Congenitally missing maxillary lateral incisors: update on the functional and esthetic parameters of patients treated with implants or space closure and teeth recontouring.

Maxillary lateral incisor agenesis (MLIA) is a condition that affects both dental esthetics and function in young patients, and represents an important challenge for clinicians. Although several treatment options are available, the mesial repositioning of the canines followed by teeth recontouring into lateral incisors; or space opening/maintenance followed by implant placement have recently emerged as two important treatment approaches. In this article, the current and latest literature has been reviewed in order to summarize the functional and esthetic outcomes obtained with these two forms of treatment of MLIA patients in recent years. Indications, clinical limitations and the most important parameters to achieve the best possible results with each treatment modality are also discussed. Within the limitations of this review, it is not possible to assert at this point in time that one treatment approach is more advantageous than the other. Long-term followup studies comparing the existing treatment options are still lacking in the literature, and they are necessary to shed some light on the issue. It is possible, however, to state that adequate multidisciplinary diagnosis and planning are imperative to define the treatment option that will provide the best individual results for patients with MLIA.

Submersão severa de dentes decíduos: diferentes abordagens de acordo com o momento do diagnóstico / Severe submerged deciduous teeth: different approaches in accordance with the time of diagnosis

Introdução: a submersão severa de dentes decíduos, condição em que a superfície oclusal do dente apresenta-se nivelada ou abaixo da margem gengival, é rara e são poucos os casos relatados na literatura. Devida importância deve ser atribuída aos casos de submersão severa a fim de evitar potenciais problemas de desenvolvimento oclusal. Quanto mais precoce o diagnóstico e a intervenção, maior a chance de restabelecimento do desenvolvimento normal da dentição. Objetivo: apresentar dois casos de submersão severa de dentes decíduos com diferentes abordagens cirúrgico-ortodônticas de acordo com o momento do diagnóstico, englobando as possíveis etiologias, diagnóstico e opções de tratamento. Conclusão: a intervenção precoce nos casos de submersão severa de dentes decíduos previne problemas durante o desenvolvimento da dentição.

Introduction: the severe submersion of deciduous teeth, a condition in which the occlusal surface of the tooth presents in the level or below of the gingival margin, is rare and few cases have been reported in the literature. Due importance should be given to cases of severe submersion in order to avoid potential problems of occlusal development. How early diagnosis and intervention should be realized, greater the chance of restoring the normal development of teeth. Objective: to present two cases of severe submerged deciduous teeth with different orthodontic-surgical approaches according to the time of diagnosis, involving the possible etiology, diagnosis and treatment options. Conclusion: early intervention in cases of severe submersion of deciduous teeth prevents problems during the development of the dentition.

Comparison between two methods for resin removing after bracket debonding

OBJECTIVE: The aim of this study was to assess - using scanning electron microscopy (SEM) - the effectiveness of two abrasive discs, one made from silicon and one from aluminum oxide, in removing adhesive remnants (AR) after debonding orthodontic brackets. METHODS: Ten randomly selected bovine teeth were used, i.e., 2 in the control group, and the other 8 divided into two groups, which had orthodontic brackets bonded to their surface with Concise Orthodontic Adhesive (3M). The following methods were employed - in one single step - to remove AR after debracketing: Group A, Optimize discs (TDV) and Group B, Onegloss discs (Shofu), used at low speed. After removing the AR with the aforementioned methods, the teeth were prepared to undergo SEM analysis, and photographs were taken of the enamel surface with 50x magnification. Six examiners evaluated the photographs applying the Zachrisson and Årtun enamel surface index (ESI) system (1979). RESULTS: Group A exhibited minor scratches on the enamel surface as well as some AR in some of the photographs, while Group B showed a smoother surface, little or no AR and some abrasion marks in the photographs. No statistically significant differences were found between the two methods and the control group. CONCLUSIONS: The two abrasive discs were effective in removing the AR after bracket debonding in one single step.

OBJETIVO: o objetivo deste trabalho foi avaliar, por microscopia eletrônica de varredura, a eficácia de dois discos abrasivos de silicone e óxido de alumínio para a remoção da resina remanescente após a descolagem de braquetes ortodônticos. MÉTODOS: foram utilizados 10 dentes bovinos selecionados aleatoriamente, sendo 2 para o grupo controle e os demais divididos em dois grupos, os quais receberam colagem de braquetes ortodônticos com resina ortodôntica Concise (3M). Os métodos de remoção da resina após a descolagem dos acessórios ortodônticos em apenas uma etapa foram: Grupo A - disco Optimize (TDV); e Grupo B - disco Onegloss (Shofu), empregados em baixa rotação. Após a remoção da resina remanescente pelos métodos mencionados, os dentes foram preparados para serem submetidos à análise em microscopia eletrônica de varredura, obtendo-se fotografias da superfície do esmalte com aumento de 50X. Seis examinadores avaliaram as fotografias seguindo a escala de avaliação de Zachrisson e Arthun (1979). RESULTADOS: no Grupo A, observou-se pequenos arranhões na superfície do esmalte, bem como pouco remanescente de resina em algumas das fotografias; enquanto, no Grupo B, observou-se maior lisura, pouco ou nenhum remanescente de resina e alguns riscos nas fotografias. Não houve diferença estatisticamente significativa entre os dois métodos avaliados e o grupo controle. CONCLUSÃO: os dois discos abrasivos mostraram-se eficientes para remoção da resina remanescente após a descolagem de braquete em única etapa.

Congenitally missing maxillary lateral incisors: functional and periodontal aspects in patients treated with implants or space closure and tooth re-contouring.

To evaluate functional and periodontal aspects in patients with unilateral or bilateral congenitally missing maxillary lateral incisors, treated with either implants or space closure and tooth re-contouring. The sample consisted of 68 volunteers, divided into 3 groups: SCR - space closure and tooth re-contouring with composite resin (n = 26); SOI - implants placed in the area of agenesis (n = 20); and CG - control group (n = 22). A modified Helkimo questionnaire and the Research Diagnostic Criteria for Temporomandibular Disorders were used by a single, previously calibrated evaluator to assess signs and symptoms of temporomandibular joint disorder. The periodontal assessment involved the following aspects: plaque index, bleeding upon probing, pocket depth greater than 3 mm, gingival recession, abfraction, periodontal biotype and papilla index. The data were analyzed using Fisher's exact test and the nonparametric Mann-Whitney and Kruskal-Wallis tests (α=.05). No differences in periodontal status were found between treatments. None of the groups were associated with signs and symptoms of temporomandibular joint disorder. Both treatment alternatives for patients with congenitally missing maxillary lateral incisors were satisfactory and achieved functional and periodontal results similar to those of the control group.