RESUMO

El trauma dental es un problema común en la consulta diaria que no siempre se maneja de forma adecuada. En este artículo se presenta el caso de una paciente que a temprana edad recibió un golpe que afectó el desarrollo radicular de la pieza 1.1. Con el tiempo salió a relucir una serie de complicaciones como: necrosis pulpar, pigmentación coronal, presencia de gran lesión perialpical y aparición recurrente de fístula, lo que le llevó a realizarse una serie de tratamientos que a la larga fracasaron hasta que 37 años despúes, mediante los avances de la tecnología, se logró resolver el caso realizando una cirugía apical con colocación de un endoimplante con lima de níquel titanio (NiTi). Este caso clínico demuestra que con el paso del tiempo, el afán de la paciente por mantener su pieza dental en boca y la aparición de nuevos materiales y técnicas, hoy en día, se pueden llegar a resolver casos sumamente complejos que normalmente estarían destinados a la exodoncia.

The dental trauma is a common problem in daily practice not always handled properly. This article describes the case of a patient who received an early knock that affected radicular development of tooth 1.1. Eventually a number of complications appeared such pulp necrosis, coronal pigmentation, presence of large perialpical lesion and recurrent appearance of fistula, which led the patient to realized a series of treatments that eventually failed until 37 years later, through advances in technology, it was possible to solve the case by making an apical surgery with placement of an endoimplant with a nickel titanium (NiTi) file. This case shows that with the passage of time, the desire of the patient to keep teeth in her mouth and the appearance of new materials and techniques, nowadays, highly complex cases that would normally be destined for extraction can be solve.

RESUMO

OBJECTIVES: In an effort to contribute to proper dental planning and define possible dental phenotypes of nonsyndromic cleft lip and/or palate (CL/P), this study aimed to investigate the occurrence of taurodontism, root dilaceration, and tooth transposition in persons with nonsyndromic CL/P, specifically analyzing the differences among gender, cleft types, and the most affected teeth. DESIGN: This retrospective study analyzed 974 panoramic x-rays from nonsyndromic Brazilians older than 16 years and categorized into the following four groups: group 1, 250 persons with unilateral cleft lip and palate; group 2, 250 persons with unilateral cleft lip; group 3, 224 persons with cleft palate; and a control group of 250 persons without clefts. Radiographs were digitalized with a scanner and analyzed. RESULTS: In the Brazilian population studied, the prevalence of taurodontism was 60.4% in group 1, 62.4% in group 2, 67.0% in group 3, and 42.8% in the control group. Root dilacerations had a prevalence of 31.2% in group 1, 29.6% in group 2, 26.3% in group 3, and 27.2% in the control group. The teeth most affected by taurodontism were 17 and 27; whereas root dilacerations were most common in teeth 38 and 48. No tooth transpositions were found in any radiograph analyzed. CONCLUSIONS: Taurodontism is significantly more prevalent in Brazilians with nonsyndromic CL/P than in persons without clefts; whereas the prevalence of root dilaceration no different from that in the control group. However, root dilacerations in anterior teeth were increased in groups 1 and 2 when compared to the control group.

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RESUMO

O uso de radiografias panorâmicas é cada vez mais aceito e rotineiro no dia a dia do cirurgião dentista. Esta também vem sendo muito usada para o planejamento cirúrgico de exodontias de terceiros molares. Porém, alguns trabalhos colocaram em discussão a fidelidade deste exame em detectar pequenas alterações anatômicas e a possibilidade de distorção de imagem do exame. Neste trabalho analisamos 27 dentes extraídos com seus respectivos exames radiográficos panorâmicos prévios à exodontia. Foi detectado que houve diferença significativa no que tange ao critério de número de raízes avaliado no exame radiográfico e no elemento extraído e também no que diz respeito à dilaceração radicular verificada neste exame e no dente.

Panoramic radiography is actually one of the most used imaginologic exams in clinical dentistry. It is also very used for surgical planning of third molars extraction. However, some papers raise some discussion about the accuracy of this exam in detecting small anatomic changes and the possibility of distortion of the image. In this paper, 27 dental elements (all upper third molars) that were extracted were analyzed, and comparison between the real aspect of the root morphology of the teeth that were extracted and the number of roots with the respective image on the panoramic radiography were performed. Significant differences were detected between these two observations in the number of roots and root dilaceration.

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