Interceptive Approach to Treatment of Impacted Maxillary Canines

Impaction of maxillary canines can be prevented by early intervention in the mixed dentition phase after the correct diagnosis of malocclusion, reducing the complexity of the treatment. This article reports the case of a 10-year-old patient who possessed impacted maxillary canines and, after early extraction of primary canines, had reestablished favorable permanent successors' eruption axis. This 5-year radiographic follow-up study with panoramic radiography shows that this can be used in practice and that an effective control strategy ensures the accuracy in the inclination of the impacted canines. Treatment success is related to early diagnosis and strategic interceptive treatment choice.

Facial and dental injuries due to dog bite in a 15-month-old child with sequelae in permanent teeth: a case report

This article reports a longitudinal follow-up of a 15-month-old child with dental trauma resulting from an attack by a dog. The injury consisted of laceration of the facial tissues and loss of the upper central deciduous incisors, in addition to loss of bone tissue in the same area. A malformation of the crown of the right central permanent incisor and complete change of the shape of the left central permanent incisor were observed. The etiological factors of childhood injuries as well as the importance of dental emergency care are discussed and the 14-year clinical and radiographic follow up of the case is presented.

The association between prune belly syndrome and dental anomalies: a case report

Background: Prune belly syndrome is a rare condition produced by an early mesodermal defect that causes abdominal abnormalities. However, the literature indicates that disturbances related to ectodermal development may also be present. This is the first case report in the literature to suggest that dental abnormalities are part of the broad spectrum of clinical features of prune belly syndrome. Because the syndrome causes many serious medical problems, early diagnosis of abnormalities involving the primary and permanent dentitions are encouraged.Case presentation: The authors report the clinical case of a 4-year-old Caucasian boy with prune belly syndrome. In addition to the triad of abdominal muscle deficiency, abnormalities of the gastrointestinal and urinary tracts, and cryptorchidism, a geminated mandibular right central incisor, agenesis of a mandibular permanent left incisor, and congenitally missing primary teeth (namely, the mandibular right and left lateral incisors) were noted.Conclusion: This original case report about prune belly syndrome highlights the possibility that dental abnormalities are a part of the broad spectrum of clinical features of the syndrome. Therefore, an accurate intra-oral clinical examination and radiographic evaluation are required for patients with this syndrome in order to provide an early diagnosis of abnormalities involving the primary and permanent dentitions.

Comparação entre os exames radiográficos convencional e digitalizado em relação ao plano de tratamento de superfícies oclusais

O objetivo deste estudo foi comparar as decisões de tratamento restaurador de superfícies oclusais, sem cavitação, quando realizadas através dos aspectos clínicos e radiográficos, convencional e digitalizado. Foram examinados, 33 sítios das superfícies oclusais de 30 molares permanentes extraídos, com e sem pigmentação. O plano de tratamento para cada região foi realizado por 5 cirurgiões-dentistas, professores universitários, utilizando dois tipos de exames: exame visual de fotografias e radiografia interproximal convencional (IV + RXC); e exame visual de fotografias e radiografia digitalizada (IV + DIGORA). O padrão de validação para os planos de tratamento foi realizado através do aspecto histológico. A sensibilidade em determinar a não-necessidade de tratamento restaurador foi, em média, tanto para a IV + RXC quanto para a IV + DIGORA, de 0,23. A especificidade foi, em média, de 0,83 e 0,86, para a IV + RXC e IV + DIGORA, respectivamente. Quando comparou-se os planos de tratamento intra-examinadores, não foi encontrada diferença estatisticamente significante à nível de 5%. Baseado nestes dados, pode-se concluir que os métodos radiográficos, convencional e digitalizado, não demonstraram diferenças na efetividade da determinação do plano de tratamento de superfícies oclusais sem cavitação.

O efeito da retração dos dentes anteriores sobre o ponto A em pacientes submetidos ao tratamento ortodôntico corretivo

OBJETIVO: avaliar o efeito da retração anterior sobre o ponto A sagital e verticalmente, bem como a correlação e a previsibilidade do comportamento dessas estruturas. METODOLOGIA: sessenta telerradiografias em norma lateral foram usadas, tomadas no início e no final do tratamento ortodôntico corretivo, a partir de 30 pacientes (22 feminino e 8 masculino) com idade entre 10 e 17 anos antes do tratamento, com má oclusão de Classe II, divisão 1 ou Classe I, que foram submetidos às extrações dos quatro primeiros pré-molares ou somente dois primeiros pré-molares superiores. Além das variáveis .1NA,1-NA, 1.PP e 1-A, mensurações lineares horizontais e verticais foram feitas em relação a uma linha de referência construída a partir da linha SN menos 7º e uma linha perpendicular a ela. Todos os dados foram mensurados duas vezes, e as médias foram submetidas ao teste t emparelhado, de correlação linear e de regressão. RESULTADOS: em média, o ponto A retraiu 0,71mm e movimentou para baixo 2,38mm, seguindo 1,03mm e 4,13mm de retração, respectivamente, do ápice radicular e da borda incisal, e 2,35mm de extrusão dentária. A retração do ponto A apresentou correlação positiva em relação ao ápice radicular (r = 0,75; alfa < 0,0001) e em relação à retração da borda incisal (r = 0,70; alfa < 0,0001), mostrando um comportamento ântero-posterior previsível. CONCLUSÕES: concluiu-se que o ponto A retraiu-se e movimentou-se para baixo seguindo o dente, e a retração do ponto A em relação aos incisivos foi previsível.

Morfologia das 3ª e 4ª vértebras cervicais representativa do surto de crescimento puberal

OBJETIVOS: determinar a morfologia das 3ª e 4ª vértebras cervicais representativa dos estágios de pré-pico, pico e pós-pico de velocidade de crescimento estatural, definidos previamente pelos centros de ossificação do primeiro dedo em radiografias carpais ou do dedo polegar. MÉTODOS: foram utilizadas 120 telerradiografias em norma lateral de 106 pacientes selecionados da clínica de Ortodontia Preventiva e Interceptiva da Faculdade de Odontologia de Araçatuba-UNESP e Profis/HRAC-USP que apresentavam as correspondentes radiografias carpais ou do dedo polegar. As telerradiografias foram divididas em três grupos de 40 radiografias, de acordo com os estágios maturacionais pré-pico, pico e pós-pico, definidos pela imagem do primeiro dedo. A morfologia dos corpos das 3ª e 4ª vértebras cervicais foi determinada por dois examinadores devidamente calibrados em dois tempos diferentes. CONCLUSÕES: concluiu-se que o formato retangular horizontal com borda inferior reta foi representativo do estágio de pré-pico, independentemente da vértebra analisada. Já o formato retangular horizontal com borda inferior curva, especialmente se encontrado em C4, ou o formato quadrado com borda inferior reta caracterizaram o pico de velocidade de crescimento. O formato quadrado ou, principalmente, o retangular vertical com borda inferior curva determinaram o estágio de pós-pico de velocidade de crescimento da adolescência.

Estudo longitudinal do sucesso clínico-radiográfico de dentes tratados com medicação intracanal de hidróxido de cálcio

INTRODUÇÃO: O tratamento endodôntico é de fundamental importância para abolir a infecção presente em dentes que apresentam necrose pulpar. OBJETIVO: O objetivo do presente estudo foi avaliar clínica e radiograficamente a eficácia dos tratamentos de canais radiculares de dentes com lesão periapical crônica, efetuados pelos graduandos em Odontologia, da Faculdade de Odontologia de Araçatuba - UNESP. MATERIAL E MÉTODO: Foram selecionados 100 pacientes que possuíam dentes com lesão periapical crônica para serem tratados. Após o preparo biomecânico, os canais radiculares receberam uma medicação intracanal de hidróxido de cálcio durante o período de 14 dias. Os canais radiculares foram obturados com cimento endodôntico à base de hidróxido de cálcio. Foi realizada a proservação por um período entre oito e 11 meses. RESULTADO: A análise dos resultados permitiu constatar a porcentagem de 78,46% dos casos com reparo total da lesão periapical e de 21,54% dos casos em que não houve evidências de reparo. CONCLUSÃO: Ocorreu reparo das lesões periapicais nos dentes tratados pelos graduandos da Faculdade de Odontologia de Araçatuba - UNESP.

Sealability of MTA and calcium hydroxide-containing sealers

Objectives: The aim of this study was to evaluate the apical sealability of Fillapex (R), Endo-CPM-Sealer (R) and Sealapex (R). Material and Methods: Ninety-four freshly extracted single-rooted teeth were selected and decoronated. All teeth were radiographed to confirm the existence of a single and straight root canal, which was prepared using Protaper Universal and 2.5% sodium hypochlorite. The teeth were randomly divided in groups of 10 specimens each according to the sealer, and the canals were filled using the single cone technique and one of the sealers. Four additional teeth were used as controls. The teeth were submitted to dye leakage with Rhodamine B for 24 h but using vacuum on the initial 15 min. Thereafter, they were cut longitudinally and the leakage was measured in a linear fashion from apex to crown. Data were analyzed by ANOVA and Tukey's tests at 5% significance level. Results: Fillapex (R) and Sealapex (R) showed significantly less dye leakage than Endo-CPM-Sealer (R) (p<0.05). Conclusions: It was concluded that Fillapex (R) and Sealapex (R) were able to prevent apical dye leakage differently from Endo-CPM-Sealer (R).

Evaluation of the apical infiltration after root canal disruption and obturation

The aim of this study was to evaluate two root canal filling techniques used in teeth that had their apical foramen disrupted and compare the apical infiltration with an ideal clinical situation. Twenty-seven freshly extracted single-rooted teeth were selected and radiographed to confirm the existence of a single and straight root canal. The crowns were removed at a mean distance of 11 mm from the apex. The teeth had the root canals instrumented and were randomly assigned to 3 groups (n=9): ND group-root canals were filled using the lateral compaction technique and no disruption was performed; DRF group-the apical constriction was disrupted by advancing a #40 K-file 1 mm beyond the original working length, the canals were reinstrumented to create an apical ledge at 1 mm from the apical foramen and were obturated with a master gutta-percha cone with same size as the last file used for reinstrumentation; DF group - the teeth had the apical constriction disrupted and the canals were obturated with a master gutta-percha cone that fit at 1 mm from the apex. The teeth were submitted to dye leakage test with Rhodamine B for 7 days, using vaccum on the initial 5 min. The teeth were sectioned longitudinally and the leakage was measured in a linear fashion from apex to crown. There was no statistically significant difference (p>0.05) between the groups that had the apical foramen disrupted (DF, DRF), but significant difference was found between the disrupted groups and the non-disrupted one (p<0.01). In conclusion, none of the evaluated techniques was able to prevent apical infiltration, so working length so the working length determination has to be established and maintained carefully.

Occurrence of yeasts, enterococci and other enteric bacteria in subgingival biofilm of HIV-positive patients with chronic gingivitis and necrotizing periodontitis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiota associated with chronic osteomyelitis of the jaws

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Patient comfort in periapical examination using digital receptors

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Alternative Treatment Modalities for Immature Intruded Permanent Incisors: Report of 2 Cases

Intrusion of permanent teeth is one of the most severe types of traumatic injuries. Different treatment strategies have been proposed, and the best approach for each case depends on the stage of root development, severity of the intrusive luxation, presence of alveolar fracture and number of intruded teeth. The purpose of this paper is to describe the treatment management of 2 cases of severely intruded immature permanent maxillary central incisors in 71/2- and 8-year-old children. In case 1, the traumatized tooth was treated by surgical repositioning, while in case 2 watchful waiting for spontaneous re-eruption was the treatment of choice. Treatment strategies were successful in both cases, as demonstrated by the continuation of root development, maintenance of pulp vitality, and absence of signs of per/apical pathosis during the follow-up period. Regardless of the treatment strategy, traumatically intruded teeth should undergo periodical clinical and radiographic surveillance on a long-term basis to allow early detection of possible complications. (Pediotr Dent 2009;31:340-5) Received March 11, 2008 vertical bar Last Revision June 25, 2008 vertical bar Revision Accepted July 16, 2008

The performance of conventional and fluorescence-based methods for occlusal caries detection An in vivo study with histologic validation

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of cyclosporin A on alveolar bone homeostasis in a rat periodontitis model

Objectives: the administration of cyclosporin A has been associated with significant bone loss and increased bone remodeling. The present investigation was designed to evaluate the effects of cyclosporin A on alveolar bone of rats subjected to experimental periodontitis, using serum, stereometric and radiographic analysis.Methods: Twenty-four rats were divided into one of the following groups with six animals each: group I, control rats; group II, in which the animals received a cotton ligature around the lower first molars; group III, in which the rats received a cotton ligature around the lower first molars and were treated with 10 mg/(kg body weight day) of cyclosporin A; group IV, in which the rats were treated with 10 mg/(kg body weight day) of cyclosporin A. At the end of experimental period, at 30 days, animals were killed and the serum calcium and alkaline phosphatase levels were measured in all groups. The distance from the alveolar bone crest to the cemento-enamel junction was measured radiographically for each mesial surface of the lower first molars of each rat. After histological processing, the stereological parameters: volume densities of multinucleated osteoclasts (V-o), alveolar bone (V-b), marrow (V-m), and relation of eroded surface/bone surface (Es/Bs) were assessed at the mesial region of the alveolar bone.Results: Significant decreases in serum calcium were observed in those groups that received cyclosporin A therapy. No significant changes in serum alkaline phosphatase were observed. The therapy with cyclosporin A combined with the ligature placement decreased the V-b and increased the V-o, V-m and Es/Bs at the mesial surface of lower first molars. on the other hand, the radiographic data showed that cyclosporin A therapy diminished the alveolar bone loss at the mesial surface of the lower first molars.Conclusions: Therefore, within the limits of this study, we suggest that cyclosporin A at immunosuppressive levels can bring about an imbalance in the alveolar bone homeostasis in rats. However, in the presence of inflammatory stimulation, the inhibition of the immune system by cyclosporin A may decrease the initial periodontal breakdown.