Mudanças radiculares em caninos superiores impactados e pré-molares adjacentes após tração ortodôntica com molas helicoidais : um estudo longitudinal retrospectivo com exames de TCFC

Introdução: Os caninos superiores impactados (CSI) historicamente têm sido uma importante razão para a consulta ortodôntica devido ao alto impacto estético e funcional que representam em um indivíduo. Apesar de ser um tema amplamente estudado, existem poucos relatos encontrados na literatura sobre os efeitos da tração ortodôntica de caninos em sua raiz e em estruturas adjacentes. Os objetivos deste estudo foram: 1. Comparar alterações dimensionais radiculares entre os caninos superiores impactados (CSI) por vestibular e palatino, antes e após a tração ortodôntica; 2. Comparar as alterações dimensionais radiculares no osso alveolar e nos premolares adjacentes aos caninos superiores impactados por vestibular e palatino, antes e após a tração; e 3. Avaliar a influência da complexidade do tratamento de tração ortodôntica dos caninos superiores impactados sobre a sua dimensão radicular, do pré-molar adjacente e seu osso alveolar. Metodologia: Trata-se de um estudo retrospectivo longitudinal, sendo que para o primeiro objectivo, a amostra foi composta por exames de Tomografias Computadorizadas de Feixe Cônico (TCFC) de 30 indivíduos com CSI uni e bilateral, pré e pós tração ortodôntica, compondo um total de 43 CSI que foram divididos em 2 grupos: vestibular (n=17) e palatino (n=26). Para o segundo objectivo, a amostra compreendeu exames de TCFC de 25 indivíduos com CSI uni e bilateral pré e pós tracção ortodôntica, e um total de 36 primeiros pré-molares adjacentes que foram divididos em 2 grupos de acordo com o lado de impacção: vestibular (n=17) e palatino (n=21). As medidas de comprimento e área do canino e pré-molar adjacente foram realizadas nas secções coronais, sagitais e axiais. As dimensões do osso alveolar adjacente foram avaliadas no corte coronal. Variáveis demográficas, características esqueléticas também foram obtidas. Conclusões: A posição do canino impactado não teve influencia sobre as alterações dimensionais em sua raiz após a tração, exceto na secção axial cervical onde houve aposição. No pré-molar e osso alveolar adjacentes, a tração ortodôntica não teve influencia sobre as alterações dimensionais. A complexidade da tração ortodôntica do CSI por vestibular ou palatino não interfere nas alterações dimensionais de sua raíz, do pré-molar e osso alveolar adjacentes.Introduction: Historically maxillary impacted canines (MIC) have been an important reason for an orthodontic appointment due to the high aesthetic and functional impact they represent in an individual. Despite being a widely studied topic, there are few reports in the literature about the effects of orthodontic traction on the root of themselves and on adjacent structures. The aims of this study were: 1. To compare dimensional root changes between buccal and palatal MIC, before and after the traction with coil springs; 2. To compare the dimensional root and alveolar bone changes in the first premolar adjacent to MIC (PAMIC), between buccal and palatine MICs, before and after the traction with coil springs; and 3. To determine the influence of the orthodontic traction treatment’s complexity of MIC on the radicular dimensions, and adjacent premolar and its alveolar bone. Methodology: Longitudinal, retrospective study. For the first objective, the sample was constituted by Cone Beam Computed Tomographies (CBCTs) pre and post-orthodontic traction, of 30 subjects with unilateral and bilateral MIC, for a total of 43 MIC that were divided into 2 groups: buccal (n = 17) and palatal (n = 26). For the second objective, the sample consisted of CBCTs pre and post-orthodontic traction of MIC uni or bilateral of 25 subjects, for a total of 36 PAMICs that were divided into 2 groups: buccal (n = 15) and palatal (n = 21). MIC and PAMIC root changes in length and area were measured in the coronal, sagittal and axial sections. The alveolar bone dimensions of the PAMIC were evaluated in the coronal section. Demographic variables, occlusal and skeletal class characteristics were also obtained. Conclusions: The impacted canine position does not have an influence on the dimensional alterations in its root after traction except in the axial cervical section where there was apposition. The complexity of orthodontic traction of CSI by vestibular or palatal does not interfere with the dimensional alterations of its adjacent root, premolar, and alveolar bone

Long COVID y salud oral: ¿estamos listos?

According to recent epidemiological reports, the pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is close to disappearing or, at least, we will have to live with it in an endemic form, due, in part, to the immunity generated by vaccines and, on the other hand, herd immunity. While this is happening, the world nervously awaits the appearance of new variants or zoonotic diseases, such as the recent monkeypox.Según recientes reportes epidemiológicos, el síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2) pandémico está próximo a desaparecer o, por lo menos, a que tengamos que convivir con él en forma de endemia, debido, en parte, a la inmunidad generada por las vacunas y, por otro lado, a la inmunidad de rebaño. Mientras esto sucede, el mundo espera nervioso la aparición de nuevas variantes o enfermedades zoonóticas, como la reciente viruela símica

Methods for determining the occlusal plane

In oral rehabilitation, it is fundamental to accurately determine the orientation of the occlusal plane in patients with different occlusal alterations such as severe wear, partial and total edentulism and their consequences. It is important that the occlusal plane be as close as possible to the position occupied in natural dentition, since it mainly affects occlusal function, the masticatory muscles, the temporomandibular joint, phonetics and aesthetics. In addition, correct determination is the basis of treatment planning, as it is the aesthetic and functional reference plane, and determines the previous guide, mandibular movement patterns, masticatory efficiency and vertical dimension. Thus, the purpose of this study was to provide a review of the current scientific literature on the most commonly used and reliable methods for determining the occlusal plane. According to the literature, the occlusal plane should be located in the position occupied by the natural teeth, and its determination is made following a clinical sequence starting with the anterior sector at rest and while smiling, continuing with the posterior sector. There is no method of choice. However, individual analysis of each patient is important to determine the most adequate method. Methods including cephalometric and/or three-dimensional analysis provide greater precision for treatment planning.Para el rehabilitador oral, resulta fundamental determinar con precisión la orientación del plano oclusal en pacientes con distintas alteraciones, como desgastes severos, edentulismo parcial, total y sus consecuencias. Es importante que este sea lo más cercano posible a la posición queocupaba en dentición natural, ya que influye principalmente en la función oclusal, de los músculos masticatorios, en la articulación temporomandibular, en la fonética y en la estética. Además, la correcta determinación constituye la base de la planificación, por ser el plano de referencia estético y funcional; determina la guía anterior, los patrones de movimiento mandibular, la eficiencia masticatoria y la dimensión vertical. Por ello, el propósito de este estudio es evaluar los métodos más utilizados y confiables para la determinación del plano oclusal, mediante una revisión de la literatura científica actual. A partir de lo investigado, se concluye que el plano oclusal debe ubicarse en la posición que ocupaban los dientes naturales, y su determinación incluye una secuencia clínica, que se inicia por el sector anterior en reposo y sonrisa, y continúa con el sector posterior. No existeun método absoluto. Es importante el análisis individual de cada paciente para decidir qué métodosserán los más indicados. Existen métodos que icluyen el análisis cefalométrico o tridimensional, lo que aporta una mayor precisión en la planificación.&nbsp

Skeletal and dentoalveolar bilateral dimensions in unilateral palatally impacted canine using cone beam computed tomography

Abstract Background The aim of this investigation was to compare skeletal and dentoalveolar measurements of subject with unilateral palatally impacted canine versus the unaffected contralateral side on cone beam computed tomography (CBCT). Methods A cross-sectional study (split mouth design) that included 28 CBCTs (i.e., 56 sides) with unilaterally impacted maxillary canines was performed. After conducting a pilot test to gauge the researcher, heights and widths of skeletal and dentoalveolar variables obtained in the maxilla were measured using coronal and axial views. The angulations of incisors were also measured, and the side with impaction and the unaffected side were compared. Paired sample t test and Wilcoxon signed-rank test were used. Results Significant statistical differences (2 mm, p < 0.001) were found between the impacted and non-impacted side measurements from the mid-palatine raphe to the first premolar (proximal alveolar bone crest between the canine (deciduous or permanent) and first premolar); the distance were significantly lower (12.72 ± 2.25 mm) than in the side without impaction (14.67 ± 2.00 mm). Also, the central and lateral incisor angulations showed significant reductions; presenting disto-angulated incisors on the impacted canine side (86.14 ± 7.70° and 74.75 ± 12.67°, respectively) and mesial-angulated incisors on the non-impacted side (91.63 ± 6.79° and 81.21 ± 8.56° respectively). The other skeletal and dentoalveolar measurements showed no significant differences. Conclusions The width from the median raphe to the first premolar is lower in the side of maxillary palatal impacted canines than in the side without impaction. Lateral angulations of incisors were disto-angulated on the side of impacted canines. Both conditions have clinical implications in the orthodontic treatment

Tratamiento de fracturas mandibulares bicondilar y parasinfisiariacon reducción abierta y cerrada: Reporte de Caso

La mandíbula es el hueso más frecuentemente fracturado en la región facial. Dentro de estas, las fracturas condilares presentan una incidencia considerable pero su tratamiento sigue siendo tema de discusión, autores apoyan la reducción cerrada como tratamiento conservador, mientras que otros se inclinan por tratamientos quirúrgicos como reducción abierta. El presente reporte de caso describe las características clínicas y radiográficas de la fractura bicondilar y parasinfisiaria izquierda, y su tratamiento, en un paciente masculino de 18 años de edad, que presentó trauma maxilofacial generado por accidente en moto.

Prevalence of impacted teeth and supernumerary teeth by radiographic evaluation in three Latin American countries : a cross-sectional study

Supernumerary teeth are those that exceed the usual dental formula. There are different classifications depending on their anatomical location, shape and number. The objective of this study was to determine the prevalence of impacted and supernumerary te

Tridimensional assessment of the dental follicle dimensions of impacted mandibular third molars using cone-beam CT

The present study was performed to compare follicle dimensions of impacted mandibular third molar (IMTM) with different impaction angulations using cone beam computed tomography (CBCT). Forty-nine individuals with IMTM (24 male, 25 female) were selected. Their age range was 25-55 years. The sample was divided into three IMTM groups either vertical (n=16), mesioangular (n=18) or horizontal (n=15) position based on Winter?s classification (the angle between the longitudinal axis of the second and third molars). Follicular spaces (FS) from available CBCT imaging were measured from the midpoint of the teeth?s crown in several dimensions (mesial, distal, occlusal, apical, vestibular and lingual) in axial, sagittal and coronal planes. An ANOVA, T-student, Kruskal?Wallis and Mann-Whitney U tests were used. A comparison of the mesial FS for all groups revealed significant differences (p<0.001). Significant difference was also found for vestibular FS between the vertical and mesioangular IMTM groups (p=0.04). Buccolingual FS for all groups revealed no significant differences (p=0.074), whereas significant difference was found for the vertical and horizontal IMTM groups (p=0.02). No significant statistical differences were found for occlusal (p=0.54), apical (p=0.06), and lingual (p=0.64) FS. In this sample IMTM follicles have different dimensions according to their degree of angulation. Mesioagulated and horizontally positioned IMTMs seems to consistently have some increased FS dimensions (mesial and vestibular aspects)

Assessment of fractures in endodontically treated teeth restored with and without root canal posts using high-resolution cone beam computed tomography

Root fractures are a diagnostic challenge for dentists in endodontic treatment. This study aimed to determine the relationship between the characteristics of tooth fractures and the presence of root canal posts in endodontically treated teeth using high-resolution cone beam computed tomography (CBCT). Fifty high-resolution CBCT scans of endodontically treated teeth with a diagnosis of fracture were obtained, of which 30 were from women and 20 were from men. These scans were acquired with three Veraviewepocs 3D units and one 3D Accuitomo 170 unit, with a 40 × 40-mm field of view and 125 ?m voxel size. The variables assessed included the type of fracture, extent of fracture, type of retention, post length, cause of endodontic failure, location of the lesion, and time required to detect the fracture (difficulty score). For data analysis, the chi-squared test, Student?s t-test, and multiple linear regression (? 0.05). On the other hand, the type of fracture significantly influenced the time required for its detection. Additionally, the most difficult plane for detecting the fracture and the difficulty score were associated, with statistically significant results. The type of fracture in endodontically treated teeth was not associated with the type of post used for restoration. All of the CBCT systems used to detect tooth fracture showed the same efficiency

Tratamiento de un quiste periapical con relleno de injerto óseo mezclado con fibrina rica en plaquetas adyacente a un implante post exodoncia: Reporte de un Caso

En este caso presentamos el tratamiento realizado en una paciente de 63 años con una lesión quística apical en el maxilar superior que involucra un incisivo lateral, diagnosticada con la ayuda imagenológica de una tomografía computarizada de haz cónico (TCHC) complementada con signos y síntomas clínicos, el procedimiento consistió en una enucleación quirúrgica dejando un defecto amplio de perdida ósea, por lo que se trató con regeneración de xenoinjerto combinada con fibrina rica en plaquetas (PRF), y adyacente se colocó implante post-exodoncia. Se hace un seguimiento de su evolución a los 8 meses con TCHC, para su valoración se evalúa los cambios imagenológica del antes y el después utilizando atenuación de rayos para determinar la densidad ósea. Como en este caso las dos tomografías fueron realizadas en distintos equipos se determinó unificar los archivos Dicom en un solo software (Dolphin Imagen 3D 11.8). El uso combinado del PRF y un xenoinjerto muestran cambios de densidad que promueve la cicatrización y aceleración de la formación de nuevo hueso, dando seguridad para la colocación de un implante circundante evaluado con TCHC.

Three-dimensional evaluation of mandibular canine impaction characteristics and their relationship with lower incisor root morphometry

To three-dimensionally evaluate the characteristics of mandibular canine impaction with the morphometry of the roots of the lower incisors. Cone-beam computed tomography (CBCT) scans of 35 individuals (18 males and 17 females) with a mean age of 14.37±