Reabsorción dentinaria interna coronaria: informe de un caso clínico / Coronary internal dentine resorption: report of a clinical case

Objetivo: La reabsorción dentinaria interna es un pro- ceso causado por la actividad odontoclástica asociada princi- palmente a la inflamación pulpar crónica y/o traumatismos, y se caracteriza por la pérdida progresiva de tejido dentinario y la posible invasión al cemento. El presente informe describe el diagnóstico y tratamiento de un molar inferior que presentó un cuadro sintomático de reabsorción dentinaria interna. Caso clínico: Un paciente de 38 años fue derivado a la consulta por presentar una zona de reabsorción interna en un segundo molar inferior. Durante el examen clínico y ra- diográfico se tomó una radiografía preoperatoria periapical con radiovisiógrafo en la que se observó la presencia de un área compatible con el diagnóstico de reabsorción dentinaria interna, el que fue posteriormente confirmado por medio de una tomografía computada de haz cónico. La imagen de la lesión se presentó como una zona radiolúcida deformante de bordes nítidos, localizada a nivel de la cámara pulpar. El tra- tamiento consistió en la extirpación de la pulpa coronaria y de la instrumentación, desinfección y obturación de los conduc- tos radiculares y la cavidad de acceso. En el control clínico y radiográfico realizado luego de 3 años se observó que el paciente estaba asintomático y las estructuras perirradiculares se encontraban dentro de los límites normales. La observación histológica del material removido de la cámara pulpar reveló la presencia de un tejido granulomatoso con numerosos vasos sanguíneos y escasos focos micro hemorrágicos. Hasta el momento, el tratamiento endodóntico es el pro- cedimiento indicado para el tratamiento de la reabsorción dentinaria interna. Se destaca la importancia de la tomografía computada de haz cónico para el diagnóstico y tratamiento temprano de las reabsorciones dentinarias internas a efectos de contar con un pronóstico favorable (AU)

Aim: Internal dentine resorption is aprocess caused by odontoclastic activity, mainly associated with chronic pulpal inflammation and/or trauma, and it'scharacterized by a pro- gressive loss of dentine tissue and the possible invasion of the cementum. This report describes the diagnosis and treatment of a lower molar that presented a symptomatic case of inter- nal dentine resorption. Clinical case: A 38-years old patient was referred to the office because of presenting an area of internal resorption in a lower second molar. During clinical and radiographic exam- ination, a periapical preoperative radiograph with radiovisio- graph was taken, in which the presence of an area compatible with the diagnosis of internal dentine resorption was observed, which was later confirmed by a cone-beam computed tomog- raphy.The image of the lesion was presented as a deforming radiolucent area with sharp edges, located at pulp chamber level. Treatment consisted of the removal of the coronary pulp and the instrumentation, disinfection and filling of the root ca- nals and the access cavity. In the clinical and radiographic control carried out 3 years after procedure, it was observed that the patient was asymptomatic and the periradicular struc- tures were within normal limits. The histological observation of the removed material from the pulp chamber revealed the presence of a granulomatous tissue with numerous blood ves- sels and scarce micro hemorrhagic focus. Until now, the endodontic treatment is the indicated pro- cedure to treat internal dentine resorption. It is necessary to highlight the importance of the cone-beam computerized to- mography for the early diagnosis and treatment of internal dentine resorptions in order to have a favorable outlook (AU)

Class II malocclusion treatment changes with the Jones jig, Distal jet and First Class appliances

Abstract Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.

Three-dimensional assessment of external apical root resorption after maxillary posterior teeth intrusion with miniscrews in anterior open bite patients

ABSTRACT Objective: The objective of this study was to assess the external apical root resorption (EARR) of the maxillary posterior teeth after intrusion with miniscrews. Methods: Fifteen patients (13 females and 2 males) with age ranging from 14.5 to 22 years (mean 18.1 ±2.03 years) were selected to participate in this study. All patients presented with anterior open bite of 3 mm or more. An intrusion force of 300 g was applied on each side to intrude the maxillary posterior teeth. Cone beam computed tomography (CBCT) scans were taken pretreatment and post-intrusion and were analyzed to evaluate the EARR. Results: The maxillary posterior teeth were intruded in average 2.79 ± 0.46 mm (p< 0.001) in 5.1 ± 1.3 months, and all examined roots showed statistically significant EARR (p< 0.05) with an average of 0.55 mm, except the distobuccal root of the left first permanent molars and both the palatal and buccal roots of left first premolars, which showed no statistically significant changes. Conclusions: The evaluated teeth presented statistically significant EARR, but clinically, due to the small magnitude, it was not considered significant. Moreover, the CBCT provided a good visualization of all roots in all three planes, and it was effective in detecting minimal degrees of EARR.

RESUMO Objetivo: o objetivo desse estudo foi verificar a existência de reabsorção radicular apical externa (RRAE) em dentes posterossuperiores após intrusão ancorada em mini-implantes. Métodos: quinze pacientes (13 mulheres e 2 homens) com a idade variando entre 14,5 e 22 anos (média de 18,1 ± 2,03 anos) foram selecionados para participar desse estudo. Todos os pacientes possuíam mordida aberta anterior de 3mm ou mais. Uma força de 300 gramas foi aplicada em cada lado para intruir os dentes posterossuperiores. Tomografias computadorizadas de feixe cônico (TCFC), adquiridas antes do tratamento e após a intrusão, foram comparadas para se avaliar a RRAE. Resultados: os dentes posterossuperiores foram intruídos em média 2,70 ± 0,46 mm (p< 0,001) em 5,1 ± 1,3 meses, e todas as raízes examinadas mostraram RRAE estatisticamente significativa (p< 0,05), com média de 0,55 mm, exceto pela raiz distovestibular dos primeiros molares permanentes esquerdos, e pelas raízes palatina e vestibular dos primeiros pré-molares esquerdos, que não apresentaram mudanças estatisticamente significativas. Conclusões: os dentes avaliados apresentaram RRAE estatisticamente significativa, a qual, porém, não foi considerada clinicamente significativa, devido à sua reduzida magnitude. Além disso, a TCFC possibilitou uma boa visualização de todas as raízes nos três planos espaciais, e foi eficaz para detecção de níveis mínimos de RRAE.

Ankylosis of Permanent First Molar: Diagnosis by Cone Beam Computed Tomography / Anquilosis del Primer Molar Permanente: Diagnóstico por Tomografía Computarizada con Haz Cónico

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.

Miniplacas como dispositivos de anclaje temporal (DAT) en la verticalización del segundo molar inferior impactado / Miniplates as temporary anchorage devices (TAD) for uprighting the impacted second mandibular molar

La impactación de los segundos molares inferiores permanentes es una patología con una incidencia del 0.03 or ciento a 0.04 por ciento del total de dientes retenidos, que en la mayoría de los casos debido a una posición impredecible del tercer molar, el resultado final es la exodoncia de ambas piezas dentarias.Dentro de los dispositivos de anclaje temporal, existen dos tipos, los minimplantes y las miniplacas. A través de este caso clínico se demuestra la eficiencia de las miniplacas en la verticalización de los segundos molares inferiores impactados sobre otras medidas terapéuticas debido a que su uso es un método predecible, rápido y seguro que no genera efectos secundarios indeseables. Además, estas miniplacas son colocadas a distancia de las piezas dentarias, por lo que no interfiere en los movimientos dentales.

Mandibular second molar impaction is a pathology with an incidence of 0.03% - 0.04% of the total of the impacted teeth due to animpredictible position of the third molar in most cases. As a consequence, where the final result is dental extraction of both teethThere are two types of temporary skeletal anchorage devices minimplants and miniplates. This case shows the miniplate efficiency in thesecond molar verticalization which is a predictible, fast and safe method without any side effects when compared with other treatments.In addition, miniplantes do not interfere with dental movements because they are placed far enough from the teeth.

Efeitos da movimentação dentária mesiodistal para área de rebordo alveolar atrófico: avaliação por meio de modelos digitais / Mesiodistal dental movement toward atrophic alveolar ridge: digital models assessment

Objetivos: O objetivo deste estudo foi avaliar em adultos com perdas dos primeirosmolares inferiores permanentes, as inclinações e angulações dentárias dos dentesadjacentes, bem como a espessura do rebordo após movimentação mesial desegundos molares para suprir a perda e verticalização dos segundos molares parareabilitação protética. Métodos: Foram selecionados 2 grupos de estudo. O GrupoFechamento (GF) foi composto por 12 hemiarcos com ausência de primeirosmolares permanentes e espaços variando entre 2 a 7mm, que foram tratadasortodonticamente com fechamento do espaço. O Grupo Abertura (GA) foi compostopor 14 hemiarcos com ausência de primeiros molares permanentes e espaçosvariando entre 7,1 a 12mm, que foram tratadas ortodonticamente com verticalizaçãodo segundo e terceiro molar e reabertura de espaço para reabilitação protética.Avaliou-se em modelos dentários digitais a angulação, a inclinação, a dimensãocérvico-oclusal e a espessura do rebordo. As comparações interfases e intergruposforam realizadas com os testes t-pareado e t-independente respectivamente(p<0,05). Resultados: Houve melhora na angulação dos segundos molaresinferiores tanto no GF quanto no GA, mostrando eficácia da mecânica em ambas asterapias; não houve alterações significantes nas inclinações vestibulolinguais dosdentes posteriores em ambos os grupos; a espessura do rebordo aumentou no GF emanteve-se constante no GA. Conclusões: As duas modalidades de tratamentodemonstraram resultados adequados. A escolha do plano de tratamento deveponderar a relação custo-benefício de cada caso, considerando-se a dimensãoinicial do espaço, a presença dos terceiros molares, as condições periodontaisiniciais, o tempo de tratamento e o custo financeiro...

Objectives: The aim of this study was to evaluate, in adults with loss of the firstpermanent molars, the inclinations and angles of adjacent teeth as well as thealveolar ridge thickness after mesial movement of second molars to close the spaceof the tooth loss and second molar uprighting to rehabilitation prosthetic. Methods:Two study groups were selected. The Group Closure (GC) was composed of 12quadrants with no permanent first molars and edentulous spaces varying from 2 to7mm, which were treated with orthodontic space closure. The Group Opening (GO)was composed of 14 quadrants with no permanent first molars and edentulousspaces varying from 7.1 to 12mm, which were treated with orthodontic uprighting ofthe second and third molars and reopening space for prosthetic rehabilitation. Indigital dental models were evaluated the angulation, inclination, the cervical-occlusaldimension and alveolar ridge thickness. Interphase and intergroup comparisons wereperformed with with paired t-test and independent t-test, respectively (p <0.05).Results: There was improvement in the angulation of the mandibular second molarsboth in GC and GO, showing the mechanical efficiency in both therapies; there wereno significant changes in buccolingual inclinations of the posterior teeth in bothgroups; the alveolar ridge thickness increased in GC and remained constant in GO.Conclusions: Both treatment modalities have demonstrated appropriate results. Thechoice of treatment plan should consider the cost-benefit of each case, taking intoaccount the initial dimension of the space, the presence of third molars, initialperiodontal conditions, treatment time and the financial cost...

Efeitos da movimentação dentária mesiodistal para área de rebordo alveolar atrófico: avaliação por meio de modelos digitais / Mesiodistal dental movement toward atrophic alveolar ridge: digital models assessment

Objetivos: O objetivo deste estudo foi avaliar em adultos com perdas dos primeirosmolares inferiores permanentes, as inclinações e angulações dentárias dos dentesadjacentes, bem como a espessura do rebordo após movimentação mesial desegundos molares para suprir a perda e verticalização dos segundos molares parareabilitação protética. Métodos: Foram selecionados 2 grupos de estudo. O GrupoFechamento (GF) foi composto por 12 hemiarcos com ausência de primeirosmolares permanentes e espaços variando entre 2 a 7mm, que foram tratadasortodonticamente com fechamento do espaço. O Grupo Abertura (GA) foi compostopor 14 hemiarcos com ausência de primeiros molares permanentes e espaçosvariando entre 7,1 a 12mm, que foram tratadas ortodonticamente com verticalizaçãodo segundo e terceiro molar e reabertura de espaço para reabilitação protética.Avaliou-se em modelos dentários digitais a angulação, a inclinação, a dimensãocérvico-oclusal e a espessura do rebordo. As comparações interfases e intergruposforam realizadas com os testes t-pareado e t-independente respectivamente(p<0,05). Resultados: Houve melhora na angulação dos segundos molaresinferiores tanto no GF quanto no GA, mostrando eficácia da mecânica em ambas asterapias; não houve alterações significantes nas inclinações vestibulolinguais dosdentes posteriores em ambos os grupos; a espessura do rebordo aumentou no GF emanteve-se constante no GA. Conclusões: As duas modalidades de tratamentodemonstraram resultados adequados. A escolha do plano de tratamento deveponderar a relação custo-benefício de cada caso, considerando-se a dimensãoinicial do espaço, a presença dos terceiros molares, as condições periodontaisiniciais, o tempo de tratamento e o custo financeiro.

Objectives: The aim of this study was to evaluate, in adults with loss of the firstpermanent molars, the inclinations and angles of adjacent teeth as well as thealveolar ridge thickness after mesial movement of second molars to close the spaceof the tooth loss and second molar uprighting to rehabilitation prosthetic. Methods:Two study groups were selected. The Group Closure (GC) was composed of 12quadrants with no permanent first molars and edentulous spaces varying from 2 to7mm, which were treated with orthodontic space closure. The Group Opening (GO)was composed of 14 quadrants with no permanent first molars and edentulousspaces varying from 7.1 to 12mm, which were treated with orthodontic uprighting ofthe second and third molars and reopening space for prosthetic rehabilitation. Indigital dental models were evaluated the angulation, inclination, the cervical-occlusaldimension and alveolar ridge thickness. Interphase and intergroup comparisons wereperformed with with paired t-test and independent t-test, respectively (p <0.05).Results: There was improvement in the angulation of the mandibular second molarsboth in GC and GO, showing the mechanical efficiency in both therapies; there wereno significant changes in buccolingual inclinations of the posterior teeth in bothgroups; the alveolar ridge thickness increased in GC and remained constant in GO.Conclusions: Both treatment modalities have demonstrated appropriate results. Thechoice of treatment plan should consider the cost-benefit of each case, taking intoaccount the initial dimension of the space, the presence of third molars, initialperiodontal conditions, treatment time and the financial cost.

Effects of mandibular protraction appliance associated to fixed appliance in adults

OBJECTIVE: This retrospective study aimed to conduct a cephalometric evaluation of the skeletal, dental and soft tissue effects resulting from treatment of adult patients presenting Class II malocclusion, performed with a Mandibular Protraction Appliance (MPA) combined with a fixed orthodontic appliance. METHODS: The sample consisted of teleradiographs obtained before and after treatment of 9 adult patients (initial mean age of 22.48 years) with bilateral Class II, division 1, malocclusion. Paired t test (p < 0.05) was applied to compare initial and final values. RESULTS: t test revealed an increase in anteroinferior facial height and posterior facial height. The dental changes include: extrusion of upper incisors, buccal inclination, protrusion of lower incisors, mesialization and extrusion of mandibular molars. Regarding the soft tissue component, there was an increase in nasolabial angle in addition to upper lip retrusion. CONCLUSIONS: The effects of treating Class II malocclusion adult patients, by means of using Mandibular Protraction Appliance (MPA) combined with a fixed appliance were mostly observed in the mandibular arch, and consisted of buccal inclination, protrusion and intrusion of incisors, and mesialization and extrusion of the molars.

OBJETIVO: esse estudo retrospectivo teve como objetivo avaliar, cefalometricamente, os efeitos esqueléticos, dentários e tegumentares decorrentes do tratamento com o Aparelho de Protração Mandibular em conjunto ao aparelho fixo em pacientes adultos para correção da má oclusão de Classe II. MÉTODOS: a amostra foi composta por telerradiografias pré- e pós-tratamento de nove adultos (idade inicial média de 22,48 anos), portadores de má oclusão de Classe II, divisão 1 bilateral. O teste t pareado (p < 0,05) foi empregado para comparação dos valores iniciais e finais. RESULTADOS: de acordo com o teste t, observou-se aumento da altura facial anteroinferior e da altura facial posterior. As alterações dentárias foram: extrusão dos incisivos superiores, inclinação para vestibular e protrusão dos incisivos inferiores; e mesialização e extrusão dos molares inferiores. Com relação ao componente tegumentar, houve aumento do ângulo nasolabial e retrusão do lábio superior. CONCLUSÃO: os efeitos do tratamento com o Aparelho de Protração Mandibular em conjunto com aparelho fixo em pacientes adultos para correção da má oclusão de Classe II foram direcionados, principalmente, à arcada inferior, com inclinação vestibular, protrusão e intrusão dos incisivos e mesialização e extrusão dos molares.

Association of infantile bruxism and the terminal relationships of the primary second molars

The aim of this study was to analyze the association between infantile bruxism and the terminal relationships of the primary second molars. A total of 937 pre-school children (both genders), aged from 2 to 6 years, from municipal schools in São Paulo were evaluated. In this study, a questionnaire considering the bruxism habit and the presence of headaches and/or restless sleep was answered by the parents/guardians. A clinical exam of occlusion in the anteroposterior direction (vertical plane - VP, mesial step - MS and distal step - DS) was performed by the examiners in the school environment. Student's t test, Fisher's test and a logistic regression test were applied for the statistical analysis at a significance level of 5%. The prevalence of the bruxism habit was 29.3% among the total sample. Because there was no significant difference between the sides evaluated, the left side was taken as the standard. Among those children with bruxism, 25.7% presented a mesial step terminal relationship at the primary second molars, 29.1% had DS, and 30.2% had VP. Regarding the association of the parafunctional habit with the type of terminal relationship, no significant results were found. Children who slept restlessly or suffered from headaches were verified to show a higher chance of expressing the habit (OR = 2.4 and 1.6, respectively). The prevalence of bruxism in the studied sample was 29.3%, and its association with the primary second molars' terminal relationship was not statistically significant.

Efeitos cefalométricos do Aparelho Bimetric de Wilson na correção da Classe II de Angle / Cephalometric effects of Bimetric Wilson's appliance for correction of Angle Class II

Avaliar a distalização e inclinação dos primeiros molares superiores além de analisar o efeito sobre a altura facial ântero-inferior, durante o tratamento da má oclusão de Classe II com o aparelho Bimetric de Wilson.Metodologia: foram avaliados os cefalogramas obtidos das telerradiografias laterais antes e após distalização de molares em 25 pacientes, tratados com o aparelho Bimetric de Wilson. A idade média inicial foi de 13,4 anos (+1,4). O tempo médio de distalização foi de 4,2 meses. As medidas foram testadas e repetidas quando dois fatores foram considerados, tratamento/aparelho (Bimetric) e avaliações (antes e depois) no mesmo paciente, por meio do teste estatístico ANOVA. Foi utilizado nível de significância de 5% (p<0,05).Resultados: a avaliação cefalométrica antes (T1) e pós distalização (T2) mostrou que o aparelho Bimetric de Wilson promoveu uma distalização dos primeiros molares superiores de 1,82mm, uma inclinação distal de 4,5° e um aumento da AFAI de 1,04mm.Conclusão: houve alterações nas medidas, embora sem significância estatística, nas quais a AFAI aumentou em 1,04mm. Os primeiros molares superiores distalizaram 0,43mm/mês e inclinaram-se distalmente 4,5°...

Evaluate maxillary first molars distalization and inclination after the use of Bimetric Wilson`s Appliance for Class II treatment, and its effects on the lower anterior facial height.Methodology: lateral cephalograms were taken pre and post distalization in 25 patients. Initial mean age was 13.4 years (+1.4). The average time of distalization was 4.2 months. The measures were tested and repeated when two factors were considered, treatment/appliance (Bimetric) and evaluations (before and after) in the same patient, using the ANOVA test. It was used a significance level of 5% (p <0.05).Results: the cephalometric evaluation pre and post distalization showed that the amount of distal molar movement was 1.82mm, with an inclination of 4.5° and an increase in lower anterior facial height of 1.04mm.Conclusion: the treatment promoted a distalization of 0.43mm/month, upper molars tipped 4.5° distally and lower anterior facial height increased 1.04mm. These alterations were not statistically significant...

Timing and sequence of primary tooth eruption in children with cleft lip and palate

OBJECTIVE: To determine the timing and sequence of eruption of primary teeth in children with complete bilateral cleft lip and palate. MATERIAL AND METHODS: This cross-sectional study was conducted at the Hospital for Rehabilitation of Craniofacial Anomalies of the University of São Paulo, Bauru, SP, Brazil, with a sample of 395 children (128 girls and 267 boys) aged 0 to 48 months, with complete bilateral cleft lip and palate. RESULTS: Children with complete bilateral clefts presented a higher mean age of eruption of all primary teeth for both arches and both genders, compared to children without clefts. This difference was statistically signifcant for all teeth, except for the maxillary first molar. Mean age of eruption of most teeth was lower for girls compared to boys. The greatest delay was found for the maxillary lateral incisor, which was the eighth tooth of children with clefts of both genders. Analyzing by gender, the maxillary lateral incisor was the eighth tooth to erupt in girls and the last in boys. CONCLUSION: The results suggest an interference of the cleft on the timing and sequence of eruption of primary teeth.

Root trifurcation of upper permanent second molars: anatomical aspects of clinical interest / Trifurcación de la raíz de segundos molares permanentes: aspectos anatómicos de interés clínico

The aim of this study was to analyze the relationship among the point of greatest depression on the root trifurcation floor and the furcation openings of the maxillary second molars. Sixty human extracted upper permanent second molars were analyzed and the furcation area were measured using a vertical calliper, and the values regarding the point of deepest depression were recorded. The results showed that the deepest depression in the trifurcation floor of the roots is centrally situated in 11.7 percent of the cases, whereas 88.3 percent involve mesial-buccal and distal-buccal roots. The distal furcation (F3) had the largest distance from the point of deepest depression in the trifurcation floor (A), followed by the buccal (F1) and mesial (F2) furcations when point A was below their respective openings. On the other hand, the medial furcation (F2) had the largest distance from point A, followed by distal (F3) and buccal (F1) furcations when point A was above their respective openings.

El presente estudio examinó la relación entre el punto de mayor depresión del suelo de la trifurcación de la raíz y la apertura de furcas en los segundos molares superiores. Sesenta segundos molares permanentes extraídos de humanos fueron analizados. El área de furca se midió utilizando un calibrador digital adaptado y valores sobre el punto de mayor depresión fueron registrados. Los resultados mostraron que la mayor depresión esta en el centro del suelo de las raíces en el 11,7 por ciento de los casos, mientras que 88,3 por ciento cubren las raíces mesio-vestibular y disto-vestibular. El punto de mayor depresión en el suelo de la trifurcación (A) presentó la mayor distancia desde la bifurcación distal (F3), seguido por la vestibular (F1) y mesial (F2) cuando el punto estaba por debajo de sus respectivas aperturas. Además, la bifurcación mesial (F2) presentó la mayor distancia desde el punto A, seguido por distal (F3) y vestibular (F1), cuando el punto A estaba por encima de sus respectivas aperturas.

Estudo dos métodos visual, radiográfico interproximal e a laser no diagnóstico de cárie / Validity and reproducibility of the visual, radiographic and diode laser methods in the diagnosis of caries

O objetivo deste estudo foi avaliar a validade e a reprodutibilidade dos métodos visual, radiográfico interproximal e a laser de diodo (DIAGNOdent - KaVo, Biberach, Alemanha) no diagnóstico de cáries. Três observadores ("experts") näo-calibrados efetuaram os exames em 87 sítios na superfície oclusal de 69 molares decíduos. Após a análise histológica (padräo ouro), constataram-se lesöes de cárie em 60 sítios. Para a maioria dos examinadores: a inspeçäo visual apresentou sensibilidade e acurácia superiores às dos demais métodos e especificidade inferior às dos métodos radiográfico e a laser de diodo; o método radiográfico apresentou os menores valores de sensibilidade e acurácia, enquanto revelou a maior especificidade entre todos os métodos. Apesar de ter apresentado uma sensibilidade maior do que o exame radiográfico, o laser de diodo apresentou um maior nímero de diagnósticos falsos-positivos. A reprodutibilidade dos testes apresentou grande variaçäo, tendo-se considerado a sua concordância de baixa e boa confiabilidade

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.

Peripheral giant cell granuloma--a case report.

Peripheral giant cell granuloma is a lesion arising mainly from the connective tissue of gingiva or periosteum of alveolar ridge. A case of peripheral giant cell granuloma involving a deciduous molar and the succedaneous tooth is reported. The lesion was large and interfered with occlusion. Surgical excision of the lesion along with the deciduous first molar was done. The underlying permanent first premolar was also involved, and had to be removed. The importance of an adequate salivary flow and maintenance of oral hygiene in the prevention of such lesions is stressed.

Análise morfológica comparativa do preparo de canais radiculares curvos com dois tipos de instrumentos endodônticos / A comparative morphological study of the preparation of curved root canals with two types of endodontic files

O objetivo do presente trabalho foi averiguar a ocorrência de desvio apical e a conicidade do preparo resultante do emprego de técnica de instrumentaçäo seriada em raízes mésio-vestibulares de molares superiores variando-se o tipo de instrumento (limas tipo K e Flexofile). Após o preparo, as raízes foram diafanizadas e submetidas a exame macroscópico com auxílio de lupa de 8 graus positivos. Dos resultados, consta que a lima Flexofile propiciou menor ocorrência de desvio apical, bem como melhor qualidade de preparos cônicos contínuos

Anquilose dental: relato de um caso pouco freqüente / Dental ankylosis: report of an unusual case

Este artigo descreve o diagnóstico e o tratamento de um caso pouco freqüente de anquilose total de um segundo molar decíduo inferior, associado a sintomas de dor devido a pulpite do dente afetado

Comprometimento do primeiro molar permanente após 1 ano de sua erupçäo / The possible demage of the firts permanent molar during one year after your eruption: elaboration of a prevention plan

Os autores examinaram escolares de primeiro grau, de ambos os sexos, que tinham tido seus primeiros molares permanentes erupcionados pelo período decorrido de até um ano, observando o grau de comprometimento daqueles dentes. Ao final da pesquisa e de acordo com os resultados, elaboraram proposta preventiva para os referidos dentes

Anquilose precose de segundo molar decíduo inferior: relato de um caso / Ankylosis premature of second molar lower deciduous: case related

Os autores apresentam um caso clínico de anquilose precoce envolvendo o segundo molar decíduo inferior esquerdo, em uma criança de três anos de idade atendida no Departamento de Odontopediatria e Ortodontia da FO/UFRJ, fazendo uma breve revisäo da literatura

Estudo comparativo do índice de Pont com os tipos faciais, em brasileiros apresentando oclusäo normal e maloclusäo de Classe I e de Classe II Divisäo 1 / Study comparing pont's index for different facial types in Brazilian with normal occlusion and Class I and Class II Division 1 malocclusions

O padräo médio das medidas das distâncias interpremolares e intermolares, como descrito no método de Pont, foi pesquisado em 200 pacientes leucodermas, residentes em Säo Paulo, na dentiçäo permanente, avaliando-se as influências de diferentes tipos de oclusäo (oclusäo normal, maloclusäo de Classe I e Classe II Divisäo 1), tipos faciais ( mesofacial e dolicofacial) e sexos (masculino e feminino) sobre essas medidas. Ao verificar-se a aplicabilidade do Indice de Pont para os diversos grupos, os tipos faciais e as maloclusöes favoreceram a reduçäo dos valores das distâncias interpremolares e intermolares em relaçäo à meta preconizada por esse autor. Em decorrência disso, a meta a ser atingida para cada caso deveria estar relacionada ao tipo facial e ao tipo de maloclusäo