Changes in the arch width and buccal corridor after fixed orthodontic treatment with Damon self-ligating system: premolar extraction vs. non-extraction.

INTRODUCTION: Extraction vs. non-extraction is a crucial decision in orthodontic therapy. OBJECTIVE: The aim of the present study was to investigate the changes in the dental arch width and buccal corridor after orthodontic treatment using extraction and non-extraction therapy with Damon self-ligating system. MATERIAL AND METHODS: This retrospective study consisted of 35 patients (20 female and 15 male patients with median age of 12.5 years), treated by extracting 4 or 2 premolars, and 37 patients (16 female and 21 male patients with the median age of 12.8 years), treated without premolar extraction. Both groups were treated with Damon self-ligating system. Plaster models before (T0) and after (T1) treatment were measured, and the arch width values were determined at the level of the first molars, second premolars, canines and palatal rugae. Buccal corridor width was measured using the extraoral images at T0 and T1. Paired t-test was used for the analysis of the normally distributed data, and Wilcoxon Mann-Whitney U test was used for the data with non-normal distribution. Values of p<0.05 were set as statistically significant. RESULTS: The upper intercanine width increased significantly in both groups (p<0.01). In the non-extraction group, the arch width increased significantly in the maxillary second premolar and first molar region (p<0.01) as well as in the region of the canines (p=0.04), second premolars (p=0.01) and first molars (p<0.01) of the mandible. The buccal corridor decreased significantly in the non-extraction group (p<0.01). CONCLUSION: Premolar extraction in combination with Damon self-ligating system did not lead to reduction of the dental arch width in the maxilla, nor did it increase the size of the buccal corridors.

Radiographic evaluation of enamel thickness of permanent teeth: relevance and applicability.

OBJECTIVE: This descriptive observational study aimed to determine clinically relevant and applicable data of enamel thickness (ETH), considering the mesio-distal differences of anterior and posterior permanent teeth and their relationships. MATERIAL AND METHODS: The sample consisted of right-sided standardized radiographs of 34 individuals (21 females and 13 males), aged between 13 and 24 (average 16) years, with all permanent teeth intact and without crowding. Four periapical and four interproximal radiographs were obtained and digitized. ETH measurements (mesial to distal contact points at the dentin-enamel junction) were performed after correction for radiographic image magnification. The Students' t-test was applied to the differences between paired means, with the Pearson correlation to evaluate the correlation between them. RESULTS: The mesial and distal ETH increased from the anterior to the posterior teeth. Incisor ETH ranged between 0.60 and 0.84 mm. Canines, premolars, and molars were more than 1.0 mm thick, and molar enamel reached values between 1.26 and 1.44 mm. CONCLUSION: Distal ETH was significantly greater than the mesial ETH, and progressively thicker from the anterior to posterior teeth. Interproximal reduction (IPR) of the lower central and upper lateral incisors should be avoided, reduced, or performed on their distal surfaces. There is a positive and significant correlation between ETH and the mesial and distal surfaces of the teeth. Periapical radiographs and evaluation of the remaining ETH are necessary in cases of retreatment. The location and number of tooth size discrepancies should be considered in treatment planning and appropriately compensated with IPR.

Efficacy of WaveOne Gold and ProDesign RT systems in removing filling material: a micro-CT analysis.

The remaining filling material after retreatment can harbor bacteria and organic tissues that can influence the outcome of the therapy. AIM: The aim of this study was to evalúate, by micro-CT, the amount of filling material remaining in the root canal after its removal using WaveOne Gold or ProDesign RT. MATERIAL AND METHOD: Forty human mandibular canines were instrumented with the ProTaper Next system up to the X2 instrument (25.06) and filled with gutta-percha cones and AHPlus. Teeth were divided into 2 groups (n=20): WaveOne Gold 25.07 (WOG) and ProDesign RT 25.08 (PRT) for filling removal, after which they were scanned in a micro-CT device to quantify the volume of remaining filling material. The data were subjected to log 10 transformation, Student 's t-test was performed to account for multiple observationsper sample, significance was set at 5%. RESULTS: Student 's t-test showed that there was no difference between the two systems regarding the volume of remaining filling material in the thirds: apical (p = 0.392), middle (p = 0.065), or cervical (p = 0.918). CONCLUSIÓN: Remaining filling material was present in all groups and both systems were similar in removing root filling material in mandibular canines.

A permanencia de material obturador após o retratamento pode abrigar bactérias e tecidos orgánicos que podem influenciar o resultado da terapia. OBJETIVO: O objetivo deste estudo foi avaliar, por micro-CT, a quantidade de material obturador remanescente no canal radicular após a desobturagdo com WaveOne Gold e ProDesign RT. MATERIAL E MÉTODO: Quarenta caninos inferiores humanos foram instrumentados com o sistema ProTaper Next até o instrumento X2 (25.06) e obturados com cones de guta-percha e AHPlus. Os dentes foram divididos em dois grupos (n=20): WaveOne Gold 25.07 (WOG) e ProDesign RT 25.08 (PRT) e escaneados em micro-CT para quantificagdo do volume de material obturador remanescente. Os dados foram submetidos á transformando log 10, o teste t de Student foi realizado para contabilizar múltiplas observagoes por amostra, a significáncia foi fixada em 5%. RESULTADOS: O teste t de Student mostrou que ndo houve diferenga no volume de material obturador remanescente entre os dois sistemas nos tergos: apical (p = 0,392), médio (p = 0,065) ou cervical (p = 0,918). CONCLUSÃO: O material obturador remanescente estavapresente em todos os grupos e ambos os sistemas foram semelhantes na remogdo do material obturador radicular nos caninos inferiores.

Root Regeneration with Photobiomodulation of an Upper Lateral Incisor Associated with Root Resorption Due to an Impacted Maxillary Canine: A Case Report.

Objective: To present a case report of maxillary lateral incisor root regeneration after severe root resorption, treated with photobiomodulation (PBM). Background: Impacted maxillary canines often come with the risk of maxillary lateral incisor root resorption, which is widely recognized as the predominant adverse effect in these situations. This progressive process of root resorption is currently irreversible, with no known way to reverse it. Materials and methods: A male patient was 14 years old. Radiographically it was observed that canine 23 is impacting against the root of 22 producing signs of root resorption and having a less than 1:1 crown-to-root ratio with mobility grade 1. From the beginning of the treatment, PBM-assisted orthodontics was proposed. To address the patient's dental concerns, the treatment plan outlined the extraction of the deciduous upper left canine tooth leaving the lateral as long as possible in the mouth. During each appointment, PBM was applied with a diode laser. The wavelength was 810 nm, Ap = 0.2 W, 4.4 J, 22 sec every 21 days, 13 applications in total (57.2J), with a 400 µm inactive surgical tip, in a scanning movement, 1 mm from the mucosa while moving following the vestibular surface of the upper left lateral and canine roots. Results: After 12 months, the 22 had root neoformation and complete closure of the apex with vitality. Conclusions: PBM with an 810 nm diode laser in this clinical case promoted root regeneration of an upper lateral incisor, with severe root resorption, owing to an impacted maxillary canine while still vital.

Periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines: A systematic review and meta-analysis.

OBJECTIVE: To compare the periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines to spontaneously erupted maxillary canines. DATA SOURCES: An unrestricted search was carried out of indexed databases (Medline, EMBASE, Web of Science and Scopus), reference lists of included studies, and grey literature published until December 2023. DATA SELECTION: Observational and experimental studies that addressed the focused question 'Do periodontal outcomes of buccally impacted maxillary canines that were surgically exposed and subsequently extruded and aligned using orthodontic alignment, differ from those of spontaneously erupted maxillary canines?' were included. DATA EXTRACTION: Study screening, selection and data extraction were performed independently by two authors, with disagreement resolved by a third reviewer. The risk of bias was assessed using the JBI Critical Appraisal Checklist and GRADE approach. RESULTS: A total of 857 citations were found and five studies were eligible for inclusion. Supragingival plaque accumulation and gingival inflammation were similar between impacted canines and their contralaterals in most studies. Meta-analyses revealed no significant differences in keratinised tissue width (prospective studies: MD = -0.28, 95% confidence interval [CI] = -1.13-0.56, I² = 78%; retrospective studies: MD = 0.61, 95% CI = -1.51-2.72, I² = 94%). However, a meta-analysis of prospective studies showed slightly greater mean probing depth for impacted canines compared to their contralateral canines (prospective studies: MD = 0.16, 95% CI = 0.04-0.28, I² = 0%). The evidence certainty for keratinised tissue width and probing depth outcomes was low. CONCLUSION: Surgically exposed and orthodontically aligned buccally impacted canines have slightly greater probing depths, potential bone loss and increased clinical crown length, compared to their counterparts. However, these small differences (<1 mm) are unlikely to be clinically significant.

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.

Impact of low-fusion gutta-percha cones used in variations of the continuous wave condensation technique with filling sealers based on bioceramic compounds on the quality of root canal filling.

To evaluate the impact on the quality of filling with of low-fusion and conventional gutta-percha cones. Thirty-six maxillary canines were prepared and divided into three groups: I-conventional cone with Downpack at 200 °C at 4 mm from the WL; II-low-fusion cone with Downpack at 100 °C up to 4 mm from the WL; III-low-fusion cone with Downpack at 100 °C up to 7 mm from the WL. Temperature variations were measured in thirds on the external surface of the root. The bond strength was evaluated using the push-out test. The adhesive interface was analyzed by scanning electron microscopy. The bond strength and the temperature variation data were analyzed using analysis of variance and the failure type using the chi-square test. The low-fusion cone group with 7 mm Downpack showed higher bond strength (4.2 ± 2.7) compared with conventional cones (2.8 ± 1.6) and low-fusion cones with 4 mm Downpack (2.9 ± 1.6) (p < 0.05), with occurrence of a higher number of adhesive failures to the filling material and mixed failures. Relative to temperature variation, there was less temperature change in the apical third, in the low-fusion cone with Downpack 7 mm (1.0 ± 1.0) (p < 0.05). The use of low-fusion cones allowed the continuous wave condensation technique to be performed at a lower depth of Downpack at 100 °C at 7 mm, with less heating in the apical third, without compromising the quality of filling. Using gutta-percha cones with low fusion, which permits a lower condensation temperature and reduced Downpack depth, maintains the quality of filling, in order to minimize possible damage to the periapical tissues.

Determinação do sexo a partir da morfometria geométrica e mensurações em imagens tridimensionais de dentes caninos / Sex determination from geometric morphometry and measurements in three-dimensional images of canine teeth

O presente estudo teve como objetivo avaliar a determinação do sexo por meio da análise geométrica e de mensurações a partir de imagens tridimensionais de dentes caninos, advindas de escaneamento intraoral, no Autodesk MeshMixer, bem como elaborar um roteiro prático para servir de guia na manipulação e coleta de dados nesse software. Trata-se de um estudo do tipo cego e transversal, dividido em duas etapas. Inicialmente, foram selecionadas imagens de 127 caninos (65 femininos e 63 masculinos) para a análise morfométrica geométrica, utilizando a marcação de 50 pontos, distribuídos em 27 pontos para contorno e 23 pontos para delimitação da forma das superfícies vestibular e lingual. Cada ponto de referência recebeu um valor para as coordenadas x, y e z, representando a sua posição. Na análise estatística dos dados foi utilizado um software específico para análise morfométrica geométrica, o MorphoJ, no qual foram importados os dados e submetidos à Análise Ajustada de Procrustes, Análise Discriminante e Análise da Variação Canônica. Não foram exibidas diferenças significativas para distribuição do sexo nas analises anteriores. Ainda, os dados relativos ao tamanho do centroide gerado no MorphoJ foram importados para o IBM SPSS Statistics 22.0 e submetidos ao teste t student, resultando em uma diferença estatística para o sexo. Para a aplicabilidade das mensurações digitais, foram utilizadas imagens de 345 caninos (191 femininos e 154 masculinos). Foram realizadas medidas das distâncias mesiodistais, vestibulolinguais, cervicoincisais (altura) e distâncias intercaninas de 5 pontos estabelecidos em cada canino (cúspide, cervical por vestibular e lingual, ponto máximo mesial e lingual). Todas as médias foram maiores para o sexo masculino e, com exceção da altura do elemento 33, apresentaram diferenças significativas para o sexo (p<0,05). As mensurações mesiodistais, vestibulolinguais e intercaninas (com exceção do ponto cervical por lingual), apresentaram uma boa acurácia, representadas por valores de áreas sobre a curva ROC maiores do que 0,7. O Autodesk MeshMixer apresentou-se como um ótimo auxiliar e de grande contribuição para análises dentro da Antropologia Forense. Apesar dos caninos serem elementos altamente dimórficos, para a análise morfométrica, não foram exibidas diferenças estatísticas na análise discriminante. Porém, o tamanho do centroide apresentou diferenças estatísticas e com médias maiores para o sexo masculino. As medidas realizadas nos dentes caninos apresentaram diferenças estatísticas para o sexo, com boas classificações na análise discriminante e com boas predições sexuais de acordo com os valores de especificidade e sensibilidade. A aplicabilidade de técnicas digitais de mensuração exibiu bons resultados, concordando esses dados obtidos com estudos que utilizaram as técnicas manuais de medida.

Age estimation in adults by canine teeth: a systematic review of the Cameriere method with meta-analysis on the reliability of the pulp/tooth area ratio.

The age estimation of an adult using methods accessible to the forensic routine is a goal pursued by forensic experts. Cameriere, Ferrante and Cingolani (2004) proposed the use of the pulp/tooth area ratio of canine teeth as a promising variable, but its reliability has shown conflicting results in the scientific literature. This article aimed to carry out a systematic review with meta-analysis to verify whether the pulp/tooth area ratio of canine teeth includes a variable that can be used alone to estimate dental age in adults. A systematic search was carried out in six databases using keywords related to the theme in Portuguese, English, and Spanish. The study selection process followed pre-established eligibility criteria. Assessments were carried out regarding risk of bias and publication bias of selected studies, and meta-analysis was carried out considering Pearson's correlation coefficient between pulp/tooth area ratio and chronological age as effect measure. Most selected studies showed low risk of bias; no publication bias was found when all studies were considered, and potential publication bias was found when outliers were removed. Despite the high heterogeneity among studies and the need for more research, it could be observed that the pulp/tooth area ratio has strong negative correlation with chronological age, and the pulp/tooth area ratio could be derived from both periapical radiographs and orthopantomographs. Therefore, it is suggested that there is scientific evidence that the pulp/tooth area ratio obtained from canine teeth is reliable for dental age estimation in adults.

Did in-between rinsing and agitating with distilled water prevents precipitate formation by the interaction between sodium hypochlorite and chlorhexidine canal irrigants?

The interaction of sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) produces an orange-brown precipitate. The present study evaluated the influence of distilled water (H2 O) in different irrigation protocols designed to prevent the formation of precipitate with NaOCl and CHX. Fifty canine teeth were instrumented and split longitudinally. The canal was examined with a stereomicroscope and photographed by canal-thirds. The tooth halves were repositioned and distributed randomly into five groups, according to the final irrigation protocol (n = 10): G1 (control)-Ethylenediaminetetraacetic acid (EDTA) + NaOCl + CHX, conventional irrigation (CI); G2-EDTA + NaOCl + CHX, activated with passive ultrasonic irrigation (PUI); G3-EDTA (PUI) + NaOCl (PUI) + H2 O (CI) + CHX (PUI); G4-EDTA + NaOCl + H2 O + CHX (PUI); G5-EDTA (PUI) + NaOCl (PUI) + H2 O (continuous ultrasonic irrigation [CUI]) + CHX (PUI). The specimens were evaluated with a stereomicroscope and scanning electron microscope (SEM). Energy dispersive x-ray spectroscopy analysis was performed to identify the elemental profile of the irrigated canal walls. The images were scored according to the extensiveness of precipitate. Data were analyzed (Kruskal-Wallis test, α = 5%). Under the stereomicroscope, G1 had significantly higher scores than all the other groups in all canal-thirds (p < .05). All four experimental groups showed similar scores (p > .05). There were no significant differences in precipitate formation among root-thirds in intragroup analysis (p > .05). Upon SEM examination, overall, only G5 had lower scores than G1 (p < .05). Analysis by canal-thirds showed no significant difference among groups and among canal-thirds in the intragroup analysis (p > .05). G1 showed high Cl peaks. In-between irrigation with H2 O activated by CUI is effective in preventing precipitate formation during canal debridement with NaOCl and CHX. RESEARCH HIGHLIGHTS: Continuous ultrasonic irrigation with distilled water was capable to prevent the precipitate formation. The precipitate can be classified as a chemical smear layer.

Interdisciplinary management of maxillary incisors with root resorption caused by impacted canines: A case report.

The aetiology of impacted canines is multi-factorial. Several theories have been proposed, such as lack of space, genetic predisposition, physical barriers like supernumerary teeth, odontomas and other conditions that interfere with the eruption pathway. One of the main complications that can be generated by impacted canines is the resorption of the root of the adjacent teeth. This case report examines the importance of interdisciplinary management of maxillary incisors with root resorption caused by impacted canines in a 13-year-old male patient. Careful traction of impacted canines and proper tissue management followed by space closure and retroclination of anterior incisors with orthodontic treatment. Finally, functional and aesthetic results using dental veneers for oral rehabilitation allowed the patient to obtain favourable results.

Necesidad del tratamiento ortodóntico según el índice estético dental en la etnia Kichwa Saraguro, Ecuador / Need for Orthodontic Treatment according to the Dental Esthetic Index in the Kichwa Saraguro Ethnic Group, Ecuador

Introducción: Los rasgos oclusales en un grupo étnico pueden estar asociados con factores genéticos y socioculturales que contribuyen a la morfología de los rasgos oclusales y faciales en grupos indígenas. Objetivo: Determinar la necesidad de tratamiento ortodóntico según el índice estético dental y el sexo en la etnia Kichwa Saraguro, Ecuador. Métodos : Estudio observacional, descriptivo, transversal, realizado en el año 2018 en 465 adolescentes de 12 a 16 años, pertenecientes a la etnia Kichwa Saraguro y residentes en Loja, Ecuador. Se empleó la estadística descriptiva, se obtuvo la frecuencia absoluta y el porcentaje para las variables cualitativas; la media, la desviación estándar y la mediana para variables cuantitativas. Para la determinación de normalidad de los datos se usó la prueba Kolmogorov Smirnov y para la relación del sexo con los componentes del índice estético dental y la necesidad de tratamiento ortodóntico se usó la prueba de U de Mann-Whitney y ji al cuadrado. Un valor de α = 0,05 se consideró como estadísticamente significativo. Resultados: Del total de la población, en el 61,06 por ciento se encontró una maloclusión leve con tratamiento innecesario; en el 18,06 por ciento maloclusión manifiesta con tratamiento optativo, en el 9,89 por ciento maloclusión grave con tratamiento deseable y en el 10,97 por ciento maloclusión muy grave con tratamiento obligatorio. Se encontraron diferencias significativas de p = 0,028 en dientes incisivos, caninos y premolares visibles perdidos del maxilar y la mandíbula. Conclusión: Más de la mitad de los participantes de la etnia Kichwa Saraguro presentaron maloclusión leve con tratamiento innecesario y, de acuerdo con el sexo, más de un cuarto de los participantes femeninos mostraron maloclusión manifiesta con tratamiento optativo y maloclusión grave con tratamiento sumamente deseable(AU)

Introduction: Occlusal features in an ethnic group may be associated with genetic and sociocultural factors that contribute to the morphology of occlusal and facial features in indigenous groups. Objective: To determine the need for orthodontic treatment according to the dental esthetic index and sex in the Kichwa Saraguro ethnic group, Ecuador. Methods: Observational, descriptive, cross-sectional study that was carried out in 2018 in 465 adolescents aged 12 to 16 years, belonging to the Kichwa Saraguro ethnic group and residing in Loja, Ecuador. Descriptive statistics were used. Absolute frequency and percentage were obtained for qualitative variables, and mean, standard deviation and median for quantitative variables. The Kolmogorov Smirnov test was used to determine the normality of the data, and the Mann-Whitney U test and chi-squared test were used to determine the relationship between sex and the components of the dental esthetic index and the need for orthodontic treatment. A value of α = 0.05 was considered statistically significant. Results: Of the total population, 61.06 percent were found to have a mild malocclusion with unnecessary treatment. In 18.06 percent manifest malocclusion with optional treatment was found. Severe malocclusion with desirable treatment was found in 9.89 percent and very severe malocclusion with mandatory treatment in 10.97 percent. Significant differences of p = 0.028 were found in visible missing incisors, canines and premolars of the maxilla and mandible. Conclusion: More than half of the participants from the Kichwa Saraguro ethnic group presented mild malocclusion with unnecessary treatment and, according to sex, more than a quarter of the female participants showed manifest malocclusion with optional treatment and severe malocclusion with highly desirable treatment(AU)

Caracterización de la retención de caninos maxilares en pacientes pediátricos de Ciego de Ávila / Characterization of Maxillary Canine Retention in Pediatric Patients in Ciego de Avila

Introducción: Se reportan hallazgos que permiten observar al canino maxilar impactado como una entidad de importante prevalencia. En la provincia de Ciego de Ávila son escasas las investigaciones publicadas sobre la alteración eruptiva. Objetivos: Describir variables epidemiológicas y clínicas e identificar los factores locales presentes en pacientes pediátricos con retención de caninos maxilares del municipio Ciego de Ávila en el período comprendido entre octubre de 2019 y junio de 2020. Métodos: Se realizó una investigación observacional analítica de casos y controles donde se determinaron los factores locales asociados a la retención de caninos maxilares. La población de estudio se constituyó por 388 escolares, en las edades de 11 y 17 años, pertenecientes al área de salud de la clínica estomatológica docente Dr. Luis Páez Alfonso del municipio Ciego de Ávila, en el período de estudio. Resultados: El 56,9 por ciento de los participantes pertenecían al sexo femenino; prevaleció el grupo de 11 a 13 años con el 70,7 por ciento y el color de piel blanca (74,1 por ciento). El 56,9 por ciento de los pacientes presentaban retención bilateral y el mayor porciento (60,4 por ciento) se ubicó por vestibular. La discrepancia hueso diente negativa, el micrognatismo transversal (OR de 6,3) y la pérdida prematura de dientes temporales (OR fue de 6,1) mostraron una importante significación estadística. Conclusiones: La retención de los caninos maxilares predominó en el sexo femenino, en el grupo etario de 11 a 13 años y en los pacientes pediátricos de piel blanca. La retención bilateral y la localización por vestibular de los caninos se presentaron con mayor frecuencia. Se constató la asociación entre la retención de caninos maxilares y los factores locales discrepancia hueso diente negativa, micrognatismo transversal y pérdida prematura de dientes temporales(AU)

Introduction: We report findings that allow us to observe the impacted maxillary canine as an entity of important prevalence. In the province of Ciego de Avila there is little research published on this eruptive alteration. Objectives: To describe epidemiological and clinical variables and to identify the local factors present in pediatric patients with retained maxillary canines in the municipality of Ciego de Avila between October 2019 and June 2020. Methods: An analytical observational research of cases and controls was carried out to determine the local factors associated to maxillary canine retention. The study population consisted of 388 schoolchildren between the ages of 11 and 17 years old, belonging to the health area of the Dr. Luis Páez Alfonso Stomatological Teaching Clinic in the municipality of Ciego de Avila, during the study period. Results: 56.9 percent of the participants belonged to the female sex; the group of 11 to 13 years old prevailed with 70.7 percent and the skin color was white (74.1 percent). A total of 56.9 percent of the patients had bilateral retention and the highest percentage (60.4 percent) was located in the vestibular region. Negative bone-tooth discrepancy, transverse micrognathism (OR of 6.3) and premature loss of primary teeth (OR was 6.1) showed significant statistical significance. Conclusions: Maxillary canine retention predominated in the female sex, in the 11 to 13 years age group, and in white-skinned pediatric patients. Bilateral retention and vestibular location of the canines occurred more frequently. The association between maxillary canine retention and the local factors negative bone-tooth discrepancy, transverse micrognathism and premature loss of primary teeth was found(AU)

Comparison of Corticotomy and Micro-osteoperforation during Canine Retraction: A Split-Mouth Design.

OBJECTIVE: Compare the efficacy of the micro-osteoperforation (MOP) and corticotomy techniques in terms of maxillary canine retraction. METHODS: Thirteen patients (5 females, 8 males; mean age, 18.07 ± 6.74 years) with healthy permanent dentition and requiring the extraction of maxillary first premolars were included in a split-mouth randomized clinical trial. Those subjects with previous orthodontic or endodontic treatment of the canines were excluded. At least 3 months post-extraction, MOPs and corticotomies were performed distal to the canines. Mini-screws with closed-coil springs (150 g) were used for the canine retraction. Dental casts were made at baseline (T0) and 3 months post-intervention (T1). Trained and calibrated examiners measured the distances from the canines to the second premolars on both sides. A signed-rank sum test was used to compare the amount of canine retraction achieved in 3 months (T0-T1) on the 2 sides. RESULTS: Retraction (mm) at the incisal level was similar in the corticotomy (3.34 ± 1.01) and MOP patients (2.74 ± 1.10) (P = 0.11); furthermore, there were no differences in the degree of medial retraction between the corticotomy (2.56 ± 0.67) and MOP (2.27 ± 0.82) (P = 0.31) procedures. No adverse events were observed. CONCLUSION: There were not any clinically or statistically significant differences in retraction between the interventions. At 3 months, a MOP is as effective as a corticotomy in accelerating the rate of tooth movement.

Relación entre la compresión maxilar y potencial impactación del canino superior: Scoping review / Relationship between the maxillary transverse dimension and impacted canines: Scoping review

El canino maxilar permanente corresponde al segundo diente más frecuentemente impactado en el arco dental. La etiología de esta patología aún no está totalmente definida, sin embargo, investigadores plantean la deficiencia del ancho del hueso maxilar como una posible causa. Objetivo: Investigar la evidencia que asocia menores dimensiones transversales del maxilar a la ocurrencia de la impactación de caninos superiores y esclarecer la posible relación. Materiales y métodos: Se realizó una revisión sistemática exploratoria a partir de una búsqueda amplia de la literatura en bases de datos PubMed, Cochrane, EBSCO y Multibuscador UNAB. Los artículos fueron recopilados, identificados y filtrados según el diagrama de flujo de declaración PRISMA. Resultados: La búsqueda identificó 755 estudios, de los cuales 14 fueron incluidos. Los estudios varían en diseño, edad de estudio y métodos de diagnóstico. La mitad de los estudios reporta una asociación positiva entre compresión maxilar e impactación canina superior, mientras que la otra mitad una asociación negativa. Conclusiones: No hay evidencia suficiente para poder asociar compresión maxilar con impactación de caninos superiores. Estudios con métodos de diagnóstico rigurosos son necesarios para una mejor comprensión. No obstante, se enfatiza la importancia de un diagnóstico precoz, para garantizar mejores resultados y pronóstico más favorable.

The permanent maxillary canine is the second most frequently impacted tooth in the dental arch. The etiology of this disease is not completely defined, yet some researchers propose the deficiency of the width from the maxilla as a possible cause. Objective: To investigate available evidence correlating smaller transverse maxilla dimensions with the occurrence of potential impaction of upper canines and clarify the possible relation. Materials and methods: A systematic exploratory review was carried out based on comprehensive search of the literature in databases such as PubMed, Cochrane, EBSCO and UNAB multi search engine. The articles were compiled, identified and filtered systematically according to the PRISMA flow diagram. Results: Our search identified 755 studies, 14 of which were included. These studies vary in design, patients age, and methods for detection. Half of the studies show a positive correlation between maxillary compression and potential upper canine impaction, whereas the other half show a negative correlation. Conclusions: There is not enough evidence to link maxillary compression to upper canine impaction. Studies with rigorous diagnostic methods for detection are necessary for a better understanding of this relation. Nonetheless, the importance of early diagnosis must be emphasized to guarantee better results and a more favorable prognosis.

Evaluation of maxillary canine and molar movement during the first phase of extraction space closure: a multilevel analysis.

OBJECTIVE: This study was designed to analyze and compare the cusp and apex movements of the maxillary canines and first molars during canine retraction in the first step of extraction space closure, and to evaluate if these teeth follow a curvilinear (acceleration and/or deceleration) movement rate. MATERIAL AND METHODS: Twenty-five patients (23.3 ± 5.1 years of age) were enrolled. The retraction of the maxillary canines was accomplished using nickel-titanium closed coil springs (100gf) on 0.020-in stainless steel archwire. Oblique cephalograms were traced and superimposed on the anatomic best fit of the maxilla (before the retraction [T0], and after one month [T1], three [T3], five [T5] and seven [T7] months). Statistics was based in a normally distributed data. Multilevel procedures were used to derive polynomials for each of the measurements. Student's t-test and one-way repeated measures ANOVA were conducted. The level of significance of 5% was adopted. RESULTS: Canine cusps and apexes did not follow a quadratic curve regarding horizontal movement (neither accelerate nor decelerate). Canine and molar cusps showed more horizontal movement than apexes (4.80 mm vs. 2.78 mm, and 2.64 mm vs. 2.17 mm, respectively). CONCLUSIONS: Canine did not accelerate or decelerate overtime horizontally; the cusps and apexes of the canines and molars showed more horizontal movement and larger rate at the beginning of canine retraction, followed by significantly smaller and constant movement rate after the first month.

Influence of the maxillary dimensions and anterior teeth anatomy on the buccal impaction of upper permanent canines: A three-dimensional case-control study.

OBJECTIVE: The diagnosis of impacted upper permanent canines (IUPC) is a relatively common clinical finding. The aim of this study was to investigate the association of the buccal impaction of upper permanent canines with their dimensions and the maxilla bone base. MATERIAL AND METHODS: Cone beam computed tomography files of 66 patients were allocated into: impaction group (ICG/n=33/mean age 15.7±3.9 years), with 44 impacted canines by the buccal side; control group (CG/n=33/mean age 15.66±3.99 years), matched for age and sex, with 66 canines normally erupted. The following measurements were obtained from ICG and CG groups: linear and volumetric canine dimensions, linear measurements of upper permanent central and lateral incisors, measurements of the anterior perimeter and transverse segments of the maxilla. Independent Student's t-test was used for intergroup analysis with correction of Bonferroni (α=0,005). RESULTS: Higher values were found in the means of the variables regarding to the anterior teeth crowns in the ICG group, however, without a significant difference (P<0,005). The upper arch anterior perimeter of the individuals with canine impaction through buccal area was reduced compared to CG (P=0.001). CONCLUSIONS: It can be concluded that individuals with upper buccal impacted permanent canine showed a significantly smaller anterior perimeter of the maxillary arch when compared to the control group. Although greater canine mesiodistal diameter was found in this group, there is no statistical association with the occurrence of this condition.

Influence of the maxillary dimensions and lateral incisor anatomy on the palatal impaction of maxillary permanent canines: A three-dimensional case-control study.

OBJECTIVE: The diagnosis of impacted upper permanent canines (IUPC) is a relatively common clinical finding. The aim of this study was to investigate associations between the upper permanent canines palatal impaction, lateral incisors morphology and the maxilla bone base. MATERIAL AND METHODS: Cone-beam tomography files from 62 subjects were divided into 2 groups: impaction group (ICG/n=31; mean age 14.3±2.4) with 45 canines impacted on the palatal side and age- and sex-matched control group (CG/n=31; mean age 14.3±2.3), with 62 normally erupted canines. Linear and volumetric measurements of the lateral incisors, linear transversal measures and the maxillary anterior perimeter were taken. Independent Student's t-test was used for intergroup analysis with correction of Bonferroni. RESULTS: Significant differences were found for crown length and root diameter (buccal-palatal) (P<0.005). The maxillary anterior perimeter in the ICG was reduced in relation to the GC but not significantly (P=0.008). The transverse skeletal variables of the maxilla were equivalent in the intergroup comparison (P>0.005). CONCLUSION: Smaller dimensions in the crown length and in the upper permanent lateral incisors root buccal-palatal diameter were associated with the impaction of upper permanent canines on the palatal side. The maxillary transverse morphology did not show any association with the occurrence of this condition.

Gingival recession in canines orthodontically aligned: a narrative review / Recessão gengival em caninos ortodonticamente alinhados: uma revisão narrativa

Background: The orthodontic traction of impacted canines represents a great challenge for Orthodontics. Surgical exposure of the impacted canine and the complex orthodontic mechanics applied to align the tooth back to the arch can lead to complications involving supporting tissues inducing gingival recession when the teeth are moved out of the alveolar bone. Aim: The aim of this study is to present an updated bibliographic review of the main periodontal results found in the literature after the clinical management of impacted canines and the prevalence of gingival recession. Materials and methods: Research in electronic databases PubMed, PMC, and MedLine until June 2020 and reference lists of relevant publications were used to identify studies that assessed the periodontal status of impacted and orthodontically tractioned canines. Controlled and randomized clinical trials, literature reviews, systematic reviews, studies in humans, meta- analyzes and text that had at least one occurrence relating to gingival recession, periodontal outcomes and impacted canines tractioned orthodontically, whether by buccal or palatal, superior and / or lower as the eligibility criteria. Results: 691 articles were found in a free search. After applying the eligibility criteria, 7 relevant articles were subtracted, and these results were more frequent for upper canines. Conclusion: Currently, there is no clear evidence to determine which surgical technique procedure is better to discover canines in terms of periodontal outcomes. The results found stated that clinically the evidence were insignificant when compared to teeth normally erupted.

Introdução: O tracionamento ortodôntico de caninos inclusos representa um grande desafio para a Ortodontia. A exposição cirúrgica do canino impactado e a complexa mecânica ortodôntica aplicada para alinhar o dente de volta ao arco podem levar a complicações envolvendo os tecidos de suporte, induzindo recessão gengival quando os dentes são movimentados para fora do osso alveolar. Objetivo: O objetivo deste estudo foi apresentar uma revisão bibliográfica atualizada dos principais resultados periodontais encontrados na literatura após o manejo clínico de caninos impactados e a prevalência de recessão gengival. Materiais e métodos: Foram feitas pesquisas eletrônicas no PubMed, PMC e MedLine até junho de 2020 e uma listas de referência de publicações relevantes foram usadas para identificar estudos que avaliaram o estado periodontal de caninos impactados e tracionados ortodonticamente. Ensaios clínicos controlados e randomizados, revisões de literatura, revisões sistemáticas, estudos em humanos, metanálises e textos que tiveram pelo menos uma ocorrência relacionada a recessão gengival, desfechos periodontais e caninos impactados tracionados ortodonticamente, seja por vestibular ou palatino, foram os critérios de elegibilidade. Resultados: Foram encontrados 691 artigos em busca livre. Após a aplicação dos critérios de elegibilidade, 7 artigos relevantes foram subtraídos, sendo esses resultados mais frequentes para caninos superiores. Conclusão: Atualmente, não há evidências claras para determinar qual técnica cirúrgica é melhor para descobrir caninos em termos de resultados periodontais. Os resultados encontrados afirmaram que clinicamente as evidências foram insignificantes quando comparadas a dentes normalmente

Aging changes in maxillary anterior teeth in untreated individuals: an observational longitudinal study.

OBJECTIVE: The aging of the occlusion and tooth wears influence the smile design This study aimed at evaluating the aging changes of maxillary anterior teeth in nontreated subjects. METHODS: The sample comprised dental models of 23 subjects (13 male, 10 female) with normal occlusions, taken at 13 (T1), 17 (T2) and 61 (T3) years of age. The following variables were measured in the maxillary anterior teeth using digital dental models: crown width/height proportion, anterior view width, crown angulation, gingival and incisal steps between central/lateral incisors and central incisors/canines. Interphase comparisons were evaluated using repeated measures analysis of variance followed by Tukey tests or Friedman tests. Sexual differences were evaluated using t tests (P < 0.05). RESULTS: From 13 to 61 years of age, a decrease of crown width/height proportion (P = 0.008 and P = < 0.001, for the lateral incisor and canines, respectively) and mesiodistal angulation (P = < 0.001, P = 0.001 and P = 0.025 for the central incisor, lateral incisor and canines, respectively) of the maxillary anterior teeth were observed. The steps of the gingival margin and the incisal steps decreased with aging. CONCLUSIONS: From adolescence to late adulthood, untreated individuals with normal occlusions demonstrated changes in the maxillary anterior teeth that may impair the smile esthetics and attractiveness.