Lesiones cervicales no cariosas: una revisión sistemática / Non carious cervical lesions: a systematic review

Introducción: las lesiones cervicales no cariosas (NCCL, por sus siglas en inglés) son un grupo de lesiones que afectan el área cervical del órgano dental causando hipersensibilidad dentinaria y defectos estéticos. Objetivo: analizar la literatura sobre las lesiones cervicales no cariosas, su etiología, consideraciones anatómicas, características morfológicas de la lesión y tratamientos no restaurativos. Material y métodos: se realizó una búsqueda en la base de datos PubMed, utilizando las palabras clave: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, recopilando un total de 78 artículos. Resultados: es necesario determinar la etiología antes de seleccionar las estrategias de tratamiento para las lesiones cervicales no cariosas. Conocer los distintos tipos de tejidos que componen al órgano dentario facilita la comprensión de los factores que participan en el desarrollo de las lesiones cervicales no cariosas. Esto permite que el tratamiento se enfoque más en la causa del problema que en los síntomas. Con esto podemos modificar diversos factores de manera interceptiva, los tratamientos de terapia con láser y compuestos tópicos son una estrategia mínimamente invasiva. Conclusiones: la mejor manera de describir a las lesiones cervicales no cariosas sería como una enfermedad multifactorial. Se debe prestar especial atención en los métodos de diagnóstico, identificando cofactores que propicien el avance de la lesión, como son la fricción y la biocorrosión. Esta revisión brinda datos que asocian a los factores oclusales como una de las principales causas de una enfermedad que afecta a más de la mitad de la población adulta (AU)

Introduction: non-carious cervical lesions (NCCL) are a group of lesions that affect the cervical area of the dental organ causing dentin hypersensitivity and cosmetic defects. Objective: to know, through a systematic review, the current state of non-carious cervical lesions. Material and methods: a search was conducted in the PubMed database, using the keywords: non-carious cervical lesions OR noncarious cervical lesions OR tooth wear OR tooth erosion OR dental abfraction OR abfraction, compiling a total of 78 articles. Results: determining etiology is necessary before selecting treatment strategies for non-carious cervical lesions (NCCL). Know the different types of tissues that make up the dentary organ, facilitate the understanding of the factors involved in the development of noncarious al cervical lesions. This allows treatment to focus more on the cause of the problem than on symptoms. With this we can modify various factors in an interceptive way, laser therapy treatments and topical compounds, are a minimally invasive strategy. Conclusions: the best way to describe non-carious al cervical lesions would be as a multifactorial disease to which special attention should be paid to both diagnostic methods, identifying cofactors that promote the progression of injury, such as friction and biocorrosion. This review provides data that associates occlusal factors as one of the main causes of a disease that affects more than half of the adult population (AU)

Teeth avulsion secondary to oro-tracheal intubation in a tertiary healthcare facility: a case series

General anaesthesia using endo-tracheal intubation, carried out to provide pain- free, surgical and medical procedures, sometimes results in Traumatic Dental Injuries [TDIs]. Among the rarely reported TDI complication is tooth avulsion. We present two cases of such complications, factors which can be responsible, management of such cases, and the need to educate medical and paramedical personnel on what to do if such complications arise before definitive management can be carried out by the dentist. Such awareness will go a long way in preventing unnecessary litigations which might likely occur from such routine procedures.

A ten year audit of traumatic dental injuries in children in a Tertiary Hospital in Southern Nigeria

Objective: To determine the prevalence, management and outcome of traumatic dental injuries among children treated at the Paediatric Dental Clinic of the University of Benin Teaching Hospital. Methods: Data of children with traumatic dental injuries were collected from the clinical register for all children who were treated at the Paediatric Dental Clinic from November 2004 to October 2014. Data collected included the year of trauma, age, sex, teeth injured, type of traumatic dental injury and treatment done. These were analyzed with the chi square test and probability values of p<0.05 applied. Results: Three hundred and nine children (5.0%) suffered dental trauma out of a total number of 6,169 children (age range 1-16years) seen within the study period. The mean age of the patients with dental trauma was 7.61±4.0 years. Dental injuries relating to the primary teeth was recorded in 104(33.7%). Those relating to the permanent teeth was 188(60.8%) and soft tissue injuries accounted for 17(5.5%). Many males 177(57.3%) were affected more than females 132(42.7%) but this was not statistically significant (P=0.086). There were two peak age incidences of trauma namely the 2-3years and 9-10years of age. The most common type of injury was enamel-dentin fractures 69(22.3%) in permanent teeth and lateral luxation 32(10.4%) in primary teeth. In the primary teeth related injury, the most commonly performed treatments were extractions and drug prescriptions each in 43(39.8%) while for permanent teeth were restorations 86(42.8%) and root canal treatment 57(28.4%). Conclusion: The clinic prevalence of traumatic dental injury in this study was relatively low, still this low percentage represents a large number of patients. Institution of standard treatment modalities and a long-term follow-up will minimize complications and improve outcome

Maxilla Pseudoarthrosis Ten Years After Orthognathic Surgery: case report / Pseudoartrosis Maxilar Diez Años Después de la Cirugía Ortognática: relato de un Caso

ABSTRACT: Many orthodontic treatments alone cannot reestablish an ideal occlusion, requiring correction through orthognathic surgery. An adequate surgical planning, execution and case follow-up can provide surgical stability between the maxilla and the mandible. Soft tissue conservation and proper correction during a healing phase are important to achieving this goal. Patient C.L.B.S, 38 years old, female, presented with Angle Class I occlusion, facial profile class II, maxilla with mobility, chin surgically advanced and anterior open bite. She was submitted to orthognathic surgery 10 years ago. In the panoramic radiography the absence of bone formation in the maxilla was observed, causing an open bite. For the surgery conventional radiographs were used, as well as the dental cast in articulator for model surgery and preparation of surgical guide. With the surgery an improvement in the patient's aesthetics profile and an ideal occlusion, static and functional were expected. The treatment was orthodontic-surgical, with correction of the dento-facial deformity with counter-clockwise rotation of the maxilla, lowering repositioning in 3 mm of its posterior portion through Le Fort I osteotomy, advancement of the 4 mm mandible with bilateral sagittal osteotomy, and genioplasty for posterior repositioning with a Z-osteotomy, to improve mentual harmony. There was an improvement in the profile and aesthetics of the patient, which developed an Angle Class I profile, a decrease in the mentual projection, and an aesthetic and functional improvement. The orthognathic surgery allowed the advancement of the mandible, the repositioning of the maxilla and the mentual posterior repositioning, obtaining the correction of the Angle class II profile and the anterior open bite, resulting in an important improvement of facial profile and esthetics, presence of skeletal stability, restoration of function, self-esteem and quality of life.

RESUMEN: En muchos casos, el tratamiento ortodóntico por si solo no puede restablecer una oclusión ideal, siendo necesaria una cirúrgia ortognática. Una buena planificación quirúrgica, ejecución y seguimiento del caso, pueden proporcionar estabilidad entre los maxilares. La preservación de los tejidos blandos y una fijación adecuada son esenciales para ese objetivo. La paciente CLBS, 38 años, se presentó con oclusión Clase I de Angle, teniendo perfil clase II, maxilar con movilidad, mentón quirúrgicamente avanzado y mordida abierta anterior. La paciente fue sometida a cirugía ortognática 10 años antes. En radiografía panorámica, se nota la ausencia de formación ósea debido a una fijación maxilar realizada erróneamente, lo que causó la mordida abierta. Durante la planificación, fueron utilizadas radiografías convencionales, modelos de yeso en articulador para cirugía de modelo y confección de guía quirúrgica. Con el procedimento quirúrgico se esperaba obtener una mejora en el perfil de la paciente y una oclusión ideal, estática y funcional. El tratamiento fue ortodóntico-quirúrgico, con corrección de la deformidad dento-facial con giro antihorario de la mandíbula, con reposicionamiento inferior de 3 mm de su parte posterior, por medio de osteotomía Le Fort I, avance de la mandíbula de 4 mm con osteotomía sagital bilateral, y retroceso del mentón en su posición original con osteotomía en Z, mejorando la armonía del mentón. Hubo una mejora en perfil y en la estética de la paciente, como también una mejora en el perfil, estética y funcionalidade, con diminución del mentón. La cirúrgia ortognática permitió el movimiento de la mandíbula, reposicionamiento maxilar y además fue posible retroceder el mentón, obteniendo la corrección del perfil Clase II y de la mordida abierta anterior. El resultado representa una mejora del perfil y de la estética facial, además se nota una estabilidad esquelética, con restablecimiento de la función, autoestima y calidad de vida.

Does traumatic occlusal forces lead to peri-implant bone loss? A systematic review

Abstract Observational studies have indicated that crestal bone level changes at implants are typically associated with clinical signs of inflammation, but still mechanical overload has been described as possible factor leading to hard-tissue deficiencies at implant sites without mucosal inflammation. The aim of this paper was systematically review the literature regarding the possible effect of traumatic occlusal forces on the peri-implant bone levels. Literature search was conducted using PubMed, Scielo and Lilacs, including the following terms: oral OR dental AND implant$ AND (load OR overload OR excessive load OR force$ OR bruxism) AND (bone loss OR bone resorption OR implant failure$). Databases were searched for the past 10 years of publications, including: clinical human studies, either randomized or not, cohort studies, case control studies, case series and animal research. Exclusion criteria were review articles, guidelines and in vitro and in silico (finite element analysis) research, as well as retrospective studies. The PICO questions formulated was: "does traumatic occlusal forces lead to peri-implant bone loss?" The database searches as well as additional hand searching, resulted in 807 potentially relevant titles. After inclusion/exclusion criteria assessment 2 clinical and 4 animal studies were considered relevant to the topic. The included animal studies did not reveal an association between overload and peri-implant bone loss when lower overloads were applied, whereas in the presence of excessive overload it seemed to generate peri-implant bone loss, even in the absence of inflammation. The effect of traumatic occlusal forces in peri-implant bone loss is poorly reported and provides little evidence to support a cause-and-effect relationship in humans, considering the strength of a clinically relevant traumatic occlusal force.

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.

Bruxismo e implantes dentales / Bruxism and dental implants

En ausencia de guías clínicas que permitan ponderar factores de riesgo para el manejo del paciente bruxista, respecto a los índices de supervivencia de los implantes dentales y restauraciones que soporta, se realiza esta revisión bibliográfi ca a través de una búsqueda electrónica, indagando cómo un incremento en la función muscular pudiera signifi car un factor de riesgo para el implante mismo o para sus diferentes componentes y tipos de diseño protésico. Fue encontrada una diversidad de información contrastante en cuanto a los efectos que tiene el bruxismo en pacientes que han recibido un tratamiento de implantes, respecto a diagnóstico, manejo y adecuaciones o compensaciones que pudieran ser requeridas. En este reporte se ofrecen algunas recomendaciones respecto a la valoración clínica de los individuos con historial de bruxismo para mejor estimar los riesgos de colocación de implantes en sus bocas y poder reducirlos o sobrepasarlos (AU)

The lack of clinical guides to assess the risk factor for the treatment of a patient with bruxism and its relationship with the survival rate of the dental implants and its restoration has motivated a literature review on the subject. This examination was done through an electronic search, looking for the possible association between an increased muscular function as a risk factor and the damage possibility to dental implants or their diff erent prosthetic components. The obtained information was rather contrasting regarding the eff ects that bruxism may lead on dental implant treatment, as well as on diagnosis, management, and treatment plan modifi cations. A number of recommendations are given regarding evaluations of individuals with bruxism to better estimate risk factors to control or overpass them in benefi t of the patients seeking rehabilitation through the use of dental implants (AU)

Participación del odontólogo en la asistencia de pacientes con trastornos respiratorios relacionados con el sueño / The dentist´s role in attending patients with sleep-related respiratory disorders

En esta revisión se mencionan, en primer lugar, algunas alteraciones odontológicas y oro-cráneo-faciales que son observadas con cierta frecuencia en pacientes que concurren a la consulta odontológica. Luego se realiza una descripción del rol del odontólogo en la evaluación de pacientes que pudieran presentar trastornos respiratorios relacionados con el sueño (TRRS). A continuación, se describen brevemente dos de los más frecuentes TRRS: el ronquido y la apnea obstructiva del sueño. Finalmente, se mencionan algunos recursos terapéuticos de utilidad en los TRRS, particularmente los beneficios de la implementación de la aparatología oral (AO) en estos pacientes (AU)

In this review, we first mention some odontological and oro-cranial-facial alterations that are frequently observe in patients who attend the dental office. After that, a description of the role of the dentist in the evaluation of patients who could present RDRS will be made. Besides two of the most frequent RDRS are briefly describe: snoring and obstructive sleep apnea. Finally, some useful therapeutic resources for the RDRS treatment will be comment, particularly the benefits of the implementation of oral appliances (OA) -in these patients (AU)

Stability of periodontally compromised teeth after splint and non-surgical therapy: two cases followed-up for 1 to 3 years

This article describes cases of applying non-surgical treatment including scaling and root planing, occlusal adjustment and tooth splinting of periodontally compromised lower anterior incisors Clinical and radiographic evaluations were performed over a 1–3-year period. All clinical parameters and radiographic bone levels improved in both cases. Dramatic regeneration of alveolar bone and lamina dura were observed on radiographic images, and no specific complications occurred during the follow-up period. Within the limitations of this study, these cases demonstrated the possibility of tooth rescue through non-surgical treatment and splinting of periodontally compromised teeth typically considered for extraction.

Un nuevo recurso para generar expansión transversal en los maxilares / A new resource to generate transversalexpansion in the jaws

La filosofía de la bioadaptación transversal de los maxilares preconiza una nueva forma de generar crecimiento a nivel de los tejidos dento alveolares, a través de una mecánica ortodoncia biológicamente más segura a la hora de realizar expansión transversal. El principio básico de esta filosofía no es soloel uso de brackets autoligantes, ni marcas comerciales específicas, ya que puede utilizarse cualquiera de ellas; se trata de no generar daños colaterales denominados “costos biológicos”, frecuentemente ligados a fuerzas excesivas. Se pretende proporcionar una menor fricción entre bracket y arco, reduciendo así el uso de aparatos auxiliares y el tiempo de tratamiento, aprovechando los beneficios de cada componente. Para generar el crecimiento transversal del maxilar es fundamental el uso de gomas intermaxilares, teniendo como tutores a los segundos molares superiores que son los menos afectados por las disfunciones. Podemos decir que después del correcto estímulo de una fuerza que inicie el proceso de desequilibrio y consecuente respuesta tisular, las fuerzas naturales de la musculatura oral, más las existentes en el sistema de brackets, serán suficientes para definir la necesaria bioadaptación dentoalveolar individual del paciente.

The transverse bioadaptation philosophy of the jaws advocates a new way of generating growth at thelevel of dentoalveolar tissues, through a biologically safer orthodontic mechanics when carrying outtransversal expansion. The basic principle of this philosophy is not only the use of self-ligating bracketsor specific trademarks, since any of them can be used, but also not to generate collateral damagescalled "biological costs" frequently due to excessive forces. Aiming at providing less friction betweenbracket and bow, thus reducing the use of auxiliary appliances and treatment time, taking advantageof the benefits of each component. In order to generate maxilla transversal growth the use ofintermaxillary gums is fundamental, having as tutor the upper second molars that are the least affectedby the dysfunctions. It can be stated that after the correct stimulus of a force that initiates the process of imbalance and consequent tissue response, the natural forces of the oral musculature plus thoseexisting in the bracket system will be sufficient to define the necessary individual dento alveolar bioadaptation of the patient.

The influence of primary occlusal trauma on the development of gingival recession / La influencia del trauma oclusal primario en el desarrollo de la recesión gingival

This study aimed to histometrically evaluate the presence of gingival recession in the mesial surface of the teeth of rats experimentally subjected to primary occlusal trauma. This evaluation verified the distance from the cement-enamel junction (CEJ) to the free marginal gingiva (FMG) and to the height of the alveolar bone crest (CEJ-crest bone distance). There were 10 animals, randomly divided into 2 groups: occlusal trauma (OT) (n = 5) - creation of an occlusal interference by fixing an orthodontic wire segment on the mandibular first molar occlusal face, which was randomly chosen, and a Control Group (CG) (n = 5) - five animals with no exposure to the OT variable were euthanised after 14 days to obtain the initial parameters. The inter-group evaluation showed there was no significant difference between OT × CG when the CEJ-FGM distance (P = 0.192) was evaluated after 14 days, but there was a significant difference between the two groups as regards the CEJ-alveolar crest bone distance (P = 0.0142). Thus, it can be concluded that the OT induction model, after 14 days of experiment, promoted bone resorption. This was observed by the increase in the CEJ-alveolar crest bone distance. It also did not promote gingival recession, which was evaluated by the CEJ-FGM distance.

El objetivo de este estudio fue evaluar histométricamente en ratas la presencia de recesión gingival en la superficie mesial de los dientes sometidos experimentalmente a trauma oclusal primario a partir de la evaluación de la distancia desde la unión esmalte cemento (CEJ) a la encía marginal libre y la altura de la cresta ósea restante (distancia de la CEJ-cresta ósea) Con este fin, 10 animales fueron divididos al azar en 2 grupos: trauma oclusal (TO) (n = 5) - creación de una interferencia oclusal mediante la fijación de un segmento de alambre de ortodoncia en la superficie oclusal del primer molar elegido al azar; y un grupo control (CO) (n = 5) -5 animales sin la introducción de la variable TO fueron sometidos a eutanasia después de 14 días para obtener los parámetros iniciales. La evaluación intergrupo no mostró diferencias significativas entre los grupos TO × CO al evaluar después de 14 días la distancia de la CEJ-encía marginal libre (p = 0,192) pero mostró una diferencia significativa entre los grupos TO × CO en cuanto a distancia de la CEJ-cresta ósea alveolar (p = 0,0142). Por lo tanto, se concluye que el modelo de inducción del TO después de 14 días del experimento promueve reabsorción ósea siendo observado por el aumento en la distancia de la CEJ-cresta ósea alveolar y no promueve la recesión gingival evaluada a partir de la distancia de la CEJ-encía marginal.

Efeito das forças oclusais excessivas sobre os dentes e o periodonto de inserção / Effect of excessive occlusal forces on teeth and the supporting periodontium

Os dentes e o periodonto respondem com alterações funcionais adaptativas às forças mastigatórias. Porém, estudos clínicos têm mostrado que forças oclusais excessivas podem causar injúria aos tecidos de suporte do dente, com alterações clínicas como mobilidade e migração dental, trincas de esmalte, sensibilidade térmica e frêmito. Estudos pré-clínicos em animais também têm mostrado alterações histológicas frente às forças oclusais excessivas, como espessamento do ligamento periodontal, radioluscência no ápice de dentes vitais, reabsorção óssea e radicular. Tais alterações, conhecidas como trauma oclusal, são reversíveis quando não há inflamação instalada e as forças excessivas são removidas. Por outro lado, a literatura é controversa no que se refere à relação entre o trauma oclusal e o início e progressão da doença periodontal. O presente estudo teve como objetivo revisar a literatura a respeito do efeito das forças oclusais excessivas incidentes sobre os dentes e o periodonto de inserção, em condições saudáveis ou quando o suporte encontra-se inadequado ou reduzido.

Teeth and periodontium answer with adaptive alterations to the masticatory forces. However, clinical studies have shown that excessive occlusal forces may cause an injury in the supporting tissues of the tooth, causing clinical alterations such as tooth mobility and migration, enamel cracks, thermal sensitivity and fremitus. Pre-clinical studies in animals have shown histological alterations such as widening of the periodontal ligament, radiolucency at the apex of vital teeth, bone and root resorption. These alterations, known as occlusal trauma, are reversible when there is no inflammation and the excessive forces are removed. On the other hand, literature is controversial regarding the association between the occlusal trauma and the beginning and progression of the periodontal disease. This study aimed to review the literature regarding the effect of the excessive occlusal forces on the teeth and on the insertion periodontium, under healthy conditions and inadequate or reduced support.

Afecciones pulpares de origen no infeccioso en órganos dentarios con oclusión traumática / Non-infectious pulpal disorders in dental organs with occlusal trauma

Introducción: la oclusión traumática se define como una alteración en las relaciones oclusales del sistema masticatorio, lo cual podría ser un factor conducente a un proceso inflamatorio en el ligamento periodontal, en la pulpa dental, y en tejidos blandos sensitivos. Objetivo: identificar las afecciones pulpares de origen no infeccioso en órganos dentarios con oclusión traumática en pacientes de un hospital del sector público de Mérida, Yucatán, México. Métodos: se realizó un estudio observacional y analítico, en un hospital del sector público de Mérida, Yucatán, México (2014). La muestra estuvo constituida con un total de 156 órganos dentarios de 82 pacientes, de 20 y más años de edad, que presentaron oclusión traumática en dientes permanentes y que mostraron alguna afección en tejido pulpar de origen no infeccioso, de acuerdo con la clasificación de la Academia Americana de Endodoncia. También se incluyó a los pacientes que presentaban caries, fracturas, fisuras, obturaciones, endodoncia, ortodoncia o trauma dentoalveolar. Se empleó un muestreo No probabilístico, por conveniencia. Se obtuvo el consentimiento informado y voluntario, historia médica y dental, y se realizó la evaluación de los signos y síntomas de dolor, pruebas pulpares (térmicas y eléctricas), palpación y percusión y abordaje diagnóstico con tinción/transiluminación, así como pruebas oclusales con papel de articular y examinación e interpretación de radiografías periapicales. Se utilizó estadística descriptiva. Resultado: hubo ausencia de dolor en 53 por ciento de los 156 órganos dentarios estudiados. Las alteraciones radiográficas se presentaron en 63 por ciento: entre ellas los nódulos pulpares tuvieron el mayor porcentaje (25 por ciento). La pulpitis fue reversible en 37 por ciento (n= 58); la oclusión traumática más frecuente fue la maloclusión (n= 49). En los 156 órganos dentarios estudiados, el signo clínico que mostró mayor frecuencia fue el desgaste en esmalte (n= 56). Conclusiones: las afecciones pulpares de origen no infeccioso se presentaron en alto porcentaje de dientes permanentes de pacientes con oclusión traumática(AU)

Introduction: Occlusal trauma is defined as an alteration in the occlusal relationships of the masticatory system, which may lead to inflammation of the periodontal ligament, the dental pulp and sensitive soft tissues. Objective: Iidentify non-infectious pulpal disorders in dental organs with occlusal trauma of patients from a public hospital in Mérida, Yucatán. Methods: An observational analytical study was conducted at a public hospital in Mérida, Yucatán, Mexico (2014). The study universe was 156 dental organs of 82 patients aged 20 years and over with occlusal trauma in permanent teeth and some degree of non-infectious pulp tissue disorder, based on the classification of the American Academy of Endodontics. Patients were also included who presented caries, fractures, fissures, fillings, endodontic treatment, orthodontic treatment or dentoalveolar trauma. Convenience non-probability sampling was applied. Voluntary informed consent was obtained. Medical and dental records were examined. An evaluation was carried out of pain signs and symptoms. Thermal and electric pulp tests were performed, as well as palpation, percussion and diagnostic staining/transillumination. Occlusal testing was conducted using articulating paper. Periapical radiographs were examined and interpreted. Descriptive statistics were used. Result: There was no pain in 53 percent of the dental organs studied. Radiographic alterations were present in 63 percent; the most common were pulp nodes (25 percent). Pulpitis was reversible in 37 percent (n= 58), and the most frequent occlusal trauma was malocclusion (n= 49). In the 156 teeth studied, the most common clinical sign was enamel wear (n= 56). Conclusions: Non-infectious pulpal disorders were present in a large number of permanent teeth of patients with occlusal trauma(AU)

Características clínicas periodontales de piezas con diagnóstico de trauma de oclusión secundario / Periodontal clinical features of teeth with secondary trauma of occlusion

Determinar las características periodontales de piezas con diagnóstico de trauma de oclusión secundario en pacientes atendidos en la Clínica Dental Docente de la Facultad de Estomatología ôRoberto Beltránõ de la Universidad Peruana Cayetano Heredia durante los años 2011-2012. Material y métodos: Estudio retrospectivo, descriptivo, observacional y de corte transversal, con un universo conformado por pacientes con características clínicas de trauma de oclusión secundario recibidos por los estudiantes de pregrado. Resultados: Se incluyeron 110 historias clínicas de pacientes con diagnóstico de trauma de oclusión secundario, las cuales fueron evaluadas por según los criterios de inclusión y exclusión, quedando 95 casos como referencia para el presente estudio. Las piezas diagnosticadas con trauma de oclusión secundario representan mayor afectación en cuanto a la variable movilidad dental en el 98,09% de los casos, pérdida del nivel de inserción clínica (NIC) moderada (24,2%) y severa (73,7%) y retención dental en el 100% de los casos. El tipo de pieza afectada por trauma de oclusión secundario es variable, con un 51,5% de casos con afección sólo en piezas unirradiculares, 61,54% sólo en piezas multirradiculares y 20,1% en ambos tipos de piezas. Presentándose con mayor prevalencia en los grupos etarios 41-50 (30,5%), 51-60 (27,4%) y 61-70 (24,2%) años. Conclusiones: Las piezas diagnosticadas con Trauma de Oclusión Secundario representan un mayor compromiso en cuanto a la variable movilidad dental y retención dental, así como la pérdida de nivel de inserción clínica (NIC) severa, por lo que es de vital importancia valorar el estado periodontal de las piezas comprometidas con trauma de oclusión secundario para planificar una secuencia de tratamiento apropiada y determinar las posibilidades y limitaciones de la terapia periodontal...

Determine the characteristics of periodontal diagnosis pieces Occlusion Secondary Trauma in patients treated at the Teaching Dental Clinic of the Faculty of Stomatology ôRoberto Beltránõ UPCH during 2011-2012. Material and methods: It was retrospective, descriptive, observational and cross-sectional study, with a universe formed by patients with characteristics of Secondary Occlusal Trauma (Secondary Trauma from Occlusion) received by undergraduates. Results: Clinical history of 110 patients with a diagnosis of secondary occlusal trauma, which went through inclusion and exclusion criteria, leaving 95 cases as a reference for the present study. The teeth diagnosed with secondary occlusal trauma represent more unaffected in tooth mobility variable in the 98.09% of cases, loss of clinical attachment level moderate (24.2%) and severe (73.7%) and dental retention 100% of cases. The type of teeth affected by secondary occlusal trauma is variable, with 51.5% of cases single-rooted, 61.54% multi-rooted and 20.1% in both types. Though the highest prevalence in the 41- 50 age group (30.5%), 51-60 (27.4%) and 61-70 (24.2%). Conclusions: The teeth diagnosed with secondary occlusal trauma represent more affected evaluated as tooth mobility and tooth retention variable, and the loss of clinical attachment level severe, so it is important to assess the periodontal status of teeth engaged with secondary trauma occlusion to plan a sequence of appropriate treatment and determine the possibilities and limits of periodontal therapy...

Influência da oclusão dentária em ratos submetidos a reimplante imediato: estudo histológico do periodonto e imuno-histoquimíco dos restos epiteliais de malassez e células clásticas / Influence of dental occlusion in the periodontium of the teeth rats submitted to immediately replantation: study of epithelial remains of malassez and clastic cells

Alguns fatores podem interferir no prognóstico do reimplante imediato, como a fase da rizogênese dentária, o período de tempo no meio extra-alveolar, meios de conservação, contaminação, o uso e tipo de contenção dentária e a oclusão traumática. Este estudo visa avaliar a influência da ausência ou excesso de carga oclusal no processo de reparo do periodonto, com ênfase nas características histológicas, e analisar dos restos epiteliais de Malassez e das células clásticas na raiz mesial do primeiro molar superior de ratos submetidos a reimplante imediato. Foram divididos em grupos controle (GC),infra-oclusão (GIO) e oclusão traumática (GOT) e os períodos experimentais avaliados de 3, 5, 7, 14 e 30 dias. Análises qualitativas e quantitativas foram realizadas em cortes histológicos corados pelo método da hematoxilina e eosina (HE); e células clásticas (fosfatase ácida resistente ao tartarato, TRAP) e os restos epiteliais de malassez (citoqueratina) pela técnica de imuno-histoquímica. Os dados foram submetidos ao teste de Kruskal-Wallis e pósteste de Dunn, considerando p< 0,05 como significante. No período de 5 dias, os animais do grupo GIO apresentaram espessura do ligamento periodontal e porcentagem da área de matriz extracelular fibrilar e não fibrilar significativamente menor. No 7º dia, animais do GIO mostraram uma redução significativa da porcentagem da área de matriz extracelular não fibrilar e número de células clástica, sendo o oposto no grupo GOT. Aos 30 dias a porcentagem de matriz extracelular não fibrilar e número de células clástica foram menores, e o número de perfil nuclear foi maior no GIO. A oclusão traumática aumentou significativamente o número de células clásticas, enquanto a ausência de forças oclusais retardou o aparecimento e o número das mesmas. Os restos epiteliais de Malassez foram evidenciados, principalmente presente no período de 3 dias pós-operatório e, raramente visualizados nos demais tempos experimentais. Em conclusão, baseado...

Among the factors that can interfere in the immediate tooth replantation prognosis there are the phase of root formation, the extra-alveolar period, storage media, contamination, use and type of dental splint and traumatic occlusion. This study aims to evaluate the influence of absence or excessive occlusal load on periodontal healing process, with emphasis on homeostatic function of epithelial remains of Malassez and clastic cells, dental root of rat molars submitted of immediate replantation. We used 150 male rats , with 5 weeks of life, divided into Control group ( GC ) infra occlusion ( IOG) and traumatic occlusion ( TOG) and the experimental periods evaluated 3, 5, 7, 14 and 30 days.Qualitative and quantitative analyzes were performed on histological sections stained by hematoxylin and eosin (HE); and clastic cells (TRAP) and epithelial remains of Malassez (PAN Cytokeratin) by immunohistochemistry. The data were submitted to the Kruskal-Wallis test post hoc Dunn, the statistical program Graph Prism 6.0 (α = 5%). The epithelial remains of Malassez were present in the 3-day period and absent in other experimental times, in all the groups. In the 5-day period IOG shows thickness of the periodontal ligament and the percentage of fibrillar and non fibrillar extracellular matrix area significantly lower. On the 7th day IOG showed a significant reduction of the percentage of non fibrillar extracellular matrix area and clastic number of cells, and OTG shows the opposite. At 30 days the percentage of non-fibrillar extracellular matrix and the number of clastic cells was lower, and the number of cell profiles was higher in IOG. The traumatic occlusion significantly increases the number of clastic cells, while the absence of occlusal forces retards the onset and the number of them. Early occlusal load should be avoided in the teeth subjected to immediate replantation

Regeneración tisular guiada en defecto óseo de 3 paredes: enfermedad periodontal y oclusión / Guided tissue regeneration and in a three-walled osseous defect: periodontal disease and occlusion

Relacionar la importancia del éxito en regeneración tisular guiada y el correcto diagnóstico del problema, en este caso enfermedad periodontaly un contacto prematuro en ORC producto de una obturación de amalgama incorrecta. Caso clínico: tratamiento de un defecto infraóseo de3 paredes mediante la utilización de hueso de origen bovino particulado junto con proteínas derivadas de la matriz del esmalte. Tanto los parámetros clínicoscomo los radiográficos fueron evaluados al inicio, en el postquirúrgico inmediato y a los 12 meses. Conclusión: se observó un alto grado de regeneración pasados los 12 meses del tratamiento. Parecería no ser siempre necesaria la utilización de membrana colágena. Las proteínas derivadas de la matrizdel esmalte serían un sustituto de la membrana en algunos casos. Resulta fundamental el chequeo de la situación oclusal en piezas periodontalmente comprometidas...

Relación entre la recesión ósea y atrición en cráneos secos contemporáneos / Relationship between bone recession and attrition in contemporary dry skulls

Objetivos: El objetivo de éste estudio és observar la posible influencia de las fuerzas oclusales según el grado de atrición de las piezas dentarias sobre la altura de la cresta alveolar. Material y métodos: Se estudiaron dientes de cráneos secos de la época actual y secomparó el desgaste oclusal ó atrición (A) con la pérdida de altura de la cresta alveolar (CA) ó recesión ósea (RO) y ambos registros se relacionaron estadísticamente. Resultados: De todos los dientes estudiados 2 tuvieron grado de atrición (GA) 0, 170 grado 1, 96 grado 2 y 15 grado 3. Registrando la recesión ósea (RO) las medidas extremas promedio estuvieron entre 2,80mm y 5,30mm; la mayor RO promedio se encontró en la parte media de las caras libres (pieza 23) y la menor en distal (pieza 11). Conclusión: No hay correlación entre la recesión ósea y el desgaste oclusal ó atrición.

Aim: The aim of these work is to know the relaciònship between the bonerecessiòn and the attritiòn.Materials and methods: We taken 228 teeth belonging to 25 dry skullsof actual edge and we compare the bone recession (BR) with the occlusalwaer or attrition (A) and both to be related with a statistical analyses.Results: Of all the teeth studied, 2 had attrition degree 0, 170 degree 1,96 degree 2 y 15 degree 3. Regarding the BR the measures differ between2,80 to 5,30mm. The BR major average was in the middle of the free aspect(tooth 23) and the minor in distal (tooth 11).Conclusion: There are not correlation between bone recession andocclusal wear or attrition.

Influência da oclusão dentária em ratos submetidos a reimplante imediato: estudo histológico do periodonto e imuno-histoquimíco dos restos epiteliais de malassez e células clásticas / Influence of dental occlusion in the periodontium of the teeth rats submitted to immediately replantation: study of epithelial remains of malassez and clastic cells

Alguns fatores podem interferir no prognóstico do reimplante imediato, como a fase da rizogênese dentária, o período de tempo no meio extra-alveolar, meios de conservação, contaminação, o uso e tipo de contenção dentária e a oclusão traumática. Este estudo visa avaliar a influência da ausência ou excesso de carga oclusal no processo de reparo do periodonto, com ênfase nas características histológicas, e analisar dos restos epiteliais de Malassez e das células clásticas na raiz mesial do primeiro molar superior de ratos submetidos a reimplante imediato. Foram divididos em grupos controle (GC),infra-oclusão (GIO) e oclusão traumática (GOT) e os períodos experimentais avaliados de 3, 5, 7, 14 e 30 dias. Análises qualitativas e quantitativas foram realizadas em cortes histológicos corados pelo método da hematoxilina e eosina (HE); e células clásticas (fosfatase ácida resistente ao tartarato, TRAP) e os restos epiteliais de malassez (citoqueratina) pela técnica de imuno-histoquímica. Os dados foram submetidos ao teste de Kruskal-Wallis e pósteste de Dunn, considerando p< 0,05 como significante. No período de 5 dias, os animais do grupo GIO apresentaram espessura do ligamento periodontal e porcentagem da área de matriz extracelular fibrilar e não fibrilar significativamente menor. No 7º dia, animais do GIO mostraram uma redução significativa da porcentagem da área de matriz extracelular não fibrilar e número de células clástica, sendo o oposto no grupo GOT. Aos 30 dias a porcentagem de matriz extracelular não fibrilar e número de células clástica foram menores, e o número de perfil nuclear foi maior no GIO. A oclusão traumática aumentou significativamente o número de células clásticas, enquanto a ausência de forças oclusais retardou o aparecimento e o número das mesmas. Os restos epiteliais de Malassez foram evidenciados, principalmente presente no período de 3 dias pós-operatório e, raramente visualizados nos demais tempos experimentais. Em conclusão, baseado...

Among the factors that can interfere in the immediate tooth replantation prognosis there are the phase of root formation, the extra-alveolar period, storage media, contamination, use and type of dental splint and traumatic occlusion. This study aims to evaluate the influence of absence or excessive occlusal load on periodontal healing process, with emphasis on homeostatic function of epithelial remains of Malassez and clastic cells, dental root of rat molars submitted of immediate replantation. We used 150 male rats , with 5 weeks of life, divided into Control group ( GC ) infra occlusion ( IOG) and traumatic occlusion ( TOG) and the experimental periods evaluated 3, 5, 7, 14 and 30 days.Qualitative and quantitative analyzes were performed on histological sections stained by hematoxylin and eosin (HE); and clastic cells (TRAP) and epithelial remains of Malassez (PAN Cytokeratin) by immunohistochemistry. The data were submitted to the Kruskal-Wallis test post hoc Dunn, the statistical program Graph Prism 6.0 (α = 5%). The epithelial remains of Malassez were present in the 3-day period and absent in other experimental times, in all the groups. In the 5-day period IOG shows thickness of the periodontal ligament and the percentage of fibrillar and non fibrillar extracellular matrix area significantly lower. On the 7th day IOG showed a significant reduction of the percentage of non fibrillar extracellular matrix area and clastic number of cells, and OTG shows the opposite. At 30 days the percentage of non-fibrillar extracellular matrix and the number of clastic cells was lower, and the number of cell profiles was higher in IOG. The traumatic occlusion significantly increases the number of clastic cells, while the absence of occlusal forces retards the onset and the number of them. Early occlusal load should be avoided in the teeth subjected to immediate replantation

Tooth embedded in upper lip after dento-alveolar trauma: a case report

Most of dental injuries involve maxillary anterior teeth along with soft tissue injury in children as well as in adolescent. Thorough clinical and radiographic examination is necessary to prevent any future complications. Dental trauma accompanied by soft tissue laceration is of careful importance as embedding of tooth or fractured tooth fragment in a soft tissue particularly lip is a common finding. This case report shows embedded tooth in upper lip after trauma that was unnoticed and extruded spontaneously after Smonths of trauma which was then extracted after clinical and radiographic evaluation. This case report enlightens the importance of proper clinical and radiographic examination especially in cases of dental trauma associated with soft tissue laceration