Life threatening hemorrhage associated with a dentigerous cyst in a dog: Case report.

Dentigerous cysts are the most common type of odontogenic cysts and arise from an unerupted tooth. These cysts have stereotypical radiographic and clinical findings. They can be extremely invasive but rarely present as a life-threatening emergency. This case report describes the stabilization and treatment of a 6-year-old mixed breed dog with a dentigerous cyst with concurrent life-threatening hemorrhage. The dog presented with severe oral hemorrhage from the mandibular artery and required multiple blood transfusions. It was ultimately diagnosed with a dentigerous cyst. Complications from dental issues and potential life-threatening complications, such as this case, can be prevented by routine annual oral examination and full mouth dental radiographs if an unerupted tooth is suspected.

Fibro-odontoma Ameloblástico: Revisión de la Literatura a Propósito de un Caso

El fibro-odontoma ameloblástico (FOA) es una neoplasia odontogénica benigna poco frecuente que afecta a los huesos maxilares. Posee un componente de tejido epitelial y ectomesénquima, por lo que hasta hace un tiempo era incluido dentro de la clasificación de tumores odontogénicos de origen mixto. Actualmente estas lesiones no están incorporadas en la última clasificación de los tumores odontogénicos y huesos maxilofaciales de la organización mundial de la salud y son consideradas como un odontoma en desarrollo. Clínicamente se presenta con mayor frecuencia en mandíbula y asociado a la falta de erupción de un diente. Presentamos el caso clínico de un niño de 6 años de edad que acudió a nuestro servicio maxilofacial por la no erupción de un diente temporal mandibular. El cuadro clínico y las investigaciones confirmaron la hipótesis diagnóstica de FOA con una impactación del segundo molar temporal inferior izquierdo hacia el margen basilar mandibular y el germen dentario del premolar por sobre la corona del diente retenido.

Ameloblastic fibro-odontoma (AFO) is a rare benign odontogenic neoplasm that affects the maxillary bones. It possesses both an epithelial and ectomesenchymal component, for which it was previously included in the classification of mixed odontogenic tumors. The AFO is currently not included in the latest classification of odontogenic and maxillofacial bone tumors, and is considered a developing odontoma. Clinically, it predominantly manifests in the mandible, in frequent association with the lack of eruption of a tooth. In this article, the authors present a case of a 6 year old boy with the query of an unerupted primary mandibular tooth. Both the clinical examination and the subsequent investigation confirmed the diagnostic hypothesis of an AFO with subsequent impaction of the primary left mandibular second molar, which was displaced against the base of the mandible, and the tooth germ for the left mandibular second premolar positionedover the crown of the retained tooth.

Genotype-phenotype analysis of selective failure of tooth eruption-A systematic review.

Tooth eruption is an important and unique biological process during craniofacial development. Both the genetic and environmental factors can interfere with this process. Here we aimed to find the failure pattern of tooth eruption among five genetic diseases. Both systematic review and meta-analysis were used to identify the genotype-phenotype associations of unerupted teeth. The meta-analysis was based on the characteristics of abnormal tooth eruption in 223 patients with the mutations in PTH1R, RUNX2, COL1A1/2, CLCN7, and FAM20A respectively. We found all the patients presented selective failure of tooth eruption (SFTE). Primary failure of eruption patients with PTH1R mutations showed primary or isolated SFTE1 in the first and second molars (59.3% and 52% respectively). RUNX2 related cleidocranial dysplasia usually had SFTE2 in canines and premolars, while COL1A1/2 related osteogenesis imperfecta mostly caused SFTE3 in the maxillary second molars (22.9%). In CLCN7 related osteopetrosis, the second molars and mandibular first molars were the most affected. While FAM20A related enamel renal syndrome most caused SFTE5 in the second molars (86.2%) and maxillary canines. In conclusion, the SFTE was the common characteristics of most genetic diseases with abnormal isolated or syndromic tooth eruption. The selective pattern of unerupted teeth was gene-dependent. Here we recommend SFTE to classify those genetic unerupted teeth and guide for precise molecular diagnosis and treatment.

Massive Infected Dentigerous Cyst in a Young Child.

Dentigerous cysts are odontogenic cysts that form on the crown of an unerupted or partially erupted tooth. They are specifically anchored to the cementoenamel junction. Dentigerous cysts are known to rarely involve impacted deciduous teeth. Because of this rarity, this article reports a unique case of a five-year-old female patient who developed a dentigerous cyst in relation to a developing permanent left mandibular first molar tooth with its surgical treatment and histopathological features.

Complicaciones en la extracción de terceros molares mandibulares incluídos, retenidos e impactados. Revisión de la literatura / Complications in the extraction of impacted, and retained third molars. Literature Review

La literatura científica sostiene que los terceros molares muy a menudo son lo que contemplan varías complicaciones al momento del procedimiento quirúrgico, debido no solo a su erupción sino también a sus diferentes características que suceden como anatomía, forma, posición de su erupción, etc. Para ello el estudio complementario Integral antes de pasar al acto quirúrgico es la primera opción que se hace. Para que un correcto tratamiento post-quirúrgico sea efectivo tanto antibiótico farmacológico, biomateriales integrales, etc. Objetivo: Establecer por medio de una revisión de la literatura cuáles son las acciones o procedimientos quirúrgicos ejecutándose que pueden evitar las complicaciones más prevalentes en la extracción de terceros molares mandibulares incluídos, retenidos e impactados. Materiales y métodos: Se plantea un estudio de tipo descriptivo y de análisis respectivamente con 2 tipos de bases electrónicas: PubMed y SciELO tomando como sustentación artículos que contemplen meta-análisis, revisiones sistemáticas, revisiones literarias, etc. Resultados: Se confirmó que el mejor procedimiento ante quizás una posible: hemorragia, fracturas, laceraciones, etc. es el buen manejo quirúrgico farmacológico durante la cirugía y posterior a esta. Conclusión: Con esta revisión de la literatura se llega a la idea de que un correcto diagnóstico, manejo estricto farmacológico y el conocimiento de las complicaciones que pueden suscitarse durante y posterior en las extracciones dentales son acciones correctas que se utilizan muy comúnmente durante el procedimiento quirúrgico, lo que evita sus respectivas dificultades.

After the various articles compiled by different authors, is becomes clear that the third molars are very often what contemplate various complications at the time of the surgical procedure, due not only to their eruption but also to their different characteristics that occur such as anatomy, shape, position of its eruption, etc. For this reason, the comprehensive complementary study before proceeding to the surgical act is the first option that is made. For a correct post-surgical treatment to be effective both antibiotic-pharmacological, integral biomaterials, etc. Purpose: To establish through a review of the literatura which are the actions or surgical procedures being performed that can avoid the most prevalent complications in the extraction of included, retained and impacted mandibular third molars. Materials and methods: A descriptive and analytical study is proposed, respectively, with 2 types of electronic databases: PubMed and SciELO, taking as support articles that include meta-analyses, systematic reviews, literary reviews, etc. Results: It was confirmed that the best procedure for perhaps a possible one: hemorrhage, fractures, lacerations, etc. It is good pharmacological surgical management during and after surgery. Conclusion: With this review of the literature, the idea is reached that a correct diagnosis, strict pharmacological management and knowledge of the complications that can arise during and after dental extractions are correct actions that are very commonly used during the surgical procedure. , which avoids their respective difficulties.

É possível realizar tracionamento ortodôntico cirúrgico em incisivo com dilaceração radicular? / Is it possible to perform surgical orthodontic traction on incisor with root dilaceration?

Resumo Introdução: O traumatismo dental na dentição decídua pode influenciar o desenvolvimento dos sucessores permanentes e causar um deslocamento da coroa em relação à raiz dental, gerando uma curvatura definida como dilaceração, que em grande parte dos casos impede a irrupção normal do dente permanente. Diversas são as possibilidades de tratamento, desde exodontia ao tratamento ortocirúrgico. Objetivo: O presente trabalho tem o objetivo de relatar um caso clínico de incisivo central superior esquerdo (21) com dilaceração radicular cujo tratamento envolveu procedimento cirúrgico e tracionamento ortodôntico ancorado no disjuntor maxilar. Resultado: O desfecho do tratamento foi satisfatório, visto que o dente incluso foi reposicionado e a má oclusão da paciente foi corrigida. Conclusão: O tracionamento ortocirúrgico de incisivo superior permanente com dilaceração radicular é desafiador e com prognóstico incerto. Contudo, seu reposicionamento é possível quando se realiza um diagnóstico, planejamento periodontal e biomecânico adequado (AU)

Abstract Introduction: Dental trauma in the primary dentition can influence the development of permanent successors and cause a displacement of the crown in relation to the dental root, generating a curvature defined as laceration, which in most cases prevents the normal eruption of the permanent tooth. There are several treatment possibilities, from extraction to orthosurgical treatment. Objective: The present study aims to report a clinical case of a left upper central incisor (21) with root laceration whose treatment involved a surgical procedure and orthodontic traction anchored in the maxillary breaker. Result: The treatment outcome was satisfactory, since the included tooth was repositioned and the patients' malocclusion was corrected. Conclusion: Orthosurgical traction of the permanent upper incisor with root dilaceration is challenging and has an uncertain prognosis. However, its repositioning is possible when a diagnosis, periodontal and biomechanical planning is performed.(AU)

Cystic lesion between a deciduous tooth and the succeeding permanent tooth: a retrospective analysis of 87 cases.

Objectives: The purpose of this study is to investigate the characteristics of dentigerous and radicular cysts that occur between deciduous and succeeding permanent teeth and to propose considerations for differential diagnosis of cysts at the treatment planning stage in the outpatient clinic. Materials and Methods: A total of 87 patients with a cystic lesion located between a deciduous tooth and the succeeding permanent tooth participated in the study. Twelve variables were analyzed to diagnose such a cyst. For data analysis, Fisher's exact test was used to determine the statistical significance of the variables. Results: Of the total 87 patients who participated in this study, 69 were diagnosed with dentigerous cysts and 18 were diagnosed with radicular cysts. Seven of the 12 differential factors analyzed in this study were statistically significant: age, location, symptoms, dental caries, endodontic treatment, delayed eruption, and size. Conclusion: Several criteria can be considered for diagnosis of dentigerous cysts or radicular cysts. Age, location, presence of symptoms and dental caries, previous endodontic treatment, cystic size, and delayed eruption of impacted permanent teeth are reliable factors that should be considered when diagnosing dentigerous and radicular cysts.

Periodontal parameters in orthodontically tractioned teeth: A systematic review and meta-analysis.

Objective: This systematic review aimed to evaluate periodontal parameters in orthodontically tractioned teeth compared with the respective non-tractioned contralateral teeth. Methods: Search strategies were developed for six electronic databases and gray literature. Random-effects meta-analyses were performed for the outcomes of interest. Furthermore, the certainty of the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool. Results: Overall, 2,082 articles were identified, of which 24 were selected for the qualitative synthesis. A significant difference was observed between the impacted and contralateral teeth (mean difference [MD] = 0.25; 95% confidence interval [CI] = 0.10-0.40; I2 = 0%) when the gingival index was evaluated. Additionally, impacted teeth showed a greater probing depth, with a significant mean difference between the groups (MD = 0.14; 95% CI = 0.07-0.20; I2 = 6%). Most studies had a low risk of bias; however, the certainty of the evidence was very low owing to the design of existing studies. Conclusions: The evidence in the literature indicated that tractioned teeth might show worsening of periodontal parameters related to the gingival index and probing depth; however, the evidence remains uncertain about this outcome. Furthermore, probing depth should be considered regarding its clinical significance because of the small effect size observed.

Correlation Between Radiographic and Histopathologic Findings Associated with Unerupted Teeth in Dogs.

An association between unerupted teeth and dentigerous cysts is well known,1- 4 however little is known about the presence of disease and histopathologic changes in unerupted teeth without radiographic evidence of cyst formation. Forty-two dogs representing 25 breeds, ranging in age from 5 months to 12 years were selected based on radiographic evidence of an unerupted tooth or teeth, either as a primary complaint or incidental finding. Dogs meeting the study criteria were presented to a private dental referral practice within a period of eighteen months from December 2016 through May 2018. Patients were treated with conservative en bloc resection of the unerupted tooth and overlying bone as well as debridement of any cystic structure and biopsy of the samples collected. Radiographs were evaluated using criteria previously established to assess for evidence of a cyst.1, 5- 7 A total of 68 unerupted teeth were identified; 63 (92.7%) were mandibular first premolar teeth. Of the 63 unerupted mandibular first premolar teeth, 28 (44.4%) had radiographic evidence of a cystic structure. Histopathology revealed that 21 of 28 (75.0%) had evidence of non-keratinizing stratified squamous epithelium consistent with a cyst lining. Of the remaining 35 of 63 (55.6%) mandibular first premolar teeth with no radiographic evidence of a cyst, 27 (77.1%) had no histologic evidence of epithelium associated with the impacted tooth. Notably however, the remaining 8 of 35 (22.9%) unerupted teeth without radiographic evidence of a cyst did have histologic evidence of non-keratinizing stratified squamous epithelium associated with the impacted tooth.

Radiological features of Adenomatoid odontogenic tumor: Report of a maxillary case and a mandibular one.

We present two cases of AOT, the first case concerns a 23-year-old patient with an AOT located in the maxilla and the second case involves a 37-year-old patient presenting an AOT with mandibular localization.

Aplicabilidad del método de Moyers para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 años / Applicability of the Moyers method for the estimation of the mesiodistal diameter of canines and premolars in patients of 12-18 years old

Uno de los métodos más universales empleados para predecir el ancho mesiodistal de caninos y premolares no erupcionados es el diseñado por el Dr. Edison Moyers, quien tomando como referencia la población anglosajona creó tablas de percentiles para estimar dichos valores en maxilar y mandíbula. Durante la última década varios investigadores han descubierto que, al aplicarlo en diversas poblaciones, existen diferencias significativas entre las predicciones y los valores reales. En Cuba, el método de Moyers es muy utilizado al 50% de probabilidades para la predicción en ambos sexos, pero existen pocos reportes de estudios que validen su confiablidad y los que existen utilizan muestras pequeñas de pacientes. Es por ello por lo que el objetivo de esta investigación es determinar la aplicabilidad del método de Moyers al 50% de probabilidades para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 años. Se desarrolló un estudio descriptivo y transversal desde julio de 2019 hasta febrero de 2020 con una población de 125 pacientes, 62 del sexo femenino y 63 del masculino, de entre 12 y 18 años de Cuba. Se efectuaron las mediciones de los anchos mesiodistales de los incisivos inferiores, todos los caninos y premolares. Se realizaron distribuciones de frecuencia a las variables estudiadas y los resultados se presentaron en tablas estadísticas. Para comprobar la existencia de diferencias significativas se utilizó la prueba estadística t-Student. Los resultados principales obtenidos fueron que el método de Moyers tiende a subestimar los valores para el sexo femenino entre los 0,4-0,5 mm, y para el sexo masculino entre los 0,6-0,7 mm, siendo esta diferencia significativa para los hombres. Se concluye que el método de Moyers no puede ser aplicado en la población estudiada para la predicción del ancho mesiodistal de caninos y premolares

One of the most universal methods used to predict the mesiodistal width of non-erupted canines and premolars is the one designed by Dr. Edison Moyers, an American orthodontist who, taking the Anglo-Saxon population as a reference, created percentile tables to estimate these values in the maxilla and mandible. During the last decade, several researchers have discovered that, when applied to various populations, there are significant differences between predictions and actual values. In Cuba, it is widely used at a 50% probability for prediction in both sexes, but there are few reports of studies that validate its reliability and those that do exist use small samples of patients. For this reason, the objective of this research is to determine the applicability of the Moyers method at 50% probabilities for estimating the mesiodistal diameter of canines and premolars in patients 12-18 years of age. A descriptive and cross-sectional study was developed from July 2019 to February 2020 with a population of 125 patients, 62 females and 63 males, between 12 and 18 years old from Cuba. Measurements were made of the mesiodistal widths of the lower incisors, all the canines and premolars. Frequency distributions were made to the variables studied and the results were presented in statistical tables. To verify the existence of significant differences, the statistical t-Student test was used. The main results obtained were that the Moyers method tends to underestimate the values for the female sex between 0.4-0.5 mm, and for the male sex between 0.6 and 0.7 mm, this difference being significant for men. It is concluded that the Moyers method cannot be applied in the population studied for the prediction of the mesiodistal width of canines and premolars

Unerupted Supernumerary Mandibular Fourth Premolar in a dog.

A 2.5-year-old intact male Irish setter was presented for a draining tract associated with the right mandibular first molar tooth (409). Conscious oral examination yielded two draining tracts associated with the right mandibular first molar tooth. No obvious missing teeth or other gross abnormalities associated with the oral cavity were observed. Upon anesthetized radiographic evaluation, the presence of an unerupted, abnormally positioned, supernumerary premolar tooth was observed. The following article describes the extraction of the right mandibular first molar tooth (409) as well as the unerupted supernumerary premolar tooth with associated supernumerary root and the diagnostic approach taken for this uncommon abnormality.

Fusion of Unerupted Mesiodens with a Regular Maxillary Central Incisor: a Diagnostic and Therapeutic Challenge.

The mesiodens is the most frequent type of supernumerary tooth which can appear in the maxillary midline area. The etiology of mesiodentes is not fully understood. This report shows a case of incomplete fusion of an unerupted mesiodens with a permanent maxillary central incisor, aligned in the dental arch. Intraoral and radiographic examinations indicated fusion of the crown and cervical part of the root of the supernumerary tooth with the permanent incisor. The clinical situation was further complicated by the presence of another supernumerary tooth located palatally. The treatment approach has included two phase surgical therapy to extract the supernumerary teeth. Early diagnosis and appropriate surgical treatment of mesiodentes are important to decrease the risk of clinical complications. Pre-operative 3D imaging is strongly advisable since it allows accurate data to be obtained, and reduces the extent of surgery and the possibility of procedural complications. In most cases, a multidisciplinary collaboration is necessary for precise diagnosis and predictable treatment outcome.

Aplicabilidad del método Tanaka-Johnston para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 Años / Applicability of the Tanaka-Johnston method for the estimation of the mesiodistal diameter of canines and premolars in patients of 12-18 years old

El método Tanaka-Johnston es utilizado mundialmente para predecir el diámetro de caninos y premolares no erupcionados por la conveniencia de no necesitar tablas ni radiografías para su uso. Sin embargo, durante los últimos años investigadores de varios países han demostrado que al ser utilizado en una población diferente para la que fue diseñado, puede sobrestimar o subestimar los valores. En Cuba, donde el patrón facial de la población difiere del ideal para este método, ha sido muy empleado, pero prácticamente no existen estudios donde se valide la confiabilidad o exactitud de las predicciones de este. Por tanto, el objetivo de esta investigación es determinar la aplicabilidad del método Tanaka-Johnston para la estimación del diámetro mesiodistal de caninos y premolares en pacientes de 12-18 años. Se desarrolló un estudio descriptivo y transversal desde junio de 2019 hasta enero de 2020 con una población de 140 pacientes de ambos sexos de entre 12 y 18 años de Cuba. Se efectuaron las mediciones de los anchos mesiodistales de los incisivos inferiores, todos los caninos y premolares. Se realizaron distribuciones de frecuencia a las variables estudiadas y los resultados se presentaron en tablas estadísticas. Para comprobar la existencia de diferencias significativas se utilizó la prueba estadística t-Student. Los resultados principales obtenidos fueron que el método Tanaka-Johnston tiende a sobrestimar los valores para el sexo femenino y subestimarlos para el masculino, ambos entre los 0,2 y 0,3 mm, pero esta diferencia no resulta significativa. Se concluye que el método Tanaka-Johnston puede ser aplicado en la población estudiada para la predicción del ancho mesiodistal de caninos y premolares no erupcionados.

The Tanaka-Johnston method is used worldwide to predict the diameter of canines and premolars not erupted for the convenience of not needing boards or x-rays for use. However, in recent years researchers from several countries have shown that when used in a different population for which it was designed, it can overestimate or underestimate the values. In Cuba, where the facial pattern of the population differs from the ideal for this method, it has been highly used, but there are very few studies where the reliability or accuracy of the predictions of the same is validated. Therefore, the objective of this research is to determine the applicability of the Tanaka-Johnston method for estimating the mesiodistal diameter of canines and premolars in patients aged 12-18 years. A descriptive and cross-cutting study was conducted from June 2019 to January 2020 with a population of 140 patients of both sexes between 12 and 18 years of age from Cuba. Measurements were made of the mesiodistal widths of the lower incisors, all canines, and premolars. Frequency distributions were made to the variables studied and the results were presented in statistical tables. The t-Student statistical test was used to verify significant differences. The main results obtained were that the Tanaka-Johnston method tends to overestimate the values for the female sex and underestimate them for the male, both between 0,2 and 0,3 mm, but this difference is not significant. It is concluded that the Tanaka-Johnston method can be applied in the population studied for the prediction of the mesiodistal width of unerupted canines and premolars.

[Magnets in orthodontics : which indications, which effects ? A review of the literature]. / Les aimants en orthodontie : quelles indications, quels effets ? Une revue de la littérature.

The first publication on the use of magnets in dentistry for stabilizing prosthetics on implants dates back to 1953. Clinical development in orthodontics, without having experienced a real boom, has increased over the past ten years, in parallel with the improvement of the device. The objective of this review of the literature is to synthesize clinical applications and reported iatrogenic effects. A systematic review of the international literature from the Pubmed and Cochrane databases from 1999 to July 2018 was conducted which resulted in 36 articles. The factors studied are the indications and contraindications, the means or procedure, as well as the iatrogenic effects. Original cases are presented. The correction of infraclusions is the main indication, followed by the correction of anteroposterior malocclusions and then the correction of over-erupted teeth. Traction of an impacted teeth and diastema closure have not been found in recent publications probably because of the low benefit-risk ratio. The future no longer seems to be buried magnets or left in the long term in the mouth considering there seems to be concerns in terms of toxicity (or even the risk in terms of vital prognosis). The magnets could offer interesting perspectives to manage the current limits of the aligners, the movements of anterior egression, rotation and previous torque being still problematic...

Caso raro de utilização da técnica de coronectomia em terceiro molar maxilar invertido / Rare case of the use of the coronectomy technique in third inverted maxillary molar

Dentes impactados são caracterizados pela falha na erupção dentro do tempo cronológico. O termo ''dente invertido'' se refere ao mau posicionamento do dente, caracterizando-se pelo dente na direção contrária à usual. A inversão de dente impactado é considerada um fenômeno raro. Em casos mais complexos de impacção dentária, há a necessidade de um tratamento conservador, específico e procura-se prevenir possíveis danos às estruturas anatômicas adjacentes. Por essa razão, a técnica cirúrgica denominada coronectomia, também conhecida como odontectomia parcial intencional, tem, em alguns casos, indicação de uso, pois realiza-se a exérese da porção coronária do dente, sepultando as suas raízes, quando estas se encontram em contato com estruturas nobres. Dessa forma, este trabalho tem como objetivo apresentar um caso raro da utilização da técnica de coronectomia para um terceiro molar superior invertido em paciente do sexo feminino, 26 anos, que compareceu ao serviço de Cirurgia Buco-Maxilo-Facial apresentando um terceiro molar superior, assintomático, impactado em posição invertida no lado esquerdo. Ao exame tomográfico, apresentou íntimo contato do dente 28 com as raízes do 27. A porção coronária se encontrava em posição superior, em direção a parte posterior do seio maxilar. A técnica da coronectomia foi escolhida como planejamento cirúrgico, a fim de proteger o dente 27 das possíveis consequências traumáticas que a luxação e extração completa do dente 28 poderia ocasionar. O acompanhamento clínico demonstrou que a técnica foi bem indicada, com evolução de neoformação óssea completa na região da coroa removida e o dente adjacente com vitalidade e em função mastigatória(AU)

Impacted teeth are characterized by eruption failure within chronological time. The term 'inverted tooth' refers to the mispositioning of the tooth, characterized by the tooth in the opposite direction to the usual one. Impacted tooth inversion is considered a rare phenomenon. In more complex cases of dental impaction, there is a need for conservative and specific treatment, and attempts are made to prevent possible damage to adjacent anatomical structures. For this reason, the surgical technique called coronectomy, also known as intentional partial odontectomy, has, in some cases, indication of use, where the coronary portion of the tooth is excised, burying its roots when they are in contact with noble structures. Thus, this paper aims to present a rare case of the use of the inverted upper third molar coronectomy technique in a 26-year-old female patient, who attended the Buccomaxillofacial Surgery Service presenting a superior third molar, asymptomatic, impacted in inverted position on the left side. At tomographic examination, the patient presented close contact of tooth #16 with the roots of tooth #15. The coronary portion was in the superior position, towards the posterior part of the maxillary sinus. The coronectomy technique has been chosen as a surgical planning in order to protect tooth #15 from the possible traumatic consequences that dislocation and complete extraction of tooth #16 could cause. Clinical follow-up showed that the technique was successfully indicated, with complete bone neoformation in the removed crown area and the adjacent tooth with vitality and masticatory function(AU)

Treatment after inadequate immediate replantation of accidentally extracted immature mandibular premolar during primary molar extraction.

During extraction of the primary mandibular right second molar in an 11-year-old girl, the unerupted second premolar was accidentally extracted. Clinical and radiographic examination showed that the immediately replanted immature premolar was not oriented and positioned correctly. Four hours later, treatment consisted of manual extrusion of the permanent tooth bud, rotation, and gentle repositioning into its original position. Adequate replantation was confirmed by a post-operative radiograph. After 2 years and 4 months, clinical examination revealed normal, healthy appearance of the replanted tooth, no sensitivity to percussion, no tenderness to palpation, and a slight response to a cold pulp sensibility test. A radiograph showed completely developed root with closed apical foramen, slightly irregular root morphology and shorter root length, complete obliteration of the pulp, and no signs of periapical pathosis.

Exodontia de pré-molar incluso em íntimo contato com o nervo mentoniano: relato de caso / Unerupted premolar extraction in close contact with the mental nerve: case report

Ocasionalmente, as unidades dentárias sofrem alterações em sua região de desenvolvimento natural, impossibilitando a erupção ou irrompimento em posições funcionais. Objetivo: O presente trabalho tem como objetivo relatar o procedimento ambulatorial de exodontia de pré-molar impactado em íntimo contato com o nervo mentual, observando os riscos presentes. Relato de Caso: Paciente do gênero feminino, faioderma, 30 anos de idade, procurou o serviço de Cirurgia e Traumatologia Bucomaxilofacial da OSID/UFBA para exodontia da unidade 35 inclusa, com finalidade ortodôntica, após insucesso de tracionamento prévio. O plano de tratamento incluiu exodontia do elemento 35 sob anestesia local. No pós-operatório de sete dias, foi referida presença de hipoestesiaemregião de mento e lábioesquerdo, sendo esta sintomatologia ausente após o vigésimo primeiro dia de acompanhamento. No momento, em acompanhamento de 04 meses de pós-operatório, a paciente encontra-se sem sinais e sintomas de hipoestesia em hemiface afetada, bem como retorno ao tratamento ortodôntico. Conclusão: A técnica cirúrgica minimamente invasiva é imprescindível para obtenção de bons resultados com o mínimo de repercussão para o paciente, ainda que o trauma cirúrgico devido ao afastamento do nervo mentoniano possa provocar alteração de sensibilidade pós-operatória temporária. Este caso pode contribuir para a literatura mínima disponível sobre os segundos pré-molares impactados, oferecendo uma opção de abordagem em seu plano de tratamento, de forma a evitar lesões ao nervo mentoniano e persistência de hipoestesia no pós-operatório(AU)

Occasionally, dental units undergo changes in their region of natural development, making it impossible to erupt in functional positions. Objective: The present study aims to report the outpatient procedure of impacted premolar extraction in close contact with the mental nerve, observing the present risks. Case Report: Female patient, faioderm, 30 years old, sought the Service of Oral and Maxillofacial Surgery of OSID/UFBA for extraction of included unit 35, with orthodontic purpose, after failure of previous orthodontic traction. Conclusion: The minimally invasive surgical technique is essential to obtain good results with minimal repercussion for the patient, although the surgical trauma due to the separation of mental nerve may cause a change in the temporary postoperative sensitivity. This case may contribute to the minimal literature available about impacted second premolars, offering an option of approach in its treatment plan, in order to avoid lesions to the mental nerve and persistence of postoperative hypoesthesia(AU)

Uprighting an Impacted Permanent Mandibular First Molar Associated with a Dentigerous Cyst and a Missing Second Mandibular Molar-A Case Report.

The purpose of this paper is to present a case of an impacted mandibular first molar associated with a dentigerous cyst and a missing mandibular second molar in an 11-year-old girl that was treated with combined surgical and orthodontic procedures. After clinical and radiographic evaluation, marsupialization of the cyst was decided, and a molar attachment was bonded on the buccal side of the impacted molar as a part of a full orthodontic treatment with fixed appliances. After 18 months of orthodontic traction, the molar was moved to a more advantageous position, and new bone apposition was observed on the site of the cystic lesion. Histological examination confirmed a dentigerous cyst. The molar was left to erupt spontaneously for 14 more months. A functional occlusion was finally achieved. An interdisciplinary approach proved to be an effective modality in treating a large dentigerous cyst associated with a deeply impacted first mandibular molar, presenting many advantages, such as new bone apposition and patient comfort.

Rara impacção dental de primeiro, segundo e terceiro molares com risco de fratura mandibular ­ relato de caso / Rare dental impaction of first, second and third molares with risk of mandibular fracture ­ case report

Impacções dentais são definidas como a ausência da irrupção dental causada por uma barreira física identificada ou por posição anormal do dente. A presença de impacção nos primeiros e segundos molares inferiores é de baixa incidência representando, respectivamente, 0,01% e 0,06 a 0,3%, sendo ainda, em ambas, mais comum a apresentação de forma unilateral, mésio-angulada com predileção pelo sexo feminino, o que torna as mesmas relativamente raras. Os primeiros e os segundos molares são de grande importância para o desenvolvimento normal da dentição e coordenação do crescimento facial, podendo a impacção destes alterar estes mecanismos e ainda causar problemas como cáries, periodontite, reabsorção de dentes adjacentes, formação de cisto, má oclusão e dor. As opções de tratamento para dentes impactados são exodontia, tracionamento ortodôntico ou cirúrgico- -ortodôntico, e transplante dental. O objetivo deste artigo é relatar um caso clínico de rara impacção dental de primeiro, segundo e terceiro molares com risco de fratura mandibular, em que a paciente compareceu ao ambulatório de Cirurgia Bucomaxilofacial da OSID/UFBA encaminhada para avaliação das unidades dentais impactadas. Ao exame clínico, foi observada ausência das unidades 36 e 37 na cavidade oral e unidade 38 mesioangulada e semierupcionada. O tratamento optado foi a exodontia das unidades impactadas sob anestesia geral. O tratamento mais indicado para a impacção dental é o tracionamento ortodôntico, porém este apresenta limitações frente a alguns fatores que devem ser analisados para a definição da conduta sobre estas impacções, podendo ser indicado em impacções complexas, tratamentos invasivos como a exodontia dental (AU).

Dental impactions are defined as absence of dental eruption caused by an identified physical barrier or abnormal position of the tooth. The presence of impaction in the first and second lower molars is of low incidence representing 0.01% and 0.06%, respectively, and in both cases the most common is unilateral, mesioangulated presentation with female prevalence, what makes them rare. The first and second molars are of great importance for the normal development of the dentition and the coordination of facial growth, the impaction of them may influence these mechanisms and also cause problems such as caries, periodontitis, reabsorption of adjacent teeth, cyst formation, bad occlusion, and pain. Treatment options for impacted teeth are extraction, orthodontic or surgical-orthodontic traction and dental transplantation. The aim of this article is to report a clinical case of rare dental impaction of first, second and third molars with risk of mandibular fracture, in which a female patient came to the ambulatory OSID/UFBA Oral and Maxillofacial Surgery and was referred to evaluate the impacted dental units. Clinical examination showed absence of units 36 and 37 in the oral cavity and that unit 38 was mesioangulated and semi-erupted. The treatment option was exodontia of the impacted units under general anesthesia. The most appropriate treatment for dental impaction is traction, but it has limitations that must be analyzed for definition of conduct on these impactions, it may be indicated in complex impactions and invasive treatments such as dental extraction (AU).