Multiple supernumerary teeth not associated with complex syndromes: a retrospective study

Objectives: To determine the epidemiology and describe the clinical and radiographic characteristics, the type of treatment, and the possible delayed appearance of new supernumerary teeth in patients with non-syndromic multiple hyperdontia. Patients and Methods: We conducted a small retrospective observational study of 8 patients diagnosed with nonsyndromic multiple hyperdontia. Multiple hyperdontia not associated to complex syndromes was defined as apparently generally healthy patients with one or more supernumerary teeth in two or more areas. Results: The average patient age was 16.23 years; males predominated (3:1). Multiple hyperodontia with a minimum of 2 and a maximum of 9 supernumerary teeth was found (total: 34 mean: 4.25). The most frequent location was the upper jaw (76.47%). Eumorphic teeth were seen at lower premolar level, while the rest were all heteromorphic. There was altered eruption of the contiguous teeth of 4 of the impacted supernumerary teeth all the rest being asymptomatic. Extraction was the treatment in all patients, and in one of them the delayed appearance of 4 supernumerary teeth was detected. Conclusions: Multiple hyperodontia rarely occurs without being associated with complex syndromes. Prophylactic surgical removal of the supernumerary teeth is generally the treatment of choice.

Fragile X-syndrome: literature review and report of two cases

Fragile X-syndrome is caused by a mutation in chromosome X. It is one of the most frequent causes of learning disability. The most frequent manifestations of fragile X-syndrome are learning disability, different orofacial morphological alterations and an increase in testicle size. The disease is associated with cardiac malformations, joint hyperextension and behavioural alterations. We present two male patients aged 17 and 10 years, treated in our Service due to severe gingivitis. Both showed the typical facial and dental characteristics of the syndrome. In addition, we detected the presence of root anomalies such as taurodontism and root bifurcation, which had not been associated with fragile X-syndrome in the literature. In some cases these root malformations have been associated with other sex-linked congenital syndromes, though in none of the studies published in the literature have they been related with fragile X-syndrome. This syndrome is relevant due to its high prevalence, the presentation of certain oral and facial characteristics that can facilitate the diagnosis, and the few cases published to date

Comparative study of two needle models in terms of deflection during inferior alveolar nerve block

Objectives: The purpose of this study is to determine the possible differences in deflection between two needles of same length and external gauge but with different internal gauges during truncal block of the inferior alveolar nerve. The initial working hypothesis was that greater deflection may be expected with larger internal gauge needles. Study design: Four clinicians subjected 346 patients to inferior alveolar nerve block and infiltrating anesthesia of the buccal nerve trajectory for the surgical or conventional extraction of the lower third molar. A nonautoaspirating syringe system with 2 types of needle was used: a standard 27-gauge x 35-mm needle with an internal gauge of 0.215 mm or an XL Monoprotect® 27-gauge x 35-mm needle with an internal gauge of 0.265 mm. The following information was systematically recorded for each patient: needle type, gender, anesthetic technique (direct or indirect truncal block) and the number of bone contacts during the procedure, the patient-extraction side, the practitioner performing the technique, and blood aspiration (either positive or negative). Results: 346 needles were used in total. 190 were standard needles (27-gauge x 35-mm needle with an internal gauge of 0.215 mm) and 156 were XL Monoprotect®. Incidence of deflection was observed in 49.1% of cases (170 needles) where 94 were standard needles and 76 XL Monoprotect®. Needle torsion ranged from 0º and 6º. Conclusions: No significant differences were recorded in terms of deflection and internal gauge, operator, patient-extraction side, the anesthetic technique involved and the number of bone contacts during the procedure

Complications of guided surgery and immediate loading in oral implantology: a report of 12 cases

Objectives: The growing interest in minimally invasive surgery, together with the possibility of fitting prostheses with immediate function, have led to the development of software capable of planning and manufacturing a surgical guide and prosthesis that can be placed upon conclusion of the implant surgery step. The present study evaluates the surgical and prosthetic complications of implant treatment with the guided surgery technique, together with patient comfort during and after treatment. Patients and methods: A retrospective observational study was made of 19 patients with partially or totally edentulous upper and/or lower maxillae, involving the placement of a total of 122 implants. All cases were planned and operated upon with the guided surgery technique. Results: A total of 122 implants were placed in 14 males and 5 females. The intraoperative surgical complications comprised a lack of primary stability, while the postoperative complications consisted of infections and a lack of implant osteointegration. Ten implants failed. The prosthetic complications in turn comprised loosening of the provisional prosthesis screws, prosthesis tooth fracture, and a lack of passive fit of the immediate prosthesis. The degree of patient satisfaction was evaluated using a verbal scale. Conclusions: Implant restoration with the guided surgery technique and immediate functional loading is a predictable procedure, provided patient selection and the surgical technique are adequate, affording lesser postoperative morbidity and increased patient satisfaction thanks to the immediate restoration of esthetics and function

Thermal increment due to ErCr: YSGG and CO2 laser irradiation of different implant surfaces. A pilot study

Objective: An evaluation and comparison is made of the thermal increment at different implant surfaces during irradiation with CO2 and ErCr:YSGG lasers. Study design: Five threaded and impacted implants with four types of surfaces were inserted in an adult pig rib: two implants with a hydroxyapatite surface (HA)(impacted and threaded, respectively), a machined titanium surface implant (TI mach), a titanium plasma spray surface implant (TPS), and a sandblasted, acid-etched surface implant (SBAE). A 0.5-mm diameter bone defect was made in the implant apical zone, and a type-K thermocouple (Termopar)® was placed in contact with the implant. The implants were irradiated in the coronal zone of each implant with a CO2 (4 W continuous mode) and an ErCr:YSGG laser (1.5 W, pulsed mode) first without and then with refrigeration. The temperature variations at the implant apical surface were recorded. Results: An apical temperature increase was recorded in all cases during CO2 and ErCr:YSGG laser irradiation without refrigeration. However, when the ErCr:YSGG was used with a water spray, a decrease in temperature was observed in all implants. The acid-etched and sandblasted surfaces were those most affected by the thermal changes. Conclusions: The ErCr:YSGG laser with a water spray applied to the sealing cap or coronal zone of the implants does not generate thermal increments in the apical surface capable of adversely affecting osseointegration and the integrity of the peri-implant bone tissue

Retrospective study of 145 supernumerary teeth

Objective: The goal of the present retrospective study is to describe the distribution of the supernumerary teeth in a population of patients that have been attended at the Public Clinic of the Department of Oral Surgery. Background: Supernumerary teeth and multiple hyperdontia are usually associated with different syndromes, such as Gardner syndrome, or with facial fissures; however, they can appear in patients without any pathology. Their prevalence oscillates to 0.5-3.8% in patients with permanent teeth and to 0.35-0.6% in patients with primary teeth. Patients and Methods: A total of 36,057 clinical histories of patients that were admitted at the clinic between September of 1991 and March of 2003 were revised. The following data were extrapolated: age, sex, number of extracted supernumerary teeth, localization, morphology and type of supernumerary teeth. Consequently, 102 patients were included into the present study. Results: Of the 147 supernumerary teeth identified in the oral cavities of patients 145 were extracted. The most frequent supernumerary teeth identified were mesiodens (46.9%), followed by premolars (24.1%) and fourth molars or distal molars (18%). As for location, 74.5% of the supernumerary teeth were found in the superior maxillary bone and 46.9% of the supernumerary teeth were present in the palatine/lingual area. Heteromorphology was found in two thirds of the supernumerary teeth, with conical shape being the most frequent. Finally, 29.7% of the supernumerary teeth had occlusion with permanent teeth, and mesiodens were the predominating type of supernumerary teeth that showed this feature. Conclusions: Mesiodens very frequently cause retention of permanent incisors, which erupt spontaneously after the extraction of supernumerary teeth, if there is sufficient space in the dental arch and if they conserve the eruptive force. Generally, supernumerary premolars are eumorphic and are casually discovered during radiological exam, if not producing any symptomology.

Prevalence of smoking among dentists in Catalonia - Spain (2006). Literature review of smoking cessation practices in the dental office

Objective: The objective of this study was to collect data on the prevalence of smokers among Catalonian dentists (by age and sex) and compare them with existing data on the general population, doctors, registered nurses and pharmacists. The overall prevalence of smokers in Catalonia (2006) was 34.5% of men and 24.3% of women. Data available on the prevalence of smoking among doctors (26.3% men and 22.1% women), pharmacists (19.8% men and 20.6% women) and registered nurses (34.1% men and 35.3% women) relates to the year 2002. Study design: In September 2006, Catalonian dentists (n=3,799) were asked about their habits in relation to tobacco in a self-administered questionnaire, on use and opinions with respect to dental amalgam. Five hundred and seventynine questionnaires were received, of which 538 answered the question on smoking (14.2% of the sample universe). Results: The prevalence of smokers among dentists is lower (24.9% of men and 18.4% of women) than in the general population and other healthcare professionals. In dentists in the age group between 25 and 34 years, the prevalence was 26.1% in men and 14.9% in women, while the prevalence in this age group in the general population was 43.6% and 37.1%, respectively. Conclusion: Catalonian dentists have a much lower prevalence of tobacco use than the general population and lower even than other healthcare professionals. Given that non-smoking healthcare professionals have better awareness for providing recommendations for smoking prevention and cessation, Catalonian dentists may be a valid group for performing this task for which there is scientific evidence.

Oral implant rehabilitation in a patient with Moebius syndrome

Introduction: Moebius syndrome is a rare congenital disorder characterized by unilateral or bilateral involvement of the sixth and seventh cranial nerves, resulting in a lack of facial expression and eye movements. These patients suffer a series of oral manifestations that may complicate their dental treatment, such as facial and tongue muscle weakness, uncontrolled salivation secondary to defi cient lip sealing, micrognathia, microstomia, bifi d uvula, gothic and fi ssured palate, fi ssured tongue, and glossoptosis. The underlying etiology remains unclear, though vascular problems during embryogenesis appear to be involved. Clinical case: We report the case of a woman with Moebius syndrome and total edentulism. Eight years ago she underwent complete oral rehabilitation with the placement of two implants in each dental arch. Discussion: Moebius syndrome has still an unknown etiology, although it is related to disorders during pregnancy. This kind of patient can be rehabilitated using oral implants.

Estudi paleodontològic de les restes humanes del jaciment de Forat de Conqueta (Santa Linya, Lleida)

L"estudi ha estat realitzat sobre restes dentals recuperades al jaciment de Forat de Conqueta. La majoria de les dents s"han trobat aïllades, fora del suport ossi, la qual cosa n"ha dificultat la identificació i l"estudi. Entre els objectius de l"estudi paleodontològic, volem destacar la determinació d"un nombre mínim i màxim d"individus a partir de les restes. L"estudi ha estat molt limitat a causa de la tipologia funerària (enterrament col·lectiu en cova) i del ritual d"enterrament (cremació parcial). El resultats provisionals assenyalen que el nombre mínim d"individus representats per la mostra estudiada és de 41 i que, d"aquests, fins a sis individus podrien pertànyer a un grup d"edat infantil o juvenil

Graft materials in oral surgery: revision

Oral implantology is a common procedure in dentistry, especially for fully or partially edentulous patients. The implants must be placed in the best location from both the aesthetic and functional point of view. Because of this it is increasingly more frequent to resort to regeneration techniques that use substitutes of the bone itself, in order to be able to insert the implants in the most appropriate location. Material and Methodology: A review was performed on the literature from the last ten years based on the following search limitations: "graft materials', 'allograft', 'xenograft', 'autologous graft" and 'dentistry". Results: 241 works were obtained that after reading their respective summaries, they were reduced to 38, and 9 previous works were included in order to summarize the concepts. Discussion: Autologous grafts are the 'gold standard' of the bone regeneration. They have obvious advantages, but they also have drawbacks. This is why allogeneic and xenogeneic tissues are used. The former because of their clear similarity with the recipient's tissue and the latter due to their wide availability. Given that these grafts also have drawbacks, the industry has developed synthetic materials that have properties similar to those of human bone tissue. However, as of today, the ideal material to substitute human bone has not yet been found. In recent years the tendency has been to combine these synthetic materials with the patient's own bone, which is extracted during drilling in implant placement, with bone marrow aspiration, or with bone morphogenetic proteins. Thus the intention is to equip these substances with the osteogenic capacity. Conclusions: There is currently no ideal graft material, with the exception of those materials that come directly from the patient. We hope that in the coming years we will have products that will allow us to perform rehabilitations with better results and provide a better quality of life for our patients, especially those who have more complex situations to resolve, like the patients that are operated on for head and neck cancer

Compositional amalgamations and balances: a critical approach

The amalgamation operation is frequently used to reduce the number of parts of compositional data but it is a non-linear operation in the simplex with the usual geometry, the Aitchison geometry. The concept of balances between groups, a particular coordinate system designed over binary partitions of the parts, could be an alternative to the amalgamation in some cases. In this work we discuss the proper application of both concepts using a real data set corresponding to behavioral measures of pregnant sows

Entorn de suport a la inserció de pròtesis

L’objectiu d’aquest projecte és integrar a la plataforma Starviewer ( plataforma informàtica de processament i visualització d’imatges mèdiques creada fruit de la col•laboració del Laboratori de Gràfics i Imatge (GILab) de la Universitat de Girona i l’Institut de Diagnòstic per la Imatge (IDI) de l’hospital Dr. Josep Trueta de Girona) per donar suport al diagnòstic un entorn de suport a la inserció de pròtesis, que permeti automatitzar al màxim les operacions que actualment es realitzen de forma manual. Hem de tenir en compte que, tot i que, la imatge més usada pel radiòleg es la radiografia (Rx) també treballa amb tomografia computada (TAC). El TAC dona una visió 3D de l’organisme, mentre que la Rx és 2D

La relación entre la calidad de la enseñanza y la mala práctica odontológica: relato de caso clínico

Las actividades desarrolladas en el área de la salud son de gran importancia, pues tienen como finalidad preservar la vida de los individuos y para eso deben ser desempeñadas por personas habilitadas. El aumento del número de facultades de Odontología, la disminución en la calidad de la enseñanza y el mayor ingreso de alumnos con baja capacidad para ejercer la profesión son hechos que traen consecuencias desastrosas para la sociedad. Estos hechos también se reflejan en el desempeño moral, ético y técnico-científico del profesional. El objetivo de ese relato de caso clínico es enseñar que, aunque hay una considerable oferta de instituciones de enseñanza, existe un desconocimiento científico y de técnicas adecuadas por parte de los cirujanos dentistas graduados. La paciente MSL, 17 años, sexo femenino, compareció al consultorio odontológico usando un molde tipo Vernis, sujeto al arco inferior. Tras evaluación clínica, se observó la utilización de un material incorrecto para la toma de impresión, siendo imposible su retiro con el método convencional. La planificación para su retiro se hizo por medio de seccionamiento. De esta manera, la consecuencia de la falta de conocimiento en el uso de materiales para la impresión causó gran trastorno a la paciente. Se puede concluir que el índice de impericia está relacionado directamente con la formación profesional, evidenciando la importancia de la enseñanza odontológica de calidad para una práctica clínica responsable.

Avaliação da desmineralização dentária por meio da densidade óptica e difração de raio X em dentes submetidos a clareamento exógeno

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

La relacion entre la calidad de la ensenanza y mala prática odontológica: relato de un caso clínico

The activities developed in health area are of great importance, because they have the aim to preserve the life of the men, and therefore, must be performed by authorized persons. The increase of the number of dental schools, the decline at the education quality and a higher admission of students with low ability to exercise their profession, are facts that bring disastrous consequences for society. These facts are, also, reflected at the moral, ethical and technical-scientific performance of the professional. The purpose of this clinic case is to show that although there is a significant suplly of education institutions, there is a lack of scientific and adequate technical knowledgement from the graduated dentals surgeons. The patient MSL, 17 year old, female, went to a dental clinic presenting a tray type Vernis, attached to the lower arch. After clinical evaluation, it was showed that an incorrect material was used for the impression technique, being impossible to take out the tray by the conventional manner. The planning for the removal of the tray was through the divide of it. Thus, the consequence of the lack of knowledge in the use of impression materials had caused a great incovinience to the patient. It can be concluded that the rate of malpractice is directly related to the professional preparation, highlighting the importance of quality dental education for a responsible clinical practice.