Endemic dental fluorosis in children from a brazilian slave-descendent community: a cross-sectional study / Fluorose dentária endêmica em crianças de uma comunidade quilombola brasileira: um estudo transversal

Although fluoride (F) is required for the normal growth and development of several human organs and tissues, excessive exposure to it may be potentially toxic. Groundwater may present ranging levels of F; however, the appearance, taste, and smell are not altered. Thus, the present study aimed to evaluate dental fluorosis in children from a Brazilian slave-descendent community, as well as to assess F levels in the drinking water supplies available in that area. For that, 21 children aged from 6 to 14 years living in Rincão dos Martimianos were invited to participate. Thylstrup and Fejerskov index (a 0­9 scale) was used to assess dental fluorosis on permanent teeth. Furthermore, the F concentration of two water samples (from the artesian well and a tank) was determined by using a potentiometric method. All children presented dental fluorosis to some degree, ranging from score 2 to 9. About 81% of them had dental fluorosis scores equal to or over 5. Scores lower than 5 were observed only in children younger than 8 years; on the other hand, all children older than 8 years presented scores higher than 5. Moreover, artesian well water had an F concentration of 5 mg/L and tank water 0.8 mg/L. It is suggested that the F-rich groundwater supply was most probably responsible for dental fluorosis in that area. Brazilian slave-descendent communities, therefore, should receive constant attention from their local authorities in order to guarantee a proper water supply for consumption, as well as to provide public health education(AU)

Embora o flúor (F) seja necessário para o crescimento e desenvolvimento normal de vários órgãos e tecidos humanos, a exposição excessiva pode ser potencialmente tóxica. As águas subterrâneas podem apresentar níveis variados de F; no entanto, a aparência, o sabor e o cheiro não são alterados. Desta forma, o presente estudo teve como objetivo avaliar a fluorose dentária em crianças de uma comunidade brasileira descendente de escravos, bem como avaliar os níveis de F na água potável disponível nessa área. Para isso, 21 crianças de 6 a 14 anos residentes no Rincão dos Martimianos foram convidadas a participar da pesquisa. O índice de Thylstrup e Fejerskov (uma escala de 0 a 9) foi usado para avaliar a fluorose dentária em dentes permanentes. Além disso, a concentração de F de duas amostras de água (do poço artesiano e de um tanque) foi determinada pelo método potenciométrico. Todas as crianças apresentaram algum grau de fluorose dentária, variando de 2 a 9. Cerca de 81% delas apresentaram escores de fluorose dentária iguais ou superiores a 5. Escores inferiores a 5 foram observados apenas em crianças menores de 8 anos; por outro lado, todas as crianças maiores de 8 anos apresentaram escores superiores a 5. Além disso, a água do poço artesiano tinha concentração de F de 5 mg/L e a água do tanque 0,8 mg/L. Desta forma, acredita-se que a fonte de água subterrânea rica em F foi provavelmente responsável pela fluorose dentária na região avaliada. As comunidades quilombolas brasileiras, portanto, devem receber atenção constante de suas autoridades locais, a fim de garantir o abastecimento adequado de água para consumo, bem como proporcionar educação em saúde pública(AU)

Factors associated with severe permanent first molar caries among adolescents from Acapulco, Guerrero / Factores asociados a caries severa del primer molar permanente en adolescentes de Acapulco, Guerrero

RESUMEN Objetivo: Identificar los factores asociados a caries severa del primer molar permanente en adolescentes de Acapulco, Guerrero, México. Material y métodos: Estudio transversal en una muestra de 173 adolescentes de primer a tercer grado de una secundaria pública. Se usó un cuestionario autoadministrado que obtuvo datos sociodemográficos, nivel socioeconómico, salud oral, hábitos tóxicos y dietéticos. Se identificó la caries severa con base en los códigos combinado 5-6 del Sistema Internacional de Clasificación y Gestión de Caries. Se realizó un análisis multivariado con el software estadísitico CIETmap, el cual identificó factores asociados a caries severa con la razón de prevalencia y su intervalo de confianza del 95% como estimación de la fuerza de asociación. Resultados: Fueron revisados 692 primeros molares permanentes. El 54% de los adolescentes (94/173) presentó caries severa en al menos un molar. Se encontraron dos factores asociados, consumo de 6 o más cigarros al día (RPa: 7,18, IC95%= 2,07 - 24,22) y el uso de auxiliares en la higiene oral (RPa: 0,41, IC95%= 0,34 - 0,78). Conclusión: La prevalencia de caries severa fue similar a la reportada a otros estudios. Se deben realizar acciones de promoción de la salud que ayuden a disminuir la afección en esta población.

ABSTRACT Objective: To identify the factors associated with severe caries of the first permanent molar among adolescents from Acapulco, Guerrero, Mexico. Material and methods: Cross-sectional study in a sample of 173 adolescents from first to third grade of a public high school. A self-administered questionnaire was used to obtain sociodemographic data, socioeconomic level, oral health, toxic and dietary habits. Severe caries was identified based on the combined codes 5-6 of the International Caries Classification and Management System. A multivariate analysis was performed with CIETmap statistical software, which identified factors associated with severe caries with the prevalence ratio and its 95% confidence interval as an estimate of the strength of association. Results: A total of 692 permanent first molars were examined. The 54% of the adolescents (94/173) presented severe caries in at least one molar. Two associated factors were found, consumption of 6 or more cigarettes per day (RPa: 7.18, IC95%= 2.07 - 24.22), and use of oral hygiene aids (RPa: 0.41, IC95%= 0.34 - 0.78). Conclusion: The prevalence of severe caries was similar to that reported in other studies. Health promotion actions should be carried out to help reduce caries in this population.

Traumatic dental injuries in the primary dentition and sequelae in the permanent dentition: a 7-year retrospective study / Lesões dentárias traumáticas na dentição decídua e sequelas na dentição permanente: um estudo retrospectivo de 7 anos

Objective: Traumatic dental injuries (TDIs) affect the aesthetics and function of primary teeth and can cause sequelae in their permanent successors. This study assessed the distribution of TDIs and sequelae in the primary dentition and the respective permanent dentition in children treated at the Dental Trauma Centre in Brazil. Material and Methods: This cross-sectional study was conducted by collecting data from 256 dental records over 7 years. Descriptive statistical analyses and the Fisher exact test were used (p=0.05). Results: Sixty-two patients presented with trauma in the deciduous teeth. TDIs were observed mostly in boys (64.50%) and in the 2 to 4-year age group (44.10%); most injuries occurred from fall from the child's own height (40.30%) and at home (71.20%). The most common type of trauma was subluxation (22.90%). The most prevalent clinical and radiographic sequelae were mobility (45.60%) and periapical lesion (31.80%), respectively. Regarding the permanent dentition, the most frequent sequela was hypomineralization (33.30%). Conclusion:According to this study, TDIs in deciduous teeth made up 29.24% of all the cases in the Dental Trauma Program. The major type of trauma in children was subluxation, with sequelae in both dentitions. Follow-up after trauma is important to the maintenance of primary dentition and to prevent and treat possible sequelae in the permanent dentition.(AU)

Objetivo: Lesões dentárias traumáticas (TDIs) afetam a estética e a função dos dentes decíduos e podem causar sequelas em sucessores permanentes. Este estudo avaliou a distribuição das TDIs e sequelas na dentição decídua e sua respectiva dentição permanente em crianças atendidas no Centro de Trauma Odontológico no Brasil. Material e Métodos: Trata-se de um estudo transversal realizado por meio da coleta de dados de 256 prontuários odontológicos ao longo de 7 anos. Foram utilizadas análises estatísticas descritivas e teste exato de Fisher (p <0,05). Resultados:Sessenta e dois pacientes apresentaram trauma na dentição decídua. As TDIs foram observadas principalmente em meninos (64,50%) e na faixa etária de 2 a 4 anos (44,10%); a maioria das lesões ocorreu por queda da própria altura (40,30%) e em casa (71,20%). O tipo de trauma mais comum foi a subluxação (22,90%). As sequelas clínicas e radiográficas mais prevalentes foram mobilidade (45,60%) e lesão periapical (31,80%), respectivamente. Em relação à dentição permanente, a sequela mais frequente foi a hipomineralização (33,30%). Conclusão: De acordo com este estudo, as TDIs em dentes decíduos foram de 29,24% de todos os casos do Programa de Trauma Dental. O principal tipo de trauma em crianças foi a subluxação, com sequelas em ambas as dentições. O acompanhamento após o trauma é importante para a manutenção da dentição decídua e para prevenir e tratar possíveis sequelas na dentição permanente. (AU)

Correlation analysis of temporomandibular joint changes after maxillary protraction in adolescent patients / 口腔疾病防治

Objective @#To study the effect of anterior traction on the temporomandibular joint in adolescent patients with skeletal Class Ⅲ malocclusion.@*Methods@#Twenty-nine patients with early permanent dentition with skeletal class Ⅲ malocclusions were measured by cephalometry and a coordinate system before and after maxillary protraction. The correlation between dentofacial structures and the temporomandibular joint was analyzed. @*Results @# After maxillary protraction, cephalometric measurements showed that the dentofacial structure changed significantly; ANB increased by 3.97° ± 2.32° (P<0.001); U1-SN increased by 4.97° ± 5.51° (P<0.001); L1-MP decreased by 1.26° ± 1.41° (P = 0.008); and MP-SN increased by 1.02° ± 3.90° (P = 0.003). The coordinate system measurement showed that the S-Fpx was decreased by 0.16 ± 1.52 mm (P = 0.041), the S-Ciy distance was significantly decreased by 0.09 ± 2.03 mm (P = 0.028), and there was no significant change in the temporomandibular joint spaces (A, P, and C) (P>0.05). Correlation analysis showed a moderate negative correlation between the posterior margin of the temporomandibular joint fossa and U1-SN (r = -0.427, P = 0.042). There was a moderate positive correlation between the leading edge of the condyle and ANB (r = 0.425, P = 0.043); there was no correlation between the joint space and dentofacial changes. @* Conclusion@#After treatment with maxillary protraction for adolescent skeletal class Ⅲ malocclusion, maxillary protraction had some effect on changes in the temporomandibular joint fossa and condyle and had no effect on the joint space.

Tratamento multidisciplinar tardio de luxação dentária intrusiva grave: caso clínico / Large multidisciplinary treatment of serious intrusive dental luxation: clinical case / Tratamiento multidisciplinar retardado de la luxación dental intrusiva severa: caso clínico

Introdução: Traumatismos dentoalveolares acometem uma parcela considerável da população e ocorrem por diversas causas, como quedas, acidentes automobilísticos e agressões físicas. As lesões podem variar desde simples fraturas de esmalte até avulsão dental, estando associadas a danos de caráter estético, funcional, psicológico e social. Luxações intrusivas, que por lesionarem ao máximo os tecidos periodontais e pulpares, possuem um dos piores prognósticos, tendo como consequência a necrose pulpar na quase totalidade dos casos com rizogênese completa. Os possíveis tratamentos baseiam-se no desenvolvimento radicular e severidade da lesão, incluindo aguardar re-erupção espontânea, reposicionamento cirúrgico, tracionamento ortodôntico e exodontia do dente intruído. O presente estudo tem por finalidade relatar um caso clínico expondo o tratamento tardio da intrusão traumática grave do incisivo central superior permanente. Relato de caso: paciente do sexo feminino, 10 anos de idade, sofreu traumatismo bucofacial em 2009 e foi atendida na emergência, contudo nenhum atendimento odontológico foi realizado, somente no ano de 2011 procurou atendimento especializado na clínica odontológica da Universidade Estadual de Feira de Santana-BA. Considerações Finais: A conduta mais adequada frente a traumatismos dentoalveolares é atendimento de urgência, este tem por finalidade minimizar as sequelas causadas sempre no intuito de preservar o remanescente dentário e estruturas adjacentes... (AU)

Introduction: Dentoalveolar traumas affect a considerable portion of the population and occur due to several causes, such as falls, car accidents and physical aggressions. Lesions can range from simple enamel fractures to dental avulsion, and are associated with aesthetic, functional, psychological and social damage. Intrusive luxation, which, due to maximum damage to the periodontal and pulp tissues, have one of the worst prognoses and result in pulp necrosis in almost all cases of teeth with complete rhizogenesis. Possible treatments are based on root development and severity of lesion and include waiting for spontaneous re eruption, surgical repositioning, orthodontic traction and extraction of intruded tooth. The present study aims to report a clinical case exposing the late treatment of severe traumatic intrusion of the permanent upper central incisor. Case report: a 10-year-old female patient suffered a bucofacial trauma in 2009 and was attended to at an emergency service, however no dental care was provided, only in 2011 she sought specialized care at the dental clinic of the State University of Feira de Santana - BA. Final Considerations: The most appropriate conduct in the face of dentoalveolar traumatisms is urgent care, aiming to minimize sequelae to preserve the remaining tooth and adjacent structures... (AU)

Introducción: Los traumatismos dentoalveolares afectan a una parte considerable de la población y ocurren por diversas causas, como caídas, accidentes automovilísticos y agresiones físicas. Las lesiones pueden variar desde simples fracturas de esmalte hasta avulsión dentaria, estando asociadas con daños estéticos, funcionales, psicológicos y sociales. Las luxaciones intrusivas, que causan el máximo daño a los tejidos periodontales y pulpares, tienen uno de los peores pronósticos, resultando en necrosis pulpar en casi todos los casos con rizogénesis completa. Los posibles tratamientos se basan en el desarrollo de la raíz y la gravedad de la lesión, incluida la espera de una nueva erupción espontánea, el reposicionamiento quirúrgico, la tracción ortodóncica y la extracción del diente intruido. El presente estudio tiene como objetivo reportar un caso clínico que muestra el tratamiento tardío de la intrusión traumática severa del incisivo central maxilar permanente. Caso clínico: paciente de sexo femenino, 10 años, sufrió trauma orofacial en 2009 y fue atendida en urgencias, pero no se le brindó atención odontológica, solo en 2011 buscó atención especializada en la clínica odontológica de la Universidad Estadual de Feira de Santana - BA. Consideraciones finales: El abordaje más adecuado al trauma dentoalveolar es la atención de emergencia, que tiene como objetivo minimizar las secuelas ocasionadas, siempre con el fin de preservar el diente remanente y las estructuras adyacentes... (AU)

Caries en primeros molares permanentes y factores asociados a esta en escolares de Acapulco / Caries in permanent first molars and associated factors with its in schoolchildren from Acapulco

Introducción: La caries es una de las enfermedades bucodentales más frecuentes y, por ser las primeras en emerger, los primeros molares permanentes son las piezas más susceptibles a esta afección. Objetivo: Estimar la prevalencia de caries y factores asociados a esta en los primeros molares permanentes en escolares de segundo grado de primaria. Métodos: Estudio transversal, en estudiantes de segundo grado en 17 de 67 escuelas públicas de Acapulco, Guerrero. Un cuestionario autoadministrado se utilizó para obtener datos sociodemográficos y hábitos de higiene dental. La caries y la presencia de placa dentobacteriana se midieron a través de índices epidemiológicos, el CPOD (diente cariado, obturado y perdido) y el O'Leary. Se estimó la razón de momios e intervalo de confianza de 95 por ciento, ajustada por conglomerado, como medida de la fuerza de asociación mediante análisis multivariado. Resultados: Se revisaron 3332 primeros molares permanentes, el 21 por ciento tuvo caries, el 6 por ciento tuvo obturaciones y el 1 por ciento ya se había extraído. El índice CPOD de caries grupal fue 0,27. Cinco factores estuvieron asociados a la caries de los primeros molares permanentes: higiene dental deficiente (RMa = 2,87), técnica de cepillado dental inadecuada (RMa = 1,70), tomar alguna bebida dulce antes de ir a dormir (RMa = 1,68), visitar al dentista (RMa = 0,67) y aplicación de flúor (RMa = 0,61). Conclusiones: La prevalencia de caries en los primeros molares permanentes fue 21 por ciento dentro del rango reportado en otros estudios. Fueron identificados cinco factores asociados a la caries: higiene dental deficiente, técnica de cepillado inadecuado, consumo de azúcares antes de dormir, visitas al dentista y aplicación de flúor. Estos factores orientan sobre qué medidas preventivas se deben promover en los escolares para la preservación de sus piezas dentales(AU)

Introduction: Caries is the most frequent oral disease and the first permanent molars are very susceptible to this condition because they are the first teeth to emerge. Objective: To estimate the prevalence of caries its associated factors in the first permanent molars in second grade primary school children. Methods: A cross-sectional study was carried out in second grade students in 17 out of 67primary public schools in Acapulco, Guerrero. We applied a self-administered questionnaire to obtain sociodemographic data and dental hygiene habits. Caries and the presence of dentobacterial plaque were measured through epidemiological indices, CPOD (decayed, blocked and lost tooth) and O'Leary index. The odds ratio and 95 percent confidence interval, adjusted by cluster, were estimated as a measure of strength of association through multivariate analysis. Results: We reviewed 3 332 permanent first molars, 21 percent had cavities, 6 percent had seals and 1 percent had already been removed. The CPOD index of group caries was 0,27. We found five factors associated with caries of the first permanent molars: deficient dental hygiene (RMa=2,87), inadequate tooth brushing technique (RMa=1,70), drinking a sweet drink before bedtime (RMa=1,68), visiting the dentist (RMa=0,67) and fluoride application (RMa=0,61). Conclusions: Prevalence of caries in the first permanent molars was 21 percent, within the range reported in other studies. Five factors associated with caries were identified: poor dental hygiene, inadequate brushing technique, consumption of sugars before going to sleep, visits to the dentist and application of fluoride. These factors guide what preventive measures should be promoted in schoolchildren for the preservation of their teeth(AU)

A prospective and randomized clinical trial evaluating the effectiveness of ART restorations with high-viscosity glass-ionomer cement versus conventional restorations with resin composite in Class II cavities of permanent teeth: two-year follow-up

Abstract Objective To compare the effectiveness of ART restorations using High Viscosity Glass-ionomer cement (HVGIC) with conventional restorations using resin composite in Class II cavities of permanent teeth, in a 2-year follow-up. Methodology Seventy-seven restorations were made with each restorative material, Equia Fil-GC Corporation (ART restorations) and Z350-3M (conventional restoration), in 54 participants in this parallel and randomized clinical trial. Restorations were evaluated at 6 months, 1 and 2 years using the ART and the modified United States Public Health Service (USPHS) criteria. Chi-square test and Survival Analysis (p<0.05) were used for statistical analysis. Results The success rates for ART restorations were 98.7% (6 months) and 95.8% (1 year) for both criteria. At 2 years, success rate was 92% and 90.3% when scored by the modified USPHS and ART criteria (p=0.466), respectively. The success rates for conventional restorations were 100% (6 months), 98.7% (1 year) and 91.5% (2 years) for both assessment criteria. ART restorations presented a lower survival rate by the criterion of ART (83.7%) when compared to the modified USPHS criterion of (87.8%), after 2 years (p=0.051). The survival of conventional restorations was 90.7% for both evaluation criteria. Conclusion At the 2-years follow-up evaluation, no statistically significant difference was observed between the success rate of ART restorations with HVGIC compared to conventional restorations with resin composite in Class II cavities of permanent teeth.

Hipomineralização de molares e incisivos e doença celíaca / Molar incisor hypomineralization and celiac disease

ABSTRACT BACKGROUND: Molar incisor hypomineralization (MIH) is a developmental enamel defect with multifactorial etiology. Although the relationship between celiac disease (CD) and developmental enamel defect was demonstrated, the association between CD and MIH is uncertain. OBJECTIVE: The objective of this study was to analyze the occurrence of MIH in CD patients. METHODS: Forty CD patients and a control group with 40 healthy individuals were selected. A calibrated examiner (k≥0.889) according to the European Academy of Pediatric Dentistry criteria performed the diagnosis of MIH. Data were analyzed by descriptive statistics and Fischer's exact test (α=0.05). RESULTS: Of the 80 participants, ten presented MIH with eight individuals with CD. Celiac patients presented 4.75 times the chance of occurrence of MIH than the control group (95% CI: 2.22-10.18; P=0.044). In all the evaluated teeth (n=978), 22 had MIH: 20 teeth in individuals with CD and two in those without the disease. All CD participants with MIH presented the classic form of the disease. CD participants showed 17 teeth (85.0%) with demarcated opacities, two (10.0%) post-eruptive collapses and one (5.0%) atypical restoration. The control group presented only demarcated opacities. CONCLUSION: CD increased the chance of MIH and associated with its clinical manifestations can assist in the diagnosis of CD.

RESUMO CONTEXTO: A hipomineralização de molares e incisivos (HMI) é um defeito de desenvolvimento de esmalte com etiologia multifatorial. Embora a relação entre doença celíaca (DC) e defeito de desenvolvimento de esmalte já tenha sido demonstrada, a associação entre DC e HMI ainda é incerta. OBJETIVO: O objetivo deste estudo foi analisar a ocorrência de HMI em pacientes com DC. MÉTODOS: Foram selecionados 40 pacientes com DC e um grupo controle com 40 indivíduos sem a doença. O diagnóstico da HMI foi realizado por examinador calibrado (k≥0,889) segundo critérios da Academia Europeia de Odontopediatria. Dados foram analisados por estatística descritiva e teste exato de Fischer (α=0,05). RESULTADOS: Dos 80 participantes, 10 apresentaram HMI sendo 8 indivíduos com DC. Pacientes celíacos apresentaram 4,75 vezes a chance de ocorrência de HMI que grupo controle (IC 95%: 2,22-10,18; P=0,044). No total dos dentes avaliados (n=978), 22 apresentaram HMI: 20 dentes em indivíduos com DC e 2 entre aqueles sem a doença. Todos os participantes com DC e portadores de HMI apresentavam a forma clássica da doença. Participantes com DC mostraram 17 (85,0%) dentes com opacidades demarcadas, 2 (10,0%) colapsos pós-eruptivos e 1 (5,0%) restauração atípica. Grupo controle apresentou apenas opacidades demarcadas. CONCLUSÃO: DC aumentou a chance de HMI e associada a manifestações clínicas da DC pode auxiliar no diagnóstico da doença.

Global distribution of malocclusion traits: A systematic review

Abstract Objective: Considering that the available studies on prevalence of malocclusions are local or national-based, this study aimed to pool data to determine the distribution of malocclusion traits worldwide in mixed and permanent dentitions. Methods: An electronic search was conducted using PubMed, Embase and Google Scholar search engines, to retrieve data on malocclusion prevalence for both mixed and permanent dentitions, up to December 2016. Results: Out of 2,977 retrieved studies, 53 were included. In permanent dentition, the global distributions of Class I, Class II, and Class III malocclusion were 74.7% [31 - 97%], 19.56% [2 - 63%] and 5.93% [1 - 20%], respectively. In mixed dentition, the distributions of these malocclusions were 73% [40 - 96%], 23% [2 - 58%] and 4% [0.7 - 13%]. Regarding vertical malocclusions, the observed deep overbite and open bite were 21.98% and 4.93%, respectively. Posterior crossbite affected 9.39% of the sample. Africans showed the highest prevalence of Class I and open bite in permanent dentition (89% and 8%, respectively), and in mixed dentition (93% and 10%, respectively), while Caucasians showed the highest prevalence of Class II in permanent dentition (23%) and mixed dentition (26%). Class III malocclusion in mixed dentition was highly prevalent among Mongoloids. Conclusion: Worldwide, in mixed and permanent dentitions, Angle Class I malocclusion is more prevalent than Class II, specifically among Africans; the least prevalent was Class III, although higher among Mongoloids in mixed dentition. In vertical dimension, open bite was highest among Mongoloids in mixed dentition. Posterior crossbite was more prevalent in permanent dentition in Europe.

Resumo Objetivo: considerando-se que os estudos disponíveis sobre a prevalência das más oclusões são de base local ou nacional, esse estudo teve como objetivo reunir dados para determinar a distribuição dos tipos de má oclusão em uma escala global, nas dentições permanente e mista. Métodos: foi realizada uma busca eletrônica através das ferramentas de pesquisa do PubMed, Embase e Google Acadêmico, para reunir estudos publicados até dezembro de 2016 sobre a prevalência das más oclusões, tanto na dentição permanente quanto na dentição mista. Resultados: dos 2.977 estudos encontrados, 53 foram analisados. Na dentição permanente, a distribuição mundial das más oclusões de Classe I, II e III foi, respectivamente, de 74,7% [31 - 97%], 19,56% [2 - 63%] e 5,93% [1 - 20%]. Na dentição mista, a distribuição dessas más oclusões foi de 73% [40 - 96%], 23% [2 - 58%] e 4% [0,7 - 13%]. Em relação às más oclusões verticais, observou-se prevalência de 21,98% de sobremordida profunda e 4,93% de mordida aberta. A mordida cruzada posterior afetou 9,39% da amostra. Os africanos mostraram a maior prevalência de Classe I e mordida aberta na dentição permanente (89% e 8%, respectivamente) e na dentição mista (93% e 10% respectivamente), enquanto os caucasianos apresentaram a maior prevalência de Classe II na dentição permanente (23%) e na dentição mista (26%). A má oclusão de Classe III na dentição mista foi mais prevalente entre xantodermas. Conclusão: mundialmente, nas dentições mista e permanente, as más oclusões de Classe I de Angle são mais prevalentes do que as de Classe II, especificamente entre os africanos; a menos prevalente foi a Classe III, ainda que mais prevalente entre os xantodermas na dentição mista. Na dimensão vertical, as mordidas abertas foram mais prevalentes entre xantodermas na dentição mista. A mordida cruzada posterior apresentou maior prevalência na dentição permanente na Europa.

Unilateral maxillary distomolar with multiple abnormalities in a young patient: A rare case report with mini systemic review

Supernumerary teeth are those teeth present in addition to the normal number of teeth and are mostfrequently seen in the maxillary incisors and molar regions. In the molar regions, supernumerary teethare divided into two types depending on their location: distomolars and paramolars. Distomolarsusually occur in the form of a fourth molar distal to the third molar. Distomolars are a developmentalanomaly and have been argued to arise from a combination of genetic and environmental factors.Therefore, distomolar management should be part of a comprehensive treatment plan. This articlepresents a case report of an unusual occurrence of a rare unilateral distomolar in the right of themaxilla with multiple abnormalities in a 21-year old healthy subject. In addition, a mini literaturereview includes the definition, types, prevalence, classification, etiology, complications, diagnosis,and therapeutic strategies, which may be adopted in the occurrence of distomolars.

Relationship between dental age, chronological age and cervical vertebral maturation in children and adolescents from Bucaramanga, Colombia

Objective: to determine the relationship between chronological age and dental age using Demirjian's method and Baccetti's method of cervical vertebral maturation in radiographs of children and adolescents aged 5 to 16 years in the city of Bucaramanga, Colombia. methods: an analytical observational cross-sectional study was performed in 1385 cephalometric and panoramic radiographs of 775 females and 610 males. sex, dental age according to the Demirjian's method, chronological age and degree of maturation of the cervical vertebrae according to Baccetti's method were analyzed. the univariate analysis included the calculation of measures of central tendency for quantitative variables, and frequencies and proportions for qualitative variables. spearman correlation coefficients were calculated in the bivariate analysis. in the multivariate analysis a multiple linear regression was performed. a value of p<0.05 was considered statistically significant. results: the mean chronological age was 10.8±3.3 years [Median: 11; 95 percent CI:10.6-10.6]. there was no statistically significant difference according to sex (p=0.3409). the mean of the differences between dental age and chronological age was 0.60±1.44 years. there was a strong and positive correlation between dental age and chronological age with each stage of maturation. females reached skeletal maturity at an earlier age. conclusions: chronological age shows a direct and positive relationship with dental age and stages of skeletal maturation in a colombian population.

Caracterización morfológica de la dentición permanente de un grupo de afrodescendientes de Istmina (Chocó, Colombia) / Morphological characterization of permanent dentition of a group of Afrodescendants at Istmina (Chocó, Colombia)

Objetivo: Caracterizar la morfología de la dentición permanente de un grupo de afrodescendientes de Istmina (Chocó, Colombia) Materiales y métodos: Estudio descriptivo transversal cuantitativo que determinó la frecuencia y variabilidad de 35 rasgos morfológicos dentales coronales (RMDC) de incisivos, caninos, premolares y molares mediante la metodología de la Arizona State University Dental Anthropology System en 100 individuos autoreconocidos como afrodescendientes (50 femeninos y 50 masculinos), con edades comprendidas entre los 5 y los 18 años. Resultados: Se identificaron frecuencias significativas de winging (99%), forma de doble pala de los incisivos centrales (86%), convexidad labial (41%), cresta msial (35%), cresta distal (entre 39% y 45%) surco vestibular (entre 95% y 98%), la cresta central (82% y 80%), surco mesolingual (79%), surco distolingual (81%), reducción del hipocono (86%), cúspide de Carabelli (33%) y cúspide 7 (64%). No se encontró dimorfismo sexual y asimetría bilateral en los RMDC estudiados. Conclusiones: La frecuencia y variabilidad de los RMDC incluidos en el dendograma, demostraron que el grupo de Istmina presentó una morfología dental típica de las poblaciones afrodescendientes que se distribuyen en el litoral pacífico colombiano, las cuales derivaron de grupos de la costa occidental africana incluidos en el complejo dental de África Sahariana. De igual forma, fue posible detectar la influencia de poblaciones mestizas e indígenas que ocupan el mismo espacio geopolítico.

Aim: Characterize the permanent dentition morphology of a group of Afrodescendants of Istmina (Chocó, Colombia) Materials y methods: This quantitative cross-sectional study determined the frequency and variability of 35 incisor, canine, premolar and molar morphological features of the Arizona State University Dental Anthropology System in 100 self-described individuals as Afrodescendants (50 Female and 50 male), aged between 5 and 18 years. Results: Significant frequencies of winging (99%), double blade of the central incisors (86%), convexity of the lips (41%), crest of the shoulder (35%), and distal crest (39% to 45%) were identified (95% to 98%), central ridge (82% and 80%), mesolingual groove (79%), distolingual groove (81%), hippocampus reduction (86%), Carabelli cusp ) And cusp 7 (64%). No sexual dimorphism and bilateral asymmetry were found in the MCDS studied. Conclusions: The frequency and variability of the MCDD included in the dendrogram showed that the Isthmian group had a typical dental morphology of the Afrodescendant populations distributed on the Colombian Pacific coast, which were derived from groups of the West African coast included in The dental complex of Saharan Africa. Likewise, it was possible to detect the influence of mestizo and indigenous populations occupying the same geopolitical space.

Pre-interruptive intracoronal resorption: clinical and radiographic follow-up / Reabsorção intracoronária pré-eruptiva: acompanhamento clinico e radiográfico

ABSTRACT Pre-interruptive intracoronal resorption is a radiolucent lesion localized in dentin, immediately below the amelodentin junction of unerupted teeth. It is rare, asymptomatic, and of idiopathic etiology, generally diagnosed in routine radiographs or in those for orthodontic purposes. A conservative approach, with radiographic follow-up is the treatment recommended until the tooth erupts, and then the intervention is made. However, in cases with symptoms or progression of the lesion, surgical intervention is advisable. To report a case of pre-interruptive intracoronal resorption, with a conservative approach, showing the clinical and radiographic follow-up of this condition. The patient, a nine-year-old Caucasian girl, presented to the Dental Clinic for routine examination. An initial panoramic radiograph was requested, which showed an intracoronal radiolucence in tooth 45 that had not yet erupted. Clinical and radiographic follow-up was made until the affected tooth was completely established in the oral cavity. The treatment recommended for pre-interruptive intracoronal resorption is to have knowledge of the phenomenon, associate its probable etiology and radiographic aspect, as well as its prevalence, occurrence and treatment options, by considering a conservative approach when there are no symptoms.

RESUMO A reabsorção intracoronária pré-eruptiva é uma lesão radiolúcida localizada na dentina, logo abaixo da junção amelo-detinária de dentes não irrompidos. É rara, assintomática e de etiologia idiopática, geralmente diagnosticada em exames radiográficos de rotina ou com fins ortodônticos. Uma abordagem conservadora com acompanhamento radiográfico é o tratamento recomendado até que o dente erupcione para ser feita a intervenção. Porém, em casos de sintomatologia ou progressão da lesão, aconselha-se a intervenção cirúrgica. Objetivo: Relatar o caso de reabsorção intracoronária pré-eruptiva, com uma abordagem conservadora mostrando a o acompanhamento clínico e radiográfico periódico desta condição. Paciente, sexo feminino, nove anos de idade, caucasiana, que compareceu a Clínica Odontológica para exame de rotina. Foi solicitada uma radiografia panorâmica inicial, sendo evidenciada uma radioluscência intracoronária no dente 45 ainda não erupcionado. Foi feito uma acompanhamento clínico e radiográfico até na total estabelecimento do dente acometido na cavidade oral. Conhecer a reabsorção intracoronária pré-eruptiva, associando sua provável etiologia e aspecto radiográfico, bem como sua prevalência e ocorrência e opções de tratamento, considerando uma abordagem conservadora, quando não houver sintomatologia, como tratamento recomendado.

Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review

ABSTRACT Objective: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. Methods: An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. Results: The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. Conclusions: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.

RESUMO Objetivo: o objetivo da presente revisão sistemática foi analisar as alterações dentoalveolares espontâneas, em curto e longo prazos, após a expansão lenta (ELM) ou rápida (ERM) da maxila, durante a dentição mista e permanente jovem. Métodos: uma busca eletrônica foi executada nas seguintes bases de dados: PubMed/Medline, Cochrane Library, Scopus, Embase e Web of Science. Os critérios de elegibilidade para a seleção dos artigos incluíram ensaios clínicos randomizados controlados e estudos prospectivos escritos em língua inglesa, sem restrição do ano de publicação, envolvendo pacientes que foram submetidos a ELM ou ERM durante a dentição mista ou permanente jovem. Dois revisores realizaram, de forma independente, uma busca por artigos. Inicialmente, o título e o resumo dos artigos foram lidos, e uma busca manual foi realizada nas referências dos artigos selecionados, a fim de se avaliar possíveis estudos não encontrados. Resultados: trezentos e setenta e três artigos foram encontrados com a busca, porém apenas seis foram selecionados para a revisão após a aplicação dos critérios de inclusão e de exclusão. Alterações dentoalveolares espontâneas sem significância clínica de aproximadamente 1 mm foram encontradas na arcada dentária inferior em curto e longo prazos, após a expansão lenta ou rápida da maxila. Além disso, não foram observadas diferenças significativas entre os grupos tratados e os controles. Conclusão: existe evidência suficiente para se concluir que alterações dentoalveolares espontâneas sem significância clínica tendem a ocorrer na arcada dentária inferior em curto e longo prazos após a ELM e ERM na dentição mista e permanente jovem. Mais ensaios clínicos randomizados com grupos controles adequados são necessários para melhor avaliar essa questão.

Avaliação clínica randomizada de restaurações de classe II em dentes permanentes de ART e de resina composta / Randomized clinical trial of class II restorations of ART and composite resin in permanent teeth

Este estudo avaliou a efetividade de restaurações de classe II por meio da técnica do Tratamento Restaurador Atraumático (ART), com retenções adicionais nas caixas proximais, em dentes permanentes, usando cimento de ionômero de vidro (CIV) de alta viscosidade, em comparação com restaurações convencionais de resina composta. Um exame epidemiológico foi realizado em uma população maior e representativa dos participantes da pesquisa. Cento e trinta e três participantes, de 8 a 28 anos, com boa saúde geral com uma a duas cavidades de classe II em dentes permanentes sem comprometimento pulpar e dor de dente foram incluídos neste estudo, com aprovação pelo Comitê de Ética sob o número: CAAE: 24012913.0.1001.5417. Foram feitas setenta e sete restaurações com cada material restaurador (Equia Fil-GC Corporation e Z350-3M). As restaurações foram avaliadas aos 6, 12 e 24 meses pelos critérios do ART e do Serviço de Saúde Pública dos Estados Unidos (USPHS) modificado. Correlação de Spearman e Regressão Linear Múltipla foram realizados entre as variáveis dor de dente, índice de placa visível (IPV), índice de sangramento gengival (ISG) e os índices CAST (The Caries Assessment Sprectrum and Treatment) e CPOD (contagem de dentes cariados, perdidos e restaurados) dos participantes do levantamento epidemiológico por meio do programa Statistica 7.1. Quanto à efetividade restauradora, os dados foram analisados, utilizando o programa SPSS 23.0, por meio dos testes de Mann-Whitnney, Qui-quadrado, Exato de Fisher, Qui-quadrado com tendência linear e Regressão logística pelo método Enter, quando pertinentes (p<0,050). O Teste de Kaplan-Meier avaliou as taxas de sobrevida das restaurações em relação ao critério do ART e USPHS modificado. O teste de Log-Rank comparou as curvas de sobrevida. Do índice CAST (1,53; 2,17) foi possível extrair o CPOD (0,58; 1,32) o qual apresentou menor especificidade e sensibilidade no registro da cárie. As taxas de sucesso para as restaurações de resina composta foram de 100% (6 meses), 98,7% (12 meses) e 91,5% (24 meses) para ambos os critérios de avaliação e para as restaurações de ART foram as mesmas para 6 meses (98,7%) e 12 meses (95,8%) e para 24 meses foram de 92% quando utilizado o critério do USPHS modificado e 90,3% quando utilizado o critério do ART, não sendo observada diferença estatística (p=0,466). As variáveis sexo, localidade, idade, CPOD, IPV, ISG, dor de dente, oclusão, contato proximal, tamanho da cavidade, anestesia e cooperação do paciente não apresentaram associação estatística com as taxas de sucesso das restaurações (p>0,050). Após 24 meses, as variáveis IPV e ISG não apresentaram odds ratio (OR) estatisticamente significante para as restaurações de ART (p>0,050). As restaurações de ART apresentaram uma sobrevida inferior pelo critério do ART (83,7%) quando comparado à sobrevida pelo critério do USPHS modificado (87,8%), após 24 meses (p=0,051). A sobrevida das restaurações de resina composta foi de 90,7% para ambos os critérios de avaliação. Conclui-se que não há diferença na taxa de sucesso de restaurações de classe II de ART com CIV de alta viscosidade, em dentes permanentes, com sulcos de retenção proximais, em comparação com restaurações de classe II de resina composta, após 24 meses.(AU)

This study evaluated the effectiveness of Class II restorations through the Atraumatic Restorative Treatment (ART) technique, with additional retentions in the proximal boxes, in permanent teeth, using high viscosity glass ionomer cement (HVGIC), as compared to restorations of composite resin. An epidemiological examination was conducted in a larger and representative population of the participants of study. One hundred and thirty three participants, aged 8 to 28 years, with good general health with 1 to 2 class II cavities in permanent teeth without pulp involvement and tooth pain were included in this study, with was approved by the Ethics Committee under the number: CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Restorations were evaluated at 6, 12, and 24 months by the criteria of ART and the modified United States Public Health Service (USPHS). Spearman Correlation and Multiple Linear Regression were performed between the variables tooth pain, visible plaque index (VPI), gingival bleeding index (GBI) and the CAST (The Caries Assessment Sprectrum and Treatment) and DMFT (Decayed, Missing and Filled teeth) obtained at the epidemiological survey using the Statistica program 7.1. As for restorative effectiveness, data were analyzed using the Mann-Whitnney, Chi-square, Fisher's Exact, Chi-square tests with linear trend and Logistic Regression by Enter method, where relevant (p<0.050). The Kaplan-Meier test evaluated the survival rates of the restorations in relation to the ART and modified USPHS criteria. The Log-Rank test compared the survival curves. From the CAST index (1.53; 2.17) it was possible to extract the DMFT (0.58; 1.32) which presented lower specificity and sensitivity in caries detection. The success rates for composite resin restorations were 100% (6 months), 98.7% (12 months) and 91.5% (24 months) for both assessment criteria and for ART restorations were the same for 6 months (98.7%) and 12 months (95.8%) and for 24 months were 92% when using the criteria of modified USPHS and 90.3% when using the criteria of ART, and no statistical difference was observed (p=0.466). The variables gender, locality, age, DMFT, VPI, GBI, toothache, occlusion, proximal contact, cavity size, anesthesia and cooperation of the participant did not present a statistical association with the success rates of the restorations (p>0.050). After 24 months, the VPI and GBI variables did not present a statistically significant odds ratio (OR) for ART restorations (p>0.050). ART restorations presented a lower survival rate by the criteria of ART (83.7%) when compared to the criteria of USPHS modified (87.8%), after 24 months (p=0.051). The survival of composite resin restorations was 90.7% for both evaluation criteria. It was concluded that there is no difference in the success rate of class II restorations of ART with HVGIC, in permanent teeth, with proximal retention grooves, compared to class II resin composite restorations, after 24 months.(AU)

Bilateral Fusion of Permanent Mandibular Incisors: A Rare Developmental Anomaly.

Fusion is a rare developmental anomaly. Th e prevalence ranges from 0.5% to 5% based on geographic, racial, or genetic factors, which occur as a result of physical force or pressure leading to prolonged contact of the adjacent tooth follicles thus resulting in the fusion of tooth buds. Bilateral fusion of teeth has been reported to be very rare as compared to unilateral fusion which is around 0.05%. Although asymptomatic, they can be a predisposing factor for caries and cause periodontal problems due to malalignment in the arch. Th e aim of this article is to present a rare case of bilateral fusion of mandibular anterior teeth and discuss the possible histogenetic mechanism and future treatment prospectives.

Pattern of dental caries in Korean adolescents with a high risk of caries / 대한구강보건학회지

OBJECTIVES: The purpose of this study was to analyze the pattern of dental caries in a high-risk group of Korean adolescents. METHODS: Raw data on 10,542 adolescents between the ages of 12 and 15 years from the 2012 Korean National Oral Health Survey was used. The subjects were divided into a high caries risk group and non-high caries risk group for analysis. For the statistical analyses, we utilized a frequency analysis, descriptive statistics, and a multidimensional scaling analysis. RESULTS: The pattern of dental caries in the high caries risk group were divided into six classifications for 12-year-olds and five for 15-year-olds, including the mandibular first molar occlusal surface (Cluster 1). In the high caries risk group, the frequency of Cluster 1 was approximately 4-times higher in 12-year-olds than that in the non-high caries risk group of Cluster 1, and about 3-times higher in 15-year-olds. The multidimensional scaling analysis found that in the high caries risk group, the same types of tooth surfaces formed separate groups. The prevalent dental caries pattern of 12-year-olds in the high caries risk group was left-right symmetry, while in the 15-year-olds of the high caries risk group, the caries pattern also included the antagonistic teeth, along with left-right symmetry. However, the non-high caries risk group had a pattern of left-right symmetry only in the 15-year-olds. CONCLUSIONS: When dental caries occur in the first molar, there is a high possibility of being classified into the high caries risk group. Therefore, preventative measures should focus on the antagonistic teeth and the teeth on the opposite side.

Relación entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario / Relationship between the clinical and Moyers-Jenkins methods for the evaluation of dental crowding

Se realizó un estudio descriptivo y transversal de 29 modelos de yeso de la arcada inferior que presentaron algún grado de apiñamiento, los cuales pertenecían a pacientes ingresados en el Departamento de Ortodoncia de la Clínica Estomatológica Provincial Docente "Mártires del Moncada" de Santiago de Cuba, desde octubre hasta diciembre del 2013, a fin de determinar la correspondencia entre los métodos clínico y de Moyers-Jenkins para la evaluación del apiñamiento dentario. Entre las variables analizadas figuraron: métodos de evaluación del apiñamiento, tipo de dentición y grado de apiñamiento dentario. Al analizar los 2 métodos predominaron los afectados con discrepancia severa; sin embargo, la mayoría de los que fueron evaluados como discrepancia ligera por el primero resultaron sin discrepancia al aplicar el segundo. Existió mayor precisión entre ambos métodos en las discrepancias moderada y severa.

A descriptive and cross-sectional study of 29 plaster cast of the lower arch that presented a degree of crowding was carried out, which belonged to patients admitted in the Orthodontics Department of "Mártires del Moncada" Teaching Provincial Stomatological Clinic in Santiago de Cuba, from October to December, 2013, in order to determine the correspondence among the clinical and Moyers-Jenkins methods for the evaluation of dental crowding. Among the analyzed variables there were: methods of evaluation of crowding, teething type and degree of dental crowding. When analyzing the 2 methods those affected with severe discrepancy prevailed; however, most of those that were evaluated as slight discrepancy by the first method were without discrepancy when applying the second one. Higher precision existed between both methods in the moderated and severe discrepancies.

Dental maturation assessment of Nanjing children aged 3 -16 years / 实用口腔医学杂志

[Abstract ]Objective:To estimate dental maturation norms of permanent dentition in a group of Nanjing children using Nolla's tech-nique.Methods:549 cases of panoramic radiographs (279 males and 270 females)of Nanjing children at the age range of 3 to 16 years were collected for the study.All permanent mandibular teeth on the left side (except for the third molars)were scored according to Nolla's method,and data were presented in tables and used to plot dental maturation curves for the Nanjing boys and girls.Results:Females were found to be more advanced in the degrees of dental development.Dental maturation is significantly associated with chron-ological age (for males and females:r =0.959,P <0.001 and r =0.953,P <0.001,respectively).The mathematical model of them was established,and then the fitting equation was obtained.Conclusion:The dental maturation curve and chronology of permanent dentition can provide the growth norms of permanent teeth for Nanjing children and facilitate the way for dentists to assess the growing children during diagnosis and treatment planning.