Role of professional expertise in the decision-making process for periodontally compromised teeth.

The objective of this study was to evaluate factors that may influence decision-making with regard to extraction or maintenance of periodontally compromised teeth. A questionnaire with 2 distinct clinical scenarios, each including a radiographic image, was provided to students in their final year of dental school and practicing dentists. The participants were asked to record the action that they would take in each case (tooth maintenance vs extraction) and provide a justification for their decision. The questionnaires were answered by 158 dental students and 57 dentists (N = 215). Among the sample as a whole, 31.16% of participants recommended extraction in scenario 1, while only 5.58% recommended that action in scenario 2. In scenario 1, there was a statistically significant difference in the recommendations of the dental students and the dentists, with the former group significantly more disposed to conservative action, that is, maintenance of the tooth (P < 0.001; chi-square test). When the actions recommended by participants specializing in implants or periodontics (or both) were compared with those recommended by other specialists, there was a statistically significant difference between the groups regarding maintenance and extraction (P = 0.012; Fisher exact test), with the former group recommending fewer extractions. When the responses were evaluated in terms of the participants' years of specialty practice, it was observed that professionals with fewer than 20 years of practice were more conservative in their decisions, choosing tooth maintenance significantly more often than specialists with longer experience (P = 0.031; Fisher exact test). Among the majority of both dental students and practicing dentists, the decision in both scenarios was to maintain the compromised teeth; however, the results suggested that that both the years of experience of the individual and the specialty of the practitioner can influence decision-making.

Caninos Superiores impactados bilateralmente / Bilaterally impacted upper canines

O presente estudo aborda a questão dos caninos superiores impactados, mais freqüentemente por posição palatina, focando a etiologia, diagnóstico e o tratamento. Há uma grande preocupação em reabilitar o canino retido, pela importância estratégica desse dente no arco dentário, devido sua função nas relações oclusais e estética. Os principais fatores etiológicos da impacção de caninos são a falta de espaço, ausência dos incisivos laterais, interferências mecânicas e hereditariedade. O seu diagnóstico é baseado em exame clínico e radiográfico, e o tratamento mais utilizado é a técnica cirúrgica conjugada com Ortodontia.

This study approaches the issue of the impacted upper canine teeth, which are more frequent by palatine, focusing on the etiology, diagnosis and treatment. There is great concern with rehabilitating the retained canine due to the strategic importance this tooth has on the dental arch, owing to its role in the occlusal and aesthetic relations. The main etiological features of the impaction of canines are lack of space, absence of lateral incisive teeth, mechanical interferences and heredity. Its diagnosis is based on clinical and radiographic tests, and the most commonly used treatment is the surgical procedure along with Orthodontics.