Técnicas cirúrgicas de extração em terceiros molares inclusos / Técnicas quirúrgicas de extracción en terceros molares incluidas / Surgical extraction techniques in third molars included

Objetivo: Relatar a importância da avaliação e indicação correta de técnicas cirúrgicas para extração de terceiros molares inclusos. Metodologia: Com esta revisão bibliográfica pretende-se conhecer um pouco melhor estas abordagens cirúrgicas, comparando-as, e perceber, através de estudos publicados em bases de dados como a Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Eletronic Library Online (SciELO) e PubMed, no recorde temporal de 2015 a 2021. Resultados: O presente estudo demonstrou a importância da técnica cirúrgica bem aplicada na vida profissional do cirurgião dentista, auxiliando no ato operatório para a exodontia de terceiros molares inclusos, diminuindo riscos e otimizando tempo cirúrgico e a resposta pós-operatória do paciente. Conclusão: O cirurgião dentista deve estar apto técnica e cientificamente, a fim de diagnosticar e tratar as inclusões dentárias. Importa enfatizar a importância do conhecimento de todos os critérios de indicação e contraindicação, sinonímia, conduta pré e pós-operatória, técnica e tática cirúrgica que, em conjunto, terão papel fundamental no êxito do caso abordado, atenuando as chances da ocorrência de acidentes e complicações cirúrgicas... (AU)

Objetivo: Informar la importancia de la evaluación e indicación correcta de las técnicas quirúrgicas para la extracción de los terceros molares incluidos. Metodología: Con esta revisión bibliográfica, pretendemos conocer un poco mejor estos abordajes quirúrgicos, comparándolos, y percibirlos, a través de estudios publicados en bases de datos como la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scientific Electronic Library Online (SciELO) y PubMed, en el registro temporal 2015 a 2021. Resultados: El presente estudio demostró la importancia de la técnica quirúrgica bien aplicada en la vida profesional del odontólogo, asistiendo en la cirugía para la extracción de terceros molares incluidos, reduciendo riesgos y optimizando el tiempo quirúrgico y la respuesta postoperatoria del paciente. Conclusión: El dentista debe ser capaz técnica y científicamente para diagnosticar y tratar las inclusiones dentales. Es importante destacar la importancia de conocer todos los criterios de indicación y contraindicación, sinomesia, conducta pre y postoperatoria, técnica quirúrgica y tácticas que, en conjunto, jugarán un papel fundamental en el éxito del caso abordado, atenuando las posibilidades de accidentes y complicaciones quirúrgicas... (AU)

Objective: To report the importance of the evaluation and correct indication of surgical techniques for the extraction of third molars included. Methodology: With this literature review, we intend to know these surgical approaches a little better by comparing them, and to perceive, through studies published in databases such as the Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Electronic Library Online (SciELO) and PubMed, in the time record 2015 to 2021. Results: The present study demonstrated the importance of the surgical technique well applied in the professional life of the dentist, assisting in the surgery for the extraction of third molars included, reducing risks and optimizing surgical time and postoperative response of the patient. Conclusion: The dentist should be able technically and scientifically in order to diagnose and treat dental inclusions. It is important to emphasize the importance of knowing all the criteria of indication and contraindication, synomy, pre- and postoperative conduct, surgical technique and tactics that, together, will play a fundamental role in the success of the case addressed, attenuating the chances of accidents and surgical complications... (AU)

Surgical management of compound odontoma associated with unerupted tooth: a case report.

Compound odontoma has been reported to be the most common of all odontogenic neoplasms and tumor- like lesions. It is a slow-growing, asymptomatic neoplasms found incidentally during a routine radiography examination. In general, the clinical indicators of odontoma may include eruption disturbance (non-eruption of permanent teeth, retention of deciduous teeth), expansion of the cortical bone, teeth malposition and pain. In this case, the presence of odontoma prevented the physiological eruption of permanent mandible incisor. We describe the surgical procedure to remove a compound odontoma of 21 small tooth-like structures localized in the mandible of a child boy associated with an unerupted permanent mandible incisor.

Abordaje mediante tres cavidades de un quiste dentígero de gran tamaño: a propósito de un caso / Approach with three cavities of a large dentigerous cyst: a case report

El quiste dentígero se considera un quiste odontogénico del desarrollo que está asociado a la corona de un diente no erupcionado. Suele ser asintomático y carecer de clínica asociada por lo que frecuentemente se trata de un hallazgo casual. Sin embargo puede haber situaciones en los que el quiste afecte a estructuras próximas y/o alcance gran tamaño. Se presenta un caso de un paciente de 65 años que acude derivado por su odontólogo general al constatar la presencia de una lesión radiotransparente de gran tamaño en el cuarto cuadrante. Se realizó un abordaje mediante tres cavidades de la lesión para su completa remoción, así como del cordal incluido asociado a la misma. Por último se colocó una mini placa como refuerzo

The dentigerous cyst is considered an odontogenic developmental cyst that is associated with the crown of a non-erupted tooth. It is usually asymptomatic and has no associated clinic, so it is usually a casual fi nding. However, it can affect nearby structures and / or reach large size. A case of a 65-year-old patient is presented who is referred by his general dentist to verify the presence of a large radiolucent lesion in the fourth quadrant. An approach was made using 3 cavities of the lesion for its complete removal, as well as the included wisdom tooth associated with it. Finally, a mini fi xing plate was placed as reinforcement

Mirror image: an unusual case of prolonged tooth retention in twins

Introduction: Studies of twins are important because environmental and genetic factors seem to be related to the phenotypic alterations. Objective: This paper presents a unique case of monozygotic twins with mirror image of a retained primary central incisor. Case report: Twin male brothers, 9-years-old, presented prolonged retention of the primary central upper incisor. The over-retained teeth in one twin were a mirror image of those in the other twin. The first twin presented a prolonged retention of the tooth 51 whereas the other twin presented a prolonged retention of tooth 61. After radiographic exams the over-retained teeth were extracted. Conclusion: Twins may show similarity in pattern of dental anomalies supporting the influence of genetic factors. In identical twins the location of diagnosed anomalies can be mirror imaged. This fact should lead the professional to examine the pair of twins in order to diagnose any dental anomaly that may be present.

Introdução: Estudos feitos em gêmeos são importantes porque fatores ambientais e genéticos parecem estar relacionados às alterações fenotípicas. Objetivo: Este artigo apresenta um caso raro de gêmeos monozigóticos apresentando imagem em espelho de retenção prolongada de incisivos centrais decíduos superiores homólogos. Relato do caso: Os irmãos gêmeos, com 9 anos de idade, não apresentavam história de trauma orofacial ou doença comum da infância. Após exames clínicos e radiográficos foram identificados a retenção do dente 51 no gêmeo 1 e do dente 61 no gêmeo 2. Em ambos os pacientes, os dentes 11 e o 21 estavam em erupção. O tratamento proposto foi a exodontia dos dentes decíduos com anestesia local e acompanhamento. Conclusão: Gêmeos podem apresentar semelhança no padrão de anomalias dentárias devido à influência de fatores genéticos. Adicionalmente, em gêmeos monozigóticos, a localização das anomalias diagnosticadas pode se apresentar invertidas ou imagem em espelho. Esse fato deve estimular o profissional a examinar o par de gêmeos para diagnosticar qualquer anomalia dentária que possa estar presente. O diagnóstico precoce e tratamento adequados devem ser realizados para evitar danos funcionais e estéticos em pacientes com retenções dentárias.

Enfisema subcutáneo como complicación de procedimientos de cirugía oral. Avería del instrumental utilizado / Subcutaneous emphisema after surgical third molar extraction: medical instruments failure

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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)

Intervenção cirúrgica de um canino incluso em sínfise mandibular: relato de caso / Surgical intervention of an unerupted canine in mandibular sinfisis: case report

Objetivo: relatar um caso de exodontia do dente 43, incluso, na região do mento, com o auxílio de um exame complementar eficaz e de baixo custo: radiografia lateral de mandíbula utilizando filme oclusal. Relato de caso: paciente do gênero masculino, 26 anos de idade, melanoderma e normossistêmico, buscou tratamento ortodôntico por motivos de apinhamento dental anterior e presença do dente 83 (canino inferior decíduo) não esfoliado. Para um planejamento cirúrgico correto, foi realizada a radiografia lateral do mento com filme oclusal, em que se constatou que o dente 43 encontrava-se por vestibular em relação aos dentes anteriores inferiores. Assim, o paciente foi submetido à cirurgia sob anestesia local, para exodontia do dente 43. Considerações finais: o tratamento para transmigração de caninos inferiores deve incluir minuciosos planejamentos clínico e radiográfico. O tratamento sugerido para a grande maioria dos casos é a remoção cirúrgica, devido à possibilidade de falhas dos outros meios de tratamento, ocasionando complicações posteriores. (AU)

Objective: this paper aims to describe and discuss a surgical removal of canine included in the chin region with the aid of an effective and low-cost complementary exam: lateral radiographic of the mandible using the occlusal film. Case report: a male patient, 26 years old, without systemic diseases sought orthodontic treatment due to anterior crowding and presence of an unerupted tooth 83. In order to perform a correct surgical planning, the lateral radiograph of the occlusal film was performed, where it was found that the tooth 43 was in vestibular position in relation to the lower anterior teeth. Thus, the patient underwent surgery under local anesthesia for tooth extraction. Final considerations: the treatment for transmigration of lower canines should include careful clinical and radiographic planning. The suggested treatment for the vast majority of cases is surgical removal due to the possibility of failure of the other means of treatment, causing subsequent complications. (AU)

Therapeutic Protocol for Orthosurgical Management of Class III Malocclusion in Patients With Cleidocranial Dysostosis.

Cleidocranial dysostosis (CCD) is a congenital skeletal disorder with significant manifestations in facial and dental development. Patients are affected with CCD present maxillary deficiency, late dental eruption, and supernumerary teeth. Early and multidisciplinary approach is necessary to treat CCD patients, especially to manage dental eruption and Class III malocclusion with maxillary deficiency. Several orthodontic and surgical interventions are performed to enable traction and extraction of teeth. Yet the maxillary deficiency may be protracted followed by orthodontic dental compensation. On the other hand, it is important to note that CCD patients' treatment is closely related to the severity of transversal and sagittal deformities, as well as the discrepancies in the lower third of the face. In this context, patients with facial impairment highly affected by CCD may need ortho-surgical decompensation to reach more aesthetic outcomes. The present study reports a case of a 14-year-old young patient affected by CCD. Clinically, the patient presented Class III malocclusion, maxillary deficiency, short lower facial third, posterior crossbite, and anterior open bite leading to facial disharmony. The patient underwent treatment in 2 stages: the interceptive approach aimed to transversally expand the maxilla and promote its protraction; and the corrective phase combined with the orthognathic surgery treated the patients' main complains; the anterior open bite, unerupted teeth, and chin prominence. The treatment approach applied in the clinical report allowed the correction of the malocclusion and facial profile satisfying completely the patient's expectations.

Orthodontic Management of Multiple Dilacerations.

Orthodontic alignment of un-erupted dilacerated teeth is challenging, as the bent roots resist forces applied to move them through the bone. Various treatment options are now available to treat this condition including providing prosthesis after extractions and apicectomies. However, to maintain alveolar bone in the area of the un-erupted tooth, especially if the involved tooth is in the anterior segment, the ideal treatment would be to try and bring the tooth in the arch orthodontically. Treatment requires increased time duration, compliance of the patient, and consistent force mechanics. This case report is of a 9-year boy with un-erupted and dilacerated teeth. Orthodontic treatment of prolonged duration was provided to bring these teeth into the arch, improving the esthetics and function.

Terapéutica quirúrgico-ortodóntica en adultos con dientes supernumerarios múltiples. Presentación de caso / Surgical-orthodontic therapy on adults with multiple supernumerary teeth

Se presentó a la consulta estomatológica, una paciente femenina de 39 años de edad, sin antecedentes médicos de interés, por presentar pérdida espontánea de un diente temporal. A través del examen físico intrabucal, se pudo corroborar la ausencia clínica del diente número 13, y en su lugar, la presencia de mucosa, que evidenciaba una exfoliación reciente de un diente, con notable disminución del espacio entre el incisivo lateral y la primera bicúspide superior izquierda. El examen radiográfico periapical mostró la presencia de una imagen radiopaca, ubicada entre el incisivo lateral y la primera bicúspide de la hemiarcada superior izquierda, la cual sugiere la presencia de múltiples órganos dentarios. Dada la afectación funcional, estética y psicológica de la paciente, y la existencia de discrepancia negativa moderada hueso-diente, se decidió realizar la exéresis quirúrgica de los dientes supernumerarios y en una segunda etapa, la corrección ortodóncica. El tratamiento quirúrgico se realizó sin complicaciones, pues la paciente mostró una evolución postquirúrgica positiva. Luego de la recuperación total del área intervenida, comenzaron los movimientos ortodóncicos, que finalmente permitieron obtener un resultado estético y funcional óptimo.(AU)

A 39 years old female patient, with no medical records, comes to dentistry consulting because of a temporal tooth loss. During the intraoral physical examination the absence of the 13 tooth was corroborated, and the recently exfoliation of a teeth with a considerable diminish of space between the left upper lateral incisor and the left first upper bicuspid were corroborated. The x-rays showed radiopacity, located between the lateral incisor and the first upper bicuspid of the left hemi-arcade, suggesting several dental organs. Due to functional, aesthetic and psychological influencies on the patient, and the presence of a moderated negative bone-teeth discrepancy, it was decided to practice surgical extraction of supernumerary teeth and the orthodontic correction. Surgical treatment was practiced without complications, and the patient showed a good postsurgical evolution. After a total recovery of the affected area, orthodontic movement began. It allowed an optimum aesthetic and functional outcome.(AU)

Inclusión de caninos superiores en paciente con osteogénesis imperfecta. A propósito de un caso clínico / Impacted canines in a patient with osteogenesis imperfecta: a clinical case study

La osteogénesis imperfecta (OI) es un trastorno hereditario que cursa con fragilidad ósea lo que da lugar a fracturas de repetición. Afecta por igual ambos sexos, razas y grupos étnicos y se estima su incidencia en 20 casos por cada 100.000 nuevos nacimientos. Se presenta un caso de una paciente mujer de 16 años de edad diagnosticada de OI que acude a la consulta remitida por su ortodoncista por la presencia de ambos caninos superiores incluidos con la indicación de realizar exodoncia de canino superior izquierdo y realizar tratamiento quirúrgico-ortodóncico en canino superior derecho. Se hace una revisión de la literatura para conocer los aspectos más importantes de esta enfermedad, sus manifestaciones orales, así como el manejo quirúrgico de los trastornos odontoestomatológicos teniendo en cuenta su tratamiento farmacológico con bifosfonatos (AU)

Osteogenesis imperfecta (OI) is a hereditary condition which involves bone fragility, originating recurrent fractures. It affects both sexes, races and ethnicities equally, and its occurrence is estimated in 20 cases every 100,000 new births. The case presented relates to a 16-year-old female patient with an OI diagnosis who comes with a referral from her orthodontist due to both maxillary canines being impacted, with the direction of performing an exodontia of the left maxillary canine and a surgical-orthodontic treatment of the right maxillary canine. The literature is reviewed in order to determine the most relevant aspects of this disease, its oral manifestations and the surgical management of odontostomatological conditions considering their pharmacological treatment with biphosphonates (AU)

Uso do PDT após extração de terceiro molar incluso: relato de caso / Use the PDT after third molar extraction included: case report

O objetivo do presente trabalho foi verificar, com base em uma revisão da literatura e no relato de um caso clínico, a utilização do Laser de Baixa Intensidade (LBI) associado ao agente azul de metileno (PDT) na redução do desconforto pós-operatório, cicatrização e diminuição da chance de infecção pós operatória no sítio operado após a remoção de terceiros molares inclusos. Como metodologia de trabalho foi selecionado um paciente com presença de dois terceiros molares inclusos na mesma classificação. A remoção dos terceiros molares foi realizada em um mesmo ato cirúrgico, sendo que em um lado utilizou-se aPDT após a extração e no outro o método convencional. O único medicamento utilizado foi analgésico pós operatório em caso de dor. A paciente foi avaliada no intervalo de 3, 7 e 10 dias. Os resultados encontrados demonstram que o lado operado em que se utilizou aPDT apresentou um melhor parâmetro para dor, sangramento e edema quando comparado com o lado sem aPDT. Já quanto à infecção pós operatória, essa não foi verificada em nenhum dos lados operados. Novos estudos se fazem necessários, mais estudos necessitam ser realizados devido a pouca associação entre exodontia de terceiros molares inclusos e o uso do a PDT

Orthodontic treatment of an unerupted mandibular canine tooth in a patient with mixed dentition: a case report.

BACKGROUND: The aim of this case report was to describe the surgical-orthodontic treatment of an unerupted mandibular canine tooth in a 9-year-old girl. CASE PRESENTATION: A 9-year-old white girl presented with an unerupted right mandibular canine tooth. Combined surgical-orthodontic treatment was performed to correct dental impaction and to achieve good aesthetic and functional results. CONCLUSION: Orthodontic treatment achieved all of the required objectives.

Hypophosphatemic Rickets and Pre-eruptive Spontaneous Dental Abscess.

The purpose of this report is to describe the diagnosis and dental treatment of a medically complex 14-year-old boy with X-linked hypophosphatemic rickets who presented with a pre-eruptive abscess on a mandibular molar and facial swelling.

Evaluation of the position of unerupted mandibular third molars with and without root dilacerations: a study on panoramic radiographs.

BACKGROUND: Factors that can directly influence the extraction of third molars include the position of the tooth and the presence of root dilacerations. Knowledge of these features favors an accurate therapeutic evaluation of third molars; therefore, the aim of this study was to evaluate, using panoramic radiographs, the positioning of unerupted third molars with and without root dilacerations and to verify a possible association between these two variables. METHODS: In this study, 16,136 panoramic radiographs were analyzed, including 1756 lower third molars, in which the positioning was assessed according to the Winter classification and the presence of root dilacerations was determined. The data obtained from the assessments of the frequencies of the positions and the presence of root dilacerations of impacted mandibular third molar was described. A χ2 test was applied to verify a possible association between the variables. RESULTS: The results indicated that the most frequent position was mesioangular (44.5%), followed by horizontal (24.9%), vertical (17.4%), distoangular (12.5%), inverted (0.4%), and linguoangular (0.3%). Of the mandibular third molars evaluated, 35% had root dilacerations. The chi-square test revealed a significant association between the position of the tooth and the presence of root dilacerations (P<0.0001, χ2=34.28). The frequency of root dilaceration was statistically higher for the vertical (45.5%) and distoangular positions (40.9%). CONCLUSIONS: The mesioangular position was the most prevalent location for lower third molars, and the highest frequencies of root dilacerations were observed in the vertical and distoangular positions. Knowledge about the prevalence of root dilacerations and the significant association between the position of the third molars and root dilacerations will allow safer surgical planning for dental extractions of third molars.

Dental clearance unsuccesful: cleidocranial dysplasia diagnosed at a relief of pain clinic.

A 55-year-old woman presented to Whangarei Base Hospital Emergency Department with a mandibular swelling adjacent to her unerupted tooth 48. She had never had dental radiographs taken, having had a dental clearance 20 years earlier. She wore full dentures. A panoramic dental radiograph revealed 44 unerupted teeth. Based on the clinical, oral and radiographic examinations a diagnosis of cleidocranial dysplasia (CCD) was confirmed. The patient had not been diagnosed with CCD prior to her hospital visit. Treatment included staged extractions of superficial mandibular supernumeraries and enucleation of the mandibular cyst, attempting to avoid pathological fracture. This would be followed by a six-month review and then annually as required. The case outlines the value of dental radiography in dental practice. Little is known about the prevalence of CCD in New Zealand and this is an area where future research could be conducted.

Treatment of Combined Primary Impaction of Primary Second Molars and Permanent First Molars.

Tooth impaction is defined as any tooth that fails to erupt into a normal functional position and remains unerupted in the jaw beyond the time of its normal eruption. Primary impaction of primary teeth is rare. Furthermore, a combination of eruption failure of primary second molars and horizontally impacted permanent first molars has not yet been reported. The purpose of this study was to present the treatment of two cases of primary impaction of primary second molars combined with horizontally impacted permanent first molars. The impacted primary second molars were extracted, and orthodontic traction was performed to induce normal eruption of the permanent first molars. We then regained space for the eruption of the second premolar and applied a space maintainer to secure the space and induce successful eruption of succedaneous teeth and normal function of permanent first molars in their positions.

Avaliação comparativa da radiografia panorâmica e da tomografia computadorizada de feixe cônico prévio a extração de terceiros molares inferiores / Comparative evaluation of the panoramic radiograph and cone beam computed tomography prior a lower third molars surgery

A cirurgia de terceiros molares inferiores, não irrompidos, é considerada por muitos uma cirurgia difícil que exige habilidade e treinamento, espera-se, que seja preferencialmente feita por um cirurgião dentista especialista em Cirurgia e Traumatologia Bucomaxilofacial. Acidentes e complicações podem ocorrer no trans e pós-operatório sendo o dano ao nervo alveolar inferior um dos acidentes que podem ser decorrentes da cirurgia de terceiros molares inferiores. O exame complementar por imagem mais prescrito, para observar estruturas anatômicas do complexo maxilomandibular é a radiografia panorâmica, porém, a tomografia computadorizada por feixe cônico pode ser considerado o exame imaginológico mais adequado para identificar mais precisamente a relação dos terceiros molares mandibulares com a anatomia local. Os objetivos deste trabalho foram avaliar planejamento cirúrgico para extração de terceiros molares inferiores entre a radiografia panorâmica e a TCFC e também avaliar e descrever os possíveis acidentes e complicações nas cirurgias para extração dos dentes não irrompidos e correlaciona-los aos achados incidentais imaginológicos. Para isso foram selecionadas 21 radiografias de pacientes da clínica de cirurgia, estomatologia e integrada da Faculdade de Odontologia de Bauru - USP que possuíam indicação de extração de terceiros molares inferiores e que preenchiam o requisito de suspeita de íntimo contato das raízes dos terceiros molares com o canal mandibular, que é uma indicação para a realização de TCFC. Foram realizados extrações de 21 terceiros molares não irrompidos. Durante e após a cirurgia, o cirurgião ficou responsável por realizar a coleta de dados referente a anatomia e possíveis acidentes e complicações decorrentes do ato operatório. Após a cirurgia de terceiros molares inferiores dois examinadores cegos, independentes da seleção das radiografias, do resultado da exodontia e da TCFC, avaliaram primeiramente as radiografias e 30 dias depois, as TCFC. A análise estatística entre os dois métodos foi realizada pelo Teste Exato de Fischer, com nível de significância de 5%. Nos quesitos investigados nesta pesquisa houve diferenças estatísticas significantes na avaliação radiográfica entre os dois radiologistas no item Estreitamento Mandibular e na avaliação tomográfica no item Dilaceração. Sendo possível concluir que ambos exames complementares apresentam imagens suficientes para planejamento de cirurgia dos dentes não irrompidos.(AU)

The third molar surgery, impacted or semi-impacted, is considered by many a difficult surgery that requires skills and training, it is expected, which is preferably to be done by a dental surgeon specialist in Oral and Maxillofacial Surgery. Accidents and complications can occur in trans and postoperative, damaging the inferior alveolar nerve one of the accidents that may result from the lower third molar surgery. The most prescribed x-ray to observe anatomical structures of maxilomandibular complex are the panoramic radiograph, however, cone beam computed tomography can be considered the most appropriate one to identify more precisely the relationship of mandibular third molars with the local anatomy. The objectives of this study were to evaluate surgical planning for extraction of third molars between panoramic radiography and CBCT and also assess and describe the possible accidents and complications in surgery for extraction of unerupted teeth and correlates them to incidental findings at imaging examination. For this purpose it was selected 21 radiographs of patients at the clinic of surgery, stomatology and integrated Bauru Dental School - USP that they had indication of lower third molars and also they met the requirements of suspected close contact of the third molar roots with the mandibular canal, which is an indication for performing CBCT. Extractions of 21 third molars unerupted were performed. During and after surgery, the surgeon was responsible for performing and gathering data regarding the anatomy and possible accidents and complications of the surgery. After the third molar surgery two blind independent examiners, without the selection of X-rays or the result of extraction and the CBCT, first evaluated the radiographs and 30 days later, the CBCT. The statistical analysis between the two methods was performed by Fisher's Exact Test, with 5% of significance level. The questions investigated in this study had statistically significant differences in radiographic evaluation between the two radiologists on the item Narrowing Mandibular and tomographic evaluation in Laceration item. Being possible to conclude that both additional tests have enough images for planning surgery of unerupted teeth.(AU)

Cleidocranial dysplasia syndrome (CCD) with an unusual finding in a young patient.

Cleidocranial dysplasia (CCD), an autosomal dominant disorder with a prevalence of 1 in 1,000,000 individuals, presents with a wide range of variability. Dentists are often the first to encounter patients with CCD, some of whom do not show typical manifestations. Since it has similar features to other pathologies, CCD is misdiagnosed as other conditions. A 10-year-old boy suffering from CCD was misdiagnosed as having rickets and was referred for non-eruption of a few permanent teeth along with an unaesthetic facial appearance. Clinically and radiologically, a diagnosis of CCD was made. Currently, management of this patient's orofacial manifestations is underway.