RESUMEN
BACKGROUND: External apical root resorption as a consequence of orthodontic treatment is an inflammatory pathological process that results in permanent loss of tooth structure from the root apex. OBJECTIVES: This study aimed to investigate the diagnostic potential of human dentine fractions and salivary IgG in external apical root resorption. PATIENTS AND METHODS: Saliva samples were collected from 10 patients before (T0) and after 3 (T3), 6 (T6) and 12 (T12) months of orthodontic treatment. The total dentinal extract, obtained from human third molars, was fractioned by gel filtration chromatography in three fractions denominated FI, FII and FIII. The root resorption analysis of the upper central incisors was performed by digital image subtraction method. Reactivity of salivary IgG to antigenic fractions of dentine was determined by enzyme-linked immunosorbent assay (Elisa). RESULTS: Regardless of treatment, FI dentin fraction with high MM (<300kDa) was the one that presented highest reactivity with salivary IgG. However, it was found higher salivary IgG reactivity for FII (69 to 45 kilodalton [kDa]) as compared to FIII (<45kDa) at (T6) and (T12), (P<0.05), the same periods in that the root resorptions were detected. CONCLUSION: Our results suggest that FII human dentine fraction and salivary IgG have potential to be used in diagnosis and monitoring of external apical root resorption. The development of a practical and accessible biochemical test using saliva and FII dentine fraction may help in the prevention of severe root resorption.
Asunto(s)
Dentina/química , Inmunoglobulina G/análisis , Resorción Radicular/diagnóstico , Saliva/química , Adolescente , Ensayo de Inmunoadsorción Enzimática/métodos , Femenino , Humanos , Incisivo/diagnóstico por imagen , Masculino , Tercer Molar/diagnóstico por imagen , Saliva/inmunología , Ápice del Diente , Extracción Dental , Técnicas de Movimiento Dental/efectos adversosRESUMEN
Invasive multiple cervical root resorptions after vital tooth bleaching is a rare condition. The aim of this article is to present a case of multiple external cervical root resorptions (ECRR) after a misguided home whitening treatment. A 34 year old male patient presented with slight sensitivity and mobility in several teeth. Despite the manufacturer's recommendations, the patient used a 22% carbamide peroxide-based tooth bleaching gel at home for 4 days consecutively, at night, on the upper and lower arches. Clinical examination revealed gingival swelling, probing depths ranging 5-7 mm on the buccal and proximal surfaces, and grade 2 mobility of the teeth affected by ECRR. Radiographs revealed presence of ECRR in several teeth during initial examination, and development of multiple new lesions 6 months later. The teeth were subsequently extracted. Histological analysis showed multiple dentine lacunae and areas of dentine reparation. The careful use of these products can prevent sequelae such as those reported in this clinical case. As the vital bleaching has a variable success rate, patients should be informed through a consent form of the benefits and risks of tooth bleaching treatment.
Asunto(s)
Peróxidos/efectos adversos , Resorción Radicular/inducido químicamente , Blanqueadores Dentales/efectos adversos , Blanqueamiento de Dientes/efectos adversos , Urea/análogos & derivados , Adulto , Peróxido de Carbamida , Diente Canino , Sensibilidad de la Dentina/tratamiento farmacológico , Combinación de Medicamentos , Humanos , Peróxido de Hidrógeno , Masculino , Resorción Radicular/diagnóstico , Urea/efectos adversosRESUMEN
Antecedentes: La impactación de segundos molares mandibulares permanentes (2MM) se presenta con variaciones considerables según el grupo poblacional. Además de los problemas asociados a esta alteración, podrían requerir tratamientos múltiples y complejos. Por lo tanto, el diagnóstico temprano de una alteración en el proceso de erupción del 2MM es imperativo para reducir el riesgo de impactación, la dificultad de tratamiento y la aparición de problemas asociados en las poblaciones. Propósito: Describir las características de impactación del 2MM en pacientes de 8 a 15 años en una muestra de Medellin, Colombia. Métodos: En este estudio descriptivo retrospectivo se evaluaron 1756 radiografias panorámicas de las cuales 95 presentaron impactación de 2MM. Estas se analizaron según sexo, localización en la mandíbula y tipo de inclinación, y se realizaron 13 mediciones lineales y angulares para identificar parámetros dentoesqueléticos característicos del lado de la impactación. Para el análisis de los datos se utilizó estadística descriptiva y la prueba T (p < 0,05). Resultados: La prevalencia de impactación fue del 5,4 %. La impactación bilateral con inclinación mesial fue la más frecuente. El lado izquierdo predominó en impactaciones unilaterales. El único parámetro dentoesquelético característico de impactación fue el ángulo de inclinación del 2MM con respecto al plano oclusal, con mayor severidad en el lado izquierdo. Conclusiones: Un ángulo igual o mayor a 112,94° podría indicar riesgo de impactación contra el primer molar mandibular permanente. Por lo tanto, este parámetro debería incluirse en el análisis radiográfico para el diagnóstico temprano de impactación del 2MM.
Background: Impactation of permanent mandibular second molars (2MM) occurs with significant variations according to the population group. In addition to the problems associated with it, they could require multiple and complex treatments. Therefore, the early diagnosis of an alteration in the 2MM eruption process is a must to reduce the impactation risk, the treatment difficulty and the occurrence of related problems in the populations. Purpose: To describe the 2MM impactation characteristics in an 8 to 15 year-old patient sample in Medellin, Colombia. Methods: This retrospective descriptive study evaluated 1 756 panoramic radiographs and 95 of them showed 2MM impactation. The latter were analyzed based on the sex, location in the mandible and type of inclination; 13 linear and angle measurings were then carried out in order to identify dental-skeletal parameters characteristic in the impactation side. The data analysis used descriptive statistics and a T test (p < 0.05). Results: The impactation prevalence was 5.4% and the bilateral impactation with mesial inclination was the most frequently found. Unilateral impactations prevailed in the left side of the mandible/maxilla. The only dental-skeletal parameter of impactation was the 2MM inclination angle regarding the occlusal plane, with a greater severity on the left side. Conclusions: An angle of 112.94° or greater could indicate an impactation risk on the permanent mandibular first molar. Therefore, this parameter should be included in the radiographic analysis when diagnosing the early 2MM impactation.
Asunto(s)
Resorción Radicular/diagnóstico , Erupción Dental , Implantación de Prótesis Mandibular/métodosRESUMEN
ABSTRACT This paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a) pulp necrosis with microbial contamination, b) aseptic pulp necrosis, c) developing calcific metamorphosis of the pulp and d) diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality.
RESUMO Este artigo tem por objetivo principal expor os fundamentos ou razões pelas quais, em casos de dentes com reabsorção dentária externa, incluindo as de origem ortodôntica, não se deve fazer o canal para tratá-la. Isso se faz apenas nos dentes com contaminação ou necrose pulpar, para remover a inflamação periapical induzida pelos produtos microbianos. Frente a casos de reabsorção dentária externa, as condutas devem premiar sempre a seguinte sequência: primeiro, identificar a causa com precisão; depois, planejar a forma de abordagem terapêutica e, por fim, adotar as condutas de forma muito bem fundamentada. As situações em que o tratamento endodôntico está indicado na terapêutica das reabsorções dentárias são quando houver: a) necrose pulpar por contaminação microbiana, b) necrose pulpar asséptica, c) metamorfose cálcica da polpa inicial e d) diagnóstico de reabsorção interna. Não se consegue, por via pulpar, controlar o processo reabsortivo que está ocorrendo na parte externa; afinal, as causas estão atuando no ligamento periodontal. Não há qualquer evidência que justifique fazer o tratamento endodôntico, via canal, para controlar processos reabsortivos externos, quando a polpa está com vitalidade.
Asunto(s)
Humanos , Tratamiento del Conducto Radicular/métodos , Resorción Radicular/cirugía , Resorción Radicular/diagnóstico , Resorción Radicular/etiología , Resorción Radicular/patología , Necrosis de la Pulpa Dental/cirugía , Cemento Dental/patologíaRESUMEN
This paper aims at exposing the foundations or reasons why, in cases of external tooth resorption, including those of orthodontic origin, one should not perform a root canal to treat it. That should be done only to teeth with contamination or pulp necrosis, to remove the periapical inflammation induced by microbial products. When facing cases of external tooth resorption, one's conduct must always respect the following sequence of steps: first of all, identifying the cause accurately; then, planning the therapeutic approach and, finally, adopting the conducts in a very well-founded way. The situations in which endodontic treatment is recommended for tooth resorptions are those when there are: a) pulp necrosis with microbial contamination, b) aseptic pulp necrosis, c) developing calcific metamorphosis of the pulp and d) diagnosis of internal resorption. It is not possible, through the pulp, to control the resorption process that is taking place in the external part, after all, the causes are acting in the periodontal ligament. There is no evidence that justifies applying endodontic treatment, by means of root canal, to control external resorption processes, when the pulp shows vitality.
Asunto(s)
Tratamiento del Conducto Radicular , Resorción Radicular/cirugía , Cemento Dental/patología , Necrosis de la Pulpa Dental/cirugía , Humanos , Tratamiento del Conducto Radicular/métodos , Resorción Radicular/diagnóstico , Resorción Radicular/etiología , Resorción Radicular/patologíaRESUMEN
The aim of this study was to detect apical inflammatory root resorption (AIRR) associated with periapical lesion using cone beam computed tomography (CBCT) and scanning electronic microscopy (SEM). This clinical study evaluated AIRR in 88 root apexes, from 52 permanent teeth of 14 patients, extracted for different reasons. The patients were submitted to a clinical interview, review of dental/medical histories and clinical/imaging examinations for treatment planning. All selected teeth showed unrestorable condition because of the extensive coronal breakdown due to carious lesions, and root canal infection associated with periapical lesions. CBCT images were obtained from the patients with the aim of diagnosing the periapical diseases which showed complex or doubtful conditions. Two examiners assessed the presence or absence of AIRR. Apices were also analyzed under SEM. Chi-square test was used to compare the imaging methods for detection of AIRR. The level of statistical significance was set at 5%. AIRR associated with root canal infection and apical periodontitis was found in 61.4% of the cases studied by using SEM, and at least half of the cases by CBCT. The microscopic analysis remains as a reference standard against the imaging method to identify AIRR.
Asunto(s)
Enfermedades Periapicales/diagnóstico , Resorción Radicular/diagnóstico , Ápice del Diente/patología , Adulto , Tomografía Computarizada de Haz Cónico/métodos , Caries Dental/complicaciones , Enfermedades de la Pulpa Dental/complicaciones , Femenino , Humanos , Masculino , Microscopía Electrónica de Rastreo , Planificación de Atención al Paciente , Periodontitis Periapical/diagnósticoRESUMEN
La reabsorción radicular externa cervical idiopática múltiple es una condición poco frecuente, se diagnostica cuando no puede atribuirse alguna causa específica que la origine. Objetivo: Divulgar un efecto no deseado y de poca frecuencia con afectación agresiva de múltiples dientes. Presentación de caso: Paciente de 48 años de edad, blanco, sexo masculino, antecedentes de hipertensión arterial, cólicos nefríticos a repetición, prostatitis, tratamiento ortodóncico fijo en el maxilar. En radiografía intraoral panorámica se observó en la mandíbula zonas radiolúcidas en mesial y distal en la región cervical de: 32, 33, 34, 35, 36, 37, que provocaron fractura a nivel coronario y confirmaron la reabsorción dentaria. Se realizó la exodoncia de los dientes afectados. Conclusiones: La reabsorción radicular externa cervical idiopática múltiple es poco frecuente, cursa asintomática, son numerosas las causas que pueden originarla, en el caso estudiado produjo afectación rápida y agresiva de múltiples dientes que provocó la exodoncia de los mismos. Realizar su correcto diagnóstico es esencial por lo que se requieren exámenes radiológicos y de laboratorio clínico para proponer protocolos de tratamiento de elección de acuerdo con el caso, en el momento oportuno y el seguimiento evolutivo.(AU)
Multiple idiopathic cervical external root resorption is a rare condition, diagnosed when any specific cause can be claimed. Objective: To disseminate an unwantedandinfrequent effect with aggressive involvement of multiple teeth. Case presentation:a 48 year-old, white, male patient withhistory of hypertension, recurrent kidney stones, prostatitis and fixed orthodontic treatment in the maxillary. In intraoral panoramic radiography in the mandible was observed in mesial and distal radiolucent areas in the cervical region: 32, 33, 34, 35, 36, 37 which caused fracture at coronary level and confirmed the dental resorption. The extraction of the affected teeth was performed. Conclusions: External multiple idiopathic cervical root resorption is rare, asymptomatic, there are many causes that can lead toit; in the case studied caused rapid and aggressive involvement of multiple teeth and the extraction of them. Making the correct diagnosis is essential so that radiological and clinical laboratory tests are required to propose treatment protocols of choice according to the case, at the right time and the evolutionary follow-up.(AU)
Asunto(s)
Humanos , Masculino , Adulto , Resorción Radicular/cirugía , Resorción Radicular/diagnósticoRESUMEN
Fundamento: La reabsorción radicular externa cervical idiopática múltiple es una condición poco frecuente, se diagnostica cuando no puede atribuirse alguna causa específica que la origine. Objetivo: Divulgar un efecto no deseado y de poca frecuencia con afectación agresiva de múltiples dientes. Presentación de caso: Paciente de 48 años de edad, blanco, sexo masculino, antecedentes de hipertensión arterial, cólicos nefríticos a repetición, prostatitis, tratamiento ortodóncico fijo en el maxilar. En radiografía intraoral panorámica se observó en la mandíbula zonas radiolúcidas en mesial y distal en la región cervical de: 32, 33, 34, 35, 36, 37, que provocaron fractura a nivel coronario y confirmaron la reabsorción dentaria. Se realizó la exodoncia de los dientes afectados. Conclusiones: La reabsorción radicular externa cervical idiopática múltiple es poco frecuente, cursa asintomática, son numerosas las causas que pueden originarla, en el caso estudiado produjo afectación rápida y agresiva de múltiples dientes que provocó la exodoncia de los mismos. Realizar su correcto diagnóstico es esencial por lo que se requieren exámenes radiológicos y de laboratorio clínico para proponer protocolos de tratamiento de elección de acuerdo con el caso, en el momento oportuno y el seguimiento evolutivo.
Background: Multiple idiopathic cervical external root resorption is a rare condition, diagnosed when any specific cause can be claimed. Objective: To disseminate an unwantedandinfrequent effect with aggressive involvement of multiple teeth. Case presentation:a 48 year-old, white, male patient withhistory of hypertension, recurrent kidney stones, prostatitis and fixed orthodontic treatment in the maxillary. In intraoral panoramic radiography in the mandible was observed in mesial and distal radiolucent areas in the cervical region: 32, 33, 34, 35, 36, 37 which caused fracture at coronary level and confirmed the dental resorption. The extraction of the affected teeth was performed. Conclusions: External multiple idiopathic cervical root resorption is rare, asymptomatic, there are many causes that can lead toit; in the case studied caused rapid and aggressive involvement of multiple teeth and the extraction of them. Making the correct diagnosis is essential so that radiological and clinical laboratory tests are required to propose treatment protocols of choice according to the case, at the right time and the evolutionary follow-up.
Asunto(s)
Humanos , Resorción Radicular/diagnóstico , Resorción Radicular/cirugíaRESUMEN
Este reporte de caso describe el tratamiento quirúrgico de un primer molar maxilar como solución a la perforación iatrogénica de su raíz mesiovestibular tras la colocación de un microtornillo para el refuerzo del anclaje ortodoncico en un paciente adulto. El objetivo de este caso clínico es dar a conocer una de las posibles complicaciones asociadas a la colocación de microtornillos interradiculares asociados al refuerzo del anclaje en ortodoncia, su diagnóstico y tratamiento.
The aim of this publication is to present one of the possible complications associated with the placement of interradicular miniscrews for the reinforcement of anchorage in orthodontics. This case report describes the surgical treatment of a maxillary first molar as a solution for the iatrogenic perforation of its mesiobuccal root after the placement of a microscrew for the reinforcement of the orthodontic anchorage in an adult patient.
Asunto(s)
Humanos , Adulto , Femenino , Implantación Dental Endoósea/efectos adversos , Métodos de Anclaje en Ortodoncia/efectos adversos , Resorción Radicular/cirugía , Resorción Radicular/etiología , Tornillos Óseos/efectos adversos , Diente Molar , Raíz del Diente/cirugía , Raíz del Diente/lesiones , Resorción Radicular/diagnóstico , Resultado del TratamientoRESUMEN
OBJECTIVES: Using a clinical survey, panoramic, cone-beam computed tomography (CBCT), and magnetic resonance (MR) imaging, this study was conducted to ascertain primary maxillofacial abnormalities in patients with mucopolysaccharidosis VI (MPS VI). STUDY DESIGN: Two patients previously diagnosed with MPS VI underwent clinical and imaging surveys (panoramic radiographs, CBCT, and MR imaging). RESULTS: Jaw involvement was present in all patients. The most prevalent findings were enlarged marrow spaces, osteopenia, dentigerous cyst-like follicles, effacement of the jaw structures, and osteosclerosis. This is the first study to describe temporomandibular joint (TMJ) involvement for MPS VI. CONCLUSIONS: CBCT and MR imaging were needed to observe features that were not clear in conventional radiographs. Both patients reported symptoms in the TMJ and demonstrated involvement during their examinations. A multicenter study is necessary to better document maxillofacial involvement in MPS VI.
Asunto(s)
Enfermedades Maxilomandibulares/diagnóstico , Mucopolisacaridosis IV/diagnóstico , Trastornos de la Articulación Temporomandibular/diagnóstico , Enfermedades Dentales/diagnóstico , Adolescente , Desmineralización Ósea Patológica/diagnóstico , Enfermedades Óseas Metabólicas/diagnóstico , Médula Ósea/patología , Tomografía Computarizada de Haz Cónico/métodos , Saco Dental/patología , Quiste Dentígero/diagnóstico , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética/métodos , Enfermedades Mandibulares/diagnóstico , Seno Maxilar/anomalías , Cavidad Nasal/anomalías , Osteosclerosis/diagnóstico , Linaje , Radiografía Panorámica/métodos , Resorción Radicular/diagnóstico , Diente Impactado/diagnósticoRESUMEN
INTRODUCTION: The purpose of this study was to describe a series of unicystic ameloblastomas (UAs) that presented clinical and radiographic similarities to apical periodontitis in order to call the attention of clinicians to the fact that several different diseases are able to mimic endodontic periapical lesions. METHODS: A retrospective clinicopathological analysis of 5 patients who had periapical lesions in the mandible initially diagnosed as apical periodontitis but with a final histologic diagnosis of UAs is presented. RESULTS: Three men and 2 women with a mean age of 26.4 years presented lesions involving the posterior mandible. No patient reported pain, and 3 patients showed pulp vitality of the involved teeth. Radiographically, all lesions presented periapical well-defined radiolucencies, ranging from 2 to 3 cm in diameter, and 3 cases presented root resorption. Endodontic therapy was applied in 2 patients who were referred to our clinics because of a lack of involution of the periapical lesions. All patients were submitted to periapical surgical curettage and histologically diagnosed as UA. After a mean follow-up of 45.6 months, all patients are well without signs of recurrence. CONCLUSIONS: UA may involve the periapical area of teeth, mimicking an inflammatory lesion of endodontic origin. The diagnosis of periapical lesions should be determined based on clinical and radiographic aspects. Recalcitrant lesions should be surgically explored and submitted to histologic evaluation. The early diagnosis of nonendodontic lesions mimicking apical periodontitis such as UA may prevent unnecessary endodontic treatment and wide surgical resections.
Asunto(s)
Ameloblastoma/diagnóstico , Neoplasias Mandibulares/diagnóstico , Periodontitis Periapical/diagnóstico , Adolescente , Adulto , Ameloblastoma/patología , Legrado , Prueba de la Pulpa Dental , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Masculino , Neoplasias Mandibulares/patología , Estudios Retrospectivos , Tratamiento del Conducto Radicular/métodos , Resorción Radicular/diagnóstico , Adulto JovenRESUMEN
BACKGROUND: Invasive cervical resorption (ICR) is not well understood by the professional, being misdiagnosed, leading to inappropriate treatment and unnecessary loss of tooth. INTRODUCTION: ICR is defined as a localized process of resorption, which begins in the cervical area of the tooth, just below the epithelial junction and above the ridge crest in the area of the connective tissue insertion. Possible predisposing factors include external trauma, orthodontic movement, surgical procedures, periodontal disease and its treatments, endogenous bleaching, pressure generated by wind instruments and herpes virus infection. Different approaches have been suggested for the treatment of ICR, depending on the extent of the lesion and its location. However, in some cases due to the severity of the injury, there is no alternative but to tooth extraction, followed by restoration of the edentulous area. AIM AND OBJECTIVE: Discuss etiology, diagnosis and classification of the ICR, as well as different treatment options. Also is presented a case in which extraction was carried out, installation of the implant and ceramic crown, subsequent to a treatment approach that resulted in failure in the short-term period. CONCLUSION: Early diagnosis of the ICR is critical to proper treatment and favorable prognosis. Interdisciplinary treatment should be instituted as soon as possible, avoiding the loss of the affected tooth. In advanced cases, treatment involving the installation of osseointegrated implants should be considered the first choice of treatment. CLINICAL SIGNIFICANCE: Early diagnosis of the ICR is critical do prevent unnecessary tooth loss, once the prognosis for advanced cases is doubtful.
Asunto(s)
Resorción Radicular/diagnóstico , Cuello del Diente/patología , Adulto , Coronas , Diente Canino/patología , Implantes Dentales de Diente Único , Dentadura Parcial Fija con Resina Consolidada , Diagnóstico Precoz , Estudios de Seguimiento , Humanos , Masculino , Oseointegración/fisiología , Planificación de Atención al Paciente , Pronóstico , Resorción Radicular/etiología , Resorción Radicular/terapia , Corona del Diente/patologíaRESUMEN
The aim of this work is to show the possibility of using fiber optic sensors to instrument inside parts of an artificial maxilla and measure internal tension transmitted by the orthodontic and orthopedic appliances to the dentition and the adjacent bone. Bragg gratings written in a standard optical fiber were used to monitor the maxillary teeth and a multiplexed fiber was used to monitor the surface of the maxillary bone, transversally to the longest axis of the teeth. A Universal Test Machine was used to evaluate the sensitivity of the sensor to the vertical and lateral forces applied on the teeth. A wavelength shift of approximately 0.30 nm was detected when applying loads ranging from 0 to 20 N. By applying forces using the standard orthodontic appliances installed on the dentition it was possible to detect a range of forces between 0.025 N to 0.035 N during the activation of the arch wire and extra-oral forces. The use of the internal sensors in an artificial model made possible the monitoring of the resulting forces on the internal parts of the teeth and at the position where the strain takes place within the maxilla. The sensors detected that the orthodontic forces were not transmitted to the surface of the maxilla. This information is important to elucidate and to correlate undesirable effects as tooth root absorption and local pain during the orthodontic treatment.
Asunto(s)
Maxilar/fisiología , Fibras Ópticas , Aparatos Ortodóncicos , Equipo Ortopédico , Huesos/fisiología , Humanos , Resorción Radicular/diagnóstico , Diente/fisiología , Raíz del Diente/fisiologíaRESUMEN
Introdução: a reabsorção cervical externa (RCE) é uma forma progressiva e agressiva de destruição da estrutura dental, caracterizada pela localização cervical e pela presença de tecido fibrovascular preenchendo a região reabsorvida. A RCE não apresenta uma etiologia específica, embora existam alguns fatores predisponentes para que ela ocorra. Devido à ausência de sintomas, a reabsorção cervical externa acaba se tornando um achado radiográfico, sendo detectada em exames de rotina. Algumas vezes, pode ocorrer a comunicação da lesão com o canal radicular e surgirem sintomas relacionados à pulpite. Em outros casos, clinicamente, a RCE pode ser identificada apenas como uma mancha rosa na margem gengival da coroa do dente afetado. Para o correto diagnóstico da RCE, além da técnica radiográfica convencional, é indicada a realização da tomografia computadorizada cone beam para avaliar a exata extensão e localização da lesão. O tratamento dependerá do estágio de evolução da reabsorção e, mesmo com a aplicação de materiais como o MTA, aRCE tem um prognóstico duvidoso na maioria dos casos. Objetivo: rever a literatura sobre a etiologia, diagnóstico e o tratamento da reabsorção cervical externa. Conclusão: a reabsorção cervical externa quanto mais cedo detectada melhor será seu prognóstico. Pacientes que apresentem algum fator predisponente devem ser acompanhados por meio de exame radiográfico de rotina e, quando necessário, o clínico pode solicitar tomada tomográfica para avaliar a extensão e localização da reabsorção, bem como, definir o tratamento adequado para cada caso.
Introduction: External cervical resorption (ECR) is a progressive and aggressive destruction of tooth structure, characterized by the cervical location and the presence of fibrovascular tissue filling the reabsorbed region. The ETS does not present a specific etiology, although there are some predisposing factors to occur. Due to the absence of symptoms, the external cervical resorption turns out to be a radiographic finding, being detected in routine tests. Sometimes, may occur the communication of the lesion with the root canal and develop symptoms related to pulpite. In othercases, clinically the ECR can only be identified as a pink spot at the gingival margin of the crown of the affected tooth. Besides the conventional radiographic technique,it is important for the correct diagnosis of ECR perform the cone beam computed tomography to evaluate the exact extent and location of the lesion. The treatment will depend on the evolution stage of resorption, and even with the application of materials such as MTA, the ECR has a dubious prognosis in most cases. Aim: review the literature about the etiology, diagnosis and treatment of external cervical resorption. Conclusion: External cervical resorption detected the sooner the better your prognosis. Patients who have some predisposing factor must be accompanied by routine radiographic examination and, where necessary, the clinician may request tomographic taking to assess the extent and location of resorption, as well as define the appropriate treatment for each case.
Asunto(s)
Humanos , Resorción Radicular/diagnóstico , Resorción Radicular/etiología , Resorción Radicular/terapia , Diagnóstico Precoz , Radiografía Dental , Índice de Severidad de la Enfermedad , Tomografía Computarizada por Rayos XRESUMEN
Primary hyperoxaluria is a rare, inherited autosomal recessive disease caused by defects in the metabolism of glyoxylate. Oral manifestations of hyperoxaluria are rare. However, bone and tooth resorption may be the result of chronic inflammation and the presence of osteoclastic cells surrounding the oxalate crystal deposit. A deposit of calcium oxalate in the periodontium was identified in a patient with end-stage renal disease. Dental radiographs indicated bone loss and external tooth resorption. Radiolucent image in the inferior incisor region was observed and removed. The tissue showed granulomatous inflammation with foreign body reaction and associated crystalline deposits. When viewed in polarized light, these deposits are green and presented a birefringent aspect, which were interpreted as calcium oxalate crystals compatible with oxaluria. Oral manifestations of hyperoxaluria are of particular interest because of the unusual location of the oxalate crystal deposition, resulting in aggressive tooth resorption and alveolar bone loss, which may be misdiagnosed.
Asunto(s)
Hiperoxaluria/diagnóstico , Hiperoxaluria/etiología , Trasplante de Riñón , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/etiología , Resorción Radicular/diagnóstico , Resorción Radicular/etiología , Adulto , Biopsia , Diagnóstico Diferencial , Humanos , Hiperoxaluria/patología , Masculino , Enfermedades Periodontales/patología , Resorción Radicular/patologíaRESUMEN
Os traumatismos dentários constituem, na atualidade, uma das principais causas da procura pelo cirurgião-dentista. O objetivo deste artigo é apresentar um caso clínico de traumatismo dental, abordando as diferentes reações pulpares dos dentes afetados e uma proposta de tratamento. Foram identificados dois tipos distintos de respostas pulpares ocorridas em dentes que foram sujeitos a um mesmo traumatismo (dente 21 e 11). Após o exame clínico e radiográfico, foi feito o diagnóstico diferencial entre lesão periapical no dente 21 e a imagem radiolúcida do orifício do nervo nasopalatino. Foi diagnosticado necrose pulpar no dente 21, sem lesão periapical e polpa viva no dente 11, apresentando este reabsorção interna e externa da raiz. Foi realizado o planejamento com indicação de tratamento de canal dos dentes 21 e 11, bem como a restauração estética dos mesmos com recurso de técnicas de clareamento interno e externo. O tratamento seleccionado mostrou um ótimo resultado estético com um custo relativamente baixo. O follow-up de dois anos permitiu confirmar o êxito e a longevidade do tratamento proposto.
Presently, dental trauma is one of the main causes for seeking a dental surgeon. The present paper presents a case report of dental trauma, addressing the different pulp reactions of the affected teeth and a treatment plan. The authors identified two distinct types of pulp reactions in teeth (tooth 21 and 11) subject to the same trauma. After clinical and radiographic examination, the differential diagnosis between periapical lesion on tooth 21 and radiolucency of the nasopalatine foramen was performed. Pulpal necrosis, without periapical lesion, was diagnosed in tooth 21, and live pulp in tooth 11, with internal and external root resorption. A treatment plan was designed, which included root canal treatment of teeth 21 and 11, as well as aesthetical restoration of both using internal and external bleaching techniques. This treatment resulted in optimal aesthetic outcome with relatively low cost. The 2-year follow-up confirmed the success and longevity of the treatment.
Asunto(s)
Femenino , Adulto , Blanqueamiento de Dientes , Resorción Radicular/complicaciones , Resorción Radicular/diagnóstico , Resorción Radicular/patología , Resorción Radicular/terapia , Traumatismos de los Dientes/complicaciones , Traumatismos de los Dientes/diagnóstico , Traumatismos de los Dientes/prevención & control , Traumatismos de los Dientes/rehabilitación , Traumatismos de los Dientes/terapia , IncisivoRESUMEN
Ocular hypertelorism is a congenital craniofacial malformation characterized by excessive distance between the eyes. It is one of the most expressive deformities of the human face. The aim of this case report was to discuss clinical aspects associated with the diagnosis, planning, and treatment of an orthodontic patient with ocular hypertelorism.
Asunto(s)
Hipertelorismo/terapia , Maloclusión Clase II de Angle/terapia , Ortodoncia Correctiva , Planificación de Atención al Paciente , Anodoncia/diagnóstico , Diente Premolar/anomalías , Niño , Aparatos de Tracción Extraoral , Asimetría Facial/diagnóstico , Asimetría Facial/terapia , Femenino , Humanos , Hipertelorismo/cirugía , Incisivo/anomalías , Maloclusión Clase II de Angle/diagnóstico , Diente Molar/patología , Mordida Abierta/diagnóstico , Mordida Abierta/terapia , Técnica de Expansión Palatina , Satisfacción del Paciente , Rinoplastia , Resorción Radicular/diagnóstico , Extracción Dental , Diente Supernumerario/diagnóstico , Resultado del TratamientoRESUMEN
Os tecidos mineralizados dos dentes permanentes (esmalte, dentina e cemento) em geral não sofrem processo de reabsorção, porém, em situações nas quais os tecidos dentários mineralizados sofrem destruição devido à ação de células clásticas, tem-se nesse caso a instalação de um processo de reabsorção...
Asunto(s)
Humanos , Masculino , Femenino , Anquilosis del Diente/terapia , Pulpitis/terapia , Resorción Radicular/diagnóstico , Resorción Radicular/terapia , Tratamiento del Conducto Radicular/tendenciasRESUMEN
A erupção ectópica e a impacção de caninos superiores são achados relativamente comuns em Ortodontia e Odontopediatria. O diagnóstico e planejamento do tratamento normalmente envolve exames radiográficos complementares no intuito de avaliar o posicionamento dos caninos e o possível grau de reabsorção nos elementos adjacentes. Modelos virtuais tridimencionais gerados a partir de tomografia computadorizada podem ser úteis, já que geram informações precisas e intuitivas em relação à morfologia dentária e sua localização espacial. O objetivo deste relato de caso foi descrever como a utilização dessa tecnologia auxiliou no diagnóstico de reabsorção radicular decorrente da erupção ectópica de caninos superiores em gêmeos monozigóticos.