All-on-four híbrido - implante pterigoide para solução posterior de maxila atrófica / All-on-four hybrid - pterygoid implant for posterior solution of atrophic maxilla

O edentulismo tem uma série de consequências deletérias para a saúde bucal e geral. As consequências bucais variam desde a bem conhecida reabsorção do rebordo residual até uma função mastigatória prejudicada, uma dieta não saudável, incapacidade social e má qualidade de vida da saúde bucal. Para superar essas dificuldades, pode-se dispor de procedimentos cirúrgicos, como os implantes pterigoideos. Realizar uma análise, por meio de revisão de literatura, da técnica all-on-four híbrida com implantes pterigoideos, como alternativa a reabilitação em maxila atrófica. Foi realizada uma revisão da literatura, com seleção de artigos indexados nas bases de dados PubMed, Scielo, Cochrane e Google Acadêmico. Nesses levantamentos foram utilizados termos como: "all-on-four", "implantes inclinados", "implantes pterigoideos", "implantes zigomáticos" e "maxilla atrófica", e suas correspondentes em inglês. Com essa revisão de literatura pode-se inferir que a técnica all-on-four híbrida utilizando implantes pterigoideos para reabilitação de maxila atrófica é uma possibilidade segura, eficaz e previsível que soluciona casos que apresentam limitações ósseas. Quando bem executada pelo profissional é possível devolver ao paciente função e estética anteriormente comprometidas, consequentemente reestabelecimento da qualidade de vida do indivíduo.

Edentulism has a number of deleterious consequences for oral and general health. Oral consequences range from the well-known residual ridge resorption to impaired masticatory function, an unhealthy diet, social disability and poor oral health quality of life. To overcome these difficulties, surgical procedures can be used, such as pterygoid implants. However, these are not without complications. Through a literature review, of the hybrid all-on-four technique with pterygoid implants as an alternative to rehabilitation in atrophic maxilla. For this, bibliographic research was carried out in the databases PubMed, Scielo, Cochrane and Google Scholar, using the following search terms: "all-on-four", "tilted implants", "pterygoid implants", "zygomatic implants" e "atrophic maxilla", in both Portuguese and English languages. With this literature review, It can be inferred that the hybrid all-on-four technique using pterygoid implants for rehabilitation of atrophic maxilla is a safe, effective and predictable possibility that solves cases with bone limitations. When well performed by the professional, it is possible to return previously compromised function and aesthetics to the patient, consequently reestablishing the individual's quality of life.

Nasolabial anthropometry using 3D computed tomography scan reconstruction: baseline study for nasolabial correction in Indonesian children with cleft lip and palate / Antropometría nasolabial mediante reconstrucción con tomografía computarizada 3D: estudio de referencia para la corrección nasolabial en niños Indonesios con fisura labiopalatina

Background: The normal nasolabial structure of infants and chil-dren from East Asian, specifically Indonesian, descent groups has been less explored in the literature. This anthropometric study is used as a guide in lip repair in patients with clefts. This retrospective study used archived CT images from the Indonesian population. Materials and Methods: Computed tomography records of children under 5 years of age were extracted from a provincial hospital. The images were then filtered based on the inclusion and exclusion criteria and then the 2D slices were reconstructed using the open source software Invesalius. Twenty-five variable nasolabial parameters of the nasolabial structure were then measured in the 3D rendering mode. Images with craniofacial dysmorphism or cannulas that passed over the nasolabial structure were excluded. Results were summarized using descriptive statistics. Results: Fourteen of 128 CT images were included in this study. The samples were divided into two age groups: 0-12 months and 25-54 months. There were moderate to strong, positive correlations between age and all nasolabial variables, which were statistically significant (p<0.05) except for nasal length, nares circumference, columella width, superior philtrum width, philtrum column height, and cutaneous upper lip height. Conclusions: This study described anthropometric measurements of normal nasolabial structures as a reference point for lip correction surgery. However, to obtain more accurate anthropometric guidelines, further studies with larger sample sizes are desirable. Although surgical repair of the lip is usually performed within the first year of life, some cases of surgery are performed after infancy.

Antecedentes: La estructura nasolabial normal de bebés y niños de grupos de ascendencia de Asia oriental, específicamente de Indonesia, ha sido menos explorada en la literatura. Este estudio antropométrico se utiliza como guía en la reparación del labio en pacientes con fisuras. Este estudio retrospectivo utilizó imágenes de tomografía computarizada archivadas de la población indonesia. Materiales y Métodos: Se extrajeron los registros de tomografía computarizada de niños menores de 5 años de un hospital provincial. Luego, las imágenes se filtraron según los criterios de inclusión y exclusión y luego se reconstruyeron los cortes 2D utilizando el software de código abierto Invesalius. Luego se midieron veinticinco parámetros nasolabiales variables de la estructura nasolabial en el modo renderizado 3D. Se excluyeron imágenes con dismórfica craneofacial y cánula que pasa sobre la estructura nasolabial. Los resultados se resumen mediante estadística descriptiva. Resultado: En este estudio se incluyeron catorce de 128 imágenes de TC. Las muestras se dividieron en dos grupos de edad: 0-12 meses y 25-54 meses. Hubo una correlación positiva de moderada a fuerte entre la edad y todas las variables nasolabiales, que fueron estadísticamente significativas (p<0,05) excepto la longitud nasal, la circunferencia de las narinas, el ancho de la columela, el ancho del filtrum superior, la altura de la columna del filtrum y la altura cutánea del labio superior. Conclusión: Este estudio describió las medidas antropométricas de estructuras nasolabiales normales como base para la cirugía de corrección de labios. Sin embargo, para obtener directrices antropométricas más precisas, son deseables más estudios con tamaños de muestra más grandes. Aunque la reparación quirúrgica del labio normalmente se realiza dentro del primer año de vida, en algunos casos la cirugía se realiza después de la infancia.

Tratamento reabilitador com prótese obturadora em paciente acometido por maxilectomia parcial: relato de caso / Rehabilitative treatment with obturator prosthesis in a patient suffering from partial maxillectomy: case report

Introdução: O tratamento de tumores malignos ou benignos, podem resultar em procedimentos cirúrgicos, como a maxilectomia parcial ou total, gerando comunicação bucosinusal nos pacientes. Uma forma de resolver estas alterações maxilofaciais é através do tratamento reabilitador com próteses obturadoras a fim de restabelecer a função mastigatória, estética, fonética e psicológica. Objetivo: o objetivo deste trabalho foi relatar o caso clínico de um paciente oncológico que foi reabilitado com prótese obturadora devido à maxilectomia por neoplasia maligna de seio maxilar. Relato de caso: Paciente de 62 anos, sexo masculino, procurou atendimento odontológico no Centro de Oncologia Bucal da Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) de Araçatuba ­ SP após a realização de uma maxilectomia parcial com comunicação bucosinusal e foi encaminhado para o Curso de Especialização em Prótese Dentária da Faculdade de Odontologia ­ Unesp/Araçatuba-SP para a reabilitação. Foi proposto, primeiramente a realização da prótese obturadora para fechar a comunicação bucosinusal e uma prótese total inferior para o arco antagonista e, posteriormente, a realização de uma prótese facial. Conclusão: O tratamento reabilitador com próteses obturadoras possui um bom resultado estético e funcional, favorecendo uma melhor função mastigatória e fonética, e melhorando consideravelmente a condição psicológica que é muito afetada nos pacientes submetidos a maxilectomia total ou parcial, sendo necessário uma boa interação com toda a equipe multiprofissional envolvida para que haja um melhor tratamento integrado para a reabilitação e melhora da qualidade de vida(AU)

Introduction: The treatment of malignant or benign tumors can result in surgical procedures, such as partial or total maxillectomy, generating oral communication in patients. One way to resolve these maxillofacial changes is through rehabilitative treatment with obturator prostheses in order to reestablish masticatory, aesthetic, phonetic and psychological function. Objective: the objective of this work was to report the clinical case of a cancer patient who was rehabilitated with an obturator prosthesis due to maxillectomy for malignant neoplasia of the maxillary sinus. Case report: A 62-year-old male patient sought dental care at the Oral Oncology Center of the Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) in Araçatuba ­ SP after undergoing a partial maxillectomy with oral cavity and was referred for the Specialization Course in Dental Prosthesis at the Faculty of Dentistry ­ Unesp/Araçatuba-SP for rehabilitation. It was proposed, firstly, to create an obturator prosthesis to close the bucosinusal communication and a total lower prosthesis for the antagonistic arch and, later, to create a facial prosthesis. Conclusion: Rehabilitative treatment with obturator prostheses has a good aesthetic and functional result, favoring better chewing and phonetic function, and considerably improving the psychological condition that is greatly affected in patients undergoing total or partial maxillectomy, requiring good interaction with the entire the multidisciplinary team involved so that there is better integrated treatment for rehabilitation and improved quality of life

Morphology of the Second Mesiobuccal Canal in the Maxillary Second Molar / Morfología del Segundo Canal Mesiovestibular en el Segundo Molar Maxilar

SUMMARY: Failure to locate a complete canal system affects the prognosis of root canal treatment. A missed root canal is one of the most common reasons for failed root canal treatment. The prevalence of the second mesiobuccal canal in the maxillary second molar is relatively high and has a variety of configurations. Therefore, knowledge of its morphology is required in clinical endodontics. This review presented the canal in terms of its prevalence, classification, anatomical features, and the method for locating the second mesiobuccal canal in the maxillary second molar. Root canal treatment requires knowledge of tooth morphology, appropriate access preparation, and a thorough examination of the tooth's interior. Thus, clinicians should carefully employ various methods for assessing the anatomy of the entire root canal system to prevent failure in locating the second mesiobuccal canal. This canal can be located by modifying the access cavity design and utilizing specific instruments to improve the second mesiobuccal canal system visualization.

La falta de localización de un sistema completo de canal afecta el pronóstico del tratamiento de éste. La omisión de un tratamiento de canal es uno de los motivos más frecuentes por las que el tratamiento de canal fracasa. La prevalencia del segundo canal mesiovestibular en el segundo molar superior es relativamente alta y tiene una variedad de configuraciones. Por tanto, el conocimiento de su morfología es necesario en endodoncia clínica. Esta revisión presentó el canal en términos de su prevalencia, clasificación, características anatómicas y el método para localizar el segundo canal mesiovestibular en el segundo molar superior. El tratamiento de canal requiere conocimiento de la morfología del diente, una preparación adecuada del acceso y un examen exhaustivo del interior del diente. Por lo tanto, los dentistas deben emplear cuidadosamente varios métodos para evaluar la anatomía de todo el sistema de canales radiculares para evitar fallas en la localización del segundo canal mesiovestibular. Este canal se puede localizar modificando el diseño de la cavidad de acceso y utilizando instrumentos específicos para mejorar la visualización del sistema del segundo canal mesiovestibular.

Impacto de la agenesia de incisivos laterales maxilares en la oclusión: revisión bibliográfica / Impact of maxillary lateral incisors agenesis on occlusion: bibliographic review

Objetivo: describir el impacto de la agenesia no sindrómica de incisivos laterales maxilares permanentes en la oclusión. Material y método: se realizó una búsqueda de la evidencia disponible de manera electrónica en las bases de datos PubMed, Cochrane Library, EBSCOhost, SciELO y Epistemonikos, con filtro de búsqueda de artículos publicados entre los años 2005 y 2022, y con disponibilidad de texto completo. Resultados: se seleccionaron 9 estudios publicados entre los años 2010 y 2021; 3 estudios genéticos, 4 estudios transversales y 2 revisiones sistemáticas. Conclusión: la agenesia no sindrómica de incisivos laterales maxilares permanentes se relaciona con alteraciones esqueléticas y dentales que inciden en la oclusión dental. Un diagnóstico temprano y un tratamiento oportuno, según las necesidades de cada paciente, son importantes por las repercusiones funcionales y estéticas que genera esta alteración.

Objective: to describe the impact of non-syndromic agenesis of permanent maxillary lateral incisors on occlusion. Material and method: a search of the electronically available evidence was carried out in the PubMed, Cochrane Library, EBSCOhost, SciELO and Epistemonikos databases, with a search filter for articles published between 2005 and 2022, and with full text availability. Results: 9 studies were selected, published between 2010 and 2021: 3 genetic studies, 4 cross-sectional studies and 2 systematic reviews. Conclusion: Non-syndromic agenesis of permanent maxillary lateral incisors is related to skeletal and dental abnormalities that affect dental occlusion. Because of the functional and aesthetic repercussions of this alteration, early diagnosis and timely treatment, according to the needs of each patient, are essential.

Exodontia de supranumerário paramolar e de primeiro molar com destruição coronária em região de maxila: relato de caso / Extraction of a supernumerary paramolar and first molar with coronary destruction in the maxilla area: case report

Os dentes supranumerários são descritos como uma espécie de anomalia dentária, determinada pela formação de dentes além daqueles pertencentes à dentição convencional, que geralmente promovem complicações na cavidade oral. Diversos fatores etiológicos podem estar relacionados e de acordo com sua localização, são classificados em mesiodens, distomolar e paramolar. O presente estudo tem como objetivo apresentar e descrever a exodontia de um elemento supranumerário paramolar em região de maxila, bem como a remoção cirúrgica do primeiro molar com destruição coronária em região subjacente, através de um relato de caso. Paciente E.M.J., sexo feminino, 38 anos de idade, ASA 1, procurou atendimento odontológico devido à queixa principal de dor em região do 1° molar superior esquerdo. Ao exame físico e radiográfico, foi observada grande destruição coronária do elemento 26 associado a uma fístula intraoral, além da presença de dente supranumerário paramolar na região vestibular do dente 26. O tratamento preconizado foi a remoção cirúrgica de ambos elementos e a paciente evoluiu sem intercorrências no pós-operatório. Desta maneira, pode-se concluir que a remoção cirúrgica de dente supranumerário paramolar e de unidade dentária com grande destruição coronária por lesão cariosa, mostrou-se uma alternativa segura e eficaz no presente caso.

Supernumerary teeth are described as a kind of dental anomaly, determined by the teeth´s formation other than those belonging to the conventional dentition, which generally promote complications in the oral cavity. Several etiological factors may be related and, according to their location, they are classified into mesiodens, distomolar and paramolar. This study aims to present and describe the extraction of a paramolar supernumerary element in the maxillary region, as well as the surgical removal of the first molar with coronary destruction in the underlying region, through a case report. Patient E.M.J., female, 38 years old, ASA 1, sought dental care due to the main complaint of pain in the region of the upper left 1st molar. At the clinical and radiographic examination, a great coronal destruction of element 26 associated with a intraoral fistula was observed, in addition to the presence of a supernumerary paramolar tooth on the buccal side of tooth 26. The recommended treatment was the surgical removal of both elements and the patient evolved uneventfully in the post-operative. Thus, it can be concluded that the surgical removal of a supernumerary paramolar tooth and a dental unit with great coronary destruction due to a carious lesion proved to be a safe and effective alternative in the present case.

Accuracy of Working Length Determination - Electronic Apex Locator Versus Cone Beam Computed Tomography

ABSTRACT Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

Extensive carcinoma cuniculatum of the maxilla: A rare variant of oral carcinoma

Carcinoma cuniculatum (CC), is a rare well-differentiated, low-grade variant of squamous cell carcinoma. However, diagnosis of oral CC has remained very difficult, because many pathologists and clinicians remain un acquainted with oral CC, because there are very few reported cases of this disease in the oral cavity. To our knowledge, no more than 60 head and neck cases have been reported since Flieger and Owinski first described a case involving the mandible in 1977, because there are very few published cases of this disease in the oral cavity, the aim of this report is to provide a detailed clinical and histopathologic description of carcinoma cuniculatum of the maxila, provide a brief review of the literature, and highlight the difficulties in arriving at the correct diagnosis.

Relación entre la compresión maxilar y potencial impactación del canino superior: Scoping review / Relationship between the maxillary transverse dimension and impacted canines: Scoping review

El canino maxilar permanente corresponde al segundo diente más frecuentemente impactado en el arco dental. La etiología de esta patología aún no está totalmente definida, sin embargo, investigadores plantean la deficiencia del ancho del hueso maxilar como una posible causa. Objetivo: Investigar la evidencia que asocia menores dimensiones transversales del maxilar a la ocurrencia de la impactación de caninos superiores y esclarecer la posible relación. Materiales y métodos: Se realizó una revisión sistemática exploratoria a partir de una búsqueda amplia de la literatura en bases de datos PubMed, Cochrane, EBSCO y Multibuscador UNAB. Los artículos fueron recopilados, identificados y filtrados según el diagrama de flujo de declaración PRISMA. Resultados: La búsqueda identificó 755 estudios, de los cuales 14 fueron incluidos. Los estudios varían en diseño, edad de estudio y métodos de diagnóstico. La mitad de los estudios reporta una asociación positiva entre compresión maxilar e impactación canina superior, mientras que la otra mitad una asociación negativa. Conclusiones: No hay evidencia suficiente para poder asociar compresión maxilar con impactación de caninos superiores. Estudios con métodos de diagnóstico rigurosos son necesarios para una mejor comprensión. No obstante, se enfatiza la importancia de un diagnóstico precoz, para garantizar mejores resultados y pronóstico más favorable.

The permanent maxillary canine is the second most frequently impacted tooth in the dental arch. The etiology of this disease is not completely defined, yet some researchers propose the deficiency of the width from the maxilla as a possible cause. Objective: To investigate available evidence correlating smaller transverse maxilla dimensions with the occurrence of potential impaction of upper canines and clarify the possible relation. Materials and methods: A systematic exploratory review was carried out based on comprehensive search of the literature in databases such as PubMed, Cochrane, EBSCO and UNAB multi search engine. The articles were compiled, identified and filtered systematically according to the PRISMA flow diagram. Results: Our search identified 755 studies, 14 of which were included. These studies vary in design, patients age, and methods for detection. Half of the studies show a positive correlation between maxillary compression and potential upper canine impaction, whereas the other half show a negative correlation. Conclusions: There is not enough evidence to link maxillary compression to upper canine impaction. Studies with rigorous diagnostic methods for detection are necessary for a better understanding of this relation. Nonetheless, the importance of early diagnosis must be emphasized to guarantee better results and a more favorable prognosis.

Estudio Anatómico y Prevalencia del Canalis sinuosus Evaluado Mediante Cone Beam CT en Pacientes Chilenos / Anatomical Study and Prevalence of Canalis sinuosus Evaluated by Cone Beam CT in Chilean Patients

Canalis sinuosus, canal intraóseo localizado en región maxilar anterior, contiene elementos vasculonerviosos alveolares anterosuperiores. Diversas intervenciones en región maxilar anterior como colocación de implantes, exodoncias, instalación de microtornillos ortodóncicos, procedimientos quirúrgicos, entre otros, pueden comprometer al Canalis sinuosus y/o sus canales accesorios dañando los elementos contenidos en su interior causando complicaciones como hemorragias, parestesia, disestesia, etc. Dado el gran desconocimiento de su existencia, el Canalis sinuosus frecuentemente es confundido con lesiones patológicas y/o endodónticas. Clásicamente la literatura lo describe como una variación anatómica variación anatómica, sin embargo, presenta elevadas prevalencias (51,7 %-100 %), siendo cuestionada esta aseveración. Determinar prevalencia y característica s anatómicas del Canalis sinuosus mediante Cone Beam CT en pacientes chilenos del centro radiológico IMAPROX® entre 2017- 2021. Análisis retrospectivo de 220 CBCT maxilares anonimizados, considerando variables sexo, presencia del Canalis sinuosus, Canalis sinuosus uni/bilateral, diámetro mayor del Canalis sinuosus, presencia/número de accesorios. Análisis estadístico uni y bivariado. 100 % de prevalencia del Canalis sinuosus en ambos sexos, presencia bilateral 100 %. Diámetro mayor promedio del Canalis sinuosus: 2,58 mm. El 76,8 % presentó accesorios, siendo más prevalente la presencia de 2 CA (34,1 %). Una estructura anatómica normal habitual debe presentar sobre 50 % de prevalencia para ser considerada como tal, pero no hay consensos en criterios empleados para definir variación anatómica o estructura anatómica normal habitual. Literatura describe al Canalis sinuosus como variación anatómica, pero estudios actuales muestran elevadas prevalencias: Rusia 67 %, Brasil 88 %, Turquía, Colombia y Chile 100 %. Este estudio encontró 100 % de prevalencia, sugiriendo que Canalis sinuosus es una estructura anatómica normal habitual. Sin embargo, Canalis sinuosus es poco conocido asociándose a numerosas complicaciones por procedimientos odontológicos y/o quirúrgicos en RMA pudiendo generar hemorragias, parestesia/disestesia, dolor agudo, etc. Elevadas prevalencias reportadas sugieren que Canalis sinuosus es una estructura anatómica normal habitual y no una variación anatómica, pero se requieren más estudios y consensos para aseverarlo. Es de relevancia clínica conocer la existencia y localización del Canalis sinuosus para evitar complicaciones.

Canalis sinuosus, an intraosseous canal located in the anterior maxillary region, contains anterosuperior alveolar vascular-nervous elements. Various interventions in anterior maxillary region such as implant placement, extractions, installation of orthodontic microscrews, surgical procedures, among others, can compromise the Canalis sinuosus and/or its accessory canals, damaging the elements contained inside, causing complications such as bleeding, paresthesia, dysesthesia, etc. Given the great ignorance of its existence, Canalis sinuosus is frequently confused with pathological and/or endodontic lesions. Classically, the literature describes it as an anatomical variation, however, it presents high prevalence (51.7 %-100 %), this assertion being questioned. Objective: to determine the prevalence and anatomical characteristics of Canalis sinuosus using Cone Beam CT in Chilean patients from the IMAPROX® radiological center between 2017-2021. Retrospective analysis of 220 anonymous maxillary CBCT, considering variables sex, presence of Canalis sinuosus, uni/bilateral Canalis sinuosus, largest diameter of Canalis sinuosus, presence/number of accessory canals. Univariate and bivariate statistical analysis. The 100 % prevalence of Canalis sinuosus in both sexes, 100 % bilateral presence. Canalis sinuosus average major diameter: 2.58 mm, 76.8 % presented accessory canals, with the presence of 2 accessory canals being more prevalent (34.1 %). A habitual normal anatomical structure must have a prevalence of over 50 % to be considered as such, but there is no consensus on the criteria used to define anatomical variation or normal anatomical structure. Literature describes Canalis sinuosus as anatomical variation, but current studies show high prevalence: Russia 67 %, Brazil 88 %, Turkey, Colombia and Chile 100 %. This study found 100 % prevalence, suggesting that Canalis sinuosus is an normal anatomical structure. However, Canalis sinuosus is little known as it is associated with numerous complications from dental and/or surgical procedures in anterior maxillary region, which can cause bleeding, paresthesia/ dysesthesia, acute pain, etc. High reported prevalences suggest that Canalis sinuosus is an normal anatomical structure and not an anatomical variation, but more studies and consensus are required to confirm this. It is clinically relevant to know the existence and location of Canalis sinuosus to avoid complications.

Odontoma composto em maxila: relato de caso / Compound odontoma in maxilla: a case report / Odontoma compuesto en maxilar: reporte de caso

Introdução: Os odontomas compostos são tumores odontogênicos benignos mistos, mais comumente encontrados na região anterior da maxila, com predileção pela segunda década de vida, podendo levar à má oclusão, interferência na erupção dos dentes, deslocamento e malformação dos dentes adjacentes. Em alguns casos, leva à erupção ectópica, diastemas persistentes, divergências do longo eixo do dente e assimetria facial. Devido a isso, o tratamento mais comum é a remoção cirúrgica conservadora. Relato de caso: Paciente do sexo masculino, 13 anos, com presença de odontoma composto em região anterior de maxila. O mesmo foi submetido à enucleação cirúrgica para remoção e diagnóstico adequado da lesão, a partir da análise anatomopatológica do espécime. Conclusão: Por ser uma patologia comum nos maxilares, é adequado que o profissional conheça suas principais características para o correto diagnóstico, bem como o tratamento mais adequado para cada paciente... (AU)

Introduction: Compound odontomas are mixed benign odontogenic tumors, most commonly found in the anterior maxillary region, with a predilection for the second decade of life, may lead to malocclusion, interference in the eruption of teeth, displacement and malformation of adjacent teeth. In some cases, it leads to ectopic eruption, persistent diastemas, divergences of the long axis of the tooth and facial asymmetry. Because of this, the most common treatment is conservative surgical removal. Case report: A 13 year-old male, with presence of compound odontoma in anterior region of maxilla. The patient was underwent surgical enucleation for treatment and propper diagnosis of lesion. Conclusion: As it is a common pathology in the jaws, it is appropriate for the professional to know its main characteristics for the correct diagnosis, as well as the most appropriate treatment for each patient... (AU)

Introduccíon: Los odontomas compuestos son tumores odontogénicos mixtos benignos, que se encuentran con mayor frecuencia en la región anterior del maxilar, con predilección por la segunda década de la vida, lo que puede ocasionar maloclusión, interferencia con la erupción dentaria, desplazamiento y malformación de los dientes adyacentes. En algunos casos, conduce a erupción ectópica, diastema persistente, divergencia del eje longitudinal del diente y asimetría facial. Debido a esto, el tratamiento más común es la extirpación quirúrgica conservadora. Reporte de caso: Paciente masculino, de 13 años, con presencia de odontoma compuesto en la región anterior del maxilar. El mismo fue sometido a enucleación quirúrgica para extirpación y adecuado diagnóstico de la lesión, a partir del análisis anatomopatológico del espécimen. Conclusíon: Por tratarse de una patología común en los maxilares, es conveniente que el profesional conozca sus principales características para el correcto diagnóstico, así como el tratamiento más adecuado para cada paciente... (AU)

Cirurgia de aproveitamento de dente incluso associada a odontoma: relato de caso / Surgery to use an impacted tooth associated with odontoma: case report / Cirugía para uso de diente incluido asociado a odontoma: reporte de caso

Introdução: Odontoma é o tipo mais comum de tumor odontogênico, contudo são lesões assintomáticas, de crescimento lento e indolor, descobertos geralmente em consultas de rotina, e que muito comumente são causadores de impactação dentária. Esse trabalho tem por objetivo relatar o caso clínico de uma criança que apresentava um odontoma composto na pré-maxila, ocasionando a impactação de seu incisivo central e comprometimento estético. Relato de caso: Paciente de 12 anos, em preparo para tratamento ortodôntico, no qual na etapa de exames de imagem, foi percebido um odontoma composto na região anterior da maxila o qual impedia a irrupção do dente 21, onde para que se conseguisse o melhor aproveitamento estético e funcional, foi indicado a remoção do tumor com 43 estruturas semelhantes a dentes e o tracionamento do dente associado. Conclusão: O tratamento do odontoma não costuma ter recidivas, permitindo o aproveitamento de possíveis dentes associados e manutenção de estruturas nobres adjacentes. Possibilitando também, o tracionamento do dente impactado ao arco dental, restituindo saúde e estética... (AU)

Introduction: Odontoma is the most common type of odontogenic tumor. They are asymptomatic, slow-growing lesions of unknown etiopathogenesis. They have a density similar to teeth, surrounded by a thin radiolucent halo. Objective: To report a clinical case of traction surgery of an impacted tooth associated with compound odontoma, and a brief literature review. Case report: Patient presented composite odontoma in the anterior region of the maxilla, preventing the eruption of tooth 21. The lesion was noticed during the preparation of the orthodontic treatment and for the success of such procedure, the treatment consisted of the excision of the lesion composed of 43 similar structures to teeth and the preparation of the traction of the maxillary central incisor. Conclusion: The removal of the odontoma was extremely relevant, with this, the impacted tooth was exposed, allowing the placement of the orthodontic button for its traction. Positioning the missing tooth in the dental arch, restoring health and aesthetics... (AU)

Introducción: El odontoma es el tipo más común de tumor odontogénico. Son lesiones asintomáticas, de crecimiento lento y de etiopatogenia desconocida. Tienen una densidad similar a los dientes, rodeados de un fino halo radiotransparente. Objetivo: Reportar un caso clínico de cirugía de tracción de un diente retenido asociado a odontoma compuesto, y una breve revisión de la literatura. Reporte de caso: Paciente presentó odontoma compuesto en la región anterior del maxilar, impidiendo la erupción del diente 21. La lesión fue notada durante la preparación del tratamiento de ortodoncia y para el éxito de dicho procedimiento, el tratamiento consistió en la escisión de la lesión. compuesto por 43 estructuras similares a los dientes y la preparación de la tracción del incisivo central maxilar. Conclusión: La remoción del odontoma fue de suma relevancia, con esto se logró exponer el diente impactado, permitiendo la colocación del botón de ortodoncia para su tracción. Posicionamiento del diente faltante en la arcada dentaria, restaurando la salud y la estética... (AU)

Localização topográfica da emergência do condóito nasolagrimal medido em tomografia como reparação anatômica para procedimentos de cirurgia maxilofacial / Topographic location of the nasolagrimal conduit emergence measured on ct scans as an anatomical repair for maxillofacial surgery procedures / Ubicación topográfica de la emergencia del conducto nasolagrimal medida en tomografías como reparo anatómico para procedimientos de cirugía maxilofacial

Contexto: Na cirurgia maxilofacial existem procedimentos que envolvem o ducto nasolacrimal, pelo que esta medida é um ponto de referência para evitar a sua lesão. Artigos anteriores tomam como referência o fenótipo anglo-saxão e não a população latino-americana, o que é uma grande limitação quando se extrapola para a cirurgia maxilofacial. Objetivo: Medir a distância do ducto nasolacrimal às estruturas anatômicas adjacentes em uma amostra de tomografias computadorizadas do Hospital Universitário San Ignacio em Bogotá, Colômbia, em 2021. Métodos: Foi realizado um estudo observacional retrospetivo com base em tomografias computadorizadas do HUSI. Foi utilizada uma amostragem não probabilística, na qual foram identificadas 150 tomografias computadorizadas. Informações sobre sexo, idade e distância do ducto nasolacrimal em milímetros foram coletadas em um banco de dados em planilha Excel, tendo como marcos anatômicos o entalhe piriforme, o forame infraorbitário e o assoalho da fossa nasal em cortes axiais, sagitais e coronais. Resultados: A análise das medidas mostrou que nenhuma das distribuições de medidas se comportou de forma diferente da distribuição normal. Em relação à comparação das medidas por sexo, a idade foi semelhante entre homens e mulheres, enquanto nas comparações por idade foram evidenciadas diferenças significativas. Conclusão: Os resultados são consistentes com os dados publicados em estudos anteriores. Em termos de distribuição por sexo, o comprimento do ducto nasolacrimal é maior nos homens do que nas mulheres, e a distribuição por idade indica que, à medida que a idade aumenta, a distância do ducto a estas estruturas diminui... (AU)

Background: In maxillofacial surgery there are procedures that involve the nasolacrimal duct, so this measure is a reference point to avoid its injury. Previous articles take as reference the Anglo-Saxon phenotype and not the Latin American population, which is a great limitation when extrapolating it to maxillofacial surgical procedures. Objective: To measure the distance of the nasolacrimal duct to adjacent anatomical structures in a sample of CT scans from the Hospital Universitario San Ignacio in Bogotá- Colombia in 2021. Methods: A retrospective observational study was performed based on CT scans from HUSI. A non-probabilistic sampling was used in which 150 CT scans were identified. Information on sex, age and distance of the nasolacrimal duct in millimeters was collected in an Excel spreadsheet database, taking as anatomical landmarks the piriform notch, the infraorbital foramen and the floor of the nasal fossa in axial, sagittal and coronal sections. Results: The analysis of the measurements showed that none of the measurement distributions had a behavior different from the normal distribution. In relation to the comparison of the measurements by sex, age was similar in men and women, while significant differences were evidenced in the comparisons by age. Conclusion: The results coincide with the data published in previous studies. Regarding the distribution by sex, the length of the nasolacrimal duct is greater in men than in women, and the distribution by age indicates that as age increases the distance of the duct to these structures decreases... (AU)

Antecedentes: En cirugía maxilofacial existen procedimientos que involucran el conducto nasolagrimal, por lo cual esta medida es un punto de referencia para evitar su lesión. Artículos previos toman como referencia el fenotipo anglosajón y no la población Latinoamericana, lo cual supone una gran limitante al extrapolarlo a intervenciones quirúrgicas maxilofaciales. Objetivo: Medir la distancia del conducto nasolagrimal a estructuras anatómicas adyacentes en una muestra de tomografías del Hospital Universitario San Ignacio en BogotáColombia en 2021. Métodos: Se realizó un estudio observacional retrospectivo basado en tomografías del HUSI. Se utilizó un muestreo no probabilístico en el que se identificaron 150 tomografías. En una base de datos en hoja de cálculo en Excel se recolectó información sobre sexo, edad y distancia del conducto nasolagrimal en milímetros, teniendo como reparo anatómico la escotadura piriforme, el agujero infraorbitario y el piso de la fosa nasal en los cortes axial, sagital y coronal. Resultados: El análisis de las mediciones realizadas mostró que ninguna de las distribuciones de medición tuvo un comportamiento distinto a la distribución normal. En relación con la comparación de las medidas por sexo la edad fue similar en los hombres y mujeres, mientras que se evidenciaron diferencias significativas en las comparaciones por edad. Conclusión: Los resultados coinciden con los datos publicados en estudios previos. En cuanto a la distribución por sexo, la longitud del conducto nasolagrimal es mayor en hombres que en mujeres, y la distribución por edad indica que conforme aumenta la edad la distancia del conducto a estas estructuras disminuye... (AU)

Neurofibroma solitario en maxilar superior: reporte de caso inusual / Solitary neurofibroma in upper maxillary: an unusual case report

Los neurofibromas solitarios han sido reportados en la literatura, pero son casos muy raros; por definición se presentan en pacientes que no tienen enfermedad de Von Recklinghausen, que se hereda en forma autosómica dominante, y se presenta con mayor frecuencia en hombres. Es un tumor benigno que puede presentarse solitario o múltiple; su aparición en la cavidad oral suele ser muy rara, pero su sitio de predilección es la lengua, seguido de la mucosa alveolar, paladar y encía gingival. Aparecen con más frecuencia durante la tercera década de vida, aunque se describen casos desde los 10 meses hasta los 70 años de edad. En este reporte se expondrá el caso clínico de un paciente de sexo femenino, de 17 años de edad, que acudió a consulta a la clínica dental centenario por presentar una lesión superior que cubría parte de las coronas anatómicas en piezas dentales del maxilar superior izquierdo, además, en el reporte de estudio inmunoquimicohistológico se diagnosticó neurofibroma, con expresión de S-100. Consideramos de suma importancia el reconocimiento de estos crecimientos intraorales para lograr establecer un diagnóstico definitivo cierto y veraz de la situación (AU)

Solitary neurofibromas have been reported in the literature, but they are very rare cases. By definition they occur in patients who do not have Von Recklinghausen disease, which is inherited in an autosomal dominant manner; It occurs more frequently in men. It is a benign tumor that can appear solitary or multiple. Its appearance in the oral cavity is usually very rare, but its site of preference is the tongue, followed by the alveolar mucosa, palate, and gingival gingiva. They appear more frequently during the third decade of life, although cases from 10 months to 70 years of age are described. This report will present the clinical case of a 17-year-old female patient who came to the Centennial Dental Clinic for consultation presenting an elevated lesion covering part of the anatomical crowns in dental pieces in the left upper jaw and in the report. Neurofibroma was diagnosed from the Immunochemicalhistological study, with S-100 expression. We consider the recognition of these intraoral growths of utmost importance in order to establish a true and truthful definitive diagnosis of the situation (AU)

Abordaje terapéutico del colapso transversal del maxilar superior con microimplantes (TAD´s) / Therapeutic approach of transverse maxillary collapse with microimplants (TAD's)

Introducción. La atresia o estrechez del maxilar superior es una patología de origen multifactorial que genera un colapso transversal, el mismo e implica la carencia de espacio necesario para la disposición correcta de las piezas dentales. Objetivo. El presente artículo está enmarcado en una revisión narrativa de la literatura, con el objetivo de describir el abordaje terapéutico del colapso transversal del maxilar superior con microimplantes (TAD´s), determinando los efectos esqueléticos y dentoalveolares en el maxilar superior, así como las ventajas y desventajas del tratamiento. Método. La búsqueda de artículos se realizó a través de mediante las plataformas de: Scielo, PubMed, Google Académico y Medline. Se seleccionaron 21 artículos cuyos textos completos fueron descargados para examinarlos a detalle y verificar que cumplieran con todos los criterios de inclusión, de los cuales se obtuvieron 16 artículos para elaborar esta revisión narrativa. Conclusiones. El abordaje terapéutico del colapso transversal se produce por medio de la expansión rápida del maxilar (ERM) o disyunción maxilar, en pacientes jóvenes en crecimiento; y en los pacientes adultos se suele emplear un tratamiento con técnica MARPE con microimplantes (TAD´s). El principal efecto esquelético es la apertura de la sutura maxilar que varía de 2 a 10 mm, muchos autores coinciden en que el manejo del colapso transversal del maxilar superior con microimplantes no genera efectos dentoalveolares negativos, al contrario, tiene ventajas biomecánicas debido al anclaje con el hueso, reduciendo el riesgo de movimiento dentales indeseados y permitiendo un control del crecimiento vertical.

Introduction. The atresia or narrowness of the upper jaw is a pathology of multifactorial origin that generates a transverse collapse, it implies the lack of space necessary for the correct arrangement of the dental pieces. Objective. This article is framed in a narrative review of the literature, with the aim of describing the therapeutic approach of transverse maxillary collapse with microimplants (TAD's), determining the skeletal and dentoalveolar effects in the maxilla, as well as the advantages and disadvantages of treatment. Method. The search for articles was carried out through the following platforms: Scielo, PubMed, Google Scholar and Medline. 21 articles whose full texts were downloaded were selected to examine them in detail and verify that they met all the inclusion criteria, of which 18 articles were obtained to prepare this narrative review. Conclusions. The therapeutic approach to transverse collapse occurs through rapid maxillary expansion (RME) or maxillary disjunction, in young growing patients; and in adult patients, treatment with the MARPE technique with microimplants (TAD's) is usually used. The main skeletal effect is the opening of the maxillary suture, which varies from 2 to 10 mm. Many authors agree that the management of the transverse collapse of the maxilla with microimplants does not generate negative dentoalveolar effects, on the contrary, it has biomechanical advantages due to the anchorage with the bone, reducing the risk of unwanted dental movement and allowing control of vertical growth.

Histological Evaluation of the Effect of Alendronate on the Maxillary Bone of Wistar Rats Combined with Orthodontic Movement of Intense Force / Evaluación Histológica del Efecto del Alendronate en el Hueso Maxilar de Ratas Wistar Combinado con Movimiento de Ortodoncia de Fuerzas Intensas

SUMMARY: To evaluate the histological adverse effects of alendronate administered systemically and topically in combination with orthodontic movement by intense force. Thirty-six 24-week-old female Wistar rats, ovariectomized, were used and divided into three groups (n = 12/group): control, locally treated with saline (0.07 ml/kg/week) (group 1) and experimental, treated with alendronic acid systemically (0.07 mg/kg/week) (group 2) and locally (7 mg/kg/week) (group 3). At 14 days, an orthodontic anchor was installed in the right first molar, and a force of 144 cN was applied for 28 days. The samples were processed for histological evaluation. Descriptive statistics, Shapiro-Wilk tests, one-way ANOVA with Bonferroni correction, one-way repeated measures ANOVA and chi-square tests were performed. All tests were statistically significant at p <0.05. The adverse events found in all groups were inflammation and osteoclastic activity. In the bisphosphonate-treated groups, there were statistically significant differences (p = 0.005) in the osteoclastic activity between the two hemiarcates. All rats in group 2 presented paralytic ileus. Compared to local administration, systemic treatment with alendronic acid produces more adverse effects, such as inflammation, fibrinoid necrosis, and osteoclastic activity. During the application of intense forces, it was not possible to show that there is necrosis associated with bisphosphonates.

Evaluar los efectos adversos histológicos del alendronato administrado sistémica y tópicamente en combinación con movimientos ortodóncicos de fuerza intensa. Treinta y seis ratas Wistar hembras de 24 semanas de edad, ovariectomizadas, fueron utilizadas y divididas en tres grupos (n = 12/grupo): control, tratado localmente con solución salina (0,07 ml/kg/semana) (grupo 1) y experimental, tratados con ácido alendrónico por vía sistémica (0,07 mg/kg/semana) (grupo 2) y local (7 mg/kg/semana) (grupo 3). A los 14 días se instaló un anclaje de ortodoncia en el primer molar derecho y se aplicó una fuerza de 144 cN durante 28 días. Las muestras fueron procesadas para evaluación histológica. Se realizó estadística descriptiva, pruebas de Shapiro-Wilk, ANOVA de una vía con corrección de Bonferroni, ANOVA de medidas repetidas de una vía y pruebas de chi-cuadrado. Todas las pruebas fueron estadísticamente significativas con un p <0,05. Los eventos adversos encontrados en todos los grupos fueron inflamación y actividad osteoclástica. En los grupos tratados con bisfosfonatos hubo diferencias estadísticamente significativas (p = 0,005) en la actividad osteoclástica entre los dos hemiarcados. Todas las ratas del grupo 2 presentaron íleo paralítico. En comparación con la administración local, el tratamiento sistémico con ácido alendrónico produce más efectos adversos, como inflamación, necrosis fibrinoide y actividad osteoclástica. Durante la aplicación de fuerzas intensas, no fue posible demostrar que existe necrosis asociada con los bisfosfonatos.

Análisis de las Variaciones Anatómicas y Dimensionales del Canal Nasopalatino Mediante Tomografía Computarizada de Haz Cónico / Analysis of the Anatomical and Dimensional Variations of the Nasopalatine Canal by Cone Beam Computed Tomography

El conocimiento anatómico del canal nasopalatino (CNP) es fundamental para la realización de cirugías en el sector anterior del maxilar y así prever posibles complicaciones. El objetivo de este trabajo es evaluar y determinar las variaciones anatómicas y dimensionales del CNP según sexo, edad y estado dental. Este estudio transversal analizó un total de 251 imágenes de TCHC obtenidas de la base de datos del Servicio de Imagenología Oral y Maxilofacial de la Facultad de Odontología de la Universidad Andrés Bello, Viña del Mar, Chile. Para evaluar la asociación estadística entre variaciones del CNP con sexo, edad y estado dentario se realizó la prueba T de Student, chi-cuadrado y ANOVA (p0,05). Además, se detectó diferencia significativa entre el estado dentario y la dimensión de la tabla vestibular en relación con el CNP (p<0,01). Se deben considerar las variaciones de CNP para evitar posibles complicaciones durante los procedimientos quirúrgicos.

SUMMARY: Anatomical knowledge of the nasopalatine canal (PNC) is essential for performing surgeries in the anterior sector of the maxilla and thus anticipating possible complications. The objective of this work is to evaluate and determine the anatomical and dimensional variations of the CNP according to sex, age and dental status. This cross-sectional study analyzed a total of 251 CBCT images obtained from the database of the Oral and Maxillofacial Imaging Service of the Faculty of Dentistry of the Andrés Bello University, Viña del Mar, Chile. To evaluate the statistical association between CNP variations with sex, age and dental status, the Student's T test, chi-square and ANOVA (p0.05). In addition, a significant difference was detected between the dental state and the dimension of the vestibular table in relation to the CNP (p<0.01). CNP variations should be considered to avoid potential complications during surgical procedures.

Descripción de la morfología del sistema de canales radiculares del primer molar maxilar mediante tomografía computarizada cone-beam en una población chilena / Description of the morphology of the root canal system of the maxillary first molar using cone-beam computed tomography in a Chilean population

Describir la morfología del sistema de canales radiculares del primer molar maxilar en una población chilena mediante exámenes de tomografía computarizada Cone-Beam (CBCT). Se realizó un estudio observacional descriptivo en el cual se utilizaron los exámenes CBCT de pacientes que fueron atendidos en un Centro de Radiología Maxilofacial privado durante el período comprendido entre Enero y Diciembre del año 2018 en la ciudad de Temuco, Chile, los cuales fueron observados de manera independiente por dos investigadores previamente calibrados. Se observaron 199 exámenes CBCT. En la raíz mesiobucal,predominaron las morfologías tipo II, I y IV de Vertucci respectivamente, mientras que en la raíz distobucal y palatina predominó la morfología tipo I. El canal MB2 estuvo presente en el 62,3 % de los casos, con una prevalencia significativamente mayor en pacientes jóvenes. En la mayoría de los primeros molares maxilares de los habitantes de la ciudad de Temuco se observaron tres raíces separadas y la presencia de cuatro canales. Se determinó una alta frecuencia del canal MB2 en la raíz MB.

SUMMARY: The objective of this study was to describe the morphology of the root canal system of the maxillary first molar in a Chilean population through Cone-Beam computed tomography (CBCT) examinations. A descriptive observational study was carried out in which the CBCT examinations of patients who were treated in a private maxillofacial radiology center during the period between January and December 2018 in Temuco, Chile, were used which were observed independently by two previously calibrated researchers. In this analysis 199 CBCT exams were observed. In the mesiobuccal root, Type II, I and IV morphologies predominated respectively, while in the distobuccal and palatal root, Type I morphology predominated. The MB2 canal was present in 62.3 % of cases, with a higher prevalence in young patients. Three separate roots and the presence of four canals were observed in most of the maxillary first molars of the patients in Temuco. A high frequency of the MB2 canal was determined in the root MB.

Effect of flapless piezopuncture on maxillary canine distalization. A preliminary randomized controlled trial

Several methods have been described to shorten orthodontic treatments, but the main disadvantage is their invasiveness. Animal studies have shown that piezopuncture can accelerate the rate of tooth movement without causing collateral damage. Objective: To evaluate the clinical outcome, in terms of safety and efficacy, of a flapless piezopuncture on maxillary canine distalization. Methods: A split-mouth randomized clinical trial was carried out on five patients. Piezopuncture was performed on a random side of the maxillary arch to assess the rate of canine movement on the stimulated side, compared to the non-stimulated control side after 15 (T1), 30 (T2), and 60 (T3) days. Also, immediate side effects and changes in buccal bone thickness after one year were assessed. Results: Distalization on the intervention versus control side at T1 was 1.24±0.21mm versus 0.64±0.33mm (p=0.005); at T2 it was 2.00±0.28mm versus 1.36±0.49mm (p=0.046); and at T3 it was 4.28±0.66mm versus 3.65±0.88mm (p=0.102). No adverse effects related to the surgical procedure were observed or reported by patients. The thickness of the buccal bone plate showed no significant changes. Conclusions: Flapless piezopuncture accelerates the rate of tooth movement in orthodontic patients over the first 15 days and its effect declines over the next 45 days.

Biomechanical analysis of narrow dental implants for maxillary anterior rehabilitation / Análise biomecânica de implantes de diâmetro reduzido para reabilitação da região anterior da maxila

Introdução: O conhecimento da biomecânica de implantes de diâmetro reduzido indica dimensões seguras para uso clínico. Objetivo: O objetivo do presente estudo foi comparar biomecanicamente implantes de diâmetro regular e reduzido para suporte de próteses implantossuportadas unitárias na região anterior da maxila por meio de análise de elementos finitos 3D (3D-FEA). Material e método: Quatro modelos 3D-FEA foram desenvolvidos a partir de recomposição de tomografia computadorizada e dados da literatura: um bloco ósseo na região incisiva lateral superior direita com implante e coroa. M1: 3,75 x 13 mm, M2: 3,75 x 8,5 mm, M3: 2,9 x 13 mm e M4: 2,9 x 8,5 mm. Foi aplicada carga de 178 N nos ângulos 0, 30 e 60 graus em relação ao longo eixo do implante. Foram avaliados mapas de tensão de Von Mises, tensão principal máxima e microdeformação. Resultado: M3 e M4 apresentaram maiores valores de tensão e microdeformação que M1 e M2, principalmente quando foram aplicadas forças inclinadas. Porém, M3 apresentou comportamento biomecânico melhor do que M4. Conclusão: Pode-se concluir que reduzir o diâmetro dos implantes pode prejudicar a biomecânica durante a aplicação de forças, mas a distribuição e intensidade das tensões, bem como os valores de microdeformação podem ser melhorados se o comprimento do implante for aumentado

Introduction: Narrow diameter implants biomechanics knowledge indicates safe dimensions for clinical use. Objective: Purpose of the present study was biomechanically to compare regular and narrow diameter implants to support single implant-supported prosthesis in the anterior region of the maxilla by 3D finite element analysis (3D-FEA). Material and method: Four 3D-FEA models were developed form CT scan recompositing and literature data: a bone block in the right upper lateral incisive region with implant and crown. M1: 3.75 x 13 mm, M2: 3.75 x 8.5 mm, M3: 2.9 x 13 mm and M4: 2.9 x 8.5 mm. It was applied load was of 178 N at 0, 30 and 60 degrees in relation to implant long axis. Von Mises stress, maximum principal stress and microdeformation maps were evaluated. Result: M3 and M4 did show higher tension and higher microdeformation values than M1 and M2, especially when inclined forces were applied. However, M3 presented enhanced biomechanical behavior than M4. Conclusion: It can be concluded that reduce the diameter of the implants can disadvantage to the biomechanics during the application of forces, but the distribution and intensity of the stresses, as well as the micro deformation values can be improved if the length of the implant is increased