Eruption sequestrum - case report and histopathological findings

Eruption sequestrum is an uncommon disturbance in eruption and consists of small fragments of calcified tissue overlying the crowns of erupting permanent molar teeth, especially at the time of eruption of the mandibular first molars. This paper reports a case of unilateral eruption sequestrum in a 7-year-old Brazilian boy and describes its histopathological findings. A white small fragment, 0.5 cm in diameter, with hard consistency, irregular shape and located on the occlusal surface of the erupting mandibular left first molar was excised. Microscopic examination revealed large trabeculae with empty lacunae and a minimal amount of existing spongy bone consisting of acute inflammatory cells (neutrophils). Signs of necrosis were found on the periphery. The histological analysis was consistent with non-vital bone and the diagnosis of eruption sequestrum was established. Clinical and radiographic follow-up visits scheduled at short intervals and then every 6 months revealed normal postoperative conditions.

A randomized controlled trial of a 10 percent CPP-ACP cream to reduce mutans streptococci colonization

Purpose The purpose of this study was to investigate the effectiveness of a 10 percent casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) cream to reduce mutans streptococci (MS) colonization and prevent early childhood caries. Methods The cohort was randomized at mean age of 11 days old to receive once-daily CPP-ACP cream (n=102) or no product (comparison group; n=89) from the time of first tooth eruption. All mothers were contacted by telephone at six, 12, and 18 months and advised to brush their children's teeth twice daily with low-dose fluoride toothpaste. At 24 months, all children were examined at a community clinic. Results At 24 months old, one out of 65 (2 percent) children in the CPP-ACP group had caries vs. four out of 58 (seven percent) in the comparison group (difference not statistically significant). There were fewer MS-positive children in the CPP-ACP group (26 percent) vs. the comparison group (47 percent; P=.02). A dose-response effect of CPP-ACP usage on MS was observed, where MS was present in eight percent of regular CPP-ACP users, 28 percent of irregular users, and 47 percent of non-users (P<.02). Conclusions CPP-ACP reduced the percentages of mutans streptococci-positive 24-month-old children, although it did not reduce caries prevalence.

Sintomatologia associada à erupção dentária

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Molar Incisor Hypomineralization

Enamel defects are common alterations that can occur in both the primary or permanent dentition. A range of etiological factors related to this pathology can be found in the literature. Molar Incisor Hypomineralization (MIH) is a kind of enamel defect alteration that requires complex treatment solutions, and for this reason, it is of great clinical interest for dental practice. This article describes the management of a clinical case of MIH in a 7-year-old child. The different treatment options depending on the extension of the defect, the degree of tooth eruption and the hygiene and diet habits of the patient are also discussed.

Cara inchada of cattle, an infectious, apparently soil antibiotics-dependant periodontitis in Brazil

O objetivo desta revisão das pesquisas sobre a cara inchada dos bovinos (CI), realizadas no decorrer dos últimos 30 anos, é de elucidar melhor a sua etiologia. A CI geralmente tem sido considerada de origem nutricional, causada primariamente por deficiência ou desequilíbrio mineral. A doença caracteriza-se por uma periodontite rapidamente progressiva, que afeta os tecidos peridentários a nível dos premolares e molares no período de erupção dos dentes e que se inicia geralmente em bezerros jovens. A doença causou grandes perdas econômicas aos pecuaristas da Região Centro-Oeste do Brasil, nas décadas de 1960 e 1970, com a ocupação de novas terras para criação de gado. O freqüente abaulamento lateral dos ossos maxilares nos bezerros, que deu à doença o nome popular de cara inchada, foi demonstrado ser conseqüente à periostite crônica ossificante resultante da alveolite purulenta da CI. Das lesões peridentárias foi isolado, em grande número, Bacteroides melaninogenicus, sempre junto com Actinomyces (Corynebacterium) pyogenes. Bactérias classificadas como pertencentes ao grupo sacarolí-tico e não-sacarolítico dos pigmentados de negro Bacteroides melaninogenicus e Bacteroides spp também foram isoladas, em pequeno número, de bovinos jovens sadios de fazendas CI-negativas. Ensaios in vitro mostraram que os antibióticos estreptomicina e actinomicina, bem como os sobrenadantes de cultivos de actinomicetos do solo de fazendas CI-positivas, aplicadas nas bactérias ensaiadas em concentrações subinibidoras, aumentaram significativamente (até 10 vezes) a aderência de B.melaninogenicus a células epiteliais da gengiva bovina. Esses antibióticos são produzidos no solo em conseqüência de um aumento do número de actinomicetos, incluindo os do gênero Streptomyces, quando há modificação de sua microbiota em áreas previamente ocupadas por mata virgem ou vegetação natural de Cerrado, que foram cultivadas pela primeira vez na formação de pastagem para o gado. em face da epidemiologia da CI, há fortes evidências de que a ingestão desses antibióticos pelos bovinos, junto com a forrageira, seja importante fator desencadeante para o desenvolvimento da periodontite. Através do aumento da aderência de B. melaninogenicus ao epitélio da gengiva marginal, em face da ingestão dos antibióticos pelos animais, as bactérias conseguem colonizar, formar a placa bacteriana e tornar-se patogênicas. Há evidência de que o fator desencadeante (aparentemente, os antibióticos) esteja também presente no leite de vacas-mães de bezerros afetados pela CI. Foi demonstrado que as bactérias envolvidas na periodontite produzem enzimas e endotoxinas capazes de ação destrutiva sobre os tecidos peridentários. A epidemiologia da CI, com a diminuição de sua incidência e o seu desaparecimento no decorrer dos anos, pode ser explicada pelo fato de que o prévio equílibrio da microbiota no solo virgem foi alcançado novamente e a produção dos antibióticos se reduziu. Desta maneira, a CI deve ser considerada como uma periodontite infecciosa multifatorial, causada sobretudo por bactérias anaeróbias pertencentes ao grupo Bacteroides melaninogenicus e, ao que tudo indica, desencadeada pela ingestão contínua, com a forrageira, de concentrações subinibidoras de antibióticos de solos recentememente cultivados. Esta hipótese é reforçada pela observação recente de novos surtos de CI, em áreas anteriormente positivas para a doença, em conseqüência da reforma de pastagens e capineiras após muitos anos. A natureza infecciosa da CI-periodontite foi confirmada através de experimento, em que virginiamicina mostrou-se eficaz no tratamento oral de bovinos afetados pela doença. Os antibióticos espiramicina e virginiamicina, usados como aditivos em suplementos minerais no campo, mostraram-se eficientes na prevenção da CI.

Alterações orais em crianças prematuras e de baixo peso ao nascer: a importância da relação entre pediatras e odontopediatras

OBJETIVO: Apresentar uma revisão de literatura sobre as alterações orais em crianças prematuras e de baixo peso ao nascer. FONTES DE DADOS: Foram selecionados artigos em inglês e português, desde 1976 até 2009, pesquisados no PubMed, Lilacs e na Bibliografia Brasileira de Odontologia (BBO), além de livros e consensos nacionais e internacionais. As palavras-chave utilizadas foram: prematuro, recém-nascido de baixo peso, cárie dentária, hipoplasia do esmalte dentário, manifestações bucais e dentição primária. Selecionaram-se artigos avaliando incidência, prevalência e etiologia das alterações orais, além de revisões de literatura e relatos de casos clínicos. SÍNTESE DOS DADOS: As alterações orais mais comuns em crianças prematuras e de baixo peso ao nascer são os defeitos no esmalte dentário (hipoplasias e hipocalcificações), a predisposição ao desenvolvimento de lesões de cárie dentária, as alterações na cronologia de erupção dentária e as alterações no palato com consequente aparecimento de maloclusão. Outras alterações também são relatadas, como diferenças nas dimensões das coroas dentárias e na espessura e porosidade do esmalte dentário. A interação entre pediatras e odontopediatras é fundamental no manejo dessas crianças. CONCLUSÕES: O conhecimento das alterações orais em crianças pré-termo e de baixo peso ao nascer por parte dos pediatras e odontopediatras favorece a atuação multidisciplinar com o objetivo de educar, prevenir e atenuar as possíveis mudanças físicas e dentárias nessas crianças.

Estudio radiográfico do desenvolvimento da dentição permanente de crianças brasileiras com idade cronológica variando entre 84 e 131 meses.

With the help of orthopantomograms we analyse the tooth development beside body weight and height from Brazilian healthy boys and girls. So, their dental age were compared to their chronological age. The results of this investigation, according to the methodology employed, indicated that: 1. girls showed accelerated formation of permanent teeth and mean values of dental age higher than boys; 2. the mean values of dental age in girls were higher than their chronological age in all groups; 3. the teeth development stages were appropriate in assessment of the degree of physiological maturity of a growing child.

Incontinentia pigmenti (Bloch-Sulzberger syndrome): a case report.

A syndrome--incontinentia pigmenti--of probable genetic etiology, is discussed and a new case report presented. The syndrome presents systemic and dental manifestations, which are separate although similar to those found in other disease entities, i.e., congenital syphilis, hereditary ectodermal dysplasia.

Pulpal and periodontal reactions of immature permanent teeth in the dog to intrusive trauma.

Pulpal and periodontal tissues of immature incisors of 10 dogs were radiographically and histopathologically evaluated immediately, 7, 15, 30 and 60 days after experimental intrusion induced by mechanical blows. Forty upper central and mesial lateral incisors showing incomplete root formation on radiographs were submitted to intrusive force. After the observation periods, the dogs were killed, two at a time. The hemi-maxilas were removed and processed for histopathologic examination. The traumatized teeth showed accelerated apical formation with reduced radicular length. Pulpal vitality was maintained and the subjacent tissues did not present irreversible changes. All traumatized teeth re-erupted spontaneously.

Natal and neonatal teeth: Review of the literature

Child development from conception through the first years of life is marked by many changes. Tooth eruption follows a chronology corresponding to the date when the tooth erupts into the oral cavity. These dates have been established in the literature and are subjected to small variations depending on hereditary, endocrine and environmental features. At times, however, the chronology of tooth eruption suffers a more significant alteration in terms of onset, and the first teeth may be present at birth or arise during the first month of life. The expectations about the eruption of the first teeth are great and even greater when the teeth appear early in the oral cavity. The objective of the present study was to present a review of the literature with important aspects about natal and neonatal teeth.

Conservative treatment of a radicular cyst in a 5-year-old child: A case report

The present report describes the management of a radicular cyst in a 5-year-old child. The treatment comprised extraction of the primary teeth involved followed by marsupialization. A removable appliance with a resin extension penetrating into the cystic cavity was used to help decompress the lesion. This treatment allowed rapid healing of the lesion and eruption of the permanent incisors without the need for orthodontic treatment.

Systemic and local teething disturbances: Prevalence in a clinic for infants

The aim of this study was to present data as reported by parents on primary tooth eruption and the occurrence of local and systemic manifestations in children ages 0 to 3 years seen at the baby clinic of the Araçatuba Dental School, UNESP, São Paulo, Brazil. Data from 1,813 records were analyzed, yielding 1,165 records suitable for review. Some type of local and/or systemic manifestation during primary tooth eruption was reported for 95% (1,129) children studied. The predominant manifestation was gingival irritation (85%), while the least frequent symptom (26%) was a runny nose.

Familial malignant osteopetrosis in children: A case report

The clinical, radiological, pathological and laboratory findings of two brothers with autosomal recessive malignant osteopetrosis are presented. Our findings are similar to characteristics previously reported in the literature about patients with osteopetrosis. The 6-year-old male patient was pale and had petechiae on his arms and legs. He also had macrocephalia, splenomegaly, severe pancytopenia, genu valgus, hypocalcemia, amaurosis, cessation of physical development, generalized bone sclerosis and recurrent infections with a history of multiple incidences of acute otitis media. Generalized bone sclerosis and irregular sclerosis of the maxilla and mandible were seen on radiographs. The oral mucosa was apparently normal but permanent tooth eruption was delayed although there was early loss of deciduous teeth. The recommended treatment was blood transfusion and therapy with antibiotics when necessary; a bone marrow transplant was not possible due to lack of a compatible donor.

Orthognathic Surgery in the Young Cleft Patient: Preliminary Study on Subsequent Facial Growth

Purpose: This study evaluated the long-term effects of orthognathic surgery on subsequent growth of the maxillomandibular complex in the young cleft patient. Patients and Methods: We evaluated 12 young cleft patients (9 male and 3 female patients), with a mean age of 12 years 6 months (range, 9 years 8 months to 15 years 4 months), who underwent Le Fort I osteotomies, with maxillary advancement, expansion, and/or downgrafting, by use of autogenous bone or hydroxyapatite grafts, when indicated, for maxillary stabilization. Five patients had concomitant osteotomies of the mandibular ramus. All patients had presurgical and postsurgical orthodontic treatment to control the occlusion. Radiographs taken at initial evaluation (T1) and presurgery (T2) were compared to establish the facial growth vector before surgery, whereas radiographs taken immediately postsurgery (T3) and at longest follow-up (T4) were used to determine postsurgical growth. Each patient's lateral cephalograms were traced, and 16 landmarks were identified and used to compute 11 measurements describing presurgical and postsurgical growth. Results: Before surgery, all patients had relatively normal growth. After surgery, cephalograms showed statistically significant growth changes from T3 to T4, with the maxillary depth decreasing by -3.3° ± 1.8°, Sella-nasion-point A by -3.3° ± 1.8°, and point A-nasion-point B by -3.6° ± 2.8°. The angulation of the maxillary incisors increased by 9.2° ± 11.7°. Of 12 patients, 11 showed disproportionate postsurgical jaw growth. Maxillary growth occurred predominantly in a vertical vector with no anteroposterior growth, even though most patients had shown anteroposterior growth before surgery. The distance increased in the linear measurement from nasion to gnathion by 10.3 ± 7.9 mm. Four of 5 patients operated on during the mixed dentition phase had teeth that erupted through the cleft area. A variable impairment of postoperative growth was seen with the 2 types of grafting material used. No significant difference was noted in the effect on growth in patients with unilateral clefts versus those with bilateral clefts. The presence of a pharyngeal flap was noted to adversely affect growth, whereas simultaneous mandibular surgery did not. After surgery, 11 of 12 patients tended toward a Class III end-on occlusal relation. Conclusions: Orthognathic surgery may be performed on growing cleft patients when mandated by psychological and/or functional concerns. The surgeon must be cognizant of the adverse postsurgical growth outcomes when performing orthognathic surgery on growing cleft patients with the possibility for further surgery requirements. Performing maxillary osteotomies on cleft patients would be more predictable after completion of facial growth. © 2008 American Association of Oral and Maxillofacial Surgeons.

Uprighting impacted mandibular second molars with orthodontic elastic separating rings.

A 16-year-old girl presented with complaints of recurrent spontaneous pain in the mandibular second molar region. Treatment favored use of a simple uprighting technique involving orthodontic elastic separating rings.