Pulp canal obliteration after traumatic injuries in permanent teeth - scientific fact or fiction?

Abstract: Pulp canal obliteration (PCO) is a frequent finding associated with pulpal revascularization after luxation injuries of young permanent teeth. The underlying mechanisms of PCO are still unclear, and no experimental scientific evidence is available, except the results of a single histopathological study. The lack of sound knowledge concerning this process gives rise to controversies, including the most suitable denomination. More than a mere semantic question, the denomination is an important issue, because it reflects the nature of this process, and directly impacts the treatment plan decision. The hypothesis that accelerated dentin deposition is related to the loss of neural control over odontoblastic secretory activity is well accepted, but demands further supportive studies. PCO is seen radiographically as a rapid narrowing of pulp canal space, whereas common clinical features are yellow crown discoloration and a lower or non-response to sensibility tests. Late development of pulp necrosis and periapical disease are rare complications after PCO, rendering prophylactic endodontic intervention useless. Indeed, yellowish or gray crown discoloration may pose a challenge to clinicians, and may demand endodontic intervention to help restore aesthetics. This literature review was conducted to discuss currently available information concerning PCO after traumatic dental injuries (TDI), and was gathered according to three topics: I) physiopathology of PCO after TDI; II) frequency and predictors of pulpal healing induced by PCO; and III) clinical findings related to PCO. Review articles, original studies and case reports were included aiming to support clinical decisions during the follow-up of teeth with PCO, and highlight future research strategies.

Staining effect of bovine incisors in vitro by tea solutions / 北京大学学报(医学版)

OBJECTIVE@#To determine the optimum staining condition of tea solutions on bovine incisors in vitro, by comparing the color stability of tooth surface of different concentrations of tea solutions and methods on bovine incisors in vitro.@*METHODS@#Twenty bovine incisors with color surface A1 were chosen, then randomly divided into 4 groups (n=10). Group 1: soaked with 2% tea solution continuously for 6 days; group 2: soaked with 2% tea solution for 6 days, but changed fresh tea solution everyday; group 3: soaked with 1% tea solution continuously for 6 days; group 4: soaked with 1% tea solution for 6 days but fresh tea solution changed every day. After 6 days of staining, the surface color (Δ E value) of all the samples were measured with crystal eye. After brushing 30 times with toothbrushes, the color of bovine incisors were measured again. Then the samples were soaked in artificial saliva at 37 ° C, and Δ E value was measured for 14 days.@*RESULTS@#After staining for 6 days, the Δ E values of the 2% tea solution groups were better than those of the 1% groups (20.21 vs. 16.44, 24.09 vs. 19.22, P<0.05); the groups with the same tea solution concentration, a better result was observed for the group soaked with daily fresh tea solution than for the group that experienced continuous staining (24.09 vs. 20.21, 19.22 vs. 16.44, P<0.05). Groups 1 and 2 were selected for subsequent brushing experiments. The color of both groups became lighter after brushing, and a better result was observed for the continuous staining group than for the group stained in daily fresh solution (3.06 vs. 9.51, P<0.05). The samples with better coloring effect soaked with 2% tea solution continuously for 6 days were put into artificial saliva for 14 days. There was not any significant change in coloring at the end of the first two days (1.51 vs. 1.51, P>0.05), and the color was visibly lighter after the third day (1.51 vs. 5.89, P<0.05), and no further significant change was observed until the 14th day (5.81 vs.5.89, P>0.05), which was darker coloring than that of the pre-staining group.@*CONCLUSION@#Continuous staining on bovine incisors with 2% tea solution with subsequent soaking in artificial saliva resulted in consistent coloring from day 3 to day 14, and this method could be used as an ideal model for teeth staining in vitro.

Pigmentaciones extrínsecas en el paciente pediátrico / Extrinsec stains in the pediatric patient

Las pigmentaciones extrínsecas negras son puntos o pequeñas áreas de coloración osecura que pueden unirse, formando una línea definida o difusa. Pueden contener sal férrica insoluble, sulfuro férrico y un alto contenido de calcio y fosfato. Su etiología y taxonomía sigue siendo controversial. Algunos investigadores la asocian con una baja frecuencia de caries dental en dentición primaria y permanente joven. La remoción mecánica de estas pigmentaciones requiere intervención profesional

Recidiva del color dentario por té, café y vino: in vitro / Dental bleaching regression caused by chromogenic beverages: in vitro

Este estudio, in vitro, determinó si los dientes con clareamiento presentan mayor cambio de color en el tiempo que los no tratados, al someterse a tinción con bebidas cromógenas, café, té y vino. Se utilizaron 45 incisivos sanos de bovino conservados en suero a 37ºC. Cada espécimen se dividió en dos mitades, una sometida a clareamiento con peróxido de hidrógeno al 35 por ciento y otra control. Se midió color con Espectrofotómetro Vita EasyShade. Se dividieron los especímenes al azar en grupos de 15 y fueron sumergidos en café, té y vino, durante 10 minutos, 20 veces, registrando color después de cada inmersión. Los datos fueron analizados con ANOVA y Test de Tukey, con 95 por ciento de intervalo de confianza. Los resultados mostraron que, el clareamiento modifica significativamente (p=0.05) el color en los tres grupos (GC=85.8 a 95.1; GT=87.4 a 97.3 y GV=90.8 a 99.3), la recidiva de color se observa a lo largo de las 20 inmersiones, siendo significativa la diferencia de valores ΔE iniciales (GC=18.89; GT=22.97; GV=56.46) y finales (GC=5.56; GT=5.38; GV=12.49). El grupo tratado presenta mayor descenso de unidades ΔE a lo largo de las inmersiones, por lo que es el más teñido (GCcontrol=20.98-5.01; GTcontrol=17.11-3.66; GVcontrol=54.62-11.49). Las tres bebidas cromógenas causan recidiva de color en los dientes clareados, siendo el vino el que causa mayor tinción. Se concluyó que las piezas tratadas, sometidas a los tres tipos de cromógenos, tienen mayor cambio de color que las que no lo son, pero finalmente no se oscurecen más que las no tratadas.

This in vitro study established if teeth treated with dental bleaching have a higher change of color over time than those that aren’t treated, when subjected to three chromogenic beverages (coffee, tea and red wine). 45 healthy bovine incisors were used, maintained in 0.9 percent sodium chloride, at 37ºC. Every specimen was divided into 2 half; one half was subjected to dental bleaching with 35 percent hydrogen peroxide and the other was taken as control. The color was measured with the Vita EasyShade Spectrophotometer. The specimens were randomly divided in groups of 15, and were immersed in coffee, tea and red wine for 10 minutes, 20 times, the value being recorded after each immersion. The data was analyzed with ANOVA and Tukey test, using 95 percent of confidence interval. Results show that bleaching significantly modifies (p=0.05) the color in the three groups (GC=85.8 to 95.1; GT=87.4 to 97.3 y GV=90.8 to 99.3). Color relapse in the three groups was observed along the 20 immersions. Initial ΔE values (GC=18.89; GT=22.97; GV=56.46) were significantly different than final ΔE values (GC=5.56; GT=5.38; GV=12.49). The chromogenic beverages stained more the treated group because a higher ΔE units decrease was observed in this group (GCcontrol=20.98-5.01; GTcontrol=17.11-3.66; GV control=54.62-11.49). The three chromogenic beverages produced color relapse in the bleaching teeth, being red wine the one causing more staining. It was concluded that the specimens treated subjected to three kinds of chromogenic, had higher change of color than control group, but at the end the treated group doesn’t get more stained than the control group.

Capdepont's teeth - a hereditary dentin defect: case report & review / IDientes de capdepont - un defecto de dentina hereditario. reporte de caso y revisión de la literatura

Dentinogenesis imperfecta is an autosomal dominant genetic disorder with abnormal dentin structure affecting both primary and permanent dentitions leading to discolouration and attrition of teeth. Diagnosis is usually based on family history, a detailed clinical examination and pedigree construction. Treatment involves preservation of teeth, removal of infection, restoration of function and esthetics.

La dentinogénesis imperfecta es un trastorno genético autosómico dominante, caracterizado por una estructura anormal de la dentina, que afecta tanto la dentición temporal como permanente, generando decoloración y desgaste de los dientes. El diagnóstico generalmente se basa en la historia familiar, el examen clínico detallado y la construcción de pedigrí. Su tratamiento implica la conservación de los dientes, eliminación de infección, y la restauración de la función y la estética.

Un enfoque actual sobre la relevancia de las pigmentaciones extrínsecas / Current approach to the relevance of extrinsic stains

Las manchas extrínsecas negras son consideradas un tipo especial de placa calcificada y pueden aparecer en dientes temporarios alrededor de los 2 ó 3 años de edad. Se extienden en forma paralela al margen gingival y pueden presentarse como puntos aislados o líneas continuas, principalmente sobre las caras libres.De acuerdo a investigaciones recientes, en la formación de estos depósitos estaría involucrado el ActinobacillusActinomycetemcomitans; mientras que desde el punto de vista bioquímico se encontró una elevada concentración de iones calcio y fosfato que disminuirían la solubilidad del esmalte.La presente revisión tuvo por objetivo recopilar y exponer los estudios publicados acerca las pigmentaciones extrínsecas negras, su etiología, prevalencia y relación con la baja incidencia de caries.

Black tooth stains are considered a specific type of calculus formation that may appear in deciduous dentition between the age of 2 to 3 years old. Characterized by dark dots or lines localized parallel to the gingival margin, mainly on clean tooth surfaces.Recent research studies suggest that Actinobacillus Actinomycetemcomitans plays an important role in the formation of these deposits; from a biochemical point of view it was found that high calcium and phosphate ion concentrations in saliva reducesenamel solubility. The aim of this review was to collect and analyze published studies on extrinsic tooth discoloration, its etiology, prevalence andrelation to low caries incidence.

Aesthetic management of tooth discolouration: conservative treatment for a patient with undifferentiated nasopharyngeal carcinoma / Abordagem estética da descoloração dentária: tratamento conservador de um paciente com carcinoma nasofaríngeo indiferenciado

PURPOSE: Dental aesthetics has considerable impact in our beauty-conscious society. The darkening of the anterior teeth causes concern for adolescents due to the compromised physical appearance. This article presents a clinical case of tooth staining in an individual who had undergone radiotherapy/chemotherapy for an undifferentiated nasopharyngeal carcinoma. CASE DESCRIPTION: A 14-year-old boy presented to the dental clinic complaining of pain and staining of the maxillary and mandibular incisors, canines and premolars after having undergone radiotherapy/chemotherapy and stated his desire to remove the dark stains from the surface of the teeth due to his compromised oral aesthetics. Tooth whitening was performed with hydrogen peroxide, followed by micro-abrasion. At a two-year follow-up visit, clinical success was observed and the child was very satisfied. CONCLUSION: The adoption of such methods provided efficient alternatives for the re-establishment of a healthy smile, thereby returning pleasing facial aesthetics to the patient. The minimization of distress is nearly always the focus of clinical efforts at promoting psychological health in cancer survivors.

OBJETIVO: Atualmente, a estética dentária tem um impacto considerável na sociedade. O escurecimento dos dentes anteriores causa preocupação para os adolescentes, devido à aparência física comprometida. Este artigo apresenta um caso clínico de descoloração dentária em um indivíduo submetido a radioterapia/quimioterapia para tratamento de um carcinoma indiferenciado de nasofaringe. DESCRIÇÃO DO CASO: Um adolescente do gênero masculino, de 14 anos de idade, apresentou-se à clínica odontológica com queixa de dor e pigmentação dos incisivos superiores e inferiores, caninos e pré-molares após ter sido submetido a radioterapia/quimioterapia, declarando seu desejo de remover as manchas escuras na superfície do dentes comprometidos, devido à sua estética bucal. Foi realizado um clareamento dentário com peróxido de hidrogênio, seguido por micro-abrasão. Em um período de dois anos de seguimento, foi observado o sucesso clínico e a satisfação da criança. CONCLUSÃO: A adoção de tais métodos proporciona alternativas eficientes para o restabelecimento de um sorriso saudável, resgatando assim uma imagem facial agradável para o paciente. A minimização do sofrimento é geralmente o foco dos esforços clínicos visando a promoção da saúde psicológica em pacientes que sobreviveram ao câncer.

Staining and calculus formation after 0.12 percent chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial

OBJECTIVES: Studies concerning side effects of chlorhexidine as related to the presence of plaque are scarce. The purpose of this study was to compare the side effects of 0.12 percent chlorhexidine gluconate (CHX) on previously plaque-free (control group) and plaque-covered surfaces (test group). METHODS: This study had a single-blind, randomized, split-mouth, 21 days-experimental gingivitis design, including 20 individuals who abandoned all mechanical plaque control methods during 25 days. After 4 days of plaque accumulation, the individuals had 2 randomized quadrants cleaned, remaining 2 quadrants with plaque-covered dental surfaces. On the fourth day, the individuals started with 0.12 percent CHX rinsing lasting for 21 days. Stain index intensity and extent as well as calculus formation were evaluated during the experimental period. RESULTS: Intergroup comparisons showed statistically higher (p<0.05) stain intensity and extent index as well as calculus formation over the study in test surfaces as compared to control surfaces. Thus, 26.19 percent of test surfaces presented calculus, whereas calculus was observed in 4.52 percent in control surfaces. CONCLUSIONS: The presence of plaque increased 0.12 percent CHX side effects. These results strengthen the necessity of biofilm disruption prior to the start of CHX mouthrinses in order to reduce side effects.

Amelogenesis Imperfecta, hypoplastic type associated with some dental abnormalities: a case report

Amelogenesis imperfecta (AI) is a hereditary disorder expressing a group of conditions that cause developmental alterations in the structure of enamel. AI is a serious problem that reduces oral health-related quality of life and causes some physiological problems. The treatment of patients with AI may upgrade the quality of life and reinforce their self-esteem. Among the treatment options for AI, full-mouth metal reinforced porcelain restoration constitutes an important alternative because of its properties. This paper presents a case of AI of the hypoplastic rough type associated with a group of dental anomalies, and describes the prosthetic management of the patient. A 26-year-old female patient presented with a chief complaint of discolored teeth. Clinical and radiographic examination of the patient confirmed the diagnosis of rough pattern hypoplastic AI. The patient was treated with full-mouth metal reinforced porcelain fixed bridge. The adaptation of the temporomandibular joints and masticatory muscles was carefully observed periodically during 4 months and, after this period, the patient tolerated well her new vertical dimension. The patient received instructions on cleansing of the subpontic and interproximal areas. Follow-up visits were scheduled at 3 months and then at 6 months. No esthetic or functional problems were seen after the follow up period.

Amelogenesis imperfecta (AI) é uma desordem hereditária que expressa um grupo de condições que causam alterações de desenvolvimento na estrutura do esmalte. A AI é um problema grave que compromete a qualidade de vida relacionada à saúde bucal e causa alguns problemas psicológicos. O tratamento de pacientes com AI pode melhorar sua qualidade de vida e reforçar sua auto-estima. Dentre as opções de tratamento para AI, a restauração de toda a boca com porcelana reforçada com metal representa uma alternativa importante devido a suas propriedades. Este artigo apresenta um caso de AI do tipo hipoplásica rugosa associada a um grupo de anomalias dentais, e descreve o tratamento protético da paciente. Uma paciente de 26 anos apresentou-se com queixa principal de dentes manchados. O exame clínico e radiográfico da paciente confirmou o diagnóstico de AI hipoplásica rugosa. A paciente foi tratada com a construção de próteses fixas de porcelana reforçada com metal em toda a boca. A adaptação das articulações temporomandibulares e dos músculos mastigatórios foi cuidadosamente observada periodicamente durante 4 meses e, após este período, a paciente mostrou tolerar bem sua nova dimensão vertical. A paciente recebeu instruções sobre limpeza das áreas sob o pôntico e áreas interproximais. As visitas de acompanhamento foram agendadas a cada 3 meses e subseqüentemente a cada 6 meses. Não foram observados problemas estéticos ou funcionais após o período de acompanhamento.

Validity of staining and marginal ditching as criteria for diagnosis of secondary caries around occlusal amalgam restorations: an in vitro study

This study determined the validity of marginal ditching and staining as criteria for the diagnosis of secondary caries around amalgam restorations. One hundred and twenty-four Class I amalgam restorations on extracted human teeth were submitted to standardized clinical examinations. A calibrated examiner recorded the presence of ditching in the tooth/restoration interface, the occurrence of bluish-grey staining on the occlusal surface, and their relationship with the presence and severity of secondary carious lesions. Examinations were repeated after 4 days to calculate the intra-examiner reliability. Stereomicroscopic inspection of the serial tooth sections was used as the gold-standard. Six teeth were lost during the study. Of the 118 remaining teeth, 19 (16 percent) showed occlusal bluish-grey staining and 26 showed more than 0.20 mm wide marginal ditches. Of the latter, 14 presented narrow ditches (0.20-0.45 mm), while 12 presented wide ditches (0.45 mm). The evaluation criteria presented low sensitivity and positive predictive values. Positive and negative likelihood ratios showed that the criteria exhibited, indistinctly, the same odds to determine a positive or negative result for a diseased or healthy tooth. It was concluded that marginal ditching and staining were not valid criteria for the diagnosis of secondary caries around occlusal amalgam restorations.

Este estudo determinou a validade de fendas marginais e manchamentos oclusais como critérios para o diagnóstico de cárie adjacente a restaurações de amálgama. Cento e vinte e quatro dentes humanos extraídos, restaurados com amálgama Classe I, foram submetidos a exame clínico em condições padronizadas. Um examinador treinado registrou a presença de fendas na interface dente/restauração, a ocorrência de manchamento cinza-azulado na superfície oclusal e sua relação com a presença e severidade de lesões secundárias de cárie. Os exames foram repetidos após 4 dias para cálculo da confiabilidade intraexaminador. A inspeção de cortes seriados ao estereomicroscópio foi utilizada como padrão-ouro. Seis dentes foram perdidos durante o estudo. Dos 118 restantes, 19 (16 por cento) apresentaram manchamento oclusal cinza/azulado e 26 apresentavam fendas marginais com largura superior a 0,20 mm, sendo que destes 14 tinham fendas estreitas e 12 fendas amplas. Os critérios de avaliação apresentaram valores de sensibilidade e preditivo positivo extremamente baixos, enquanto a razão de verossimilhança positiva e a razão de verossimilhança negativa evidenciaram que os critérios apresentaram a mesma chance de determinar um resultado positivo ou negativo para um dente doente ou hígido, indistintamente. Pode ser concluído que fendas/valamentos e manchamentos oclusais não se mostraram como critérios válidos para determinar presença de cárie adjacente a restaurações de amálgama.

[Microleakage in class V amalgam restorations lined with and without varnish and dentin bonding agents using different amalgams: An in vitro study]

Microleakage is an important problem for amalgam restorations and causes teeth discoloration, pulp irritation, sensitivity and caries. The aim of this study was to determine and compare the in vitro microleakage of 3 different dental amalgams with commercial names [Cinalux, Dentam, SS White] using a dentin bonding agent [Excite] and a cavity varnish [Compalite], in class V amalgam restorations. Class V preparation measuring 3x2x2 mm were cut on the facial surfaces of 78 freshly extracted human premolar teeth. The teeth were divided into 3 groups of 20 teeth and 2 groups of 9 teeth as positive and negative control. They were restored using the material of choice following manufacture's instructions, and thermocycled between 4+2 C° and 54 +/- 4 C° for 700 cycles in 105 seconds. The teeth were subsequently immersed in methylene blue dye and sectioned to allow assessment of microleakage with stereomicroscope. The obtained data were analyzed by Kruskal-wallis and Mann-whitney U tests. Non-parametric statistical analysis showed significant differences between 3 different amalgams when the cavities lined by Excite [P<0.05]. There was no significant differences between 3 different amalgams when the cavities lined by varnish. These results suggested dentin bonding agents reduced microleakage in comparison to varnish, and the type of amalgam is effective on microleakage

Análise dos traumatismos e suas seqüelas na dentição decídua: uma revisão da literatura / Analysis of dental trauma and its sequelae in the primary dentition: a review of the literature

Introdução: Estudos mostram que traumatismos na dentiçãodecídua são eventos comuns, podendo resultar em seqüelas quepodem comprometer o dente decíduo afetado. Na literatura, afreqüência dos traumatismos na dentição decídua é variável,enquanto a faixa etária, o gênero, o fator etiológico e os dentesmais afetados apresentam prevalências semelhantes. Em relaçãoao tipo de trauma mais freqüente, diferenças podem ser encontradasem razão de critérios da amostragem como o tipo de estudo e olocal de realização da pesquisa. Várias são as seqüelas que podemcomprometer os dentes decíduos após traumatismos, destacandosea descoloração coronária, a necrose pulpar, a obliteração docanal pulpar e a reabsorção radicular. Estudos apontam o tipo detrauma e a idade da criança no momento do trauma como fatoresimportantes que determinam a ocorrência destas seqüelas.Objetivo: Este artigo propôs revisar estudos relevantes daliteratura referentes aos fatores epidemiológicos e as seqüelas emdentes decíduos traumatizados, proporcionando ao leitor uma visãogeral do traumatismo na dentição decídua.Conclusão: Em conclusão à análise dos artigos revisados, pôdeseobservar uma relação direta entre o grau de severidade dostraumatismos e a ocorrência de seqüelas nos dentes decíduosafetados, enfatizando-se a importância do acompanhamentoperiódico destes casos.

Tetraciclinas y esmalte dental / Tetracyclines and dental enamel

Las tetraciclinas son antibióticos de amplio espectro frecuentemente usadas en dermatología por sus acciones antiinflamatorias en acné vulgar y en rosácea. Uno de los efectos secundarios más temidos es la alteración del esmalte dental, por lo que no se recomienda su uso en menores; sin embargo, la edad exacta no ha sido claramente determinada. Las tetraciclinas provocan manchas permanentes en el esmalte dental definitivo por su gran afinidad con el calcio y el hierro, aunque el mecanismo exacto esta en discusión. La odontogénesis para la dentadura definitiva termina a los ochos años, excepto para los terceros molares, y es durante la odontogénesis donde se produce la alteración del esmalte, secundario a estas drogas. Por ende, se puede emplear las tetraciclinas con seguridad en pacientes mayores de ocho años. Numerosos otros agentes pueden causar daños similares al esmalte. Existen diversos tratamientos de resorte odontológico para blanquear el esmalte.

Tetracyclines are broad spectrum antibiotics that are frequently used in dermatology because of their anti-inflammatory effects in acne vulgaris and rosacea. One of their worst side effects is the alteration in dental enamel, which is why it is not recommended for children; nevertheless, the exact age has not been clarified. Tetracyclines can stain permanent dental enamel for life due to their great affinity with calcium and iron; however, that exact mechanism is still under discussion. Odontogenesis for permanent teeth finishes at age 8, except for 3rd molars, and it during the odontogenesis that these drugs cause the aforementioned effects. Therefore, tetracyclines can be used in patients older than 8 years without fear of damaging the enamel. Numerous other agents can cause similar damage. There are many whitening treatments and procedures carried out by dentists.

[Comparison of nanoleakage in composite restorations following application of self-etch and total-etch adhesives in primary and permanent teeth]

Nanoleakage can cause discoloration around restoration margins, secondary caries, postoperative sensitivity and finally loss of restoration, thus adequate hybrid layer is of primary importance in prevention of nanoleakage in adhesive restorations. Because of structural differences between primary and permanent dentin, evaluation of nanoleakge in primary teeth is very important. The aim of this study was to evaluate the nanoleakage in composite restorations following application of self -etch and total-etch adhesives in primary and permanent teeth. In this experimental study, Cl V cavities were prepared in buccal surfaces of 20 extracted primary molars and 20 extracted premolars. Each group was divided into 2 subgroups: In group [A], Gluma One Bond and in group [B], iBond adhesive materials were applied. After silver nitrate staining, specimens were mesiodistally sectioned and polished and then SEM examination was carried out to measure the nanoleakage .Data were analyzed statistically using, ANOVA and Duncan tests with p<0.05 as the limit of significance. Factors tested had no significant effect on each other. Primary teeth showed more nanoleakage than permanent teeth [P<0.05]. Mean nanoleakage was significantly higher in cervical than occlusal margins [P<0.05] and also in iBond than in Gluma One Bond in primary teeth [P<0.05]. In permanent teeth, the lowest nanoleakage was observed in Gluma One Bond. The result of this study indicates that the use of total etch dentin adhesives [Gluma One Bond] in bonded restorations results in less nanoleakage in primary and permanent teeth

Clareamento caseiro em dentes vitais / Night-Guard dental bleaching

Na Odontologia atual, o clareamento dental caseiro tem sido requisitado com maior freqüência por pacientes que desejam uma estética melhorada. O Cirurgião-Dentista, como peça fundamental para o sucesso do tratamento, deve empregar a melhor técnica de acordo com a indicação e contra-indicação, levando-se em conta o diagnóstico da alteração de cor e conservação das estruturas dentais, orientando corretamente o paciente, antes, durante e após o tratameto e saber agir adequadamente em casos de sensibilidade. Possibilitar uma correta indicação, aletar para possíveis efeitos adversos e limitações, discutir riscos e benefícios do clareamento de dentes vitais é o objetivo deste trabalho.

Discromía por cirugía transeptoesfenoidal de un adenoma hipofisiario. A propósito de un caso / Dyschromia by trans-septosphenoidal surgery of a hypophyseal adenoma. Apropos of a case

Los adenomas hipofisiarios son neoplasias benignas que se presentan con cierta frecuencia en la práctica médica. Su variada sintomatología enrola disciplinas como la Ginecología, Oftalmología, Endocrinología y Neurocirugía, entre otras. El tratamiento, en muchos casos quirúrgicos, pronostica excelentes resultados con el empleo de varias técnicas, entre las que se destaca la cirugía transeptoesfenoidal, en la que se aborda la hipófisis a través del sector anterosuperior de la cavidad bucal y expone un campo muy relacionado con las estructuras dentarias. Se presenta una paciente de 38 años de edad que acudió a la clínica estomatológica por cambio de color en los 2 incisivos centrales superiores sin causa aparente de patología cromática, y cuyo único antecedente era haber sido operada de un adenoma hipofisiario a través de la porción interna del labio superior. Se revisa la literatura y se exponen algunos criterios que justifican cómo la técnica antes mencionada puede ser causa de esta alteración dentaria(AU)

Hypophyseal adenomas are bening neoplasias that appear with some frequency in medical practice. Their varied symptomatology comprises disciplines as Gynecology, Ophthalmology, Endocrinology and Neurosurgery, among others. The treatment, surgical in many cases, prognosticates excellent results with the use of several techniques, among which the trans-septosphenoidal surgery stands out. By this technique, the hypophysis is approached through the anterosuperior sector of the buccal cavity, exposing a field closely related to tooth structures. The case of a 38-year-old female patient who was seen at the dental clinic due to a change of color in the 2 central upper incisors without apparent cause of chromatic pathology and with the sole antecedent of having been operated on of a hypophyseal adenoma through the internal portion of the upper lip, was reported. Literature was reviewed and some criteria were dealt with that stated that the use of the above-mentioned technique may produce this tooth alteration(AU)

Diente rosado: ¿orienta el mecanismo de muerte? Artículo de revisión / Pink tooth: does it show the mechanism of death? Review of the literature

El fenómeno del diente rosado es una pigmentación intrínseca de color rosado, presente de manera generalizada en los dientes de quienes han muerto de manera no natural. En este artículo se presenta una revisión de la literatura publicada hasta el momento, en la que se ha estudiado todo lo relacionado con la aparición del fenómeno de diente rosado, incluyendo estudios experimentales y discusión de expertos internacionales (vía internet), además de la observación de la población de morgues, hecha por los patólogos, odontólogos y antropólogos forenses del Instituto Nacional de Medicina Legal y Ciencias Forenses de Bogotá; esto, con el fin de determinar un mecanismo específico de muerte o por lo menos guiar la investigación de las muertes médicolegales hacia un mecanismo de muerte. El diente rosado se produce por difusión de hemoglobina descompuesta a través de los canalículos dentinales, por lo que se supone es un fenómeno de hipóstasis cadavérica: otra característica importante es que no es un signo patognomónico de la asfixia mecánica, por haber sido observado en otros mecanismos de muerte

Tratamento das descoloraçöes de esmalte por fluorose dentária: estado da arte / Treatment of enamel discolorations caused by dental fluorosis: state-of-the-art

Este trabalho teve como objetivo realizar uma revisäo a respeito das terapias prospostas na literatura científica para o tratamento da fluorose. As bases de dados eletrônicas Medline, Lilacs e BBO foram utilizadas para buscar artigos que tratassem do tema em questäo. Os artigos selecionados foram avaliados de acordo com uma metodologia pré-estabelecida. Na literatura, foram encontradas nove técnicas que visavam o tratamento das descoloraçöes produzidas nos dentes pela fluorose dentária. No entanto, os estudos existentes näo fornecem evidências de que essas técnicas sejam seguras e efetivas

La odontología prehispánica en el antiguo Perú. Parte III / Prehispanic dentistry in the ancient Peru. Part III

El presente artículo, dividido en tres partes secuenciales, presenta un estudio realizado sobre la práctica odontológica en el antiguo Perú, no sólo en la época incaica sino también en la preincaica

Blanqueamiento de dientes no vitales en el consultorio usando la técnica fotoactivada / Office bleaching of nonvital teeth using the photoactivated technique

El blanqueamiento de dientes no vitales representa una opción terapéutica conservadora y válida frente a las decoloraciones dentarias de diversa etiología. El éxito en la ejecución de la misma dependerá de diversos factores tales como: uso y producto adecuados, elección de la técnica y diagnóstico correctos, entre otros