Management of an unerupted tooth and odontoma after trauma in predecessor

The purpose of this case report was to describe the surgical exposure and orthodontic management of an unerupted and ectopic maxillary right central incisor after trauma to the primary predecessor. Case report: An 11-year-old girl was referred to the Pediatric Dentistry Clinic due to eruption failure of the maxillary right central incisor. Radiographs showed the impacted central incisor located below the anterior nasal spine and its apex parallel to the palatal plane and the presence of an odontoma. General surgery was performed to remove the odontoma and two perforations in the crown of the impacted tooth were made to carry out orthodontic traction. Correct alignment was achieved after 18 months and no significant clinical or radiographic alterations were founded. Conclusion: The orthodontic management was performed successfully, and a positive esthetic outcome combined with adequate occlusion demonstrated the satisfactory results of this case.

Objetivo: O objetivo deste relato de caso foi descrever a exposição cirúrgica e o tratamento ortodôntico de um incisivo central superior direito ectópico e não irrompido após trauma do predecessor decíduo. Relato do caso: Uma menina de 11 anos de idade foi encaminhada à Clínica de Odontopediatria devido ao atraso na erupção do incisivo central superior direito. As radiografias mostraram o incisivo central impactado localizado abaixo da espinha nasal anterior e seu ápice paralelo ao plano palatino e a presença de um odontoma. A cirurgia para remoção do odontoma foi realizada sob anestesia geral e duas perfurações na coroa do dente impactado foram realizadas para a tração ortodôntica. O alinhamento correto foi alcançado após 18 meses e não foram encontradas alterações clínicas ou radiográficas significativas. Conclusão: O manejo ortodôntico foi realizado com sucesso, e um resultado estético positivo combinado à oclusão adequada demonstrou os resultados satisfatórios deste caso.

Three year follow-up and management of a severely dislocated tooth after primary trauma

Objective: This case report describes the management and a 3-year follow-up of an unerupted and ectopic positioned anterior tooth. Case Report: The patient, a girl (9 years old) was referred due to the lack of a permanent maxillary left central incisor. When she was 2 years old suffered a complete intrusion of her primary maxillary left central incisor, and the tooth re-erupted after 4 weeks. Radiographic examination revealed the impaction and severe dislocation of the permanent maxillary left central incisor. The impacted tooth was surgically exposed and placed in orthodontic traction for alignment over a period of 12 months. Results: After this period the central incisor presented satisfactory periapical and periodontal health, adequate occlusion and a good esthetic outcome. After three years of follow-up, apically rounded and no extensive damage to tooth or tissues structures were observed Conclusion: The orthodontic management had been successfully performed with excellent functional and esthetic results. Treatment of an impacted incisor is a challenge, which should be carefully planned. A clinical and radiographic follow-up by a multi- rofessional group is of outmost importance.

Objetivo: Este relato de caso descreve o manejo e um acompanhamento de 3 anos de um dente anterior incluso e ectópico. Relato de Caso: O paciente, uma menina (9 anos de idade) foi encaminhada devido à falta de um incisivo central esquerdo superior permanente. Quando ela tinha 2 anos de idade, sofreu uma intrusão completa de seu incisivo central esquerdo superior decíduo, e o dente re- erupcionou após 4 semanas. O exame radiográfico revelou a impactação e deslocamento grave do incisivo central esquerdo superior permanente. O dente impactado foi cirurgicamente exposto e tracionado ortodonticamente para alinhamento ao longo de um período de 12 meses. Resultados: Após este período, o incisivo central apresentou saúde periapical e periodontal satisfatórias, oclusão adequada e bom resultado estético. Após três anos de acompanhamento, arredondamento apical e ausência de dano extensivo às estruturas dentárias ou teciduais foi observado. Conclusão: O manejo ortodôntico foi realizado com sucesso, com excelentes resultados funcionais e estéticos. O tratamento de um incisivo impactado é um desafio que deve ser cuidadosamente planejado. Um acompanhamento clínico e radiográfico por um grupo multiprofissional é de extrema importância.

Salivary lactoferrin in HIV-infected children: correlation with Candida albicans carriage, oral manifestations, HIV infection and its antifungal activity.

OBJECTIVES: This study aimed to evaluate the concentration of lactoferrin in the saliva of HIV infected and healthy children and analyze the associations between lactoferrin levels, Candida sp. colonization, oral manifestations and medical data. Also, the antifungal ability of lactoferrin to inhibit the growth of Candida albicans isolated from saliva of these children was investigated in vitro. SUBJECTS AND METHODS: Saliva was collected from 70 HIV-infected and 50 healthy children, followed by oral manifestation assessments. The salivary lactoferrin was quantified using an ELISA Kit. The salivary samples were cultured and the Candida spp. colonies counted and then identified by sugar assimilation and fermentation. The antifungal activity of lactoferrin was analyzed in vitro with 10 isolates of C. albicans from each group. RESULTS: The HIV infected children (mean age 9.8 ± 2.8) had higher lactoferrin levels (median 6.13 µg/ml (3.58-7.89)) and were colonized three times more by Candida sp. than the control group (mean age 9.4 ± 2.4) (median 5.74 µg/ml (3.12-6.86)) (p=0.003). Statistical associations were found considering the salivary lactoferrin levels and Candida sp. and oral manifestations between the groups. No associations between lactoferrin concentrations and oral manifestations, immunosuppression, presence of AIDS and use of HAART were observed in the HIV group. The percentage of dead C. albicans due to lactoferrin was inversely proportional to C. albicans cell density for both groups (p<0.001). CONCLUSIONS: HIV-infected children have higher concentrations of lactoferrin and it was associated with Candida sp. colonization but no association with medical data was found. Also, both groups showed similar lactoferrin antifungal activity.