Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

Abstract This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

Surgical effects of rehabilitation protocols on dental arch occlusion of children with cleft lip and palate

Aim: to evaluate the surgical effects of two rehabilitation protocols on dental arch occlusion of 5-year-old children with or without cleft lip and palate. Methods: this is a retrospective longitudinal study the sample comprised 45 digitized dental casts divided into followed groups: Group 1 (G1) ­ children who underwent to cheiloplasty (Millard technique) at 3 months and to one-stage palatoplasty (von Langenbeck technique) at 12 months; Group 2 (G2) ­ children who underwent to cheiloplasty (Millard technique) and two-stage palatoplasty (Hans Pichler technique for hard palate closure) at 3 months and at 12 months to soft palate closure (Sommerlad technique); and Group 3 (G3) ­ children without craniofacial anomalies. Linear measurements, area, and occlusion were evaluated by stereophotogrammetry software. Shapiro-Wilk test was used to verify normality. ANOVA followed by posthoc Tukey test and Kruskal-Wallis followed by posthoc Dunn tests were used to compared groups. Results: For the measures intercanine distance (C-C'), anterior length of dental arch (I-CC'), and total length of the dental arch (I­MM'), there were statistical differences between G1x G3 and G2xG3, the mean was smaller for G1 and G2. No statistically significant differences occurred in the intermolar distance and in the dental arch area among groups. The occlusion analysis revealed significant difference in the comparison of the three groups (p=0.0004). Conclusion: The surgical effects of two rehabilitation protocols affected the occlusion and the development of the anterior region of the maxilla of children with oral clefts when compared to children without oral clefts.

Six-year post-surgical evaluation in the treatment protocols in the dental arches of children with oral cleft: longitudinal study

Abstract Oral cleft surgical repairs are performed using different techniques worldwide. Objective To evaluate and compare the development of the dental arches of children with unilateral cleft lip and palate before and after the primary surgeries performed with different techniques at the first months and six years of life. Methodology This is a retrospective longitudinal study. The sample comprised 56 dental casts divided int the following groups: Group 1 (G1) - cheiloplasty (Millard technique) at three months and one-step palatoplasty (von Langenbeck technique) at 12 months; and Group 2 (G2) - cheiloplasty (Millard technique) and two-step palatoplasty: anterior hard palate closure (Hans Pichler technique) at three months and posterior soft palate closure (Sommerlad technique) at 12 months. The digitized dental casts were evaluated at three months - pre-surgical (T1) and six years of life- post-surgical (T2). The following linear measurements were analyzed: intercanine (C-C'), intertuberosity (T-T') distances; anterior dental arch (I-CC'), anterior intersegment (I-C'), and total arch (I-TT') lengths. The palate area was also measured. Parametric and non-parametric tests were applied (p<0.05). Results In G1, the intragroup comparison showed statistically significant smaller I-CC' and I-C' at T2 (p=0.001 and p<0.001, respectively), while T-T', I-TT', and area comparisons were significantly greater (p<0.001, p=0.002, and p<0.001, respectively). In G2, the intragroup comparison exhibited statistically significant smaller C-C' and I-C' at T2 (p=0.004, for both), whereas T-T', I-TT' and area comparisons were significantly greater (p<0.001, p=0.004, and p<0.001, respectively). At T2, the intergroup analysis revealed that G1 had a statistically significant smaller I-CC' (p=0.014). The analysis of the intergroup differences (∆=T2-T1) showed that G1 had a statistically smaller I-CC' (p=0.043). Conclusion The two-step palatoplasty showed a more favorable prognosis for the maxillary growth than one-step palatoplasty in children with oral clefts.

Evaluation of palatal volume in children with cleft lip and palate: a comparison of two surgical protocols / Avaliação volumétrica do palato em crianças com fissura labiopalatina: comparação de dois protocolos cirúrgicos

Objective: Compare the palatal volume in children with unilateral cleft lip and palate before and after two surgical protocols. Material and Methods: Retrospective data collection was performed in a specialized hospital. The sample comprised 120 digitized dental models divided into, Group 1 (G1) ­ participants submitted to cheiloplasty at 3 months (Millard technique) and one-step palatoplasty at 12 months (von Langenbeck technique); Group 2 (G2) ­ participants submitted to cheiloplasty (Millard technique) and hard palate closure (Hans Pichler technique) at 3 months and soft palate closure at 12 months (Sommerlad technique). The dental models were evaluated at Time 1 (T1): before primary plastic surgeries, Time 2 (T2): 1st post-surgical phase, and Time 3 (T3): 2nd post-surgical phase. The volume was measured through stereophotogrammetry system software. Parametric and non-parametric statistical tests were applied (α=5%). Results: The intragroup analysis revealed that G1 had a statistically significant increase in volume at T2 followed by a reduction at T3 (p=0.003); G2 showed a statistically significant increase of dental arch volume between T1 and T2 (p=0.001). There was no statistically significant difference in the intergroup and gender analyses (p>0.05). Conclusion: The surgical protocol influenced the palatal volume of children with unilateral cleft lip and palate. This study suggested that two-step palatoplasty protocol has a tendency to be more appropriate.(AU)

Objetivo: Comparar o volume palatino em crianças com fissura unilateral de lábio e palato antes e após dois protocolos cirúrgicos. Material e Métodos: A coleta de dados retrospectiva foi efetuada em um hospital especializado. A amostra foi composta por 120 modelos dentários digitalizados divididos em, Grupo 1 (G1) ­ participantes submetidos a queiloplastia aos 3 meses de vida (técnida de Millard) e a palatoplastia em única etapa aos 12 meses (técnica de von Langenbeck); Grupo 2 (G2) ­ participantes submetidos a queiloplastia (técnica de Millard) e fechamento do palato duro (técnica de Hans Pichler) aos 3 meses de vida e fechamento do palate mole aos 12 meses (técnica de Sommerlad). Os modelos dentários foram avaliados em Tempo 1 (T1): antes das cirurgias plásticas primárias, Tempo 2 (T2):1ª fase pós-cirúrgica e Tempo 3 (T3): 2ª fase pós-cirúrgico. O volume foi mensurado por meio do software do sistema de estereofotogrametria. Testes estatísticos paramétricos e não-paramétricos foram utilizados (α=5%). Resultados: As análises intragrupos indicaram que G1 apresentou aumento estatisticamente significante em T2 seguido de redução em T3 (p=0.003). G2 apresentou crescimento estatisticamente significativo do volume palatino entre T1 e T2 (p=0.001). Não houve diferença estatisticamente significante nas análises intergrupos e entre gêneros (p>0.05). Conclusão: O protocolo cirúrgico influenciou o volume palatino das crianças com fissura unilateral de lábio e palato. Este estudo sugeriu que o protocolo da palatoplastia em duas etapas possui uma tendência de ser mais apropriado.(AU)

Innovative method to assess maxillary arch morphology in oral cleft: 3d-3d superimposition technique

Abstract This study aimed to analyze the maxillary growth and development of children with oral clefts using the innovative method of 3D-3D superimposition technique. Children with unilateral complete cleft lip (UCL) and unilateral cleft lip and palate (UCLP) participated in the study. The impressions of the dental arches were executed 1 day before and 1 year after lip repair surgery. A 3D laser scanner digitized the dental models and the stereophotogrammetry system software analyzed the 3D-3D superimpositions in two groups of matches (same child, UCL and UCLP) and one group of mismatches (different individuals). The differences were evaluated by Root Mean Square (RMS) and expressed in millimeters (mm). Kruskal-Wallis test followed by post-hoc Dunn test and Mann-Whitney test were assessed to compare the groups (α=5%). RMS was 1.34 mm (± 0.37) in UCL group, 1.41 mm (± 0.32) in UCLP group, and 3.38 mm (± 1.28) in mismatches group. RMS was significantly greater in mismatches than in matches groups (p<0.0001). No statistically significant differences occurred between genders. The 3D-3D superimposition technique showed the maxillary development after lip repair surgery in the anterior region of the palate. Thus, it is suggested that the cleft amplitude and the palatal segments proportion influenced the morphological heterogeneity and, consequently, the development and maxillary growth of children with orofacial cleft.

Resumo O objetivo deste estudo foi analisar o crescimento e desenvolvimento maxilar de crianças com fissuras orais por meio de um método inovador da técnica de sobreposição 3D-3D. Participaram do estudo crianças com fissura unilateral completa de lábio (FL) e fissura unilateral de lábio e palato (FLP). As moldagens dos arcos dentários foram realizadas 1 dia antes e 1 ano após o reparo cirúrgico labial. Um scanner a laser 3D digitalizou os modelos dentários e o software do sistema de estereofotogrametria analisou as sobreposições 3D-3D em dois grupos correspondentes (mesmo indivíduo, FL e FLP) e um grupo não-correspondente (indivíduos diferentes). As diferenças foram avaliadas pelo Root Mean Square (RMS) e expressas em milímetros (mm). O teste de Kruskal-Wallis seguido do teste post-hoc de Dunn e teste de MannWhitney foram avaliados para comparar os grupos (α=5%). RMS foi de 1.34 mm (± 0.37) no grupo FL, 1.41 mm (± 0.32) no grupo FLP e 3.38 mm (± 1.28) no grupo não-correspondente. RMS foi significativamente maior no grupo não-correspondente (p <0.0001). Não houve diferenças estatisticamente significativas entre os gêneros. A técnica de sobreposição 3D-3D evidenciou o desenvolvimento da maxila após a cirurgia labial na região anterior do palato. Assim, sugere-se que a amplitude da fenda e a proporção dos segmentos palatinos influenciam na heterogeneidade morfológica e, consequentemente, no desenvolvimento e crescimento maxilar de crianças com fissura orofacial

Oral health-related quality of life of children with oral clefts and their families

Abstract Oral health problems can influence people's Quality of Life (QoL) because of pain, discomfort, limitations, and other esthetics problems, affecting their social life, feeding, daily activities, and the individual's well-being. Objective: To compare oral health-related quality of life (OHRQoL) of children with and without oral clefts and their families. Materials and Methods: 121 children aged from 2 to 6 years, from both sexes, enrolled in the treatment routine of the Pediatric Dentistry Clinics of a Dental School and a Hospital for Cleft Treatment were divided into two groups: Group 1 - children with cleft lip and palate; Group 2 - children without cleft lip and palate. The OHRQoL was assessed using the validated Portuguese version of the Early Childhood Oral Health Impact Scale (B-ECOHIS). The questionnaire was answered individually, only once, at a private place. Mann-Whitney U test was used to verify differences between groups. Spearman's Rho test was used to associate sex and age with quality of life. The level of significance was set at 5% (p<0.05). Results: According to the parents' perception on the OHRQoL of children with and without cleft lip and palate, oral health of children with oral clefts (Group 1) had a statistically significant impact on OHRQoL. The correlation of sex with impact on OHRQoL did not show statistically significant differences. On the other hand, the higher the age the higher the impact on QoL. Conclusions: The group comparison revealed that the cleft lip and palate negatively impacted on OHRQoL of 2 to 6-year-old children and their parents.

3D analysis of effects of primary surgeries in cleft lip/palate children during the first two years of life

Abstract This study aimed at monitoring the maxillary growth of children with cleft lip/palate in the first two years of life, and to evaluate the effects of primary surgeries on dental arch dimensions. The sample consisted of the three-dimensional digital models of 25 subjects with unilateral complete cleft lip and palate (UCLP) and 29 subjects with isolated cleft palate (CP). Maxillary arch dimensions were measured at 3 months (before lip repair), 1 year (before palate repair), and at 2 years of age. Student’s ttest was used for comparison between the groups. Repeated measures ANOVA followed by Tukey’s test was used to compare different treatment phases in the UCLP group. Paired ttest was used to compare different treatment phases in the CP group. P<0.05 was considered statistically significant. Decreased intercanine distance and anterior arch length were observed after lip repair in UCLP. After palate repair, maxillary dimensions increased significantly, except for the intercanine distance in UCLP and the intertuberosity distance in both groups. At the time of palate repair and at two years of age, the maxillary dimensions were very similar in both groups. It can be concluded that the maxillary arches of children with UCLP and CP changed as a result of primary surgery.

Do technology-based devices improve carious lesion detectionin children with oral cleft? / Os aparelhos baseados em tecnologia melhoram a detecção de lesões de cárie em crianças com fissura labiopalatina?

Objetivo: Comparar o exame visual-tátil com os exames baseados em tecnologia na detecção de lesões de cárie em crianças com fissuras labiopalatina. Material e Métodos: 405 faces mesial, distal, vestibular e palatina dos dentes permanentes anteriores superiores próximos a área da fissura de 95 crianças com idade entre 6-12 anos (média 10 anos± 2 anos e 9 meses) foram avaliadas por dois examinadores previamente calibrados. Os seguintes métodos de detecção de lesão de cárie foram usados: exame visual-tátil (Método 1), exame visual-tátil com o auxílio do microscópio operatório (Método 2), exame visual por meio de um aparelho de fluorescência por LED (Método 3). ICDAS foi o sistema usado para classificar todas as lesões de cárie nos três métodos. A sonda OMS foi usada durante o exame visual-táctil. O microscópio operatório foi usado em magnificação de 10x. O aparelho de fluorescência por LED (Evince ®) tinha uma câmera ligada à peça de mão e conectada ao computador. Os métodos auxiliares de detecção de cárie foram comparados ao exame visual-táctil pelo teste de Friedman (P < 0,05). Resultados: Não houve diferença estatisticamente significante na eficácia dos métodos de detecção de lesão de cárie (P = 0,786). Conclusão: O microscópio operatório e o aparelho de fluorescência por LED não mostraram diferença na a detecção de lesão de cárie para avaliar dentes próximos à área da fissura labiopalatina.

Objective: To compare the visual-tactile examination with the technology-based caries detection examinations in children. Material and Methods: Two previously calibrated examiners assessed 405 mesial, distal, labial, and palatal surfaces of the upper anterior permanent teeth next to the cleft area of 95 children aged 6 to 12 years (mean age of 10 years ± 2 years and 9 months) with oral clefts but without the presence of any associated syndrome or craniofacial anomaly. The following detection methods were used: visual-tactile examination (Method 1), visual-tactile examination through operating microscope (Method 2), visual examination through LED-based fluorescence device (Method 3). ICDAS was the system used to score all caries lesions for all methods. WHO probe was used during the examination with visual-tactile examination. Operating microscope was used at x10 magnification. LED-based fluorescence (Evince™) had a video camera coupled to the handpiece and linked to a computer. The adjunct caries detection methods were compared to visual-tactile examination by Friedman test (P < 0.05). Results: The efficacy of carious lesion detection methods were statistically similar (P = 0.786). Conclusion: Both the operating microscope and the LED-based fluorescence device did not improve caries lesion detection in the permanent anterior teeth next to the cleft area.

Impact of malocclusion on oral health-related quality of life inBrazilian children with cleft lip and palate / Impacto da má oclusão na qualidade de vida relacionada à saúde oral de crianças brasileiras com fissura de lábio e palato

This cross-sectional study aimed to evaluate the impact of malocclusion on the oral health-related quality of life (OHRQoL) in Brazilian children with non-syndromic oral cleft sat tertiary craniofacial center. Material and Methods: Sixty-nine children with non-syndromicoral clefts, aged between 8 and 10 years, were selected and divided into groups according to the cleft type: Group 1 – Children with complete unilateral cleft lip and alveolus; Group 2 – Children with unilateral cleft lip and palate; Group 3 –Children with cleft palate. Each child ans wered the Child Perceptions Questionnaire 8-10 (CPQ8-10) which is a multiple-choice questionnaire, with 29 questions on the impact of oral diseases on the OHRQoL. Then, a visual examination of dental occlusion was carried out. Kruskal-Wallis and Mann-Whitney tests were used to determine statistical significant differences among groups(p<0.05). Results: No statistically significant differences were verified for the impact of cleft type (p=0.895) and malocclusion (p=0.528) on HRQoL of Brazilian children with oral clefts. Conclusion: The malocclusion did not impact onthe OHRQoL of 8-10 year-old children with nonsyndromicclefts...

Este estudo transversal avaliou o impacto da má oclusão sobre a qualidade de vida relacionada à saúde oral de crianças brasileiras com fissuras labiopalatina não sindrômicas de um centro de tratamento craniofacial. Material e Métodos: Sessenta e nove crianças com fissurelabiopalatina não sindrômica, com idades entre oito e dez anos, foram selecionadas e divididas em grupos de acordo com o tipo de fissure: Grupo 1 – Crianças com fissura completa de lábio e alvéolo; Grupo 2 – Crianças com fissura completa de lábio e palato; Grupo 3 –Crianças com fissura de palato. Cada criança respondeu o Child Perceptions Questionnaire 8-10 (CPQ 8-10) que é um questionário de múltipla escolha, com 29 perguntas sobre o impacto das doenças orais sobre a qualidade devida. Em seguida, o exame visual da oclusão foi realizado. Os testes de Kruskal-Wallis and Mann-Whitney foram usados para determinar as diferenças estatisticamente significativas entre os grupos (p<0,05). Resultados: Diferenças estatisticamente significativas não foram verificadas para o impacto do tipo de fissura (p=0,895) e má oclusão (p=0,528) na qualidade de vida de crianças brasileiras com fissuras labiopalatinas. Conclusão: A má oclusão não teve impacto sobre a qualidade de vida de crianças com idade entre oito a dez anos com fissure de lábio e palato não sindrômica...

Three-dimensional Digital Evaluation of Dental Arches in Infants with Cleft Lip and/or Palate

The aim of this study was to measure and compare the dimensions of the dental arches on three-dimensional digital study models in children with and without cleft lip and palate before the primary surgery. The sample consisted of 223 digital models of children aged 3-9 months, divided into 5 groups: without craniofacial deformities, unilateral and bilateral incomplete cleft lip and alveolus, unilateral and bilateral complete cleft lip and alveolus, unilateral cleft lip and palate, and bilateral cleft lip and palate. Dental casts of the maxillary dental arches of the children were used. The dental casts underwent a process of scanning through 3D scanner and the measurements used for the correlation among groups were made on the scanned images. Statistical analysis was performed by t test and ANOVA followed by Tukey test. The results showed that the intercanine distance and anterior cleft width was wider in children with unilateral cleft lip and palate. The intertuberosity distances and posterior cleft width was wider in children with bilateral cleft lip and palate among the groups. Children with cleft lip and palate before the primary surgery had wider maxillary arch dimensions than the children without cleft lip and palate.

O propósito deste trabalho foi mensurar e comparar as dimensões dos arcos dentários em modelos digitais tridimensionais de crianças com ou sem fissuras de lábio e palato antes das cirurgias primárias. A amostra foi composta de 223 modelos de gesso de crianças, de 3 a 9 meses, divididas em 5 grupos: sem deformidades craniofaciais, fissura pré-forame incompleta, fissura pré-forame completa, fissura transforame unilateral e fissura transforame bilateral. Modelos de gesso dos arcos dentários superiores das crianças foram utilizados para avaliação. Os modelos passaram por um processo de digitalização, por meio de escâner 3D e as medidas utilizadas para a correlação entre os grupos foram realizadas diretamente nas imagens escaneadas. A análise estatística foi realizada por meio do teste t e ANOVA seguido pelo teste de Tukey. Os resultados mostraram que a distância intercaninos e a amplitude anterior da fissura foram maiores nas crianças com fissura transforame unilateral. A distância intertuberosidades e a amplitude posterior da fissura foi maior nas com fissura transforame bilateral entre os grupos estudados. As crianças com fissura de lábio e palato apresentam as dimensões dos arcos maxilares maiores que as crianças sem fissura labiopalatina antes das cirurgias primárias.

Evaluation of the intercanine distance in newborns with cleft lip and palate using 3D digital casts

OBJECTIVE: The purpose of this present study was to compare, by means of 3D digital casts, the anterior transverse dimension of the dental arch of newborns with and without cleft lip and palate. MATERIAL AND METHODS: The sample was composed of ninety-four children aged from 3 to 9 months divided into three study groups: Group I - children without craniofacial deformities (control group); Group II - children with unilateral cleft lip and palate; Group III - children with bilateral cleft lip and palate. Impressions were executed before lip and palate repair in patients with clefts. Dental casts were digitized using a 3D scanner linked to a computer. Measurements of the intercanine distance were measured on the digital casts. Intergroup comparisons were performed using ANOVA (p<0.05). RESULTS: The results showed a mean of 36.5 mm for unilateral cleft lip and palate group, 34.8 mm for bilateral cleft lip and palate group and 27.52 mm for the control group. There was a statistically significant difference between the control group and both groups of patients with cleft lip and palate. There was no statistically significant difference between complete unilateral and bilateral cleft lip and palate groups. CONCLUSIONS: Patients with complete cleft lip and palate were born with an increased anterior dimension of the maxillary dental arch compared to non cleft patients. .

In vivo evaluation of tissue response to new endodontic sealers

Introduction: The sealers can be in direct contact with the periapical tissues. Thus, these materials must have appropriate physical and biological properties, providing conditions for repair to occur. Objective: The aim of this study was to evaluate the response of rat subcutaneous tissue to endodontics sealers. Material and methods: Three materials comprised the groups: group I - Zinc Oxide, Eugenol and Iodoform paste, group II - Portland cement with propylene glycol, and group III - MTA Fillapex® (Angelus). These materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar rats for seven and 15 days. The specimens were stained with hematoxylin and eosin and evaluated regarding to inflammatory reaction parameters through a light microscope. The data were compared using Kruskal-Wallis test with significance level of 5%. The intensity of inflammatory response against the sealers was analyzed by two blinded and previously calibrated observers for all experimental periods. Results: The histological evaluation showed that all the materials caused a moderated inflammatory reaction at seven days which decreased with time. A greater inflammatory reaction was observed at seven days in group I. The other specimens had significantly less inflammatory cells when compared to this group. Tubes with MTA Fillapex® presented some giant cells, macrophages and lymphocytes after seven days. At 15 days, the presence of fibroblasts and collagen fibers was observed indicating normal tissue healing. The group II showed similar results to those observed in MTA Fillapex® already at seven days. At 15 days the inflammatory reaction presented was almost absent at the tissue, with many collagen fibers indicating normal tissue healing. Statistical analysis showed a significant statistical difference amongst the group I (seven days) and II (15 days) (p < 0.05). In the other groups no significant statistical differences were observed. Conclusion: MTA Fillapex® and Portland cement with propylene glycol were more biocompatible than the other tested cements.

Impacção de primeiro molar permanente em paciente com fissura labiopalatina / Impactation of first permanent molar in a patient with cleft lip and palate

O cisto paradentário é um cisto odontogênico inflamatório, relacionado a um dente vital, parcialmente irrompido, associado com pericoronarite. Geralmente acomete terceiros molares inferiores, podendo, mais raramente, ocorrer em outros dentes causando distúrbios na erupção. A impacção de primeiros molares permanentes inferiores é rara e poucos casos são relatados na literatura. O dente mais frequente a apresentar impacção é o terceiro molar permanente inferior, seguido do terceiro molar superior. Sua etiologia pode envolver tanto fatores locais como sistêmicos. Este trabalho tem como objetivo apresentar um caso de impacção de um primeiro molar permanente inferior causado pela presença de um cisto paradentário, bem como o tratamento realizado.

The paradental cyst is an odontogenic inflammatory cyst, always related with vital molars, partially erupted, associated with pericoronaritis. Usually affects lower third molars, and more rarely can occur in others teeth, causing eruption disturbances. The impactation of lower first permanent molars is rare and a few cases have been reported in the literature. The most frequent tooth that presents impactation is the lower third molar followed by the maxilar third molars. Its etiology may involve both local and systemic factors. This case report has the objective to present a case of impactation of a first permanent molar caused by the presence of a paradental cyst, as well the treatment that was conducted.