Aggressive unicystic ameloblastoma affecting the posterior mandible: late diagnosis during orthodontic treatment

Maxillofacial images must be examined to find pathologies not identified during clinical examination. Unicystic ameloblastoma (UA) extending to the mandibular body and ramus was neglected on initial panoramic radiographic examination. After orthodontic therapy, a huge lesion was observed clinically and through imaging exams. After the conservative surgery, no recurrence was observed during five years of follow-up. This case emphasized the need for careful evaluation of patient images focusing on the oral diagnosis before any dental treatment planning, including orthodontic therapy.

A posteriori registration and subtraction of periapical radiographs for the evaluation of external apical root resorption after orthodontic treatment

PURPOSE: This study employed a posteriori registration and subtraction of radiographic images to quantify the apical root resorption in maxillary permanent central incisors after orthodontic treatment, and assessed whether the external apical root resorption (EARR) was related to a range of parameters involved in the treatment. MATERIALS AND METHODS: A sample of 79 patients (mean age, 13.5±2.2 years) with no history of trauma or endodontic treatment of the maxillary permanent central incisors was selected. Periapical radiographs taken before and after orthodontic treatment were digitized and imported to the Regeemy software. Based on an analysis of the posttreatment radiographs, the length of the incisors was measured using Image J software. The mean EARR was described in pixels and relative root resorption (%). The patient's age and gender, tooth extraction, use of elastics, and treatment duration were evaluated to identify possible correlations with EARR. RESULTS: The mean EARR observed was 15.44±12.1 pixels (5.1% resorption). No differences in the mean EARR were observed according to patient characteristics (gender, age) or treatment parameters (use of elastics, treatment duration). The only parameter that influenced the mean EARR of a patient was the need for tooth extraction. CONCLUSION: A posteriori registration and subtraction of periapical radiographs was a suitable method to quantify EARR after orthodontic treatment, and the need for tooth extraction increased the extent of root resorption after orthodontic treatment.

Avaliação do ângulo nasolabial, em radiografias cefalométricas laterais, dividido em ângulo superior e inferior, por uma linha paralela ao plano de Frankfort, em indivíduos portadores de má-oclusao classe II e classe III de angle / Nasolabial angle evaluation, in lateral cephalometric x-rays, divided in superior and inferior angle, by a parallel line to the Frankfort plane, in individuals bearers of class II and class III occlusion

Este estudo constou da análise do ângulo nasolabial e sua divisão em superior e inferior, por uma linha paralela ao Plano de Frankfort passando pelo ponto subnasal. Foram utilizadas 120 radiografias cefalométricas norma lateral, em pacientes portadores de má-oclusao Classe II e Classe III de Angle, 60 de cada grupo, 30 do sexo feminino e 30 do sexo masculino, na faixa etária de 13 a 43 anos, com média de idade de 241,03+-77,78 meses. Os resultados obtidos foram para o ângulo nasolabial média para toda amostra de 106,42+-9,87º, sendo para Classe II média de 109,37º+-9,10ºe para Classe III de 103,48º+-9,79º, no sexo masculino média de 107,02+-10,32º e no sexo feminino de 105,83+-9,44º. O ângulo superior apresentou média para toda amostra de 22,092º+-8,831º, sendo para Classe II a média de 26,48º+-8,68º e para a Classe III de 17,708º+-6,543º, no sexo masculino média de 22,40º+-8,85º e no sexo masculino de 21,78º+-8,87º. Para o ângulo inferior média de toda amostra de 84,429º+-8,717º, sendo para a Classe II média de 82,93º+-7,99º e para Classe III média de 85,93º+-9,21º, no sexo masculino de 84,63º+-9,21º e no sexo feminino de 84,23º+-8,26º. Conclui-se para o ângulo nasolabial e para o ângulo superior, os indivíduos Classe II diferem dos indivíduos da Classe III (Classe II maior que Classe III), com diferença estatisticamente significante; para os ângulos nasolabial e superior nao houve diferença estatisticamente significante para o sexo e interaçao entre sexo com má-oclusão; para o ângulo inferior não diferem estatisticamente os dados para má-oclusão, sexo e suas interações.