Influencia de los incisivos en forma de pala en el overjet Influence of the shovel-shaped incisors in the overjet

Objetivo: Determinar la prevalencia de incisivos en forma de pala y su asociación con el overjet. Material y Métodos: La muestra estuvo conformada por 270 niños de 7 a 11 años de una Institución pública de Chilca. Se realizó una evaluación clínica para determinar la presencia o ausencia de los incisivos en pala y de qué tipo se trataba según la clasificación de Hrdlicka. Asimismo, se registró la medida del overjet con una sonda periodontal PCP 11.5B Hu Friedy®. Finalmente, se realizó la prueba de Chi cuadrado para determinar la asociación entre ambas variables. Resultados: La prevalencia de incisivos en forma de pala fue de 72,60% con mayor frecuencia en el género femenino. Se halló una mayor prevalencia de forma de pala en los incisivos laterales (71,85%) que en los centrales (67,77%). El tipo de forma de pala predominante fue el de tipo I en ambos grupos de incisivos (31,85% y 31,48%). No se encontró una asociación estadísticamente significativa entre los incisivos en forma de pala y el overjet. (p=0.075). Conclusiones: La presencia de rebordes marginales gruesos de la forma de pala, aumenta el volumen vestíbulo palatino de la pieza dentaria, haciendo que el incisivo se incline hacia vestibular para así compensar el grosor del contacto de los rebordes marginales con los incisivos inferiores. Sin embargo, dicha discrepancia de tamaño que se presenta, no altera de manera significativa, la medida del overjet

Association of dens in dente with shovel-shaped tooth and conical tooth in anterior teeth

Objetivo: Determinar la asociación del dens in dente con el diente en pala y el diente cónico en piezas anteriores. Material y Métodos: La muestra incluyó radiografías panorámicas y periapicales digitales de 564 pacientes de 7 a 14 años y 11 meses en la Clínica Docente UPC. Se consideró dens in dente a la pieza dentaria que presentó una estructura en forma de cinta radiopaca de igual densidad que el esmalte que se extendía desde el cíngulo hacia el canal radicular. El diente en pala fue registrado al observarse una opacidad del esmalte en los bordes de la cresta marginal. Las piezas dentarias en las que se halló una reducción en el ancho mesiodistal de la corona en dirección gingivoincisal fueron registradas como diente cónico. Los incisivos del maxilar superior fueron evaluados mediante radiografías periapicales para determinar el tipo de dens in dente según la clasificación de Oehlers. Resultados: La prevalencia de dens in dente fue de 19.5%, la del diente en pala fue de 78.19% y la del diente cónico fue de 7.2%. La prevalencia bilateral del dens in dente fue de 47.28%. El género femenino presentó mayor prevalencia de esta alteración (11.2%) que el género masculino (8.3%). El tipo I de la clasificación de Oehlers fue el más común con un 69.34%. Los incisivos laterales fueron los más afectados por el dens in dente (6.9%), seguido por los incisivos centrales (0.4%). Conclusión: Existe asociación entre dens in dente y diente cónic

Anesthetic technique for inferior alveolar nerve block: a new approach

BACKGROUND: Effective pain control in Dentistry may be achieved by local anesthetic techniques. The success of the anesthetic technique in mandibular structures depends on the proximity of the needle tip to the mandibular foramen at the moment of anesthetic injection into the pterygomandibular region. Two techniques are available to reach the inferior alveolar nerve where it enters the mandibular canal, namely indirect and direct; these techniques differ in the number of movements required. Data demonstrate that the indirect technique is considered ineffective in 15% of cases and the direct technique in 13-29% of cases. OBJECTIVE: The aim of this study was to describe an alternative technique for inferior alveolar nerve block using several anatomical points for reference, simplifying the procedure and enabling greater success and a more rapid learning curve. MATERIAL AND METHODS: A total of 193 mandibles (146 with permanent dentition and 47 with primary dentition) from dry skulls were used to establish a relationship between the teeth and the mandibular foramen. By using two wires, the first passing through the mesiobuccal groove and middle point of the mesial slope of the distolingual cusp of the primary second molar or permanent first molar (right side), and the second following the oclusal plane (left side), a line can be achieved whose projection coincides with the left mandibular foramen. RESULTS: The obtained data showed correlation in 82.88% of cases using the permanent first molar, and in 93.62% of cases using the primary second molar. CONCLUSION: This method is potentially effective for inferior alveolar nerve block, especially in Pediatric Dentistry

Knowledge and attitude of parents or caretakers regarding transmissibility os caries disease

Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease

Evaluation of demineralization produced by in situ cariogenic challenge on dental enamel at different posteruptive age

O objetivo deste estudo in situ foi avaliar a microdureza superficial e longitudinal do esmalte de dentes com diferentes idades pós-eruptivas (antes da erupção na cavidade bucal, após 2 a 3 anos da erupção, após 4 a 10 anos da erupção e mais de 10 anos de erupção), submetidos aos desafios cariogênicos. Para isso, foram utilizados 24 espécimes de esmalte humano de cada idade pós-eruptiva, após um ordenamento conforme a dureza. Os espécimes foram aleatoriamente divididos entre doze voluntários. Durante o período experimental, os espécimes foram submetidos ao acúmulo de biofilme dentário, sobre o qual foi gotejada uma solução de sacarose a 20% oito vezes ao dia, para provocar um alto desafio cariogênico. Após 7 dias, uma das metades (direita ou esquerda) do aparelho recebeu profilaxia com jato de bicarbonato de sódio para remoção do biofilme dentário, seguido de um novo acúmulo de biofilme até completar o período experimental de 14 dias. A comparação entre as microdurezas superficial e longitudinal obtidas nos diferentes grupos foi realizada por meio da Análise de Variância e Teste de Tukey, adotando-se um nível de significância de 5%. Os resultados demonstraram que os valores de microdureza superficial inicial têm uma tendência crescente com o passar dos anos, sendo encontrada diferença estatisticamente significante apenas entre o esmalte incluso e o de mais de 10 anos de erupção. Depois do período in situ, os resultados obtidos mostraram que a porcentagem de perda de dureza superficial (%PDS) dos espécimes de esmalte com diferentes idades pós-eruptivas do grupo que recebeu e não profilaxia revelaram uma tendência decrescente dos valores de %PDS com o passar dos anos, estes valores não apresentaram diferença estatisticamente significante. No entanto, encontrou-se uma diferença estatisticamente significante entre o grupo que recebeu a profilaxia e o que não recebeu, independentemente da idade pós-eruptiva. Ao respeito da microdureza longitudinal, os resultados mostraram que o volume mineral, de forma geral, tem uma tendência crescente dos valores com o passar dos anos. Na análise individual de cada profundidade constatou-se que a 10µm existia uma diferença estatisticamente significante entre os espécimes inclusos e os de mais de 10 anos de erupção. Na profundidade de 30µm encontrou-se diferença significante apenas dos espécimes inclusos e de 2-3 anos sem profilaxia com todos os outros grupos restantes. Na profundidade de 50µm os espécimes inclusos apresentaram diferença significante com os de 4 a 10 anos e mais de 10 anos de erupção. Além disso, encontrou-se uma diferença significante entre o grupo que recebeu a profilaxia e o que não recebeu nestas profundidades, independentemente da idade pós-eruptiva. A partir da profundidade de 70µm os espécimes inclusos foram diferentes das outras idades pós-eruptivas, além disso, não houve diferença estatisticamente significante entre os grupos com e sem profilaxia. De acordo com as condições e com a metodologia adotada na presente pesquisa, foi possível concluir que houve diferença entre a microdureza superficial inicial dos espécimes com diferentes idades póseruptivas, mostrando um comportamento crescente de mineralização. Sendo, no entanto esta diferença significante somente entre os espécimes inclusos e os de mais de 10 anos de erupção. Quando os espécimes das diferentes idades pós-eruptivas foram submetidos a desafio cariogênico in situ, com e sem remoção do biofilme dentário e analisado tanto superficial quanto em profundidade mostraram um comportamento de perda de dureza decrescente de acordo com a idade de maturação e a profundidade do esmalte. A realização da remoção mecânica do biofilme, através da profilaxia com jato de bicarbonato de sódio, promoveu menor perda de dureza tanto superficialmente quanto em profundidade, sendo estatisticamente significante quando comparado com os espécimes que não receberam profilaxia. Os resultados sugerem que a susceptibilidade a cárie diminui com o passar dos anos, possivelmente pela maturação pós-eruptiva.This in situ study evaluated the surface and longitudinal microhardness ofenamel in teeth at different posteruptive ages (before eruption in the oral cavity, 2-3 years after eruption, 4-10 years after eruption and more than 10 years after eruption), submitted to cariogenic challenges. The study sample was composed of 24 specimens of human enamel at each posteruptive age, after arrangement according to hardness. The specimens were randomly divided into twelve volunteers. During the study period, the specimens were submitted to accumulation of dental biofilm, by dripping a 20% sucrose solution 8 times a day, to induce a high cariogenic challenge. After 7 days, one half (right or left) of the appliance was submitted to prophylaxis with sodium bicarbonate jet to remove the dental biofilm, followed by further accumulation of biofilm until completion of the study period of 14 days. Comparison between the surface and longitudinal microhardness obtained for the different groups was performed by analysis of variance and the Tukey test, at a significance level of 5%. The results demonstrated that the initial surface microhardness values have a tendency to increase over the years, with statistically significant difference only between unerupted enamel and more than 10 years after eruption. After the in situ period, the results demonstrated that he percentage of loss of surface hardness (%LSH) of enamel specimens at different posteruptive ages in groups with and without prophylaxis exhibited a tendency to decrease the %LSH values with time, yet without statistically significant difference. However, there was statistically significant difference between the groups with and without prophylaxis, regardless of the posteruptive age. With regard to longitudinal microhardness, the results demonstrated that the mineral volume, in general, had a tendency to increase over the years. Individual analysis at each depth revealed that, at 10 µm, there was statistically significant difference between unerupted specimens and more than 10 years after eruption. At 30 µm, there was significant difference only between unerupted specimens and 2-3 years after eruption without prophylaxis compared to all other groups. At 50 µm, the unerupted specimens exhibited significant difference compared to 4-10 years and more than 10 years after eruption. Moreover, there was significant difference between the groups with and without prophylaxis at these depths, regardless of the posteruptive age. After 70 µm of depth, the unerupted specimens were different compared to the other posteruptive ages; moreover, there was no statistically significant difference between groups with and without prophylaxis. According to the present conditions and methodology, it was concluded that there was difference between the initial surface microhardness of specimens at different posteruptive ages, revealing increasing mineralization. However, this difference was significant only between unerupted specimens and more than 10 years after eruption. When specimens at different posteruptive ages were submitted to in situ cariogenic challenge, with or without removal of dental biofilm and submitted to both surface and depth analysis, decreasing loss of hardness was observed with the increase in maturation age and enamel depth. Mechanical removal of dental biofilm by prophylaxis with sodium bicarbonate jet promoted less loss of both surface and longitudinal hardness, with statistically significant difference compared to specimens not submitted to prophylaxis. The results suggest that the susceptibility to caries is reduced with time, possibly due to posteruptive maturation

Evaluating the Thickness of the Root Canal Dentin Wall in Primary First Molars Using Cone-beam Computed Tomography

Aim: To evaluate the thickness of the root canal dentin wall in the cervical, middle, and apical third of primary first molars. Materials and methods: Cross-sectional study consisting of 30 cone-beam computed tomography (CBCT) images of primary maxillary and mandibular first molars, with crown, and root integrity. The wall dentin thickness of each canal was measured in three axial views, divided into distal (D), mesial, lingual/palatine, and buccal surfaces. Results: The smallest dentin wall thickness of the maxillary molar was located on the mesial surface of the mesiobuccal (MB) canal apical third (mean 0.55 ± 0.04 mm). The buccal and palatal (P) surfaces of the distobuccal (DB) and P canals showed the smallest dentin thickness on the cervical third (0.62 ± 0.02 mm). On the mandibular molar, we found the smallest dentin thickness on the apical third [lingual surface of the MB canal and buccal surface of the mesiolingual (ML) canal] with a mean of 0.41 ± 0.07 mm. Additionally, the dentin thickness is average of the D canal was about 0.67 ± 0.11 mm. Conclusion: It is essential to understand the primary first molar’s anatomy to reduce possible complications in pediatric patients from instrumentation during root canal treatments. Clinical significance: Pulpectomy is among the most challenging procedures in pediatric dentistry and the knowledge of the root anatomy of primary teeth allows the professional to make better clinical decisions and reduce possible risks during root canal treatment.Revisión por pare

Caries oclusal incipiente : Un nuevo enfoque

No obstante que el conocimiento sobre el diagnóstico y tratamiento de la caries dental haavanzado, el diagnóstico de las lesiones oclusales todavía constituye un reto para los clínicos ylos epidemiólogos. Los conocimientos sobre la enfermedad, así como los conceptos, formas dediagnóstico y tratamiento de la odontología han evolucionado debido, principalmente, a tresgrandes factores: (1) la visión de la caries dental como una enfermedad y, consecuentemente, laposibilidad de intervenir más tempranamente; (2) el uso del flúor y (3) la aparición de materialesrestauradores adhesivos, que permiten restauraciones más conservadoras. Esta nueva perspectivaha conducido al surgimiento de una odontología preventiva que hoy reconoce la presencia delesiones cariosas ocultas, menores e incipientes. La necesidad del diagnóstico temprano esfundamental, en el sentido de que mientras más pronto se realice la intervención, menor será lapérdida de estructura dentaria y mayor la posibilidad de éxito en la recuperación de la salud bucal.En los últimos tiempos han surgido diversos métodos de diagnóstico y, con ellos, dudas sobre cuáles el ideal y que pueda, además, cumplir las siguientes características: alto grado de sensibilidad yespecificidad, bajo costo y fácil aplicación diaria. A pesar de los grandes adelantos tecnológicosobservados en el diagnóstico de caries dental, se considera que el examen clínico correcto,acompañado por el examen radiográfico, es un método eficaz para el diagnóstico de lesionesincipientes, que se caracterizan por aparecer principalmente en las superficies oclusales. Cuandohay dudas sobre el diagnóstico de lesiones incipientes se recomiendan métodos alternos ycomplementarios de tipo invasivo

Association between knowledge and attitudes towards pediatric obstructive sleep apnea and dental specialty

Objective: To associate the knowledge and attitudes about Pediatric Obstructive Sleep Apnea (POSA) with the specialty of dentists in Metropolitan Lima, Peru. Methods: A cross-sectional, analytical observational study was carried out during 2021–2022. Two hundred and ten orthodontists and pediatric dentists were surveyed using the adapted and validated Spanish translation of the OSAKA-KIDS questionnaire and additional sociodemographic questions. Results: The data indicated an association between dental specialty and the professional’s knowledge about POSA. Orthodontists were 59% less likely to have acceptable knowledge, compared to pediatric dentists (p =.013, IC 95% 0.21–0.83). The study revealed an association between the professional’s attitudes and three intervening variables: age (p =.025), clinical experience (p =.049) and sector of practice (p =.020). Conclusion: Knowledge was associated with the dental specialty of professionals in the sample included, whilst attitudes were not.Revisión por pare