Evaluation of the root morphology of mandibular first premolars using cone-beam computed tomography in a peruvian population / Evaluación de la morfología radicular de primeros premolares mandibulares mediante tomografía computarizada de haz cónico en una población peruana

Introduction: The morphology of the root canal of the first premolars is not always the same and therefore a good knowledge of its dental anatomy is essential. Aim: To assess the morphology of roots and root canals of mandibular first premolars in a Peruvian population using cone-beam computed tomography (CBCT). Materials and Methods: This was a descriptive cross-sec-tional study. A total of 370 mandibular first premolars fulfilling the inclusion criteria were evaluated using CBCT, and the number of roots and root canals, the Vertucci's classification of root canal configuration, age, sex and side of the tooth were registered. Results: One and two roots were presented in 96.2% (n=356) and 3.8% (n=14), respectively, of the mandibular first premolars analyzed, and one canal was present in 67.6% (n=250) and two canals in 32.2% (n=119). A type I root canal configuration was found in 67.6% (n=250) of the cases followed by type V with 26.2% (n=97). A statistically significant association was found between the number of roots and canals (p<0.001) and age also had a significant influence on this variable (p=0.0043). Conclusions: The presence of one canal in mandibular first premolars is the most frequent, although there is a considerable prevalence of two in the population studied. The number of roots is associated with the number of canals, with age having a significant influence on these variables.

Introducción: La morfología del canal radicular de los primeros premolares no siempre es la misma y por ello es fundamental un buen conocimiento de su anatomía dental. Objetivo: Evaluar la morfología de las raíces y conductos radiculares de primeros premolares mandibulares en una población peruana mediante tomografía computarizada de haz cónico. Materiales y Métodos: Este fue un estudio transversal descriptivo. Se evaluaron mediante tomografías un total de 370 primeros premolares mandibulares que cumplían con los criterios de inclusión, y se registró el número de raíces y conductos radiculares, la clasificación de Vertucci de la configuración radicular, la edad, el sexo y el lado del diente. Se realizaron las pruebas de chi-cuadrado y una regresión logística binaria (p<0,05). Resultado: Se presentó una y dos raíces en el 96,2% (n=356) y 3,8% (n=14), respectivamente, de los primeros premolares mandibulares analizados, y un canal estuvo presente en el 67,6% (n=250) y dos canales en el 32,2% (n=119). Se encontró una configuración del conducto radicular tipo I en el 67,6% (n=250) de los casos seguido del tipo V con un 26,2% (n=97). Se encontró una asociación estadísticamente significativa entre el número de raíces y conductos (p<0.001) y la edad también influyó significativamente en esta variable (p=0.0043). Conclusión: La presencia de 1 canal en primeros premolares mandibulares es la más frecuente, aunque existe una prevalencia considerable de 2 en la población estudiada. El número de raíces está asociado al número de canales, teniendo la edad una influencia significativa en estas variables.

Association of mandibular canine impaction and anatomical factors: A multicentre retrospective panoramic study in Latin America.

INTRODUCTION: Mandibular canine impaction is infrequent in dental eruption anomalies and treatment is very challenging. The aim of this multicenter retrospective panoramic study in Latin America was to evaluate panoramic radiographic imaging characteristics of mandibular canine impaction (impaction area, mandibular base contact, transmigration, impaction height and sex) and their associations. MATERIAL AND METHODS: This cross-sectional study evaluated 212 digital panoramic radiographs from three radiological centres in Tingo Maria (Peru), Bogota and Tunja (Colombia). The study included children of both sexes with impacted mandibular canines. Mandibular alpha angle, contact with mandibular basal bone (MBB), impacted sector according to 10 sectors with an adaptation of the Ericson and Kurol method, presence of transmigration and the impacted height were measured and the relationship among these measures was analyzed. Fisher's exact test, Chi-square and binary logistic regression were used. (P<0.05). RESULTS: The mandibular canine impaction showed contact with the MBB (32.08%), dental transmigration (36.79%), mainly located at an apical (40.09%) and sub-apical (36.79%) level. Transmigration mainly occurred in sectors 6 (33.30%) and 10 (25.60%) (P<0.001). It was found that for each year of increase in age, the possibility of contact with the MBB decreased (ß=0.89, P=0.010), and as the alpha angle increased by one degree the probability of contact with the MBB decreased (ß=0.97, P=0.001) and the probability of transmigration increased (ß=1.05, P<0.001). CONCLUSIONS: One third of the impacted canines were in contact with the MBB, while another third presented dental transmigration and were mainly located apically and subapically of the incisor roots. These imaging features should be taken into account when planning orthodontic treatment.

Alveolar morphometry in young adults with and without agenesis of the upper lateral incisor: A retrospective study.

INTRODUCTION: We aimed to compare alveolar morphometry in young adults with agenesis of the upper lateral incisor versus the side without agenesis and versus matched controls. MATERIAL AND METHODS: In this observational retrospective study, cone beam computed tomography scans were obtained of 36 upper hemiarches from young adults aged 15 to 30 years. The hemiarches were distributed into three groups: group 1: 12 upper hemiarches presenting agenesis of the upper lateral incisor; group 2: 12 upper hemiarches from the opposite side without agenesis of the upper lateral incisor (control group 1); and group 3: 12 upper hemiarches without agenesis of the upper lateral incisor matched for age and sex with respect to the affected group (control group 2). A trained and calibrated investigator performed all the alveolar measurements at two different times, including sagittal, coronal and axial slices of each hemiarch. Paired Student's t-tests, Chi-square and repeated measures ANOVA with Bonferroni correction were used, (P<0.05). RESULTS: Apical mesial evaluation of group 1 (4.22±1.19mm) was significantly lower (P<0.001) than that of groups 2 (6.72±1.17mm) and 3 (7.58±1.67mm). Apical distal evaluation also showed differences (P<0.001) among the three groups, with the dimension being smaller in group 1 with agenesis (4.53±1.14mm), followed by group 2 without agenesis (6.23±1.55mm) and the healthy control group 3 (7.73±1.71mm). CONCLUSIONS: Lateral incisor agenesis significantly reduces the alveolar dimensions of the affected area. In cases of unilateral agenesis, the unaffected side also shows sequelae, with decreased dimensions compared to cases without agenesis. This condition should be taken into account when making therapeutic decisions regarding rehabilitation with implants or canine replacement.

Conservative Treatment of Bilateral Impacted Mandibular Canines Traction.

The objectives of the treatment of impacted canines differ according to the characteristics of dental malocclusion. Traction of the tooth is a conservative and viable alternative, which allows for maintaining stability and occlusal function. The following case report describes the treatment of an 11.6-year-old female patient, who presented bilateral impaction of mandibular canines in contact with the midline, mixed dentition in the inter-transitional period, class I angle malocclusion, with light crowding teeth. The treatment comprised three phases. The first phase, verticalization of the mandibular canines in mixed dentition, was performed to pull the impacted bilateral mandibular canines towards the dental arch to achieve their verticalization, maintaining the molar relationship, and the position of the upper and lower incisors. In the second phase, osteogenic rest was planned to relieve post-traction stress while awaiting the replacement of the mixed dentition. Finally, the third phase in permanent dentition was to align and level canines within the arch after extraction of the deciduous canines. For the viability of the permanent mandibular canines in the dental arch, orthosurgical traction was implemented, with a traction system with closed nickel-titanium coil springs with a transitory rigid dental-mucous-supported anchorage device, which allowed control and protection of the adjacent teeth and movements with helical forces of a controlled three-dimensional range. The results of the treatment were adequate, achieving consolidated molar and canine relationships, overjet, overbite, and optimal facial balance.

Concordance of the facial biotype between Bjork-Jarabak cephalometrics and photographic analysis of the facial opening angle.

Background: Analysis of the facial biotype can provide useful information for orthodontic diagnosis and can determine the type of growth of a patient to guide orthodontic treatment. The objective of this study was to determine the concordance of the facial biotype according to Bjork-Jarabak cephalometric analysis and photographic analysis of the angle of facial opening in Peruvian individuals. Material and Methods: This retrospective study included 244 cephalometric radiographs and frontal photographs of the same patients obtained from a database. The facial biotype (mesofacial, brachyfacial, or dolichofacial) was determined with the Björk-Jarabak polygon (cephalometric) and the angle of facial opening (photographic). Two trained investigators performed all the measurements. The concordance of the facial diagnosis was determined using correlations of the interclass coefficient and the kappa test. p<0.05. Results: In cases with a mesofacial biotype, both analyses coincided in 60 individuals (68.2%), while in those diagnosed with a dolichofacial biotype, the analyses only coincided in 17 individuals (10.4%). There was no concordance between the two methods regarding the brachyfacial biotype since according to the angle of facial opening none of the individuals presented a brachyfacial biotype (kappa weighted test= 0.020, p=0.586). Conclusions: Cephalometric and photographic analyses should be complementary and one should not substitute the other. Attention should be focused on dolichofacial and brachyfacial biotypes, which showed less concordance between evaluations. So, more studies are needed to follow this line of research. Key words:Facial biotype, cephalometry, photography, facial type, radiography.

Three-dimensional decision support system for treatment of canine impaction.

INTRODUCTION: This study aimed to develop a 3-dimensional (3D) characterization of the severity of maxillary impacted canines and to test the clinical performance of this characterization as a treatment decision support tool. METHODS: Cone-beam computed tomography images obtained from 83 patients with 120 impacted maxillary canines were included. Quantitative information on the canine 3D position and qualitative assessment of root damage of adjacent teeth were evaluated. A severity index was constructed on the basis of the quantitative findings. Clinical applicability was tested by comparing clinical diagnosis and treatment planning for conventional records vs the 3D characterization via a 2-part survey. RESULTS: The average quantitative assessments of impacted maxillary canine position were 6.4 ± 3.6 mm from the midsagittal plane, 11.6 ± 3.1 mm in height relative to the occlusal plane, 31.5° ± 18° of roll, and 48.8° ± 14.3° of pitch. The severity index ranged from 0-13 with a mean score of 4.5 ± 2.2. Overlap with adjacent teeth was the greatest contributor (33%) to the index. Bicortically impacted canines caused the most severe root damage. Cone-beam computed tomography was preferred for assessing root damage and overall severity, whereas conventional imaging was sufficient for height and angulation assessment. The 3D report was very important or important for evaluating root damage, canine position, overall severity, and overlap. The 3D report changed most of the decisions relating to biomechanics, patient education, and treatment time estimate. The decision of exposure and traction vs extraction was changed 22% of the time after the presentation of the 3D report. CONCLUSIONS: The overlap with adjacent teeth frequently contributes the most to the severity index. The 3D report provided relevant clinical information regarding the canine position, damage to adjacent teeth, and the severity index, with a profound impact on the decisions of the clinicians regarding biomechanics, patient education, and treatment time estimate.

Postoperative chronic pain in arthroplasty papillon-lefèvre syndrome: 17-year dental follow-up: case report / Síndrome de papillon-lefèvre: seguimiento dental de 17 años: reporte de caso

Introduction: The present report describes the case of a 12-year-old patient with 17-year follow-up who was previously diagnosed with Papillon-Lefèvre Syndrome (PLS), which is a rare autosomal recessive irregularity in the cathepsin C gene (CTSC) characterized by palmoplantar hyperkeratosis and premature loss of primary and permanent teeth. Case Report: A specific mutation in the c.203 T > G gene inducing loss of function leading to PLS was detected, as was a mutation in the HLA-DRB1*11 allele, which is associated with this syndrome. There is no consanguinity of the parents, and the siblings are entirely healthy. Early identification of the main characteristics of this syndrome is imperative. Accurate diagnosis by genetic analysis allows differential diagnoses and timely comprehensive dental treatment. Conclusions: Additionally, it allows consultation with a dermatologist to maintain or improve the quality of life of patients with this condition due to progressive worsening and severity of the main physical manifestations. Keywords: Papillon-Lefevre Disease; Keratoderma, Palmo-plantar; Cathepsin C; Periodontitis; Skin Diseases, Genetic; Case reports

Introducción: El presente reporte describe el caso de un paciente de 12 años de edad con 17 años de seguimiento a quien previamente se le diagnosticó Síndrome de Papillon-Lefèvre (PLS), el cual es una rara irregularidad autosómica recesiva en el gen de la catepsina C (CTSC) caracterizada por hiperqueratosis palmoplantar y pérdida prematura de dientes primarios y permanentes. Reporte de Caso: Se detectó una mutación específica en el gen c.203 T > G que induce pérdida de función que conduce a PLS, así como una mutación en el alelo HLA-DRB1*11, que se asocia a este síndrome. No presenta consanguinidad de los padres, padres y hermanos totalmente sanos. La identificación temprana de las principales características de este síndrome es imperativa. El diagnóstico certero por análisis genético permite diagnósticos diferenciales y tratamientos odontológicos integrales oportunos. Conclusiones: Adicionalmente, permite la consulta con un dermatólogo para mantener o mejorar la calidad de vida de los pacientes con esta condición debido al progresivo empeoramiento y severidad de las principales manifestaciones físicas.

Sagittal Position of the Upper Incisor in Relation to the Forehead in Peruvian Individuals with Different Skeletal Relationships.

AIM: The aim of this study was to determine the sagittal position of the upper incisor considering Andrews' analysis based on the position of the forehead in Peruvian individuals with different skeletal relationships. MATERIALS AND METHODS: This retrospective, cross-sectional study included 212 lateral head radiographs of Peruvian individuals (males: 85, mean age 21.38 ± 6.88, and females: 127, mean age 21.18 ± 6.95), with different skeletal relationships (Class I group = 96, Class II group = 57, Class III group = 59). The values of the ANB, SNA, SNB angles as well as the forehead anterior limit line (FALL) and goal anterior limit line (GALL) points were identified in the radiographs, and then a vertical line was drawn in each point to determine if the upper incisor was positioned forward (protruded), backward (retruded) or within (adequate) these lines. Two trained and calibrated investigators performed all the measurements. The Chi-square test was used to evaluate associations. A p-value < 0.05 was considered statistically significant. RESULTS: Overall, the sagittal position of the upper incisor showed a significant association with the sagittal skeletal relationship (p = 0.001). The upper incisors showed an adequate position (41.7%), protruded position (56.10%), and retruded position (42.40%), for Class I, II, and III skeletal relationships, respectively, as highest percentages in each Class. Statistical significance was found for females only (p = 0.005). CONCLUSION: Skeletal Class I mainly showed an adequate position of the upper central incisor, whereas for Class II a protruded position was most frequently found, and Class III presented a retruded position. CLINICAL SIGNIFICANCE: Andrews' analysis based on the position of the forehead in Peruvian individuals is a valuable tool for orthodontic diagnosis. How to cite this article: Bazán-Mendoza JR, Arias-Modesto PB, Ruíz-Mora GA, et al. Sagittal Position of the Upper Incisor in Relation to the Forehead in Peruvian Individuals with Different Skeletal Relationships. J Contemp Dent Pract 2023;24(11):821-825.

Three-dimensional evaluation of mandibular canine impaction characteristics and their relationship with lower incisor root morphometry.

Background: To three-dimensionally evaluate the characteristics of mandibular canine impaction with the morphometry of the roots of the lower incisors. Material and Methods: Cone-beam computed tomography (CBCT) scans of 35 individuals (18 males and 17 females) with a mean age of 14.37± 10.26 years were evaluated. Forty-three impacted mandibular canines (IMbC) were evaluated. Their location, sector and level of impaction were determined. Likewise, the distances of the canines to the occlusal plane, the angulations with respect to the midline and adjacent lateral incisors, the length of the impacted canines, and of the lower incisors were measured. Finally, the presence of incisor root resorption was determined. Chi-square and Kruskal Wallis tests were employed (P<0.05). Results: The buccal position of the IMbCs was the most predominant (65.1%), and the location below the apical middle third of the lower incisor root was the most frequent (32.6%). No statistical significance was found between root resorption and location, level and impaction sector. Only mild root resorption and impaction sector 5 was significant (66.70%; P<0.001). The proximity of the follicle and crown of the IMbC did not affect the root structure of the lower incisors. 72.1% and 52.2% of mandibular canines did not present contact of the impacted canine or its follicle with the adjacent tooth respectively. Root lengths were similar in the different types of impactions (P>0.05). Conclusions: IMbCs are mostly positioned buccally and below the apical middle third of the root of the lower incisors. Likewise, the proximity of their follicles and crowns does not seem to affect the root structure of the lower incisors, producing minimal and infrequent root resorption. Key words:Mandibular canine impaction, incisor root morphometry, cone-beam CT.

Root morphology of lateral incisors adjacent to impacted maxillary canines: A cone-beam computed tomography retrospective cross-sectional study.

INTRODUCTION: To compare the root morphology of the maxillary lateral incisors (MLIs) adjacent to an impacted (IMC) versus non-impacted maxillary canine (non-IMC). MATERIALS AND METHODS: This cross-sectional study included cone beam computed tomography (CBCT) images derived from 154 subjects (with unilateral/bilateral impacted maxillary canines or without canine impaction). Each MLI was considered as a unit of analysis. Thus, the study group included 122 MLIs adjacent to impacted maxillary canine (IMCG) and the control group included 122 MLIs adjacent to a non-impacted maxillary canine (CG). Groups were matched by age, sex and evaluation side. Root length, root dilaceration angle and root convergence angle were evaluated in both the coronal and sagittal planes. Comparisons between groups were made with Student's t-test and the chi-square test with Bonferroni correction (P<0.008, P<0.01, respectively). RESULTS: The root measurements of the MLIs showed some significant differences between the groups. The coronal root length was 0.52mm shorter but not highly significant (P=0.032), the coronal root dilaceration angle was 7.51° smaller (P<0.001), and the coronal root convergence angle was 1.28° greater (P<0.001) in the IMCG compared to the CG. The orientation of root dilaceration in the MLIs showed significant differences between the groups: it was mostly distopalatal in the GC (87.5%), to a lesser extent in the IMCG (58.9%) and also mesiopalatal in the IMCG (22.3%), (P=0.001). CONCLUSIONS: The root morphology of MLIs adjacent to an IMC showed a tendency of shorter length, smaller root dilaceration and greater root convergence in the coronal section than MLIs adjacent to a non-IMC.

Primary failure of eruption: occlusal and dentoalveolar characteristics in mixed and permanent dentition. A study with cone beam computed tomography.

Background: The main objective of this study was to describe the dentoalveolar and occlusal characteristics of subjects with primary failure of eruption (PFE) in cone beam computed tomography (CBCT) and compare them with a control group without the anomaly. Material and Methods: This retrospective and comparative study evaluated CBCT images of 80 permanent molars divided into 2 groups of 40 molars each, which had or did not have PFE characteristics. Using CBCT a calibrated orthodontist performed 23 measurements related to the distances of the cusps to the occlusal, palatal and mandibular planes and measured the buccal-palatal and mesiodistal widths of the molar crowns and their root lengths. Independent Student's t or Mann-Whitney U tests were used to compare occlusal and dentoalevolar characteristics between groups according to the normality of the data. P<0.05. Results: Molars affected by PFE were smaller in coronal dimensions in the PFE compared to the non-PFE group (Buccal-palatal crown width 11.60±0.95mm vs. 12.21±1.09 mm; p<0.001; and mesiodistal crown width 10.81± 1.07 mm vs. 11.84±1.32mm, respectively; p<0.001). The distal and mesial root lengths were approximately 2 mm smaller in the PFE group (p<0 .001). The three-dimensional bony position was more convergent with respect to the palatal plane, i.e., the crown was more inclined palatally and distally in the PFE compared to the non-PFE group. Conclusions: Patients with molars affected by PFE present smaller bucco-palatal, mesio-distal coronal widths and mesial and distal root lengths than those without PFE and in these teeth the crowns are more inclined palatally and distally in upper molars. These specific characteristics may be pathognomonic of PFE and should be considered by clinicians when evaluating or treating patients with this condition. Key words:Occlusal characteristics, primary failure of eruption, cone-beam CT.

Multiple eruptive delay as a variant of primary eruption failure. A preliminary case report.

Primary failure of eruption (PFE) is an autosomal disease that occurs in approximately 0.06% of the population and is defined as the malfunction of dental eruptive mechanisms with delay and absence of these processes in a non-ankylosed tooth. Treatment options for patients with eruptive delays range from prosthetic to surgical interventions. Although this condition is relatively rare, the occurrence of eruptive disorders in clinical dental practice is becoming more frequent. Correct diagnosis of this eruptive anomaly plays an essential role in treatment planning. The aim of this case report was to describe the treatment of a case of multiple PFE with a biomechanical approach to extrusive traction using NiTi closed coil springs and a customized rigid anchorage. In conclusion, complex orthodontic cases with eruptive delay and variants of PFE can be successfully intervened to make morphologically and functionally compromised dental organs viable, if diagnosed and treated in a timely and preventive manner by a multidisciplinary approach using alternative biomechanics for efficient osteogenic traction.

Interposition Arthroplasty in Untreated Chronic Dislocation of the Elbow.

OBJECTIVE: To describe the clinical outcomes of interposition arthroplasty with transposition of the medial epicondyle to the coronoid process and articulated external fixation in patients with untreated chronic dislocation of the elbow. METHODS: Fourteen consecutive patients diagnosed with untreated chronic elbow dislocation performed a complete radiological and physical examination. The same surgeon treated all patients with a same technique. Passive mobilization started immediately in addition to the vigorous care of the surgical wound and surrounding skin. RESULTS: A total of 14 patients were treated, with a mean age of 31 years, with the nondominant side being the most affected (65%). In the immediate postoperative period, the initial Mayo Elbow Performance Score was 60 pts. In all cases, the distraction from the articulated fixator was removed, and there was an average of 16 pts improvement at the time of removal. A hinged elbow orthosis was placed for 4 weeks starting strengthening and obtained radiographic integration of the neocoronoids; ranges of motion of flexion 122°, extension -6°, and pronosupination 70°, without data of any direction instability. CONCLUSION: Considering that this is one of the longest series with a follow-up of more than 60 months of evolution in our patients, the result is completely satisfactory, achieving the objective of a minimum range of motion of 100° in addition to elbow stability.

Preceding anti-spike IgG levels predicted risk and severity of COVID-19 during the Omicron-dominant wave in Santa Fe city, Argentina

The SARS-CoV-2 Omicron variant has increased infectivity and immune escape compared with previous variants, and caused massive COVID-19 waves globally. Despite a vast majority ([~]90%) of the population of Santa Fe city, Argentina, had been vaccinated and/or had been infected by SARS-CoV-2 by the arrival of Omicron, the epidemic wave that followed was by far the largest one experienced in the city. A serosurvey conducted prior to the arrival of Omicron allowed to assess the acquired humoural defences preceding the wave and to evaluate associations with infection risk and severity during the wave. A very large proportion of the 1455 sampled individuals had immunological memory against COVID-19 at the arrival of Omicron (almost 90%), and about half (48.9%) had high anti-Spike IgG levels (>200 UI/ml). The antibody titres were strongly associated with the number of vaccine shots and the vaccine platform received, and also depended markedly on prior COVID-19 diagnosis and the days elapsed since last antigen exposure (vaccine shot or natural infection). Following-up 514 participants provided real-world data linking antibody levels with protection against COVID-19 during a period of high risk of exposure to an immune-escaping highly transmissible variant. Pre-wave antibody titres were strongly associated with COVID-19 incidence and severity of symptoms during the wave. Also, receiving a vaccine shot during the follow-up period reduced the COVID-19 risk drastically (15-fold). These results highlight the importance of maintaining high defences through vaccination anticipating or during a period of high risk of exposure to immune-escaping variants.

Adaptation of a Single-Cone in Prepared Teeth with Two Reciprocating Systems.

Introduction: This ex vivo study aimed to compare the adaptation of single gutta-percha cone in teeth prepared with the Wave One Gold and Reciproc Blue reciprocating systems through cone-beam computed tomography. Materials and Methods: A total of 40 recently extracted mono radicular premolars were randomly assigned into two groups (n=20) corresponding to Reciproc Blue and Wave One Gold reciprocating systems and adapted to a single cone system. Each group was evaluated by cone-beam computed tomography at 1 mm, 2 mm and 4 mm from the apical foramen. We evaluated the number of walls adapted by the cone, quality of filling and the number of spaces between the filling and the walls of the root canal. The Mann-Whitney U and T-tests were employed to associate and compare both groups (P<0.05). Results: At 1 mm in the lingual wall the Wave One Gold system did not adapt by 45% compared to 15% with Reciproc Blue (P<0.05). Likewise, the single-cone filling technique of the Reciproc Blue system showed better sealing quality obtaining an ideal category (75%) compared to Wave One Gold (40%) (P<0.05). The amount of space (mm) found between the cone and the filling walls was greater with Wave One Gold. However, these values were not statistically significant. Conclusions: Based on this ex vivo study the better adaptation of root canals and ideal filling condition was more frequent with Reciproc Blue than Wave One Gold system, mainly at 1 mm from the radicular apex.

Dentigerous cyst and the importance of early detection. report of a pediatric case.

Dentigerous cysts are a common cystic pathology that develop between the first and third decade of life and are mainly associated with impacted or erupted mandibular third molars followed by maxillary canines and maxillary third molars. These kinds of cysts are the result of the proliferation of enamel epithelium after its formation, the pathogenesis of which is not clear. Few of these cysts have been reported in pediatric patients. The following case report presents the rare occurrence of a dentigerous cyst in a 6-year-old boy and describes the treatment administered.

Los quistes dentígeros son una patología quística común que se desarrolla entre la primera y la tercera década de la vida, y se asocian principalmente con terceros molares mandibulares incluidos o erupcionados, seguidos de caninos superiores y terceros molares superiores. Este tipo de quistes son el resultado de la proliferación del epitelio del esmalte después de su formación, cuya patogenia no está clara. Se han informado pocos de estos quistes en pacientes pediátricos. El siguiente reporte de caso presenta la rara ocurrencia de un quiste dentígero en un niño de 6 años y describe el tratamiento administrado.

Concrescence in anterior teeth assessed by cone beam computed tomography. A case report.

Dental concrescence is an anomaly in which the cementum overlying the roots joins, causing the union of two different teeth. It is often reported in posterior dentition, affecting certain dental procedures such as root canal treatment, periodontal procedures, orthodontic movement and dental extraction. This case report describes the successful diagnosis and treatment of a 20-year-old male with a moderate skeletal class II who was referred for a radiographic evaluation after 1 year of failed orthodontic movement of teeth 1.1 and 1.2. The radiographic assessment with a Cone Beam Computed Tomography allowed discard other related pathologies and diagnose a dental concrescence. The patient underwent orthognathic surgery in which the class II was corrected, and the concrescence was treated with a prosthetic approach.

La concrescencia dental es una anomalía en la que el cemento que recubre las raíces se une, y provoca la unión de dos dientes diferentes. A menudo, se presenta en la dentición posterior y afecta ciertos procedimientos dentales, como el tratamiento del conducto radicular, los procedimientos periodontales, el movimiento de ortodoncia y la extracción dental. Este informe de caso describe el diagnóstico y tratamiento exitoso de un hombre de 20 años con una clase II esquelética moderada, que fue remitido para una evaluación radiográfica después de 1 año de movimiento ortodóncico fallido de los dientes 1.1 y 1.2. La valoración radiográfica con una tomografía computarizada de haz cónico permitió descartar otras patologías relacionadas y diagnosticar una concrescencia dentaria. El paciente fue sometido a una cirugía ortognática en la que se corrigió la clase II y se trató la concrescencia con abordaje protésico.

Antecedentes de vacunación en pacientes con COVID-19 / COVID-19 patients and vaccination

Introduction: Vaccines against COVID-19 are effective. However, a percentage of people with a complete vaccination scheme are at risk of contracting and becoming ill from COVID-19. These cases are known as "vaccinated cases of infection". Objective: To identify the clinical characteristics of patients with SARS-CoV-2 infection with a history of vaccination for COVID-19. Methods: Retrospective cohort study in 271 vaccinated and positive patients who attended medical units in Baja California Sur, with or without a complete scheme and registered in SINOLAVE. Clinical characteristics, management, sequelae and mortality were analyzed. Descriptive statistics and association measures were used. Authorized by the ethics and research committees. Results: Age 48.5 ± 12.1 years, 19.5% met the definition of infection in vaccinated, 93% with outpatient management, 3.7% mortality, the most frequent comorbidity: diabetes / hypertension. 92% of the cases vaccinated with Cansino had COVID, followed by Pfizer with 26%. There is a higher risk of hospitalization and mortality in patients with an incomplete scheme. Conclusions: The vaccines are effective, most of the cases were ambulatory. Patients vaccinated with Cansino showed a higher COVID infection, the reinforcement of this vaccine could reduce the disease in patients already vaccinated. Of the patients who died, the majority did not have a complete vaccination schedule.

Introducción: Las vacunas contra la COVID-19 son efectivas. Sin embargo, un porcentaje de personas con esquema completo de vacunación tiene riesgo de contagiarse y enfermar por COVID-19. Estos casos se conocen como "casos de infección en vacunados". Objetivo: Identificar las características clínicas de los pacientes con infección por SARS-COV-2 con antecedente de vacunación para COVID-19.Métodos: Estudio de cohorte retrospectivo con 271 vacunados y positivos que acudieron a las unidades médicas en Baja California Sur, con esquema completo o sin él y registrados en el SINOLAVE. Se analizaron características clínicas, manejo, secuelas y mortalidad. Se utilizó estadística descriptiva y medidas de asociación. El estudio fue autorizado por los comités de ética e investigación. Resultados: Edad: 48.5 ± 12.1 años; 19.5% cumplieron con la definición de infección en vacunados; 93% con manejo ambulatorio; mortalidad del 3.7%; la comorbilidad mas frecuente: diabetes/hipertensión. El 92% de los casos vacunados con Cansino presentaron COVID, seguido por los que recibieron Pfizer, con el 26%. Existe mayor riesgo de hospitalización y mortalidad en pacientes con esquema incompleto. Conclusiones: las vacunas son efectivas, la mayoría de los casos fueron ambulatorios. Los pacientes vacunados con Cansino mostraron mayor infección por SARS-CoV-2; el refuerzo de esta vacuna, podría disminuir la enfermedad en los pacientes ya vacunados. De los pacientes que murieron, la mayoría no tenía esquema completo de vacunación.

Three-dimensional changes in root angulation of buccal versus palatal maxillary impacted canines after orthodontic traction: A retrospective before and after study.

INTRODUCTION: The aim of this study was to three-dimensionally compare the root angulation changes after orthodontic traction of buccally versus palatally maxillary impacted canines (MICs). MATERIAL AND METHODS: This retrospective study included patients from a private dental office of both sexes, older than 12 years, with at least one unilateral or bilateral buccal or palatal MIC, no loss of permanent teeth, with complete apical closure at the beginning of traction, and with CBCTs taken at pretreatment (T0) and after orthodontic traction (T1). The sample was divided in two groups according to their impaction site: buccal versus palatal. In all the scans, the MIC was segmented and the root angulation changes after traction were evaluated. The assessment included the sigma angle (projected on the XZ plane or coronal tomographic view), the delta angle (projected on the XY plane or axial view) and the epsilon angle (projected on the YZ plane, or sagittal view). Intragroup comparisons were performed with Wilcoxon signed-rank tests. Intergroup comparisons were performed with t-tests or Mann-Whitney U tests. Finally, the influence of MIC characteristics on the measured angles were evaluated with multiple linear regression analyses (α=0.05). RESULTS: Thirty-three patients (16 men, mean age: 20.38; 17 women, mean age 18.37) with forty-five orthodontically treated MIC (19 buccal versus 26 palatal) were finally included. The palatal MICs showed greater mediolateral uprighting than the buccal MICs, root displacement towards the midsagittal plane, as demonstrated by the sigma angle (palatal group: 37.58±15.08°; buccal group: 29.17±31.15°; P=0.164) and delta (palatal group: -76.90±26.55°; buccal group: -30.56±41.67°; P<0.001)angle changes. The buccal MICs showed greater anteroposterior uprighting, anterior root displacement, as demonstrated by the epsilon angle (palatal group: -4.63±12.37°; buccal group: -25.96±17.79°; P<0.001). CONCLUSIONS: Mediolateral and anteroposterior root angulation show significant differences after traction between buccal and palatal MICs. Palatal MICs showed greater medial root displacement while buccal MICs showed greater anterior root displacement. This condition should be considered for better planning of traction and orthodontic finishing.

Prevalence of impacted teeth and supernumerary teeth by radiographic evaluation in three Latin American countries: A cross-sectional study.

BACKGROUND: Supernumerary teeth are those that exceed the usual dental formula. There are different classifications depending on their anatomical location, shape and number. The objective of this study was to determine the prevalence of impacted and supernumerary teeth in a sample of panoramic radiographs from three Latin American countries. MATERIAL AND METHODS: A retrospective and cross-sectional study with a quantitative approach, in which the radiographic observation and analysis of 2000 panoramic radiographs, provided by different radiological centers in Peru, Colombia and Bolivia were performed. An examiner, specialized in Stomatology and Oral Surgery, carried out the radiographic analysis to detect the presence of impacted teeth and supernumeraries teeth. All the images were evaluated in a dark room in digital format. The SPSS version 23 package was used for statistical analysis. The Chi-square test was used to determine the association of age, sex, and nationality with the presence of impacted or supernumerary teeth. The level of significance was p< 0.05. RESULTS: The prevalence of impacted teeth was 1.7%, with the upper left canine being the most frequent (58.85%). The prevalence of supernumeraries was 3.15% (76 cases), the most frequent being the mesiodens with 1.7% (34), and Peru showing the highest prevalence of mesiodens. No association was found regarding sex. CONCLUSIONS: The prevalence of impacted teeth evaluated in three recognized radiologic centers from three Latin American countries was low, with the upper left canine being the most frequently impacted tooth. Likewise, the prevalence for supernumerary teeth was also low, with mesiodens having the highest prevalence. Key words:Supernumerary tooth, impacted tooth, panoramic radiograph.