Eruption of Impacted Teeth in Cleft Lip and Palate Patients following Alveolar Bone Graft.

INTRODUCTION: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft. MATERIALS AND METHODS: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiabá, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed. RESULTS: Forty-two patients treated at the institution from 2004 to 2011 had their charts retrospectively reviewed. They were 54.7% male and 45.2% female. The group aged 9 to 11 years was most affected, representing 59.5% of cases. A unilateral cleft was the most prevalent craniofacial anomaly (85.7%). A total of 57 impacted teeth were observed. Maxillary canines were the most commonly impacted teeth (97.6%) and the most frequently identified in patients with a transforamen incisor cleft (TIC) (76.3%). Orthodontic traction was required for both impacted maxillary canines and impacted lateral incisors (64.3 and 35.7% respectively). The orthodontic traction was required only in patients with a TIC (p = 0.0101). CONCLUSION: The canine teeth were the most commonly impacted teeth, found mainly in patients with a TIC. After placement of the alveolar bone graft in patients with a preforamen incisor cleft (PIC), all impacted teeth erupted spontaneously. CLINICAL SIGNIFICANCE: An impacted tooth can have negative consequences on a patient's quality of life. Thus, a survey evaluating the incidence and prognosis of impacted teeth after an alveolar bone graft for CLP was important.

Eruption of Impacted Teeth after Alveolar Bone Graft in Cleft Lip and Palate Region.

AIM: This study aimed to assess the eruption of impacted teeth in cleft lip and/or palate (CLP) after alveolar bone graft. MATERIALS AND METHODS: Research was carried out through a cross-sectional study at the Craniofacial Rehabilitation Center of the University General Hospital of the University of Cuiaba, Mato Grosso, Brazil. Variables related to cleft, cleft side, gender, age, laterality of cleft, impacted teeth, and orthodontic traction were analyzed. RESULTS: Forty-two patients treated at the institution from 2004 to 2011 were recruited. There were 54.76% males and 45.24% females. The age group between 9 and 11 years was most affected in 59.53% of cases. The unilateral cleft was the most prevalent (85.71%). A total of 57 impacted teeth were observed. Maxillary canine was the most prevalent impacted teeth (97.61%) and more frequent in transforamen incisor cleft (TIC) (76.3%). The orthodontic traction was needed in both maxillary canines and lateral incisor impacted teeth, 64.3 and 35.7% respectively. The orthodontic traction was needed only in TIC (p = 0.0101). CONCLUSION: The canine teeth were the most prevalent, mainly related to the TIC and all impacted teeth erupted spontaneously in the preforamen incisor cleft (PIC) after placement of the bone graft. CLINICAL SIGNIFICANCE: There was spontaneous eruption of impacted teeth after secondary alveolar bone graft in CLP.

Avaliação da eficiência do bastão de gelo e gás refrigerante na determinação da vitalidade pulpar / Assessment of the efficience of ice stick and refrigerant gas in the determination of pulpal vitality

O presente estudo teve por objetivo avaliar a eficácia do bastão de gelo e do gás refrigerante, a base de tetrafluoretano, na determinação da vitalidade pulpar em dentes humanos. Foram investigados 749 dentes anteriores superiores de 93 pacientes, com idade entre 10 e 49 anos. Os testes seguiram o protocolo: o isolamento da área com rolos de algodão; secagem do dente; aplicação do estímulo térmico na superfície vestibular dos dentes, no centro da coroa por tempo máximo de 10 segundos; testes realizados, em cada dente, com intervalos de 5 minutos e em caso de resposta positiva de dor, o paciente era instruído a levantar o antebraço esquerdo. Considerando o material, o gás refrigerante mostrou maior índice de resposta positiva (73,82%) com diferença estatisticamente significante (p?0.05) em relação ao bastão de gelo. Comparando a situação clínica, os dentes cariados apresentaram o maior índice de resposta positiva (p?0.05) quando estimulados pelo tetrafluoretano (85,87%). Os dentes íntegros apresentaram índices intermediários de resposta positiva (72,31%) e o menor índice foi apresentado pelos dentes restaurados (67,27), estatisticamente diferentes entre si (p?0.05). Analisando a idade, a faixa etária de 40-49 evidenciou os menores índices de respostas positivas (p?0.05) com o bastão de gelo. As maiores porcentagens de resposta positiva ocorreram nas faixas de 20-29, 30-39 e 40-49 anos, estatisticamente diferentes (p?0.05) das demais. Pôde-se concluir que o gás refrigerante, em comparação ao bastão de gelo, mostrou maior eficiência na determinação de resposta positiva da vitalidade pulpar dos dentes anteriores superiores.

The objective of this study was to evaluate the effectiveness of the ice stick and refrigerant gas, tetrafluoroethane base, in the determination of human teeth pulpal vitality. Seven hundred and forty nine maxillary anterior teeth of 93 patients, aged between from 10 to 49 years,were investigated, The tests followed the protocol: area isolation with cotton rolls, tooth drying; application of thermal stimulus on the teeth vestibular surface in the center of the crown, tests on each tooth by a maximum time of 10 seconds with intervals 5 minutes and in case of positive response, the patient was instructed to lift the left forearm. Considering the material, the refrigerant gas showed higher positive response rate (73.82%), which was statistically significant (p ?0.05) compared to the ice stick. Comparing the clinical situation, the decayed tooth showed the highest rate of positive response (p ?0.05), when stimulated by the refrigerant gas (85.87%). The intact teeth had intermediate rates of positive response (72.31%) and the lowest ones were presented by the restored teeth (67.27), statistically different from each other (p ?0.05). Analyzing the age, the age range of 40-49 showed the lowest rates of positive responses (p ?0.05) with the ice stick. The highest percentage of positive responses occurred in the age ranges of 20-29, 30-39 and 40-49 years, statistically different (p ?0.05) from the others. It can be concluded that refrigerant gas, compared to the ice stick, showed more efficiency in determination of pulpal vitality positive response in the anterior upper teeth.