Tratamiento quirúrgico de enucleación completa y análisis histológico de un mucocele en el labio inferior en un niño: Reporte de Caso.

Objective: The aim of this case report is to describe the surgical removal of a mucocele and its histological analysis, in a child. Case Report: An 11-year-old female patient attended the Pediatric Dentistry clinic complaining of a lower lip lesion. During the anamnesis, the mother reported that the child had a habit of biting and sucking the spot frequently. Clinical examination showed the lesion was compatible with a mucocele. The proposed treatment was a complete enucleation of the lesion under local anesthesia. The incision and tissue divulsion were performed for maximum preservation of the mucosa, avoiding a possible recurrence. Total adjacent glands removal was also performed. The lesion was placed in 10% formaldehyde for histopathological analysis (H&E Staining), which showed dense connective tissue presenting chronic inflammatory infiltrate and extravasated mucin, presence of granulation tissue delimiting the area of extravasated mucin and presence of minor salivary glands. The patient was advised to quit the habit, and after seven days the sutures were removed. At the one-year follow-up there was no recurrence of the lesion. Conclusion: The proposed treatment proved to be effective without recurrence of the lesion.Objetivo: El objetivo de este reporte de caso es describir la extirpación quirúrgica de un mucocele y su análisis histológico en un niño. Informe del caso: una paciente de 11 años de edad asistió a la clínica de Odontopediatria quejándose de una lesión en el labio inferior. Durante la anamnesis, la madre informó que el niño tenía la costumbre de morder y chupar el lugar con frecuencia. En el examen clínico, la lesión fue compatible con un mucocele. El tratamiento propuesto fue una enucleación completa de la lesión bajo anestesia local. La incisión y la divulgación del tejido se realizaron para la máxima preservación de la mucosa, evitando una posible recurrencia. También se realizó la extracción total de las glándulas adyacentes. La lesión se colocó en formaldehído al 10% para el análisis histopatológico (tinción H&E), que mostró tejido conectivo denso que presenta infiltrado inflamatorio crónico y mucina extravasada, presencia de tejido de granulación que delimita el área de mucina extravasada y presencia de glándulas salivales menores. Se aconsejó al paciente que abandonara el hábito, y después de siete días se retiraron las suturas. En el seguimiento de un año no hubo recurrencia de la lesión. Conclusión: El tratamiento propuesto demostró ser efectivo sin recurrencia de la lesión

Molar incisor hypomineralization and operatory treatment need in permanent teeth

Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorO presente estudo CASO-CONTROLE teve como objetivo principal verificar a associação entre a Hipomineralização de molares e incisivos (HMI) e a necessidade de tratamento operatório em dentes permanentes. Avaliou-se também o grau de ansiedade relacionada à consulta odontológica e o impacto das condições bucais na qualidade de vida. Os grupos CASO e CONTROLE foram selecionados a partir da lista de pacientes nascidos de 2002 a 2004, atendidos na Clínica de Odontopediatria da FO-UERJ nos anos de 2011 e 2012. O grupo CASO foi composto por pacientes com necessidade de tratamento operatório em pelo menos um dente permanente. O grupo CONTROLE, por pacientes sem necessidade de tratamento operatório em dentes permanentes. Os exames foram realizados por um examinador calibrado. Hipomineralização do esmalte e cárie foram avaliadas ao nível de superfície dentária. A avaliação do risco de cárie baseou-se no método do Cariograma. A escala de imagens faciais foi utilizada para avaliar a ansiedade antes e depois da consulta. O impacto das condições bucais na qualidade de vida foi avaliada pelo Childs Perception Questionnaire (CPQ8-10). A amostra constou de 155 pacientes, com idade entre 7 e 11 anos, sendo 57 CASOS e 98 CONTROLES. No grupo CASO, 47,4% dos pacientes apresentaram HMI, enquanto no grupo CONTROLE este percentual foi de 13,3%. A chance de ter dentes permanentes com necessidade de tratamento operatório foi 5,89 (IC: 2,69-12,86) vezes maior para pacientes com HMI. O número médio de primeiros molares permanentes e de superfícies de primeiros molares permanentes com necessidade de intervenção operatória foi significativamente mais alto dentre as crianças com HMI (p0,05). Os valores da subcategoria de limitações funcionais foram um pouco mais elevados para o grupo CASO na presença de HMI, mas a diferença também não foi significativa (p=0,05). Com base nos dados do presente estudo, pôde-se concluir que: a HMI aumentou a necessidade de tratamento operatório da dentição permanente significativamente; a ansiedade após a consulta foi maior naqueles que tinham necessidade de tratamento operatório; a necessidade de tratamento operatório não interferiu significativamente na auto-percepção do impacto das condições bucais na qualidade de vida.This CASE-CONTROL study aimed to evaluate the association between Molar incisor hypomineralization (MIH) and the need of operatory treatment in permanent teeth. Dental anxiety and the impact of oral conditions on the quality of life were also assessed. CASE and CONTROL groups were selected from the list of patients assisted at the Pediatric Dental Clinic of the State University of Rio de Janeiro, Brazil in 2011 and 2012 who were born in 2002, 2003 and 2004. CASES were those who needed operatory treatment in at least one permanent tooth and CONTROLS were those who did not need any operatory treatment in permanent teeth. One single calibrated examiner performed all the examinations. Enamel hypomineralization and caries were assessed at the tooth surface level. Caries risk was assessed using Cariogram. The facial images scale was used to assess dental anxiety before and after the dental appointment. The Childs Perception Questionnaire (CPQ8-10) assessed the impact of oral conditions on the quality of life. The sample comprised 155 patients, aged 7 to 11 years, 57 CASES and 98 CONTROLS. Among CASES, 47.4% of the children had MIH, and among CONTROLS, MIH was present in 13.3% of the children. The chance of needing operatory treatment in permanent teeth was 5.89 (CI: 2.69-12.86) times higher in patients with MIH. The mean number of first permanent molars and the mean number of tooth surfaces of first permanent molars, which needed operatory intervention, were significantly higher among children with MIH (p0.05). Functional limitations scores were slightly higher in the CASE group when MIH was present, but not statistically significant (p=0.05). Based on the data of the present study it can be concluded that: MIH increased the need of operatory intervention in permanent teeth significantly; dental anxiety after the dental appointment was higher among those who needed operatory treatment in permanent teeth; childs perception about the impact of oral conditions on the quality of life was not different between those who needed and did not need operatory intervention in permanent teeth

Dentinogenesis imperfecta type II: a case report

Objective: Dentinogenesis imperfecta (DI) type II is a rare dentin development disorder with an autosomal dominant inheritance that affects both functional and aesthetic aspects of deciduous and permanent dentitions. This study reports the clinical case of a patient diagnosed late with this anomaly. Material and methods: Male patient, 33 years old, sought dental care complaining of dental aesthetic dissatisfaction. During clinical examination, it was observed that the teeth had a brownish color, with wear and tear of the dental enamel and dentin exposure. Radiographically, the teeth presented the pulp chambers and root canals obliterated, in addition to bulbous crowns. The patient reported that several members of his family had the same condition. The established clinical diagnosis was DI type II. Conclusion: In this case, type II dentinogenesis imperfecta was diagnosed late and without adequate therapeutic intervention, causing aesthetic and functional damage to the patient.Objetivo: Dentinogênese imperfeita (DI) tipo II é um distúrbio raro do desenvolvimento da dentina com herança autossômica dominante, afetando aspectos funcionais e estéticos das dentições decídua e permanente. Este estudo relata o caso clínico de um paciente com diagnóstico tardio dessa anomalia. Materiais e métodos: Paciente do sexo masculino, 33 anos, procurou atendimento odontológico queixando-se de insatisfação estética dentária. Durante o exame clínico, observou-se que os dentes apresentavam coloração amarromzada, desgaste do esmalte e exposição da dentina. Radiograficamente, os dentes apresentavam as câmaras pulpares e canais radiculares obliterados, além de coroas bulbosas. O paciente relatou que diversos membros de sua família apresentavam o mesmo quadro. O diagnóstico clínico estabelecido foi DI tipo II. Conclusão: Neste caso, a dentinogênese imperfeita tipo II foi diagnosticada tardiamente e sem intervenção terapêutica adequada, causando prejuízo estético e funcional ao paciente

The effect of pulp inflammation and premature extraction of primary molars on the successor permanent teeth: A retrospective study

Background: Untreated caries on primary molars often leads to pulp inflammation and extraction. Aim: To retrospectively investigate the effect of pulp inflammation and extraction of primary molars on their successors regarding alignment in the dental arch and developmental enamel defects (DED). Design: The participants in this study were children at public schools in Petropolis (Brazil), who participated in a 3-year longitudinal clinical trial. Children (N = 44) were selected for the present study if they had at least one erupted premolar of which the predecessor primary molar presented pulp inflammation at baseline or during any of the 6-month follow-up assessments. All premolars were examined for DED and misalignment. Distinction was made between extraction performed before (E <8) or after the age of 8 years (E ≥8). Distinction was also made between pulp inflammation occurred before (P < 7) or after the age of 7 years (P ≥ 7). A logistic regression analysis was performed, and the odds ratio was calculated. Results and conclusions: Misalignment occurred more frequently in E <8 as compared to E ≥8 (OR = 2.85; P =.03). There was no significant difference in DED between P < 7 and P ≥ 7. Conclusion: Misalignment of premolars occurs more frequently when the predecessor primary molars are extracted before the age of 8 years

Complete enucleation surgical treatment and histological analysis of a mucocele in lower lip in a child: Case Report.

Objective: The aim of this case report is to describe the surgical removal of a mucocele and its histological analysis, in a child. Case Report: An 11-year-old female patient attended the Pediatric Dentistry clinic complaining of a lower lip lesion. During the anamnesis, the mother reported that the child had a habit of biting and sucking the spot frequently. Clinical examination showed the lesion was compatible with a mucocele. The proposed treatment was a complete enucleation of the lesion under local anesthesia. The incision and tissue divulsion were performed for maximum preservation of the mucosa, avoiding a possible recurrence. Total adjacent glands removal was also performed. The lesion was placed in 10% formaldehyde for histopathological analysis (H&E Staining), which showed dense connective tissue presenting chronic inf lammatory infiltrate and extravasated mucin, presence of granulation tissue delimiting the area of extravasated mucin and presence of minor salivary glands. The patient was advised to quit the habit, and after seven days the sutures were removed. At the one-year follow-up there was no recurrence of the lesion. Conclusion: The proposed treatment proved to be effective without recurrence of the lesion.Objetivo: El objetivo de este reporte de caso es describir la extirpación quirúrgica de un mucocele y su análisis histológico en un niño. Informe del caso: una paciente de 11 años de edad asistió a la clínica de Odontopediatria quejándose de una lesión en el labio inferior. Durante la anamnesis, la madre informó que el niño tenía la costumbre de morder y chupar el lugar con frecuencia. En el examen clínico, la lesión fue compatible con un mucocele. El tratamiento propuesto fue una enucleación completa de la lesión bajo anestesia local. La incisión y la divulgación del tejido se realizaron para la máxima preservación de la mucosa, evitando una posible recurrencia. También se realizó la extracción total de las glándulas adyacentes. La lesión se colocó en formaldehído al 10% para el análisis histopatológico (tinción H&E), que mostró tejido conectivo denso que presenta infiltrado inflamatorio crónico y mucina extravasada, presencia de tejido de granulación que delimita el área de mucina extravasada y presencia de glándulas salivales menores. Se aconsejó al paciente que abandonara el hábito, y después de siete días se retiraron las suturas. En el seguimiento de un año no hubo recurrencia de la lesión. Conclusión: El tratamiento propuesto demostró ser efectivo sin recurrencia de la lesión