento e prognóstico. Descreve também as várias modalidades de resoluçäo do problema preconizadas pelos autores, destacando as peculiaridades de cada técnica

Correçäo da erupçäo ectópica de primeiros molares permanentes / Correction of the ectopic eruption of maxillary first permanent molars: report of a case

Neste trabalho, as autoras descrevem o tratamento empregado na correçäo de primeiros molares permanentes superiores ectópicos em uma criança atendida na FOUFF e fazem consideraçöes sobre a etiologia, o diagnóstico e os demais tipos de tratamentos referentes à ectopia dos molares

Erupçäo ectópica do primeiro molar permanente / Ectopic eruption of first permanent molar

Erupçäo ectópica do primeiro molar permanente refere-se ao ângulo de erupçäo normalmente mesial em relaçäo ao normal para este dente, causando uma reabsorçäo atípica na raíz distal do segundo molar decíduo. Em alguns casos a ectopia é autocorrigível e o molar permanente erupciona em oclusäo normal, em outros há necessidade de algum tipo de tratamento para distalizar o molar ectópico, levando-o à sua posiçäo correta. A prevalência de ectopia do primeiro molar é em torno de 3 por cento na populaçäo em geral