RESUMEN
OBJECTIVE: To evaluate the mandibular buccal shelf (MBS) in terms of the angulation and bone depth and thickness according to sex, age, and sagittal and vertical skeletal patterns in a Colombian population using cone-beam computed tomography (CBCT). Accordingly, the optimal site for miniscrew insertion in this area was determined. METHODS: This descriptive, retrospective study included 64 hemi-arches of 34 patients. On CBCT images, the angulation, buccal bone depth (4 and 6 mm from the cementoenamel junction [CEJ] of MBS), and buccal bone thickness (6 and 11 mm from the CEJ of MBS) were measured at the mesial and distal roots of the mandibular first and second molars. RESULTS: There were no statistically significant differences in the angulation, depth, and thickness of MBS between male and female patients. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. The osseous characteristics were significantly better in participants aged 16-24 years. Class III patients exhibited the best osseous characteristics, with the bone depth at 6 mm being significantly different from that in Class I and Class II patients. Although values tended to be greater in patients with low angles, the difference was not statistically significant. CONCLUSIONS: MBS provides an optimal bone surface for miniscrew insertion, with better osseous characteristics at the distal root of the mandibular second molar, 4 mm from CEJ. Adolescent patients, Class III patients, and patients with a low angle exhibit the most favorable osseous characteristics in the MBS area.
RESUMEN
El objetivo de este estudio fue describir las características epidemiológicas de segundos molares mandibulares permanentes impactados unilateralmente en una muestra de la ciudad de Medellín, Colombia. Se trató de un estudio retrospectivo en el cual se evaluaron radiografías panorámicas de 6785 pacientes, de las cuales se analizaron un total de 28 radiografías en la muestra final. Fueron correlacionados el segundo molar mandibular impactado (grupo de estudio) y el contralateral no impactado (grupo control) con respecto a tres ángulos de referencia (intermolar, del plano oclusal e interplanar), el sexo y lado de impactación. Se encontró una prevalencia de 3,5 por cada 1000 radiografías evaluadas. El lado de mayor impactación fue el derecho; dos de los tres ángulos analizados (intermolar e interplanar) fueron los que arrojaron las diferencias más grandes entre el grupo de estudio y el grupo control. No se encontraron diferencias estadísticamente significativas según el sexo. Se concluyó que la prevalencia de segundos molares mandibulares permanentes impactados es baja, siendo mayor en el lado derecho, sin diferencias por sexo, y de preferencia el uso del ángulo interplanar como medida para la evaluación del riesgo de impactación (>7,9°).
The objective of this study was to describe the epidemiological characteristics of unilateral permanent mandibular second molars impacted, in a sample from Medellín, Colombia. It was a retrospective study in which we evaluated panoramic radiographs of 6785 patients, for a total of 28 radiographs analyzed in the final sample. The mandibular second molar impacted (study group) and the contralateral not impacted (control group) were correlated, with respect to three reference angles (intermolar, of the oclussal plane and interplanar), sex and impaction side. We found a prevalence of 3.5 for every 1000 radiographs evaluated. The most frequent side of impaction was the right side; two of the three angular measurements (intermolar and interplanar) had the biggest differences between the study and control group. We did not find significant statistical differences between males and females. It was concluded that the prevalence of impacted permanent mandibular second molars is low, there is a highest impaction in the right side, there are no differences between genders, and the use of the interplanar angle is preferable as a measurement to predict the impaction of permanent mandibular second molars (>7.9°).
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto Joven , Dientes Fusionados/cirugía , Dientes Fusionados/diagnóstico por imagen , Radiografía Panorámica , Estudios Retrospectivos , Colombia , Dentición Permanente , Arco Dental , Diente Molar/cirugía , Diente Molar/diagnóstico por imagenRESUMEN
Introducción: la impactación de los caninos maxilares es una alteración poco frecuente en la vía de erupción quedebe ser diagnosticada y pronosticada a tiempo. Se hizo un análisis descriptivo en una muestra de dieciocho pacientes de la Facultad de Odontología de la Universidad de Antioquia en Medellín, Colombia, recolectando información epidemiológica y aplicando análisis radiográficos de impactación de caninos maxilares para verificar su asociación predictiva. Métodos: se hizo valoración clínica de los pacientes con impactación de caninos maxilares y se tomaron, escanearon y trazaron digitalmente unaradiografía panorámica y tres periapicales de cada diente objeto de estudio, en las cuales se aplicaron los análisis de Lindauer, Warford, Power y Short, y Clark. Resultados y conclusiones: se encontró prevalencia de impactación canina del 2,9%, mayoren pacientes de sexo femenino, en el primer cuadrante, en ubicación vestibular y con malposición asociada del incisivo lateral adyacente. Adicionalmente, se observó una fuerte concordancia y asociación positiva entre el análisis de Warford, y el de Powery Short, mas no de estos con el análisis de Lindauer. Se concluye que para predecir el pronóstico de caninos maxilares impactados es válido realizar tanto el análisis angular como el sectorial en radiografías panorámicas.
Introduction: maxillary canine impaction is a rare alteration in the eruption pathway that must be diagnosed andprognosticated on time. A descriptive analysis was performed in a sample of 18 patients of the School of Dentistry of the University of Antioquia in Medellín, Colombia, in order to collect epidemiological information and apply some radiographic maxillary canineimpaction analysis to verify its predictive association. Methods: a clinical evaluation of the patients with canine maxillary impactionwas carried out and a panoramic radiographs and three periapical of each studied tooth were taken, scanned, and digitally traced, then Lindauer, Warford, Power and Short, and Clark analysis were performed. Results and conclusions: a prevalence of canineimpaction of 2,9% was found, significantly higher in females, in the first quadrant, in a labial location and with an associated adjacent lateral incisor malposition. Additionally, a high concordance and a positive association between Warford and Power andShort analysis was noted, but not with the Lindauer analysis. It was concluded that to predict the prognosis of canine maxillary impaction it is valid to apply the angular as well as the sector analysis in panoramic radiographs.
