Evaluation of extra-narrow diameter implants in the oral rehabilitation of young patients after oral trauma: A prospective study.

BACKGROUND/AIM: Oral trauma is a common event in young patients and can lead to tooth loss, especially after avulsion of a tooth. The aim of this study was to evaluate the survival, esthetic outcomes, ridge preservation, and patient satisfaction of extra-narrow diameter implants (NDIs) as a temporary rehabilitation treatment for young patients who had lost permanent maxillary incisors after an avulsion. MATERIALS AND METHODS: This study comprised a prospective clinical and experimental study on a case series of 13 patients (age: 10-14 years) with a history of avulsion of one or more maxillary incisors. The patients received 19 mini-drive locks implants (Intralock) with acrylic resin crowns, divided into two evaluation arms: immediate implant placement (n = 10) and delayed implant placement (n = 9). The cases were followed up every 3 months with an initial tomography (T0) before implant placement and after 1 year (T1). The clinical stability of the implant in the bone and the retention of the provisional implant crown were evaluated, and the esthetic index was calculated at each follow-up. Intragroup and intergroup differences in alveolar ridge height and thickness were compared at T0 and T1, and a questionnaire was administered to assess the patient's perception of the treatment. RESULTS: The implant survival rate after 1 year was 78.9%. Alveolar ridge height and thickness increased in all cases at T1 (p < .05). Patients who received immediate implants had greater initial and final alveolar ridge thickness. The esthetic index progressively increased over the investigated time period (p = .001). Only one female patient presented with crown infraocclusion after 1 year. The patients' esthetic perceptions of their smiles significantly improved after treatment (p = .001). CONCLUSIONS: Extra-NDI had good survival rates, were effective at maintaining alveolar bone, and promoted aesthetic recovery and patient satisfaction with treatment during the period studied.

Autotransplantation of Immature Third Molars and Orthodontic Treatment After En Bloc Resection of Conventional Ameloblastoma.

Ameloblastoma treatment can lead to significant bone defects; consequently, oral rehabilitation can be challenging. We present the case of a 14-year-old girl diagnosed with a conventional ameloblastoma in the mandible who was treated using en bloc resection and rehabilitated with autotransplantation of the immature third molars and orthodontic treatment. The lesion was in the region of the lower left canine and premolars, and en bloc resection resulted in a significant alveolar bone defect. Autotransplantation of the lower third molars to the site of the lower left premolars was performed. After 2 years, the upper left third molar was transplanted to the site of the lower left canine. During the orthodontic treatment period, considerable alveolar bone formation was observed in the region of the transplanted teeth, and roots developed. To the best of our knowledge, this is the first reported case of alveolar bone formation induction caused by tooth transplantation after ameloblastoma treatment.

Eighteen-month clinical and radiographic evaluation of two root canal-filling materials in primary teeth with pulp necrosis secondary to trauma.

AIM: This study compared clinically and radiographically the use of zinc oxide and eugenol cement (ZOE) and a commercial calcium hydroxide and polyethylene glycol-based paste (Calen(®) ) thickened with zinc oxide as root canal-filling materials for primary teeth with pulp necrosis secondary to trauma within 18months of follow up. MATERIAL AND METHODS: Eligible patients of both genders aged 2years and 6months to 5years and 10months who had been referred for dental treatment at a pediatric dental trauma service and presented at least one anterior primary tooth (central and/or lateral incisor) with pulp necrosis secondary to traumatic injury were selected. Twenty-six children (n=31 teeth) with mean age of 3.4years met the inclusion criteria and were enrolled after parental written consent. The root canals were instrumented and filled with either ZOE (group I; n=15 teeth) or Calen(®) paste [composition: 2.5g calcium hydroxide, 0.5g zinc oxide, 0.05g colophony, and 1.75ml polyethylene glycol 400 (vehicle)] thickened with zinc oxide (Calen(®) /ZO; group II; n=16 teeth). ZO was added to the Calen(®) paste for slowing paste resorption, which should ideally occur simultaneously with the physiologic resorption of primary tooth roots. Clinical success after 18months of follow up was considered as absence of pain, tooth mobility or fistula, and radiographic success as the partial or total remission of apical periodontitis, absence of pathological root resorption or presence of new bone formation. RESULTS: Eighteen months after treatment, the teeth obturated with ZOE and Calen(®) /ZO presented statistically similar (Fisher's exact test; P >0.05) success rates of 93.3% and 87.5%, respectively. CONCLUSION: Our results showed the clinical and radiographic outcomes for Calen(®) /ZO to be equal to those for ZOE after 18months, suggesting that both materials can be indicated for obturating primary teeth with pulp necrosis after trauma.

Surgical repositioning of a traumatically intruded permanent incisor in a patient with rheumatic fever: case report.

Intrusive luxation of permanent teeth is a relatively uncommon type of injury to the periodontal ligament. However, it is one of the most severe types of dentoalveolar trauma. By definition, intrusive luxation consists of the axial displacement of the tooth into the alveolar bone, accompanied by comminution or fracture of the alveolar bone. Here we report the treatment management of a traumatically intruded immature permanent central incisor by surgical repositioning undertaken in a 10-year-old child with rheumatic fever 10 days after sustaining a severe dentoalveolar trauma. The intraoral examination showed the complete intrusion of the permanent maxillary right central incisor and the radiographic examination revealed incomplete root formation. Prophylactic antibiotic therapy was prescribed and the intruded tooth was surgically repositioned and endodontically treated thereafter. The postoperative course was uneventful, with both clinically and radiographically sound conditions of the repositioned tooth up to 3 years and 2 months of follow-up. These outcomes suggest that surgical repositioning combined with proper antibiotic prophylaxis and adequate root canal therapy may be an effective treatment option in cases of severe intrusive luxations of permanent teeth with systemic involvement.

Alternative treatment modalities for immature intruded permanent incisors: report of 2 cases.

Intrusion of permanent teeth is one of the most severe types of traumatic injuries. Different treatment strategies have been proposed, and the best approach for each case depends on the stage of root development, severity of the intrusive luxation, presence of alveolar fracture and number of intruded teeth. The purpose of this paper is to describe the treatment management of 2 cases of severely intruded immature permanent maxillary central incisors in 7 1/2- and 8-year-old children. In case 1, the traumatized tooth was treated by surgical repositioning, while in case 2 watchful waiting for spontaneous re-eruption was the treatment of choice. Treatment strategies were successful in both cases, as demonstrated by the continuation of root development, maintenance of pulp vitality, and absence of signs of periapical pathosis during the follow-up period. Regardless of the treatment strategy traumatically intruded teeth should undergo periodical clinical and radiographic surveillance on a long-term basis to allow early detection of possible complications.

Sequelae in primary teeth after traumatic injury / Sequelas em dentes decíduos após injúrias traumáticas

Objective: Determine the prevalence of injuries due to dislocation in the primary dentition and the associated sequelae in children treated at Pediatric Dentistry Clinic of the School of Pharmacy, Dentistry and Nursing, Federal University of Ceará. Material and Methods: The research protocol was reviewed and approved by the Institutional Research Ethics Committee Medical School of the Federal University of Ceará, Fortaleza, Ceará, Brazil. It was conducted through a transversal retrospective observational investigation. Data were collected from the medical records from 2000 to 2014. We use the statistical analysis software SPSS (Statistical Packacge for the Social Sciences) 17.0 for Windows. Results: The sample consisted of 52 patients, totaling 75 traumatized primary teeth. The average age at injury was 37.6 months and the most affected gender was male (65.4 %). Most injuries occurred at home (57.7 %) and consequently to fall from height (73%). The most common type of dislocation for injury was intrusion (53.3 %) and color change (42.7%), pulp necrosis (37.3 %) and obliteration of the root canal (13.3%) the most frequent sequelae. Conclusion: The high prevalence of sequelae (74.7 %) shows that proper treatment should happen at right time in order to reduce the occurrence of sequelae. (AU)

Objetivo: Determinar a prevalência de lesões por luxação na dentição primária e as sequelas associadas em crianças atendidas na Clínica de Odontopediatria da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Material e Métodos: O protocolo de pesquisa foi revisado e aprovado pelo Comitê de Ética em Pesquisa Institucional da Faculdade de Medicina da Universidade Federal do Ceará, Fortaleza, Ceará. Este estudo foi realizada através de uma investigação observacional retrospectiva transversal. Os dados foram coletados dos registros médicos entre os anos 2000 e 2014. Utilizamos o software de análise estatística SPSS (Statistical Packacge for the Social Scientes) 17.0 para Windows. Resultados: A amostra foi composta por 52 pacientes, totalizando 75 dentes primários traumatizados. A idade média de lesão foi de 37,6 meses e o sexo mais atingido foi o sexo masculino (65,4%). A maioria das lesões ocorreu em casa (57,7%) e, consequentemente, a queda de altura (73%) foi o motivo mais de maior prevalência. O tipo mais comum de luxação por lesão foi a intrusão (53,3%) e alteração de cor (42,7%), necrose pulpar (37,3%) e obliteração do canal radicular (13,3%) as sequelas mais frequentes. Conclusão: A alta prevalência de sequelas (74,7%) mostra que o tratamento adequado deve ocorrer no momento adequado para reduzir sequelas.(AU)

Tratamento da má-oclusão de Classe III ­ uma análise sistemática da literatura / Treatment of Class III malocclusion ­ a systematic analysis of literature

Resumo O objetivo deste trabalho foi de determinar, por meio de uma revisão sistemática da literatura, os tipos e os efeitos dos aparelhos ortodôntico-ortopédicos dentofaciais no tratamento da má-oclusão esquelética de Classe III de Angle, em pacientes em crescimento, selecionando artigos com maior impacto de evidência científica. Para se alcançar esse objetivo, realizou-se uma busca retrospectiva de 1994 a 2019, nas bases de dados eletrônicas (Pubmed). Foram pesquisados os termos "Class III malocclusion", "malocclusion, Angle Class III/therapy" e "orthopedic treatment Class III". Os critérios de seleção foram configurados para incluir apenas ensaios clínicos randomizados da plataforma Pubmed. Os artigos foram selecionados e avaliados, de forma independente, por dois autores (kappa 0,88), baseados nos critérios de inclusão e exclusão. A estratégia de busca resultou em 25 artigos, sendo 18 resultantes da plataforma Pubmed. Após a análise desses estudos, concluiu-se que o tratamento da má-oclusao de Classe III em pacientes ainda em crescimento tem como principal modalidade terapêutica o uso da máscara facial de tração maxilar. Outros aparelhos ortodôntico-ortopédicos vêm sendo utilizados, porém com respostas mais dentoalveolares. Em pacientes que já cessaram o crescimento e não optaram pela cirurgia ortognática para a correção de suas deficiências, a abordagem com mini-implantes e miniplacas vem sendo utilizada com resultados bastante positivos, gerando excelentes tratamentos e em menor quantidade de tempo, porém ainda há poucas evidências científicas que suportam a eficácia dessa modalidade terapêutica.(AU)

Abstract The aim of this study was to determine through a systematic literature review the types and effects of dentofacial orthodontic-orthopedic appliances in the treatment of Angle Class III skeletal malocclusion in growing patients, selecting articles with higher impact of scientific evidence. To reach this goal, a retrospective search from 1994 to 2019 was carried out in the electronic databases (Pubmed). The terms "Class III malocclusion", "malocclusion, Angle Class III/therapy" and "orthopedic treatment Class III" were searched. Selection criteria were set to include only randomized trials of Pubmed platform. The articles were independently selected and evaluated by two authors (kappa 0.88), based on inclusion and exclusion criteria. The search strategy resulted in 25 articles, 18 resulting from the Pubmed platform. After analyzing these studies, it was concluded that the treatment of Class III malocclusion in patients still growing has as main therapeutic modality the use of facial mask of maxillary traction. Other orthodontic-orthopedic appliances have been used, but with more dentoalveolar responses. In patients who have already ceased growth and did not chose orthognathic surgery to correct their deficiencies, the approach with mini-implants and miniplates has been used with very positive results, generating excellent treatments and in a shorter time, however there are still few scientific evidences that support the effectiveness of this therapeutic modality (AU)

Prevalence of permanent teeth avulsion in a brazilian trauma center: a 12 years retrospective study / Prevalência de avulsão de dentes permanentes em um centro de trauma brasileiro: estudo retrospectivo de 12 anos

Objetivo: O objetivo deste estudo é realizar um estudo retrospectivo dos casos de avulsão de dentes permanentes em pacientes de 12 anos do Centro de Trauma Bucodentário (CENTRAU) da da Faculdade de Odontologia da Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará. Material e Métodos: Foi realizado um estudo retrospectivo transversal caracterizado pela observação direta de arquivos de exames dentários de uma demanda espontânea de vítimas de traumas dentários que se apresentaram ao Centro de Trauma Bucodentário (CENTRAU) durante o período entre Maio de 2001 a Maio de 2013. Resultados: A análise foi realizada em 1.104 arquivos, dentre os quais 66 pacientes reportaram ter sido vítima de avulsão dentária com 88 dentes tendo sido avulsionados, com idades variando entre 6 e 30 anos. Dentro os 88 dentes avulsionados, 59 (67,04%) foram reimplantados. Apenas 9 (15,5%) casos o reimplante foi imediato. O meio de armazenamento mais utilizado foi a cavidade oral, por 8 (30,7%) pacientes. Em 26 (39,4%) casos, a causa de avulsão foi queda. Conclusão: Nesse estudo, ficou claro que os casos de avulsão do CENTRAU corresponderam a uma baixa ocorrência dentre os casos atendidos neste centro.

Objectives: The aim of this study is to perform a retrospective study of cases of avulsion of permanent teeth in patients from 12 years of the Oraldental Trauma Center (CENTRAU) of the School of Dentistry of Faculty of Pharmacy, Dentistry and Nursing in Federal University of Ceara. Material and Methods: A retrospective transversal study characterized by direct observation of dental records was performed of a spontaneous demand sample of dental trauma victims who presented to the Oraldental Trauma Center of UFC (CENTRAU) during the period from May 2001 to May 2013. Results: The analysis was done on 1,104 records, in which 66 patients reported having been victims of avulsion with 88 avulsed permanent teeth with ages ranging between 6 and 30 years. Among the 88 avulsed teeth, 59 (67.04%) were replanted. Only in 9 (15.5%) cases replantation was immediate. The storage medium that was the most widely used was the oral cavity by 8 (30.7%) patients. In 26 (39.4 %) cases, the cause of avulsion was falling to the ground. Conclusion: In this study, it was clear that cases of avulsion in CENTRAU corresponded to a low occurrence of all cases seen in the center.

Decoronation as an alternative procedure for dental ankylosis after dental reimplantation due to trauma in a growing child:case report / Decoronação como procedimento alternativo para anquilose dentária após reimplante dental devido a trauma emcrianças em crescimento: relato de caso

A anquilose dentária ocorre por meio da fusão de superfície da raiz com o osso alveolar, devido à necrose do ligamento periodontal. Trauma local, infecção periapical, desordens endócrinas e metabólicas, esforço mastigatório excessivo, falta de força eruptiva do sucessor permanente e alterações genéticas são alguns dos fatores que podem levara anquilose. Embora não haja um tratamento conhecido para anquilose dento alveolar, existem procedimentos alternativos, tais como manter o dente anquilosado ou sua raiz, extração seguida de fechamento ortodôntico, autotransplante, implante,osteotomia da unidade dento-óssea ou decoronação.A decoronação é um procedimento em que a coroado dente anquilosado é removido cirurgicamente abaixo da junção cemento-esmalte e a raiz é sepultada. Após o procedimento, mantenedor de espaço estético-funcional é instalado para evitar a perda de espaço até a oportunidade de proporcionar um tratamento de reabilitação definitiva. Nosso objetivo é relatar o caso de paciente LSM, fêmea, 8 anos de idade, que se apresentou para o Centro de Trauma Bucodentário da Universidade Federal do Ceará após colidir contra uma parede. Avulsão do elemento dentário 21 ocorreu e o dente foi armazenado em leite. O reimplante ocorreu uma hora após a injúria. O tratamento realizado foi decoronação e instalação de um mantenedor de espaço estético e funcional. Este relato de caso apresenta um acompanhamento clínico de 6 meses e 3 anos de acompanhamento radiográfico.

Dental ankylosis occurs by fusion of the root surface with the alveolar bone due to necrosis of the periodontal ligament. Although there is not a known treatment for dentoalveolar ankylosis, there are alternative procedures that may be realized as a way to prevent serious consequences. Decoronation is a procedure which the crown of the ankylosed tooth is surgically removed below the cemento-enamel junction and the root is buried. Our aim is to report the case of patient LSM, female, 8 years-old, who came to the Oral dentalTrauma Center of Federal University of Ceará after colliding against a wall. Avulsion of the dental element 21 occured and the tooth was stored in milk.The reimplantation occurred one hour after the injury. After two years of the dental trauma, the treatment performed was decoronation and installation of anaesthetic and functional space maintainer. This case report presents a clinical and radiographic follow-up of 6 months and 3 years. In the 6-month evaluation, the buried root showed signs of resorption, but without bone loss, the aesthetic space maintainer was stillwell adapted and the alveolar ridge have no signals of gingival or bony issues. After three years, radiographic evaluation showed complete root resorption and signs bone formation in root previous site. Decoronation is aprocedure that aim to maintain the alveolar bone ridge width, height and continuity and may be indicated to dental ankylosis, being a successful procedure in the reported case, allowing the patient to maintain the aesthetic, function and preserve the alveolar processto a future reahabilitation.

Effectiveness of electronic apex locator during the root canal length in primary teeth: an in vitro study

To evaluate the use of electronic apex locator to measure the root canal length in primary teeth, comparing this measure with the measurements obtained by conventional radiography and by the direct measurement of the root canal lenght.Material and Methods:The sample consisted of nine multi-rooted primary teeth, totaling 32 root canals. Endodontic access was performed with a spherical diamond tip, then the pulp was extirpated and the canal irrigated with 0.9% saline. An endodontic file was used to measure the root canal length by electronic apex locator, using the Novapex ® according to the manufacturer's instructions, and by direct method. An endodontic ruler was used to determine fileÆs length. Conventional radiographic was also performed. Statistical analysis was performed by analysis of variance (ANOVA). The level of significance was 95%.Results:The average of the root canal length was 9.98 ± 2.16 to the direct method; 11.52 ± 1.87 to conventional radiography; and 10.91 ± 1.92 to the electronic apex locator. The results of this study showed a high correlation between the values given by the different methods, regardless of the presence or absence of physiological root resorption. There were not statistically significant differences amongst the methods studied (p> 0.05).Conclusion:Electronic apex locator was an accurate method measure the root canal length in primary teeth, and its use is indicated in endodontic treatment of these teeth...

In Vivo study of an intracanal dressing of calcium hydroxide/chlorhexidine in necrotic primary teeth

AIM: To evaluate the clinical and radiographic success of endodontic treatment in human primary teeth with necrotic pulp with and without radiographically visible furcal/periapical lesion treated with a calcium hydroxide (CH) and chlorhexidine (CHX) intracanal dressing. The tested hypothesis was that there is no difference in the clinical and radiographic success in primary teeth medicated with CH pastes prepared with polyethylene glycol (PEG) or CHX. METHODS: Thirty-two teeth with necrotic pulp were used in this randomized clinical study: 12 without and 20 with lesion. Canals were prepared and medicated with CH pastes with polyethylene glycol (CH/PEG) (n=16) or 2% CHX gel (CH/CHX) (n=16). Definitive filling was done after 30 days. The teeth were clinically and radiographically examined during 12 months to determine the success of the endodontic therapy. Data from clinical and radiographic examination of the initial condition and 12 months after treatment were compared using the Z test (α = 0.05). RESULTS: There was no significant difference (p>0.05) in the success rate of teeth with and without lesion medicated with CH/PEG or CH/CHX. No significant difference (p>0.05) was found between the pastes regardless of the presence of lesion. CONCLUSIONS: Combination of CHX and CH was not more effective than the CH/PEG paste, as similar clinical and radiographic success rate was observed in teeth medicated with either type of intracanal dressing.

Distribuição de estresse em incisivo central superior sob situações traumáticas semelhantes com diferentes cargas: uma análise tridimensional de elementos finitos / Stress distribuition on maxillary central incisor under similar traumatic situations with different loading forces: a 3-D finite element analysis

Aim: The present study aimed to analyze the stress distribution in the dentoalveolar structures of a maxillary central incisor submitted to two situations of impact loading. Materials and Methods: The following loading forces were applied using a three-dimensional finite element model: a force of 500 N at an angle of 45° on the buccal surface of the crown and a 2000 N force acting in the same direction and surface of the tooth. Results: Harmful stress was observed in the second situation, suggesting damage to both the tooth and adjacent tissue. However, the damage found in soft tissues such as dental pulp, was negligible. Conclusion: Injuries resulting from the traumatic situations were more damaging to the integrity of the tooth and its associated hard-tissue structures.

Sequelas em dentes permanentes após trauma nos predecessores decíduos e sua implicação clínica / Sequelaes in permanent teeth following traumatic injuries to primary predecessors and clinical implication

A necrose pulpar representa a cessação dos processos metabólicos do tecido pulpar, desestruturação e concomitante perda de suas defesas naturais. A partir da necrose pulpar, a cavidade pulpar torna-se progressivamente colonizada por vários micro-organismos habitantes da cavidade bucal e sistemas interligados. Assim, os dentes com necrose pulpar e áreas radiolúcidas periapicais apresentam inúmeros morfotipos microbiológicos no sistema de canais radiculares. Não obstante, de longa data, tem sido questionada a sobrevivência de micro-organismos nos granulomas periapicais. Nesta revisão, verificou-se que na atualidade, pela técnica da cultura microbiológica ou por métodos moleculares, cocos, bacilos e filamentosos, gram-negativos e positivos, predominantemente anaeróbios estritos, identificados no sistema de canais radiculares, também são recuperados na região periapical. Esses micro-organismos também são identificados pela coloração de Brown e Brenn ou pela microscopia eletrônica de varredura no ápice radicular e na estrutura da lesão, numa frequência que oscila de 4% a 100%. Estruturalmente, organizam-se num material amorfo, iodoso, de composição polissacarídica - os biofilmes periapicais.

Starting from the pulp necrosis the pulp cavity becomes progressively colonized by several microorganisms' inhabitants of the oral cavity and interconectives systems. Thus, the teeth with pulp necrosis and radiolucencies periapical areas present countless microbiological morfotypes in the root canal system. Nevertheless, of long date, the survival of the microorganisms in the periapical granuloms has been questioned. In this review it was verified that currently, by culture or molecular methods that the coccus, bacilli and filamentous, gram-negative and positive, predominantly strict anaerobes, identified in the root canal system also are recovered in the periapical lesions. Such microorganisms are also identified for the coloration of Brown and Brenn or for the scanning electronic microscopy in the root apex and in the structure of the lesion, in a frequency that oscillates from 4% to 100%. Structurally, they are organized in an amorphous material, muddy, of polysaccharide composition- the periapical biofilms.

Root resorption after dental traumas: classification and clinical, radiographic and histologic aspects

Introduction: One of the most common sequelae observed after dental trauma is root resorption. Objective: The aim of this study was to classify and discuss the external root resorption after a dental trauma, based on a literature review. Literature review: A bibliographic search was performed in the following databases: Medline, PubMed, and Lilacs, from 1997 to 2010. The following descriptors were used: Root resorption, Dental trauma and Classification. From a total of 152 articles found, 25 were selected: 24 in English and 1 in Spanish. Classic articles were also used in our study. External root resorption after dental traumas can be divided into superficial, inflammatory and replacement. It can also be verified in primary dentition as physiological and atypical resorptions. Conclusion: Each type of resorption presents clinical features as well as radiographic and histological aspects. Therefore, the dentist should know these characteristics to perform an early diagnosis and appropriate treatment, minimizing the sequelae related to this problem. Moreover, in primary dentition, the differential diagnosis between physiological and pathological resorption is important to avoid over-treatment.

Evaluation of intruded primary incisors.

Tooth intrusion consists of the displacement of the tooth into its alveolus and is the most common trauma during early infancy. This work aims to evaluate the aspects related to tooth intrusion in primary teeth by monitoring 16 patients (22 teeth) for a period between 3 and 36 months. Of the patients who suffered from tooth intrusion, 56.25% were male and 91% of the intruding teeth were upper central incisors. In all cases the treatment indicated was to await spontaneous re-eruption: total re-eruption occurred in 42.5% of cases, partial re-eruption in 47% of cases and in 10.5% there was no re-eruption. Twenty-three percentage of the teeth suffered necrosis, 33% suffered internal or external root resorption and none suffered root canal obliteration. Fifty-seven percentage indicated healthy pulps independent of degree of re-eruption.

Prevalência de trauma dental em crianças atendidas na Universidade Federal do Ceará / Prevalence of dental trauma in children attending the Federal University of Ceará

Objetivo: Avaliar a prevalência dos traumas dentários de crianças atendidas na disciplina de Odontopediatria da Universidade Federal do Ceará. Metodologia: Durante o período de janeiro de 2002 a dezembro de 2005, 312 pacientes apresentaram-se à clínica citada, totalizando 489 dentes traumatizados, sendo as informações contidas em suas fichas clínicas coletadas e submetidas à análise estatística. Resultados: A amostra foi constituída por 61,9% meninos e 38,1% meninas, numa proporção de 1,6:1. A maior freqüência de trauma ocorreu na primeira infância (33,7%), sendo a média da idade de 5,8±0,6 anos. A causa mais comum de trauma foi queda (63,5%) e a maioria (60,3%) das injúrias traumáticas ocorreram em casa. Os incisivos centrais superiores foram os dentes mais afetados (82,7%). Luxação intrusiva foi o tipo de trauma mais comum na dentição decídua (32,3%), e fratura coronária de esmalte e dentina sem exposição pulpar, na dentição permanente (46,7%). A maioria dos pacientes procurou atendimento 1-7 dias após a ocorrência do trauma (25,0%). Conclusão: Na dentição decídua as injúrias traumáticas por luxação foram mais prevalentes, e na dentição permanente, ocorreram mais fraturas coronárias nesta amostra.

Purpose: This cross-sectional study aimed to measure the prevalence of dental trauma in children treated at the Pediatric Dentistry Clinic of the Federal University of Ceara (UFC), Brazil, from January 2002 to December 2005. Methods: The sample consisted of 312 patients who presented a total of 489 injured teeth. The patients' clinical records were retrieved and provided the information used for statistical analyses. Results: Subjects were 61.9% males and 38.1% females (ratio of 1.6:1), with mean age of 5.84±0.62 year-old. Trauma was more frequent during the first infancy (33.7%), and the most common etiological cause was falls (63.5%). Most trauma injuries (60.3%) occurred at home. The maxillary central incisors were the most affected teeth (82.7%). Intrusive luxation and coronary fracture of the enamel and dentin without pulp exposure were the most common type of trauma in primary (32.3%) and permanent (46.7%) dentition, respectively. Conclusion: In this sample, luxation injuries were the most prevalent type of dental trauma for primary dentition, while more coronary fractures prevailed for permanent dentition.

Obliteração do canal pulpar do incisivo central superior esquerdo de uma paciente jovem após trauma - Acompanhamento clínico-radiográfico / Pulp canal obliteration of upper left central incisor of a young patient after trauma - Monitoring clinical-radiographic

Uma das complicações tardias que podem ocorrer em dentes que sofreram trauma é aobliteração do canal pulpar (OCP). Essa condição torna o dente mais susceptível ao desenvolvimentode necrose pulpar. A conduta clínica após o diagnóstico de OCP não estábem definida. Enquanto alguns cirurgiões-dentistas optam pelo tratamento endodônticoradical, outros elegem o acompanhamento clinicoradiográfico. Esse trabalho teve comoobjetivo apresentar um caso clínico do elemento dentário incisivo central superior esquerdopermanente de uma paciente jovem de 7 anos de idade com OCP após intrusão.O tratamento de escolha foi o acompanhamento clinicoradiográfico e, 18 meses após odiagnóstico, o dente continua apresentando vitalidade pulpar. Embora, os dentes que apresentemobliteração do canal pulpar tenham maior risco de desenvolverem necrose pulpar,o tratamento endodôntico profilático, nesses casos, não deve ser uma conduta de rotina.

One of the late complications that can occur on teeth that have suffered trauma is thepulp canal obliteration (PCO). This condition makes the tooth more susceptible to thedevelopment of pulp necrosis. The clinical management after the diagnosis of OCP isnot well defined. While some dentists opt for radical endodontic treatment, others preferthe monitoring clinical-radiographic. This study aimed to present a clinical case of toothupper left central incisor of a young patient of 7 years of age with OCP after intrusion.The treatment of choice was the monitoring clinical-radiographic and, 18 months afterdiagnosis, the tooth continues to show vitality’signs. Although, teeth showing pulp canalobliteration are at greatest risk of developing pulp necrosis, endodontic prophylactictreatment in such cases should not be a routine practice.

Estudo sobre meios de conservação de dentes avulsionados - uma revisão da literatuta / Storage media for avulsed teeth - a literature review

A avulsão dental ocorre em 16% dos casos de traumatismos dentários, sendo três vezes mais frequente em meninos do que em meninas e ocorrendo com maior frequência em crianças de 07 a 11 anos de idade. O tratamento mais indicado é o reimplante imediato, na tentativa de se preservar principalmente a vitalidade do ligamento periodontal. Na impossibilidade deste procedimento, a vítima do traumatismo ou o seu responsável deve armazenar o dente em um meio de conservação adequado e procurar o dentista imediatamente para que ele possa fazer o reimplante. Nesse sentido, vários autores têm investigado o melhor meio para a manutenção da vitalidade das células remanescentes do ligamento periodontal até o momento do reimplante. Esta revisão de literatura tem o intuito principal de discutir qual ou quais os meios mais indicados para a manutenção da vitalidade das células do ligamento periodontal durante o período em que o dente permanece fora do alvéolo

Colagem de fragmento em casos de fraturas coronorradiculares com aumento de coroa clínica - relato de caso / Reattachment of a dental fragment after a crown-root fracture with crown lengthening - a case report

As fraturas coronorradiculares, por acometerem a parte da coroa e da raiz dental, geralmente, são subgengivais e invadem o espaço biológico, podendo o limite apical da fratura situar-se aquém, além ou no nível da crista óssea. Dependendo do grau e do local da fratura e da existência de adequado fragmento dentário, o dente pode ser restaurado através da colagem do fragmento, sendo necessário realização prévia de um procedimento que restitua as distâncias biológicas. O aumento da coroa clínica consiste na remoção de osso e gengiva e tem como finalidade tornar supragengival o limite apical da fratura. Este trabalho tem como objetivo apresentar, através de caso clínico, a técnica de colagem de fragmento associada ao aumento de coroa clínica como um dos métodos terapêuticos para as fraturas coronorradiculares. Podemos concluir, então, que em casos de fraturas coronorradiculares com invasão do espaço biológico por palatino, esta técnica está especialmente indicada e é uma das formas mais rápidas de restituir a função e estética dental, além de ser simples, de baixo custo, conservadora e ter grande aceitação por parte dos pacientes e dos profissionais.

Avaliação histológica do efeito do Timerosal incolor ou da Rifamida no tratamento da superfície radicular de dentes de rato com necrose do ligamento periodontal reimplantados experimentalmente / Histological evaluation of non-colored Timerosal or Rifamida effect in the treatment of root surfaces of rat's teeth which presented necrosis of the periodontal ligament of experimentally replanted teeth

O presente trabalho teve por objetivo avaliar histologicamente o efeito do timerosal incolor ou da rifamida no tratamento da superfície radicular de dentes de rato com necrose do ligamento periodontal reimplantados experimentalmente. Para o presente trabalho foram utilizados 54 ratos (Ratus Norvegicus, Albinus, Holtzman), machos com peso variando entre 100 e 120 gramas, que foram divididos em três grupos de 18 animais. Após a exodontia os incisivos superiores direito permaneceram em meio ambiente por 45 minutos sendo em seguida imersos por 10 minutos em rifamida (Grupo I) ou timerosal incolor (Grupo II) ou soro fisiológico como Grupo controle (Grupo III). Os animais então foram sacrificados em grupos de seis aos 15, 30 ou 60 dias e as peças processadas para análise histológica. De acordo com os resultados não pode-se identificar diferenças estatisticamente significativas entre os grupos experimentais, sendo que o processo predominante foi a anquilose

The present study had as objective to evaluate histologically the non-colored timerosal or rifamida effect in the treatment of root surfaces of rat's teeth which presented necrosis of the periodontal ligament of experimentally replanted teeth. In this present work 54 male rats (Ratus novergicus, Albinus, Holtzman) with weight varying from 100 to 120 grams, which were divided into three groups of 18 animals each. After the extraction procedure the right upper incisors remained in dry condition for 45 minutes; after that the were put for 10 minutes in rifamida (Group I) or non-colored timerosal (Group II) or saline solution as the control group (Group III). Then, the animals were sacrificed in groups of six at 15, 30 or 60 days and the pieces submitted to histological analysis. According to the results no statistically significant differences were identified from the experimental groups, and ankylosis was the main process observed