Aplicación de nuevas tenologías tridimensionales para la planificación, diagnóstico y valoración de las necesidades de tratamiento ortodóncico y ortodóncico-quirúrgico

El análisis teórico anterior, basado en una amplia y exhaustiva revisión bibliográfica, es el fundamento para plantear los objetivos e hipótesis del proyecto de investigación propuesto. La radiografía cefalométrica es un método muy importante de utilidad tanto para clínicos como para investigadores del crecimiento facial. La mayoría de los análisis cefalométricos existentes se basan en el uso de radiografías laterales y posteroanteriores. Sin embargo, este tipo de análisis cefalométricos convencionales tienen diversas limitaciones (165, 166). En la radiografía lateral es difícil determinar diferencias entre lado derecho e izquierdo debido a la superposición de imágenes y por la diferente mangificación de ambos. Además, no se pueden detectar deformidades en el área mediofacial. En la radiografía posteroanterior y basilar, las imágenes se pueden distorsionar por la posición de la cabeza durante el procesamiento de la imagen. Además, la interpretación de estas imágenes se torna compleja debido a la superposición de las estructuras craneales. La cefalometría convencional requiere de múltiples mediciones de ángulos para evaluar la dirección de movimiento de un punto de referencia. A pesar de ello, es dificultoso determinar lo que ocurre en el complejo craneo-dento-facial midiendo únicamente una serie de ángulos proyectados en películas radiográficas en 2D. Además, la cefalometría convencional 2D proyecta las estructuras en 3D en 2D. Por ello, es difícil comparar directamente longitudes y ángulos para la evaluación de los efectos del tratamiento y para la planificación del tratamiento. Pero quizá el punto más importante a nivel clínico sea, sin embargo, encontrar diferencias o cambios en los diferentes exámenes y determinar el plan de tratamiento quirúrgico para el tratamiento de la deformidad del complejo craneo-dento-facial

Teaching Experience Based on Self-Evaluation Techniques and Clinical Dental Reasoning by Means of New Technologies

En este artículo se analiza la introducción de un sistema de autoevaluación on-line para demostrar las competencias adquiridas por parte del alumnado tras la participación de un especialista en Odontología que permita la aplicación de una ciencia básica como es la Histología en el razonamiento clínico y en la práctica Odontológica. El alumnado mostró una mayor satisfacción con el método así como mejoró la capacidad de adquisición de las competencias específicas de la asignatura.This article discusses the introduction of online self-assessment in order to demonstrate the skills acquired by students after the participation in class of a dentistry specialist who applies of a basic science such as histology in clinical reasoning and in dental practice. The students showed greater satisfaction with the new method as well as an improved ability in order to acquire the specific subject skills

Odontoma compuesto asociado a canino permanente inferior incluido

El odontoma representa el tumor odontogénico más frecuente. Normalmente está asociado con un diente permanente impactado, localizándose entre la corona del diente y el proceso alveolar, impidiendo su correcta erupción. El tumor odontogénico asociado con más frecuencia a un canino incluido es el odontoma compuesto, dada la localización preferente de esta entidad en la zona anterior del maxilar. En este artículo se describe el diagnóstico y tratamiento de un paciente de 42 años de edad con presencia de un canino permanente inferior asociado a un odontoma.The most prevalence odontogenic tumor is odontoma. Frequently odontomas are associated with a permanent impacted tooth, interfering with normal tooth eruption. Compound odontoma is a comparatively common odontogenic tumor, which may associate with an included canine. The purpose of this report is to present a case of 42y patient with an included lower canine associated with an odontoma

Decoronation: An Alternative Treatment for Replacement Root Resorption

Introduction. Ankylosis and disrupted or altered root development are frequent complications associated with intrusive luxation and tooth avulsion lesions. Various forms of treatment have been described according to the severity of the trauma and root development. The literature shows that decoronation is an ideal treatment in cases where replacement resorption occurs. Methods. Two clinical cases are presented: involving intrusive luxation [15-year-old female patient with an affected maxillary left lateral incisor (2.2)] and a replanted avulsed tooth [8-year-old male patient with avulsion of the right maxillary central incisor (1.1)]; both cases presented advanced root resorption so that decoronation with a prosthetic tooth replacement was decided as the final treatment option. Results. In the short-term follow-up, patients were asymptomatic and had no functional problems. Radiographs showed that crestal bone height had been preserved. Conclusions. Preserving the decoronated root in the alveolar process not only helps to maintain bone volume but also enables vertical bone growth and facilitates the future insertion of an implant

Interleukin 1 receptor antagonist (IL1RN) genetic variations condition post-orthodontic external root resorption in endodontically-treated teeth

External pical root resorption (EARR) is a frequent iatrogenic problem following orthodontic treatment in endodontically-treated teeth, about which the literature reports substantial variability in post-orthodontic treatment EARR responses. The main focus of the present study is to clarify whether variants in the interleukin-1 receptor antagonist gene coding for the IL-1ra protein have a positive/negative influence on EARR of endodontically-treated teeth. Ninety-three orthodontic patients were genetically screened for a single nucleotide polymorphism (SNP: rs419598) in the IL1 cluster. The sample was classified into 2 groups: group 1 (affected-group) showed radiographic EARR of more than 2mm; group 2 (control-group), had no EARR or EARR <= to 2mm following orthodontic treatment on root-filled teeth. Logistic regression analysis was performed to obtain an adjusted estimate between the SNPs studied and EARR. Genotype distributions, allelic frequencies, adjusted odds ratios (OR) and 95% confidence intervals were also calculated. We found that subjects homozygous [1/1(TT)] for the IL1RN gene [OR: 10.85; p=0.001; CI: 95%] were at risk of EARR in root-filled teeth. Genetic variants in the antagonist axis balance of the IL1RN(rs419598) have a direct repercussion on the predisposition to post-orthodontic EARR in root-filled teeth. Variants in allele 1 of the interleukin-1 receptor antagonist gene(rs419598) are associated(p=0.001**) with an increased risk of suffering post-orthodontic EARR in root-filled teeth

Apexification with mineral trioxide aggregate plug in the upper anterior teeth: Presentation of three clinical cases

AbstrAct Introduction: the aim is to describe the treatment of three immature permanent incisors associated to apical periodontitis, based on the placement of an apical mineral trioxide aggregate (MtA) plug for apexification. case series: Apexification was carried out by opening the pulp chamber, with debridement of the canal following anesthesia and isolation of the tooth. the canal was filled with pure calcium hydroxide in powder form, dissolved in saline solution for one week, and the aperture was sealed with IrM (Dentsply, Germany). One week later, the calcium hydroxide was removed and an MtA apical plug was positioned, sealing with a humid cotton pellet and IrM (Dentsply, Germany). After setting of the MtA, conventional endodontic treatment was carried out using gutta-percha, with definitive restoration of the tooth. conclusion: All three cases, treated with MtA showed complete apical repair with rounding of the apex at radiographi

Resultados de la implementación del plan de innovación docente universitaria en odontopediatría

La necesaria adaptación de los métodos de aprendizaje a la filosofía del Espacio Europeo de Educación Superior (EEES) exige un esfuerzo docente para estar en situación de asumir dichos cambios en los nuevos planes de estudio. Se realizó una evaluación del sistema de aprendizaje en 74 alumnos de la asignatura de Odontopediatría del Grado de Odontología. Se dividió la asignatura en bloques temáticos confeccionándose para cada uno el temario en la plataforma virtual así como un manual escrito y videos multimedia de refuerzo. Por último, se realizó una evaluación del rendimiento académico y el grado de satisfacción del alumno en el nuevo programa de aprendizaje en base a la filosofía del Espacio Europeo de Educación Superior (EEES)

Decoronation: An Alternative Treatment for Replacement Root Resorption

Introduction. Ankylosis and disrupted or altered root development are frequent complications associated with intrusive luxation and tooth avulsion lesions. Various forms of treatment have been described according to the severity of the trauma and root development. The literature shows that decoronation is an ideal treatment in cases where replacement resorption occurs. Methods. Two clinical cases are presented: involving intrusive luxation [15-year-old female patient with an affected maxillary left lateral incisor (2.2)] and a replanted avulsed tooth [8-year-old male patient with avulsion of the right maxillary central incisor (1.1)]; both cases presented advanced root resorption so that decoronation with a prosthetic tooth replacement was decided as the final treatment option. Results. In the short-term follow-up, patients were asymptomatic and had no functional problems. Radiographs showed that crestal bone height had been preserved. Conclusions. Preserving the decoronated root in the alveolar process not only helps to maintain bone volume but also enables vertical bone growth and facilitates the future insertion of an implant

Unusual Case of Extraction of Maxillary Lateral Incisors and Mandibular Central Incisors

This article’s purpose is to report a case where maxillary lateral incisors and mandibular central incisors are extracted and a canine substitution was performed as the best therapeutic option in order to obtain symmetry in a malocclusion with an upper lateral incisor with poor prognostic, solve moderate crowding, get enough space for the permanent dentition, and provide stability to the results. Case Report. An 11-year-old boy with straight profile with acute-to-normal nasolabial angle and protruded lips, mixed dentition, lower and upper severe crowding, and a bilateral molar angle Class I. The left maxillary lateral incisor failed endodontic treatment secondary to an intrusive traumatic lesion in the primary and permanent dentition. The treatment of choice was the extraction of both upper lateral incisors and both central lower incisors. The patient finished with molar and canine angle Class I and coincident midlines and was functionally stable; both lateral and protrusive jaw movements were effectively made by the first premolars and central incisors and canines without improper contacts of the rest of the teeth. Overbite of one-third and correct overjet were also achieved, and the esthetic outcome was satisfactory due to the composed material restorations of both the central and lateral incisors, as well as recontouring of the first maxillary premolars.status: publishe

GWAS of Post-Orthodontic Aggressive External Apical Root Resorption Identified Multiple Putative Loci at X-Y Chromosomes.

Personalized dental medicine requires from precise and customized genomic diagnostic. To conduct an association analysis over multiple putative loci and genes located at chromosomes 2, 4, 8, 12, 18, X, and Y, potentially implicated in an extreme type of external apical root resorption secondary to orthodontic forces (aEARR). A genome-wide association study of aEARR was conducted with 480 patients [ratio~1:3 case/control]. Genomic DNA was extracted and analyzed using the high-throughput Axiom platform with the GeneTitan® MC Instrument. Up to 14,377 single nucleotide polymorphisms (SNPs) were selected at candidate regions and clinical/diagnostic data were recorded. A descriptive analysis of the data along with a backward conditional binary logistic regression was used to calculate odds ratios, with 95% confidence intervals [p < 0.05]. To select the best SNP candidates, a logistic regression model was fitted assuming a log-additive genetic model using R software [p < 0.0001]. In this sample the top lead genetic variants associated with aEARR were two novel putative genes located in the X chromosome, specifically, STAG 2 gene, rs151184635 and RP1-30E17.2 gene, rs55839915. These variants were found to be associated with an increased risk of aEARR, particularly restricted to men [OR: 6.09; 95%CI: 2.6-14.23 and OR: 6.86; 95%CI: 2.65-17.81, respectively]. Marginal associations were found at previously studied variants such as SSP1: rs11730582 [OR: 0.54; 95%CI: 0.34-0.86; p = 0.008], P2RX7: rs1718119 [OR: 0.6; 95%CI: 0.36-1.01; p = 0.047], and TNFRSF11A: rs8086340 [OR: 0.6; 95%CI: 0.38-0.95; p = 0.024]), found solely in females. Multiple putative genetic variants located at chromosomes X and Y are potentially implicated in an extreme phenotype of aEARR. A gender-linked association was noted.This research was funded by the European Orthodontic Society Research Award, 2017.S