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1.
Eur J Orthod ; 46(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38001047

RESUMO

OBJECTIVE: To assess if the dental follicle volume of palatally impacted canines (PICs) affects the relative root position of the adjacent lateral incisors (LIs) and first premolars (FPs). MATERIALS AND METHODS: A retrospective cross-sectional study of 49 patients with unilaterally PICs with dental follicles who had CBCT imaging previously taken. Four orthodontic centers in different countries provided the sample. A mean difference of 5° between the angular measurements (mesiodistal tip, buccolingual inclination, or mesiodistal rotation) of the LI and FP adjacent to the PIC and the controls was considered clinically relevant. A value of 0.05 was set for significance level and a power of 80%. The minimum sample size was determined to be 26 patients. These patients were further assigned to an LI sample (n = 49) and an FP sample (n = 23), dependent on the direct contact of the dental follicle to that adjacent tooth. A manual segmentation technique was used to obtain the volumetric measurements of the dental follicle. Angular measurements of adjacent teeth were then compared to the contralateral nonimpacted side, which acted as the control. A multivariant regression analysis was performed using IBM SPSS software, and statistical significance was set at α = 0.05. RESULTS: Adequate intra-rater reliability was accomplished. The multivariant regression analysis implied that there is no difference in the mean change in the tip, torque, and rotation of the LI and FP between the impacted and control sides when dental follicle volumes are considered (P = .509 for the LI sample and P = .804 for the FP sample). LIMITATIONS: CBCT imaging of dental follicle border delimitations, partial volume effect, and scattering are limitations. This is a convenience sample where the FP subsample is small. CONCLUSION: The dental follicle volume of the PICs does not seem to influence the relative position of the adjacent LI and FP mesiodistal tip, buccolingual inclination, and mesiodistal rotation. Early intervention could have been suggested to avoid certain malocclusion traits if significant displacements were demonstrated.


Assuntos
Saco Dentário , Dente Impactado , Humanos , Saco Dentário/diagnóstico por imagem , Estudos Retrospectivos , Reprodutibilidade dos Testes , Estudos Transversais , Dente Canino/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Maxila
2.
BMC Oral Health ; 20(1): 159, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32487188

RESUMO

BACKGROUND: Pericoronal radiolucent lesions are a common radiographic finding, but it is rare that they occur in multiple forms. Multiple calcifying hyperplastic dental follicles (MCHDF) are entities with few cases described to date; nevertheless, they appear to have a very particular phenotypic pattern. CASES PRESENTATION: Case 1: A 10-year-old male was evaluated radiographically, revealing four impacted canines, each accompanied by unilocular pericoronal radiolucency. Case 2: A 16-year-old male was planning orthodontic treatment; following his radiological evaluation all third molars were found to be accompanied with pericoronal radiolucencies. Enucleation, and third molar removal along with the pericoronal tissue were the respective treatments. Microscopically, in both cases, the specimens shown odontogenic epithelium, and type I and II calcifications in the hyperplastic follicles, all these characteristics were consistent with MCHDF. CONCLUSION: Although MCHDF are a rare entity, they must be considered in the differential diagnosis of multiple pericoronal lesions. Under the light of the current evidence, the histological findings may be relatively heterogeneous, but their integration with both the clinical data, which are apparently particular, and with the radiographic characteristics, can lead to a definitive diagnosis.


Assuntos
Saco Dentário/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Radiografia Panorâmica/métodos , Dente Impactado/diagnóstico por imagem , Adolescente , Criança , Saco Dentário/cirurgia , Cisto Dentígero/diagnóstico por imagem , Humanos , Masculino , Doenças Mandibulares/diagnóstico por imagem , Dente Molar , Dente Serotino/cirurgia , Dente Impactado/patologia , Dente Impactado/cirurgia
3.
Eur J Oral Sci ; 126(6): 439-448, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30216610

RESUMO

We sought to investigate site-specific expression of bone-regulatory factors expressed by human dental follicles and to compare the stimulated expression of tumour necrosis factor (ligand) superfamily, member 11/tumour necrosis factor receptor superfamily, member 11b (RANKL/OPG) in human dental follicle cells (HDFCs) from different patients. Analysis of bone-regulatory markers in follicles from 12 different study participants was performed using RT-qPCR and immunofluorescence; apical and coronal segments from each dental follicle were processed independently. Four additional dental follicles were used for cell cultures; HDFCs were precultured in osteogenic medium to initiate differentiation and thereafter cultured with 10-6 M forskolin (FSK) to activate the protein kinase cAMP (PKA/cAMP) signalling pathway and induce RANKL/OPG expression. We demonstrate that RANKL expression is significantly higher in the coronal part of follicles than in the apical part. High levels of collagen type 1 (COL1), alkaline phosphatase (ALP) and Gap-junction protein, alpha 1, 43 kDa (CX43) were expressed, whereas expression of Sp7 transcription factor (OSX), bone morphogenetic protein 2 (BMP2), colony-stimulating factor 1 (CSF-1), chemokine (C-C motif) ligand 2 (MCP1), and OPG was low in all samples. The immunofluorescence localization of CSF-1, MCP1, osteocalcin (OCN), RANKL, and BMP2 was not specific for either part of the follicles. In conclusion, a consistently high expression of CX43 suggests that gap-junction communication in HDFCs is essential for the eruption process. Furthermore, the induced expression of RANKL in HDFCs varies significantly between individuals and may relate to clinical variations in tooth eruption.


Assuntos
Reabsorção Óssea/metabolismo , Saco Dentário/metabolismo , Osteogênese/fisiologia , Adolescente , Fosfatase Alcalina/metabolismo , Proteína Morfogenética Óssea 2/metabolismo , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/genética , Reabsorção Óssea/patologia , Diferenciação Celular , Quimiocina CCL2/metabolismo , Quimiocinas/metabolismo , Criança , Colforsina/farmacologia , Colágeno Tipo I/metabolismo , Conexina 43/metabolismo , Dente Canino/diagnóstico por imagem , Dente Canino/patologia , Saco Dentário/diagnóstico por imagem , Saco Dentário/patologia , Feminino , Expressão Gênica , Humanos , Fator Estimulador de Colônias de Macrófagos/metabolismo , Masculino , Osteoblastos , Osteoclastos , Osteogênese/genética , Ligante RANK/metabolismo , Receptor Ativador de Fator Nuclear kappa-B/metabolismo , Receptores do Fator de Necrose Tumoral/metabolismo , Transdução de Sinais , Fator de Transcrição Sp7/metabolismo
4.
Niger J Clin Pract ; 19(5): 616-21, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27538550

RESUMO

BACKGROUND AND AIMS: Surgical removal of impacted teeth is a common operation in oral surgery. Thus, pathological potential of impacted third molars is extensively studied. However, many of those studies based on data collected from analysis of radiographs only. The purpose of this retrospective study was to compare the follicles of symptomatic and asymptomatic impacted third molars histopathologically for a number of characteristics. MATERIALS AND METHODS: Records of the patients who had been previously operated for impacted third molars were reviewed. Eighty-three patients were selected and divided into two groups, clinically symptomatic and clinically asymptomatic. None of the patients had a radiographic pericoronal radiolucency of wider than 2.5 mm. Histopathological samples of the patients were obtained and re-examined by two pathologists. Two groups were statistically compared for 12 histological parameters. RESULTS: Eleven of the 12 parameters had statistically significant differences (P < 0.05), whereas one parameter (odontogenic remnants) was found not to be significantly different between the groups. CONCLUSION: A delay in impacted third molar surgery can lead to further pathological changes in dental follicles and can increase severity of the inflammation. Moreover, dimensions of the pericoronal radiolucency may not provide a correct interpretation of the pathological changes in the region.


Assuntos
Saco Dentário , Dente Serotino , Dente Impactado , Saco Dentário/diagnóstico por imagem , Saco Dentário/patologia , Histocitoquímica , Humanos , Dente Serotino/diagnóstico por imagem , Dente Serotino/patologia , Estudos Retrospectivos , Dente Impactado/diagnóstico por imagem , Dente Impactado/patologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-26679362

RESUMO

OBJECTIVES: The purpose of this study was to identify the spatial relationship and/or association between odontomas and the gubernaculum tract or the dental sac and the characteristic findings for radiographic diagnosis of odontomas. STUDY DESIGN: The visualizations of the odontomas and the gubernaculum tract were retrospectively analyzed using cone beam computed tomography or multidetector computed tomography. RESULTS: Most of odontomas were within the gubernaculum tract or dental sac of unerupted permanent teeth on computed tomography. In some odontomas, the gubernaculum tract existed as a well-defined low density tract extending from the top of odontomas on computed tomography. CONCLUSIONS: A close spatial relationship and/or association between odontomas and the gubernaculum tract or dental sac on computed tomography may be used as one of the criteria for radiographic diagnosis of odontomas. Development of odontomas may be associated with the gubernaculum tract or dental sac of unerupted permanent teeth.


Assuntos
Neoplasias Maxilomandibulares/diagnóstico por imagem , Odontoma/diagnóstico por imagem , Germe de Dente/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Tomografia Computadorizada de Feixe Cônico , Saco Dentário/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Estudos Retrospectivos , Dente não Erupcionado
6.
Int J Clin Exp Pathol ; 8(12): 15708-18, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26884840

RESUMO

Kissing molars (KMs) is an extremely rare condition of impacted third molars, pointed in the opposite direction in a single follicular space; it consists exactly in a full impacted of permanent molars which occurs only in the lower jaw. Actually, about less than thirty cases have been reported in scientific literatures. The aetiology and pathogenesis of this pathological double dental inclusion remain unknown; above all events that lead two molars to appear, as KMs remain mysterious. The association to metabolic connective diseases such as mucopolysaccharidosis was emphasized. KMs considered as an isolated event, may be associated to an abnormal position of the tooth-bud from lower permanent molars, or fourth supernumerary tooth (distomolar). Recently, hyperplastic dental follicle (HDF), with a down regulation of matrix metal-proteinases and up regulation of several genes of collagens, has been mentioned in association with KMs. In this paper, after having analyzed three new cases of KMs that have been treated, we report a new hypothesis. This last is based on the failure in the dental follicle's ability to initiate or continue properly resorption of the overlying alveolar bone, by many exogenous factors which may act on eruptive phase that would lead to its rotation with its contents coming out a pathological situation of KMs. The therapy of choice is related to the surgical removal of KMs through a double odontectomy with transalveolar method. Other treatments can be, eventually, orthodontic therapy of the impacted teeth and a radiological follow-up without surgery.


Assuntos
Saco Dentário/patologia , Cisto Dentígero/etiologia , Dente Serotino/patologia , Dente Impactado/etiologia , Adulto , Biópsia , Tomografia Computadorizada de Feixe Cônico , Saco Dentário/diagnóstico por imagem , Saco Dentário/cirurgia , Cisto Dentígero/diagnóstico por imagem , Cisto Dentígero/patologia , Cisto Dentígero/cirurgia , Feminino , Humanos , Hiperplasia , Masculino , Pessoa de Meia-Idade , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Valor Preditivo dos Testes , Radiografia Panorâmica , Fatores de Risco , Extração Dentária , Dente Impactado/diagnóstico por imagem , Dente Impactado/patologia , Dente Impactado/cirurgia
7.
Am J Orthod Dentofacial Orthop ; 147(1): 52-60, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25533072

RESUMO

INTRODUCTION: Severe incisor root resorption (SIRR) associated with impacted maxillary canines is rare but has important implications. Early diagnosis and treatment are imperative. In this investigation, we aimed to identify predisposing factors for impacted canine-linked SIRR. METHODS: Clinical and radiographic data of 55 consecutive patients (77 canines) with SIRR of 96 incisors were compared with data from 57 consecutive control subjects (72 canines). The studied variables were age, sex, position of the impacted canine, size of the dental follicle, and incidence of anomalous lateral incisors. RESULTS: Lateral incisors were more often affected than central incisors, and bilateral SIRR was common. When each variable was examined separately, SIRR was significantly associated with female sex, severely mesiodistally displaced and vertically positioned canines in the middle third of the adjacent incisor root, dental follicles wider than 2 mm, and normal lateral incisors. The multivariate statistical analysis showed that the risk for SIRR was significantly higher in female subjects (4.2 times) with enlarged dental follicles (8.3 times) and normal lateral incisors (5.8 times). CONCLUSIONS: SIRR should be carefully screened in female patients with enlarged dental follicles and normal lateral incisors. A greater degree of canine displacement might also be associated with SIRR.


Assuntos
Dente Canino/patologia , Incisivo/patologia , Reabsorção da Raiz/etiologia , Dente Impactado/complicações , Adolescente , Fatores Etários , Anodontia/complicações , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Canino/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Saco Dentário/patologia , Diagnóstico Precoce , Feminino , Humanos , Incisivo/anormalidades , Incisivo/diagnóstico por imagem , Masculino , Maxila/diagnóstico por imagem , Maxila/patologia , Odontometria/métodos , Radiografia Interproximal/métodos , Radiografia Panorâmica/métodos , Fatores de Risco , Reabsorção da Raiz/diagnóstico por imagem , Fatores Sexuais , Erupção Ectópica de Dente/complicações , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/patologia , Dente Impactado/diagnóstico por imagem , Adulto Jovem
8.
Orthod Fr ; 85(4): 355-61, 2014 Dec.
Artigo em Francês | MEDLINE | ID: mdl-25443408

RESUMO

Unerupted permanent canines can present orthodontists with special challenges. Conventional two-dimensional panoramic radiographs identify the presence or absence of unerupted canines and can only help approximate their locations, when used with various classification schemes in attempts to describe their locations and estimate treatment difficulties. This article suggests using three-dimensional cone beam CT imaging as a direct objective method of evaluation and treatment planning, thereby eliminating the need for using a subjective system of classifying palatally-impacted permanent canines.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Dente Canino/diagnóstico por imagem , Planejamento de Assistência ao Paciente , Dente Impactado/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Ortodontia Corretiva , Doses de Radiação , Erupção Ectópica de Dente/diagnóstico por imagem
9.
J Craniofac Surg ; 25(3): e283-7, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24777014

RESUMO

BACKGROUND: Third molar surgery is considered the most frequently performed procedure in oral surgery. Although there are some indications for the removal of this tooth, such as the possibility of cystic degeneration or a tumor of the adjacent pericoronal follicle, there is no consensus in the literature about their prophylactic removal. OBJECTIVES: The aims of this study were to investigate the pathological alterations related to mandibular third molar dental follicles and to perform a narrative literature review. METHODS: A prospective clinical, radiographic, and histopathologic study was conducted with pericoronal follicles of third molars. After histopathologic evaluation and establishment of diagnosis, 2 groups were defined: G1 (pericoronal tissues with pathological alterations based on histopathologic analysis) and G2 (pericoronal tissues without pathological alterations based on histopathologic analysis). In addition, a systematic review of the literature was performed. RESULTS: One hundred thirteen specimens were analyzed. G1 was the most prevalent (P = 0.0004). Lesions were found in patients between 20 and 25 years of age (P < 0.004). The most prevalent histological diagnosis was the paradental cyst (47.7%; P < 0.0001). The narrative literature review showed that the majority of cases were mainly dentigerous cysts (P < 0.05). CONCLUSIONS: The mandibular third molars in young adults showed a direct relationship with age and a statistical propensity for the development of these cystic alterations, notably paradental cysts.


Assuntos
Saco Dentário/patologia , Dente Serotino , Cisto Periodontal/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Saco Dentário/diagnóstico por imagem , Saco Dentário/cirurgia , Cisto Dentígero/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dente Serotino/diagnóstico por imagem , Cisto Periodontal/diagnóstico por imagem , Estudos Prospectivos , Radiografia , Adulto Jovem
10.
Eur J Orthod ; 36(4): 450-6, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24123189

RESUMO

OBJECTIVES: To assess the diagnostic value of panoramic views (2D) of patients with impacted maxillary canines by a group of trained orthodontists and oral surgeons, and to quantify the subjective need and reasons for further three-dimensional (3D) imaging. MATERIALS AND METHODS: The study comprises 60 patients with panoramic radiographs (2D) and cone beam computed tomography (CBCT) scans (3D), and a total of 72 impacted canines. Data from a standardized questionnaire were compared within (intragroup) and between (intergroup) a group of orthodontists and oral surgeons to assess possible correlations and differences. Furthermore, the questionnaire data were compared with the findings from the CBCT scans to estimate the correlation within and between the two specialties. Finally, the need and reasons for further 3D imaging was analysed for both groups. RESULTS: When comparing questionnaire data with the analysis of the respective CBCT scans, orthodontists showed probability (Pr) values ranging from 0.443 to 0.943. Oral surgeons exhibited Pr values from 0.191 to 0.946. Statistically significant differences were found for the labiopalatal location of the impacted maxillary canine (P = 0.04), indicating a higher correlation in the orthodontist group. The most frequent reason mentioned for the further need of 3D analysis was the labiopalatal location of the impacted canines. Oral surgeons were more in favour of performing further 3D imaging (P = 0.04). CONCLUSIONS: Orthodontists were more likely to diagnose the exact labiopalatal position of impacted maxillary canines when using panoramic views only. Generally, oral surgeons more often indicated the need for further 3D imaging.


Assuntos
Dente Canino/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica/estatística & dados numéricos , Reabsorção da Raiz/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adolescente , Adulto , Idoso , Dente Pré-Molar/diagnóstico por imagem , Criança , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Tomada de Decisões , Saco Dentário/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional/estatística & dados numéricos , Incisivo/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Ortodontia/estatística & dados numéricos , Estudos Retrospectivos , Reabsorção da Raiz/classificação , Cirurgia Bucal/estatística & dados numéricos , Coroa do Dente/diagnóstico por imagem , Adulto Jovem
11.
Indian J Dent Res ; 24(2): 183-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23965443

RESUMO

OBJECTIVE: To assess the incidence of cystic changes in the impacted lower third molar (ILTM) in which the pericoronal (follicular) space is less than 2.5 mm as measured from the radiograph. The relationship between the cystic changes and patient's age, sex, and angular position and contact of ILTM with adjacent tooth was also evaluated. MATERIALS AND METHODS: Follicular space less than 2.5 mm as measured from the panoramic radiograph was included in the study. A total of 73 tissue samples collected during the extraction ILTM were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with an adjacent tooth. RESULTS: There were 37 male and 36 female patients, age ranging from 17 to 35 years (mean 23.95 years). Out of 73 specimens, 17 (23.3%) showed cystic changes; among them 16 (22.1%) showed dentigerous cysts and 1 (1.2%) showed odontogenic keratocysts. Most of the cystic changes occurred in the 26-30 year age range. The cystic changes showed male predominance but could not gain statistical significance. The relationship between cystic changes and angular position was statistically significant (P < 0.05). Higher probability was found in distoangular positioned ILTM. The relationship between cystic changes and communication of ILTM with the second molar was not statistically significant. CONCLUSION: Incidence of cystic changes in ILTM justifies extraction of the impacted tooth associated with symptoms. The decision to extract or not to extract impacted third molar should be individualized, rather than generalized.


Assuntos
Cistos Maxilomandibulares/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adolescente , Adulto , Fatores Etários , Saco Dentário/diagnóstico por imagem , Cisto Dentígero/diagnóstico por imagem , Cisto Dentígero/patologia , Epitélio/patologia , Feminino , Humanos , Hiperplasia , Cistos Maxilomandibulares/patologia , Masculino , Doenças Mandibulares/patologia , Dente Molar/diagnóstico por imagem , Dente Serotino/patologia , Cistos Odontogênicos/diagnóstico por imagem , Cistos Odontogênicos/patologia , Radiografia Panorâmica , Fatores Sexuais , Colo do Dente/patologia , Dente Impactado/patologia , Adulto Jovem
12.
J Am Dent Assoc ; 144(4): 389-95, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23543693

RESUMO

BACKGROUND: Children often receive inferior alveolar nerve blocks (IANBs) when their third molars are just beginning to develop. The location of the third-molar follicle is close to where the needle penetrates during an IANB. The authors examined the possible association between IANBs and missing third molars. METHODS: The authors examined 439 potential sites of third-molar development for evidence of third-molar follicles on panoramic radiographs of randomly selected children 7 years and older. The authors conducted a statistical comparison of the incidence of missing third-molar follicles in a control group of children who had no history of receiving IANBs with children in a test group who had a definitive history of receiving IANBs by means of generalized estimating equations. RESULTS: The authors found a statistically significant greater incidence of missing third-molar follicles in mandibular quadrants that had a definitive history of receiving IANBs compared with mandibular quadrants that had no history of receiving IANB. CONCLUSION: IANBs administered to young children when the third-molar tooth bud is immature may stop third-molar development. Owing to the significant clinical implications, further research is needed to verify these results. PRACTICAL IMPLICATIONS: Dentists inadvertently may be stopping the development of third molars when administering IANBs to children.


Assuntos
Anodontia/epidemiologia , Nervo Mandibular , Dente Serotino/anormalidades , Bloqueio Nervoso , Fatores Etários , Boston/epidemiologia , Criança , Estudos de Coortes , Saco Dentário/diagnóstico por imagem , Saco Dentário/fisiologia , Feminino , Humanos , Incidência , Masculino , Dente Serotino/diagnóstico por imagem , Agulhas/efeitos adversos , Bloqueio Nervoso/efeitos adversos , Bloqueio Nervoso/instrumentação , Odontogênese/fisiologia , Radiografia Panorâmica , Estudos Retrospectivos , Fatores Sexuais
13.
Clin Oral Investig ; 17(2): 553-64, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22543896

RESUMO

OBJECTIVES: The aim of this study was to evaluate the prevalence of root resorption of maxillary incisors caused by impacted maxillary canines using low-dose dental computed tomography and to gain additional knowledge of the underlying aetiology and the progression of root resorption. MATERIALS AND METHODS: A total of 440 patients (mean age, 24.7 years) with 557 impacted maxillary canines were examined regarding their location and the occurrence of root resorption of maxillary incisors. RESULTS: The frequency of root resorption was 2 % of central and 7.7 % of lateral maxillary incisors. The location of the 557 impacted canines within the dental arch was palatal in 67.5 %, buccal in 15.4 % and central in 17.1 %. No significant differences could be shown with respect to the width and the shape of the dental follicle of the impacted maxillary canines and the presence of root resorption of incisors. The presence of root resorption of central (p < 0.0001) and lateral (p < 0.023) maxillary incisors was significantly correlated with an existing contact relationship of the impacted maxillary canines. CONCLUSIONS: Our investigation confirms the theory of prior reports comprising a much larger patient population, hypothesising that the dental follicle of impacted maxillary canines does not cause resorption of adjacent maxillary incisors per se. CLINICAL RELEVANCE: Root resorption of maxillary incisors is correlated with effects of contact of the impacted maxillary canines, and these findings should be considered in treatment planning. Our findings are consistent with other reports and may develop new treatment approaches for the treatment of this sequela.


Assuntos
Dente Canino/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Reabsorção da Raiz/epidemiologia , Dente Impactado/epidemiologia , Adolescente , Adulto , Idoso , Processo Alveolar/diagnóstico por imagem , Áustria/epidemiologia , Criança , Arco Dental/diagnóstico por imagem , Cemento Dentário/diagnóstico por imagem , Polpa Dentária/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Dentina/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Palato/diagnóstico por imagem , Prevalência , Estudos Retrospectivos , Reabsorção da Raiz/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Erupção Dentária/fisiologia , Dente Decíduo/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adulto Jovem
14.
Pediatr Dent ; 34(5): 397-402, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23211916

RESUMO

PURPOSE: Early diagnosis and treatment of pulp infection in primary incisors are important for preventing systemic infection and damage to the permanent tooth bud. The purpose of this retrospective case-control study was to identify radiographic changes associated with pulp infection in primary incisor roots and their developing permanent dental follicles. METHODS: Oblique occlusal radiographs of 102 primary maxillary incisors with sinus tracts were compared to 390 radiographs of incisors from healthy same-age children. RESULTS: Compared with controls, teeth with sinus tracts had more inflammatory root resorption (odds ratio [OR]=50.7, P<.001), pulp pathosis (OR=13.0, P<.001), deep caries (OR=3.9, P<.001), past traumatic injury (OR=3.4, P<.001), enlarged dental sac (OR=10.8, P<.001), loss of lamina dura of the dental sac (OR=27.5, P<.001), and increased radiolucency of the dental sac of the corresponding permanent tooth bud (OR=19.5, P<.001). In multivariate logistic regression, 2 variables were associated with radiographic changes in the primary root (inflammatory resorption, P<.001; and pulp pathosis, P=.004). Two variables associated with changes in the permanent tooth bud (loss of lamina-dura and increased radiolucency) were independently associated with the presence of a sinus tract, P<.001. CONCLUSION: Deep caries, inflammatory resorption, pulp pathosis, loss of lamina-dura, and increased radiolucency of the dental sac were statistically associated with presence of a sinus tract.


Assuntos
Fístula Dentária/diagnóstico por imagem , Necrose da Polpa Dentária/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Incisivo/diagnóstico por imagem , Reabsorção da Raiz/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Dente Decíduo/diagnóstico por imagem , Análise de Variância , Infecções Bacterianas/complicações , Infecções Bacterianas/diagnóstico por imagem , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Cárie Dentária/complicações , Cárie Dentária/diagnóstico por imagem , Fístula Dentária/etiologia , Necrose da Polpa Dentária/complicações , Feminino , Humanos , Incisivo/lesões , Incisivo/patologia , Lactente , Modelos Logísticos , Masculino , Maxila , Radiografia , Estudos Retrospectivos , Reabsorção da Raiz/etiologia , Traumatismos Dentários/complicações , Dente Decíduo/lesões
16.
Am J Orthod Dentofacial Orthop ; 141(4): 427-35, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22464524

RESUMO

INTRODUCTION: The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. METHODS: The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. RESULTS: No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. CONCLUSIONS: An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment.


Assuntos
Dente Canino/patologia , Incisivo/diagnóstico por imagem , Maxila/diagnóstico por imagem , Extrusão Ortodôntica/métodos , Reabsorção da Raiz/etiologia , Ápice Dentário/diagnóstico por imagem , Dente Impactado/terapia , Adolescente , Adulto , Cefalometria , Criança , Dente Canino/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Incisivo/fisiopatologia , Masculino , Odontogênese/fisiologia , Radiografia Interproximal , Radiografia Dentária Digital , Radiografia Panorâmica , Estudos Retrospectivos , Fatores de Risco , Reabsorção da Raiz/diagnóstico por imagem , Ápice Dentário/fisiopatologia , Coroa do Dente/diagnóstico por imagem , Coroa do Dente/patologia , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/patologia , Dente Impactado/classificação , Dente Impactado/diagnóstico por imagem , Adulto Jovem
17.
Int. j. morphol ; 29(2): 526-531, June 2011. ilus, mapas, tab
Artigo em Inglês | LILACS | ID: lil-597486

RESUMO

This study investigated the immunodetection of PCNA in epithelial components of dental follicles associated with impacted third molars without radiographical and morphological signs of pathosis. A total of 105 specimens of dental follicles associated with impacted third molars with incomplete rhizogenesis (between Nolla's stage 6 and 9) were surgically removed from 56 patients. Epithelial cell proliferating was determined by using immunohistochemical labeling. Statistical analysis was performed using the Fisher exact test. Of the 105 dental follicles collected, 6 were PCNA-positive ( 6 percent). The specimens with squamous metaplasia and epithelial hyperplasia had higher rates of positivity for PCNA, as well as those with proliferative remnants of odontogenic epithelium. In conclusion, this study shows that dental follicles at this stage of development have low proliferative potential, but suggests that squamous metaplasia, hyperplasia of the epithelial lining and presence of proliferative odontogenic epithelial rests in the connective tissue may be early signs of developing lesions of odontogenic origin.


Se investigó la inmunodetección de PCNA en los componentes epiteliales de los folículos dentales asociados a terceros molares retenidos sin signos radiográficos y morfológicos de la patología. Fueron extraídos quirúrgicamente, de 56 pacientes, 105 muestras de folículos dentales asociados a terceros molares retenidos con rizogénesis incompleta (entre los estadíos de Nolla 6 y 9) La proliferación de células epiteliales se deteminó mediante inmunohistoquímica. El análisis estadístico se realizó mediante la prueba exacta de Fisher. De los 105 folículos dentales recogidos, 6 fueron PCNA-positivos ( 6 por ciento). Las muestras con metaplasia escamosa e hiperplasia epitelial tuvieron mayores tasas de positividad para PCNA, así como aquellos con restos de proliferación del epitelio odontogénico. En conclusión, este estudio mostró que los folículos dentales en esta etapa del desarrollo tienen un potencial proliferativo bajo, pero sugiere que la metaplasia escamosa, la hiperplasia del epitelio y la presencia de restos epiteliales odontogénicos, en proliferación en el tejido conectivo, pueden ser signos tempranos de lesiones en el desarrollo de origen odontogénico.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Antígeno Nuclear de Célula em Proliferação/análise , Saco Dentário/patologia , Dente Serotino/patologia , Dente Impactado , Imuno-Histoquímica , Radiografia Panorâmica , Saco Dentário/diagnóstico por imagem , Dente Serotino/diagnóstico por imagem
18.
Eur J Orthod ; 33(1): 93-102, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21270321

RESUMO

The diagnostic accuracy for the localization of impacted canines and the detection of canine-induced root resorption of maxillary incisors were compared between conventional radiographic procedures using one two-dimensional (2D) panoramic radiograph with that of two three-dimensional (3D) cone beam computed tomography (CBCT) scans. The clinical records of 60 consecutive patients who had impacted or ectopically erupting maxillary canines were identified from those seeking orthodontic treatment. For each case, two sets of radiographic information were obtained. The study sample was divided into two groups: group A (n = 30) included those for whom a dental pantomograph (DPT) and CBCT obtained with a 3D Accuitomo-XYZ Slice View Tomograph were available and group B (n = 30) who had a DPT and CBCT obtained with a Scanora. The DPT and CBCT images were subsequently analysed by 11 examiners. Statistical analysis included an evaluation of the agreement between observers based on the standard error of the measurement, kappa statistics and coefficient of concordance, as well as an assessment of the differences between 2D and 3D imaging employing Wilcoxon signed rank and McNemar tests. There was a highly significant difference between the 2D and 3D images in the width of the canine crown (P < 0.001) and in canine angulation to the occlusal plane. Moreover, there was a highly significant difference between the DPT and Scanora CBCT images in canine angulation to the midline (P < 0.001). There was also a significant difference between 2D and 3D images with respect to canine location (P = 0.0074 for group A and P = 0.0008 for group B). The presence or absence of root resorption of the lateral incisor was also significantly different in both groups (P = 0.0201 and P < 0.001 for groups A and B, respectively). Detection of central incisor root resorption was significantly different between the Accuitomo and DPT images (P = 0.045). There was also a significant difference in the severity of lateral incisor root resorption between the DPT and CBCT in both groups (P = 0.02). The results of this study suggest that CBCT is more sensitive than conventional radiography for both canine localization and identification of root resorption of adjacent teeth.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Dente Canino/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia Panorâmica/métodos , Reabsorção da Raiz/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Adolescente , Adulto , Criança , Tomografia Computadorizada de Feixe Cônico/estatística & dados numéricos , Arco Dental/diagnóstico por imagem , Saco Dentário/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento Tridimensional/métodos , Incisivo/diagnóstico por imagem , Masculino , Intensificação de Imagem Radiográfica/métodos , Radiografia Dentária Digital/métodos , Radiografia Dentária Digital/estatística & dados numéricos , Radiografia Panorâmica/estatística & dados numéricos , Estudos Retrospectivos , Ápice Dentário/diagnóstico por imagem , Coroa do Dente/diagnóstico por imagem , Erupção Ectópica de Dente/diagnóstico por imagem , Raiz Dentária/diagnóstico por imagem , Ecrans Intensificadores para Raios X , Adulto Jovem
19.
J Oral Maxillofac Surg ; 69(5): 1291-4, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21256650

RESUMO

PURPOSE: Increased levels of reactive oxygen species lead to oxidative stress and tissue damage. Malondialdehyde (MDA) is one of many low-molecular-weight endproducts of lipid peroxidation that increases with oxidative stress. The aim of this study was to determine oxidative stress in dental follicles (DFs) of radiologically asymptomatic impacted third molars (ITMs) using MDA. MATERIALS AND METHODS: This study involved 40 DFs of 40 patients referred for clinically and radiographically asymptomatic ITMs. Forty healthy gingival tissues in the same patients were obtained during surgical removal of teeth as a control group. DF widths on periapical radiographs narrower than 2.5 mm were included in the study. All tissues samples were analyzed for MDA as an indicator of oxidative stress. RESULTS: Levels of MDA were significantly higher in DFs from ITMs than those from healthy gingival tissues of the same patients (P < .01). CONCLUSION: The results suggest that significant oxidative stress may occur in DFs of asymptomatic ITMs. The findings suggest that increased MDA may play an important role in oxidative stress in DFs. In light of these preliminary findings of the present study, further investigations and comprehensive studies are required to determine the role of antioxidants that scavenge free radicals in DFs.


Assuntos
Saco Dentário/metabolismo , Malondialdeído/análise , Dente Serotino/metabolismo , Dente Impactado/metabolismo , Adolescente , Adulto , Doenças Assintomáticas , Saco Dentário/diagnóstico por imagem , Feminino , Gengiva/metabolismo , Humanos , Peroxidação de Lipídeos/fisiologia , Masculino , Mandíbula/metabolismo , Mandíbula/cirurgia , Dente Serotino/cirurgia , Estresse Oxidativo/fisiologia , Radiografia Interproximal , Radiografia Panorâmica , Alvéolo Dental/metabolismo , Alvéolo Dental/cirurgia , Dente Impactado/cirurgia , Adulto Jovem
20.
J Craniofac Surg ; 21(3): 854-7, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20485068

RESUMO

OBJECTIVE: The aim of this study was to examine the pathologic changes and immunoexpressivity of p63 gene in dental follicles (DFs) of asymptomatic partially and completely impacted lower third molars. STUDY DESIGN: Clinical and radiologic examinations included 50 DFs with no signs of abnormal radiolucency (follicular space <2.5 mm), taken from 50 patients. RESULTS: Histopathologic examinations of the specimens revealed 47 normal dental follicular tissues, 1 ameloblastoma, and 2 dentigerous cysts. p63 Immunoexpressivity was stronger in the DFs of the group with completely impacted teeth (64%),than it was in the case of DFs of the group with partially impacted teeth (40%). CONCLUSIONS: Stronger p63 gene immunoexpression in the group with completely impacted teeth might be a consequence of bigger number of stem cells than it is in the case of the group with partially impacted teeth. This study also supports prophylactic removal of impacted teeth because of the development of pathologies associated with them.


Assuntos
Saco Dentário/patologia , Proteínas de Membrana/metabolismo , Dente Serotino/patologia , Dente Impactado/patologia , Adolescente , Adulto , Ameloblastoma/metabolismo , Ameloblastoma/patologia , Saco Dentário/diagnóstico por imagem , Saco Dentário/metabolismo , Cisto Dentígero/metabolismo , Cisto Dentígero/patologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Neoplasias Maxilomandibulares/diagnóstico por imagem , Neoplasias Maxilomandibulares/metabolismo , Neoplasias Maxilomandibulares/patologia , Masculino , Dente Serotino/diagnóstico por imagem , Dente Serotino/metabolismo , Radiografia , Dente Impactado/diagnóstico por imagem , Dente Impactado/metabolismo
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