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OBJECTIVE: This study evaluated the efficacy of Valeriana officinalis L. and Passiflora incarnata L. to control anxiety, surgical discomfort, and changes in vital signs of patients undergoing extraction of two unilateral third molars. MATERIALS AND METHODS: This study is a randomized, triple-blinded clinical trial. Fifty-four patients were allocated into three groups (Valeriana officinalis L., Passiflora incarnata L., and placebo). Anxiety levels were assessed using the State-Trace Anxiety Inventory (STAI) index, surgical discomfort using the QCirDental, and through the measurement of vital signs. The surgical times evaluated were before (T0), during (T1), and after surgery (T2). RESULTS: There was evidence that both Valeriana officinalis L. and Passiflora incarnata L., reduced STAY-S scores between T0 and T2 (p < .05), unlike placebo (p = .129). There was no change in surgical discomfort in all groups over time, and vital signs presented variable results. CONCLUSION: Phytotherapy drugs showed a reduction in anxiety state compared to the placebo group during third molar extraction procedure.  CLINICAL TRIAL REGISTRATION: klRBR-6kcxvrc, March 10, 2022.

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El crimen organizado se ha convertido en un flagelo a nivel internacional conformado por grupos al margen de la ley que realizan todo tipo de actividades que involucran desde tráfico de personas, secuestros, extorsiones, narcotráfico y muchos otros delitos. Producto de este fenómeno, la desaparición y ejecución de personas es cada día más frecuente, en muchos casos los cuerpos son quemados o desmembrados para impedir o hacer más difícil la identificación. La odontología forense se ha convertido en una disciplina transcendental en la identificación de cadáveres y restos óseos, además de contar con múltiples métodos para estimar la edad aproximada de una persona. Se presenta el caso de un descuartizamiento múltiple de tres individuos masculinos donde era indispensable identificar si alguno correspondía a una persona menor de 18 años.

Organized crime has become an international scourge made up of outlaw groups that carry out all kinds of activities ranging from human trafficking, kidnapping, extortion, drug trafficking and many more. As a result of this phenomenon, the disappearance and execution of people is becoming more frequent every day, in many cases the bodies are burned or dismembered to prevent or make identification more difficult. Forensic odontology has become a transcendental discipline in the identification of corpses and skeletal remains, in addition to having multiple methods to estimate the approximate age of a person. The case of a multiple dismemberment of three male individuals is presented, where it was essential to identify a person under 18 years of age.

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Introducción: Las complicaciones, asociadas al brote anormal de los terceros molares, es posible evitarlas con la germenectomía de estos dientes. Objetivo: Caracterizar la evolución de la germenectomía de terceros molares en pacientes con diagnóstico cefalométrico de brote anormal. Métodos: Se realizó un estudio observacional, descriptivo y transversal en el Servicio de Cirugía Maxilofacial del Hospital Provincial "Saturnino Lora Torres", desde febrero de 2019 hasta marzo de 2021. Se estudiaron 32 pacientes de 13 a 15 años de edad, interviniéndose quirúrgicamente 78 terceros molares. Las variables fueron edad, sexo, color de la piel, localización y posición del tercer molar; así como las complicaciones trans y posoperatorias y la evolución. Resultados: Entre los 32 pacientes incluidos en el estudio predominó el sexo femenino (62,5 por ciento) y la edad de 14 años (40,6 por ciento). Las complicaciones ocurridas durante la germenectomía fueron más frecuentes en la arcada inferior. Aunque no fueron detectadas diferencias estadísticamente significativas según localización (valor de p>0,05); con 30 transoperatorias para un 38,4 por ciento y 75 posoperatorias para un 96,2 por ciento. Conclusiones: Se evidencia una evolución marcadamente favorable posterior a la germenectomía de terceros molares en la población de pacientes con diagnóstico cefalométrico de brote anormal. En ellos el sangrado transoperatorio y el dolor posoperatorio constituyen las complicaciones a considerar en este tipo de procedimiento quirúrgico(AU)

Introduction: Complications associated with the abnormal eruption of third molars can be avoided with germenectomy of these teeth. Objective: To characterize the evolution of third molar germenectomy in patients with a cephalometric diagnosis of abnormal bud. Methods: An observational, descriptive and cross-sectional study was carried out in the Maxillofacial Surgery Service at Saturnino Lora Torres Provincial Hospital, from February 2019 to March 2021. Thirty two patients aged 13 to 15 years were studied, with 78 third molars undergoing surgery. The variables were age, sex, skin color, location and position of the third molar; as well as trans and postoperative complications and evolution. Results: Among the 32 patients included in the study, the female sex (62.5 percent) and the age of 14 years (40.6 percent) predominated. Complications that occurred during germenectomy were more frequent in the lower arch. Although no statistically significant differences were perceived according to location (p value > 0.05); with 30 intraoperative for 38.4 percent and 75 postoperative for 96.2 percent. Conclusions: There is evidence of a markedly favorable evolution after germenectomy of third molars in the population of patients with cephalometric diagnosis of abnormal bud. In them, transoperative bleeding and postoperative pain are the complications to consider in this type of surgical procedure(AU)

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Bone tissue engineering seeks biomaterials that enable cell migration, angiogenesis, matrix deposition, and tissue regeneration. Blood concentrates like platelet-rich fibrin (L-PRF) offer a cost-effective source of cells and growth factors to enhance healing. The present study aimed to evaluate heated serum albumin with liquid PRF (Alb-PRF) and L-PRF clinically and biochemically after placement in dental sockets following mandibular third molar extraction. In a controlled, split-mouth study involving 10 volunteers, 20 extracted molars were treated with either Alb-PRF or L-PRF. Post-extraction, pain, trismus, infection presence, and swelling were measured. The concentrations of different analytes in the surgical sites were also examined. The data were statistically analyzed, with significance defined at p < 0.05 (t-test). No significant difference was noted between the groups for pain and trismus, but Alb-PRF showed a significant reduction in swelling on day seven. The Alb-PRF group showed lower levels of pro-inflammatory cytokines (GM-CSF, IL-1b, IL-6, IFNy, IL-8, IL-15, RANTES, and MIP-1a) after seven days, with only higher expressions of MIP-1b, IL-1b, and MCP-1 found in the L-PRF group. Differences were observed in the release of analytes between L-PRF and Alb-PRF, with Alb-PRF significantly reducing edema after seven days. Alb-PRF reduced edema, while L-PRF increased inflammatory cytokines. When compared to L-PRF, Alb-PRF reduced edema and the release of inflammatory cytokines, suggesting promising effects in socket healing while underscoring the role of growth factors and cytokines in potential applications of blood concentrates.

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OBJECTIVES: To compare the multilayer panoramic radiography (MPAN) and conventional panoramic radiography (CPAN) in the evaluation of mandibular third molars using cone-beam computed tomography (CBCT) as a reference. METHODS: CPAN, MPAN, and CBCT scans from 33 dry human mandibles were acquired using the OP300 Maxio unit, totalizing 56 mandibular third molars to be evaluated. Three examiners evaluated each third molar according to their position, depth of impaction in the mandibular ramus, proximity between the dental root apexes and the mandibular canal, and the presence of radiographic signs of proximity to the mandibular canal. In addition, when there was a distance between the root apexes and the mandibular canal, it was measured. As a reference, these same parameters were assessed in the CBCT scans by a fourth examiner. For the statistical analysis, the weighted Kappa, Bland Altman, and Wilcoxon tests were performed (α = 0.05). RESULTS: The agreement between the assessments performed in the panoramic modalities with the CBCT ranged from 66.1% to 100.0% for the categorical variables. Overall, the agreement values of CPAN and MPAN with CBCT were similar. The distances between the dental root apex and the mandibular canal for both CPAN and MPAN were significantly underestimated compared to CBCT (p < 0.05). The intra- and interexaminer agreements of the examiners ranged from poor to almost perfect; in general, the agreements were higher in the evaluation performed in the MPAN than in the CPAN. CONCLUSIONS: The MPAN performs similarly to CPAN for evaluating mandibular third molars and their proximity relationship to the mandibular canal. CLINICAL RELEVANCE: Preoperative evaluation of lower mandibular third molars is usually performed using CPAN. Recently, a new tool, MPAN, was developed, which has not yet been tested for the evaluation of mandibular third molars and showed similar performance to CPAN in the present study. Future studies using MPAN are encouraged to evaluate other diagnostic tasks.

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Introducción: La posición del tercer molar mandibular durante su erupción puede influir en el resultado del tratamiento de ortodoncia o que se necesita recurrir a este nuevamente. Objetivo: Describir la posición de los terceros molares mandibulares durante su erupción en pacientes que recibieron tratamiento ortodóncico en el consultorio Desing Dental en la ciudad de Santo Domingo de los Tsáchilas, Ecuador. Método: se realizó un estudio descriptivo transversal, el universo lo constituyeron el total de pacientes que recibieron tratamiento ortodóncico en edades comprendidas entre 13 y 33 años¸ el muestreo fue aleatorio simple y la muestra quedó conformado por 23 pacientes, 11 del sexo masculino y 12 del femenino. La recolección de la información se realizó a través de la revisión documental de los informes radiográficos mediante una guía confeccionada para este fin. Los resultados se presentaron en tablas y fueron contrastados con los de otras investigaciones. Se respetaron los principios éticos. Resultados: La posición de los terceros molares más común según edad y sexo fue: para el sexo masculino de 11 pacientes, 2 presentaron la vertical, 8 la mesioangular y 1 la horizontal; mientras que, en el sexo femenino con una muestra de 12 pacientes: 2 pacientes presentaron la posición vertical, 8 la mesioangular y 2 la distoangular. Conclusiones: La posición más frecuente de los terceros molares durante su erupción en los pacientes con tratamiento de ortodoncia fue la posición mesioangular.

Introduction: The position of mandibular third molar during its eruption can influence on the outcome of orthodontic treatment or the need to turn to an orthodontic treatment again. Objective: To describe the position of mandibular third molars during eruption in patients who received orthodontic treatment at the dental office Desing Dental, in the city of Santo Domingo de los Tsáchilas, Ecuador. Method: A cross-sectional descriptive study was carried out; the universe was constituted by the total of patients who received orthodontic treatment, patients between 13 and 33 years of age; the sampling applied was simple random and the sample selected gathered 23 patients, 11 male and 12 female. The information collected was obtained throught a documentary review of the radiographic reports, using a guide prepared for this purpose. The outcomes were presented in tables and were contrasted with those of other investigations. Ethical principles were respected. Results: The most common position of the third molars according to age and sex was as follow: From the 11 male patients, in 2 of them the position was vertical, 8 mesioangular and 1 horizontal; whereas in the 12 female patients, in two of them the position was vertical, 8 mesioangular and 2 distoangular. Conclusions: The most frequent position of third molars during eruption in patients undergoing orthodontic treatment was the mesioangular position.

Introdução: A posição do terceiro molar inferior durante sua erupção pode influenciar no resultado do tratamento ortodôntico ou que seja necessário recorrer a ele novamente. Objetivo: Descrever a posição dos terceiros molares inferiores durante sua erupção em pacientes que receberam tratamento ortodôntico no consultório Desing Dental na cidade de Santo Domingo de los Tsáchilas, Equador. Método: Foi realizado um estudo descritivo transversal, o universo foi constituído pelo número total de pacientes que receberam tratamento ortodôntico entre 13 e 33 anos, a amostragem foi aleatória simples e a amostra foi composta por 23 pacientes, 11 masculinos e 12 femininos. A coleta de informações foi realizada por meio da revisão documental dos laudos radiográficos utilizando um roteiro elaborado para esse fim. Os resultados foram apresentados em tabelas e contrastados com os de outras investigações. Os princípios éticos foram respeitados. Resultados: A posição mais comum dos terceiros molares de acordo com idade e sexo foi: para o sexo masculino de 11 pacientes, 2 apresentaram a vertical, 8 a mesioangular e 1 a horizontal; enquanto, no sexo feminino com uma amostra de 12 pacientes: 2 pacientes apresentaram a posição vertical, 8 a mesioangular e 2 a distoangular. Conclusões: A posição mais frequente dos terceiros molares durante sua erupção em pacientes com tratamento ortodôntico foi a posição mesioangular.

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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)

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Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria: We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane "risk of bias" tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.

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Objective: This study aims to determine the frequency of retained third molars in relation to facial biotype, the data were collected by using the patients' 2D studies (panoramic and cephalometric) attending the imaging center ZETA-EXMED in the period November 2018 to December 2021, in the city of Lima, Peru. Methods: The type of study used for this research are observational, descriptive, cross-sectional, and retrospective. For the present study, 6000 cases were evaluated, each case consists of one panoramic radiographic image and one cephalometric image, both taken to the patient on the same date, of these, only 150 cases that met the selection criteria were included in this study. Measurements about frequency of retained third molars in relation to facial biotype were done by a trained and calibrated researcher, using NemoCeph software for the cephalometric tracing. The statistical analysis was done using SPSS program version 1.0.0.1401 (SPSS Inc., USA) and the Chi square test (p <0.05). Results: Of the 150 cases observed, 91 were women (60.66%) and 59 were men (39.33%). According to the results, dolichofacial biotype had the highest frequency among males with a total of 27 cases (45.80%), while the brachyfacial biotype was more prevalent among females, with a total of 35 cases (38.50%). In addition, out of the total number of retained third molars evaluated (403 pieces), 141 were present in cases with dolichofacial biotype, followed by the mesofacial biotype with 139 pieces and finally the brachyfacial biotype with 123 pieces. Regarding the evaluation of retained third molars according to their position and facial biotype, 63 retained third molars were found in mesioangulated position and 28 retained third molars in dolichofacial / distoangular position, followed by 48 pieces in the vertical position in brachyfacial. Conclusions: There is not significant association between the quantity of retained third molars and their positions, in relation to facial biotype, although there is a significant association between facial biotype and the patient's sex, so it was concluded that Dolichofacial biotype has the highest frequency in males, while the Brachyfacial biotype is seen more frequently among females.

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Las extracciones quirúrgicas de terceros molares pueden, si no son atendidas oportunamente, conllevar infecciones postoperatorias de gravedad. Este estudio se realizó sobre una población de 103 pacientes provenientes de la Provincia de Chimborazo, Ecuador con el fin de estudiar posibles infecciones postoperativa después de la extracción de terceros molares. Para ello, se realizó la estratificación de la población en función de la edad (15 a 25, 26 a 30, 31 a 40, 41 a 50 y 51 a 60 años), sexo, estudios escolares (inicial, básica, bachiller y profesional) y nivel socioecónomico (bajo, medio y alto). A la par, se estudió la presencia de bacterias altamente patógenas como la S. mutans y P. gingivalis en la cavidad bucal de las personas con infección postoperatoria. Los resultados revelaron que las molestias asociadas a la extracción de estos terceros molares son más frecuentes entre la población de 15 a 30 años, y es la población femenina la más proclive a tales inflamaciones. Los pacientes de menores recursos económicos fueron lo que acudieron a estos centros asistencias asociados al bajo costo de los mismos. Al analizar la posición del tercer molar respecto al segundo se observó una mayor frecuencia en la posición B. Asimismo, se determinó la presencia de S. mutans y P. gingivali en más de la mitad de la población tratada que debe ser atendida en el menor tiempo posible a fin de evitar males mayores. Se hace un llamado a los padres de familia y maestros para que sea orientadores de estas enfermedades(AU)

Surgical extractions of third molars can, if not treated promptly, lead to serious postoperative infections. This study was conducted on a population of 103 patients from the Province of Chimborazo, Ecuador in order to study possible postoperative infections after the extraction of third molars. For this, the population was stratified according to age (15 to 25, 26 to 30, 31 to 40, 41 to 50 and 51 to 60 years), sex, school studies (initial, basic, high school and professional) and socioeconomic level (low, medium and high). At the same time, the presence of highly pathogenic bacteria such as S. mutans and P. gingivalis in the oral cavity of people with postoperative infection was studied. The results revealed that the discomfort associated with the extraction of these third molars is more frequent among the population aged 15 to 30 years, and the female population is the most prone to such inflammation. Patients with lower economic resources were the ones who attended these assistance centers associated with their low cost. When analyzing the position of the third molar regard to the second, a higher frequency was observed in position B. Likewise, the presence of S. mutans and P. gingivali was determined in more than half of the treated population that should be treated in the minor time possible in order to avoid greater problems. A call is made to parents and teachers to guide these diseases(AU)

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Auto-transplantation has been suggested to be a favourable treatment option in comparison to prosthodontic replacements. Studies have shown an average survival rate of 89.1% for auto-transplanted teeth. This article aims to report a successful third molar auto-transplantation, despite delayed endodontic treatment because of movement control order (MCO) imposition following COVID-19 out-break in Malaysia. A 22-year-old female patient's impacted lower left third molar (38) was used as a donor to replace her lower left second molar (37), which was deemed non-restorable due to caries and root resorption as a result of impinging pressure from the impacted adjacent third molar. Successful outcome and uneventful healing were achieved over a period of one year, despite delayed endodontic treatment following auto-transplantation. A favourable auto-transplant can be achieved despite delayed endodontic treatment post-transplantation, if the procedure is performed in a good aseptic environment and bacterial load is controlled at the site (AU)

O autotransplante tem sido sugerido como uma opção de tratamento favorável em comparação com as substituições protéticas. Estudos mostraram uma taxa de sobrevivência média de 89,1% para dentes autotransplantados. Este artigo tem como objetivo relatar um autotransplante de terceiro molar bem-sucedido, apesar do atraso no tratamento endodôntico devido à imposição da ordem de controle de movimento (MCO) após o surto de COVID-19 na Malásia. O terceiro molar inferior esquerdo impactado de uma paciente de 22 anos (38) foi usado como doador para substituir seu segundo molar inferior esquerdo (37), que foi considerado não restaurável devido à cárie e reabsorção radicular como resultado da pressão de impacto do terceiro molar adjacente impactado. Resultado bem sucedido e cicatrização sem intercorrências foram alcançados ao longo de um período de um ano, apesar do atraso no tratamento endodôntico após o autotransplante. Um autotransplante favorável pode ser alcançado apesar do atraso no tratamento endodôntico pós-transplante, se o procedimento for realizado em um ambiente asséptico e com carga bacteriana controlada no local.(AU)

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Objective: This randomized clinical trial evaluated the sensitive return of the lower alveolar nerve (LAN) using two photobiomodulation therapy (PBMT) techniques, after the extraction of lower third molars or implant surgery. Materials and methods: Sixty participants with sensory impairment of LAN were randomly divided into three groups (n = 20): group C-systemic medication (control-ETNA®, 01 capsule, 8/8 h, 30 days); group laser therapy (LT) (808 nm, 100 mW, 40 sec/point, 4 J/point, intra/extraoral, irradiation following nerve path); group laser acupuncture (LA) (same parameters as the LT group, applied at six acupuncture points on the affected side (ST 4 [Dicang], M-HN-18 [Jiachengjiang], CV 24 [Chengjiang], ST 5 [Daying], ST 6 [Jiache], and point A1 [YNSA]). The following evaluations were performed, at predetermined times: general perception of paresthesia, thermal perception, vibratory mechanical perception, two-point discrimination, pain perception, and tactile perception. Data were analyzed by two-way analysis of variance (ANOVA), followed by the Tukey, except for the two-point discrimination, which was analyzed using the chi-square test. Results: In general and thermal perception, both PBMTs had better results than control; regarding cold perception, only the LT group was statistically superior to control. LA presented inferior results of neural regeneration for tests of perception of pain and tactile at the lip, and of tactile perception at the chin. In the other tests, there was no statistical difference among the groups. Conclusions: LT and the conventional drug treatment had the same effectiveness and both were superior to LA for the treatment of paresthesia of the LAN after oral surgeries.

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Introducción: El conocimiento del desarrollo dentario desde su génesis hasta su aparición en la boca, es de gran utilidad para la práctica clínica estomatológica. Objetivo: Validar un esquema de formación y desarrollo para los terceros molares. Material y Métodos: Se realizó un estudio observacional, descriptivo y transversal en el Policlínico José Martí Pérez de Santiago de Cuba, en el período comprendido desde mayo de 2016 hasta febrero de 2017. El universo estuvo constituido por 2 421 terceros molares, encontrados en 618 radiografías panorámicas de pacientes ortodóncicos de 8 a 18 años de edad. Se diseñó un esquema de formación y desarrollo el cual se validó por aspecto, contenido y criterio. Resultados: Se destaca, según el esquema propuesto, la aparición de la cripta (etapa I) a los 9,0 años como intervalo medio (etapa I), así como el inicio de los movimientos eruptivos (etapa IV) a los 9,9, para dar paso al inicio de la formación de la raíz a los 10,3 (etapa V). La validez del contenido del esquema diseñado se logró con la opinión de los 15 expertos (6 estomatólogos con categoría de doctores en ciencias y 9 especialistas de Segundo Grado en Ortodoncia), la cual fue muy buena. Conclusiones: Fue posible validar el esquema de formación y desarrollo para los terceros molares, de modo que está disponible un instrumento válido y confiable, cuyo uso y adecuada aplicación se justifican en el ámbito investigativo(AU)

Introduction: Knowledge of dental development from its genesis to its appearance in the mouth is very useful for the dental clinical practice. Objective: To validate a training and development scheme for third molars. Material and Methods: An observational, descriptive, and cross-sectional study was carried out at "José Martí Pérez" Polyclinic from Santiago de Cuba in the period from May 2016 to February 2017. The universe consisted of 2 421 third molars, found in 618 panoramic radiographs of orthodontic patients 8 to 18 years of age. A training and development scheme was designed and validated by aspect, content and criteria. Results: According to the proposed scheme, the appearance of the crypt (stage I) at 9.0 years as a medium interval (stage I), as well as the onset of eruptive movements (stage IV) at 9.9 years, stand out to give way to the beginning of root formation at 10.3 (stage V). The content validity of the designed scheme was achieved by considering the opinion of 15 experts (6 dentists with Doctors of Science degree, and 9 second-degree specialists in Orthodontics), which was very good. Conclusions: It was possible to validate the training and development scheme for third molars, so a valid and reliable instrument, whose use and adequate application are justified in the research field, is available(AU)

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A importância da permanência dos dentes naturais na cavidade bucal vem sendo cada dia mais reconhecida e almejada, seja pelo fator estético ou pelo funcional. Uma alternativa para a reabilitação de indivíduos com perdas dentárias ou exodontias indicadas é o transplante dental. Esta modalidade de tratamento corresponde à transferência de um órgão dental, para um alvéolo receptor. O presente trabalho relata e discute um caso de triplo transplante autógeno, utilizando terceiros molares, enfatizando as etapas cirúrgicas e demonstrando que após dois anos de preservação os resultados confirmam o sucesso deste tratamento. Anamnese, exames clínicos e radiográficos foram analisados de forma criteriosa, antes e após a cirurgia, sendo a radiografia panorâmica utilizada antes e após o ato cirúrgico e radiografias periapicais após, para acompanhamento individual das unidades transplantadas. Houve sucesso na realização dos transplantes dentários, obtendo regeneração pulpar e adaptação ao alvéolo receptor, mantendo o espaço dental com vitalidade e oclusão dentaria satisfatória. O procedimento apresentou sucesso significativo, obtendo êxito nas três unidades transplantadas, devolvendo o equilíbrio ao desenvolvimento crânio facial, comprovando sua eficácia na reabilitação oral em jovens com perdas prematuras de unidades dentárias... (AU)

The importance of the maintenance of natural teeth in the oral cavity has been increasingly recognized and desired, for the aesthetic and also the functional factor. An alternative for the rehabilitation of individuals with indicated tooth loss or extractions is dental transplantation. This type of treatment corresponds to the transfer of a dental organ to a recipient alveolar socket. The present work reports and discusses a case of triple autogenous transplantation, using third molars, emphasizing the surgical stages and demonstrating that after two years of preservation the results confirm the success of this treatment. Anamnesis, clinical and radiographic examinations were carefully analyzed, before and after surgery, with panoramic radiography used before and after surgery and periapical radiographs afterwards, for individual monitoring of transplanted units. Dental transplants were successful in achieving pulp regeneration and adaptation to the recipient alveolus, maintaining the dental space with vitality and satisfactory dental occlusion. The procedure was significantly successful, achieving success in the three transplanted units, restoring balance to the facial skull development, proving its effectiveness in oral rehabilitation in young people with premature loss of dental units... (AU)

La importancia de la permanencia de los dientes naturales en la cavidad bucal ha sido cada vez más reconocida y buscada, ya sea por motivos estéticos o funcionales. Una alternativa para la rehabilitación de personas con pérdida de dientes o extracciones recomendadas es el trasplante dental. Esta modalidad de tratamiento corresponde a la transferencia de un órgano dentario a un alvéolo receptor. Este trabajo reporta y discute un caso de triple trasplante autógeno, utilizando terceros molares, enfatizando los pasos quirúrgicos y demostrando que luego de dos años de preservación, los resultados confirman el éxito de este tratamiento. Se analizó cuidadosamente la anamnesis, los exámenes clínicos y radiográficos, antes y después de la cirugía, con radiografía panorámica antes y después de la cirugía y radiografías periapicales después, para el seguimiento individual de las unidades trasplantadas. Los trasplantes dentales fueron exitosos, logrando la regeneración pulpar y la adaptación al alvéolo receptor, manteniendo el espacio dentario con una oclusión y vitalidad dentarias satisfactorias. El procedimiento fue significativamente exitoso, teniendo éxito en las tres unidades trasplantadas, devolviendo el equilibrio al desarrollo craneofacial, demostrando su efectividad en la rehabilitación oral en jóvenes con pérdida prematura de unidades dentales... (AU)

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Introducción: La intervención temprana en el brote anormal de los terceros molares podría reducir la proporción de pacientes con las molestias asociadas y la aparición de alteraciones producto a la retención dentaria. Objetivo: Validar el modelo cefalométrico predictivo para el brote de los terceros molares desarrollado González Espangler. Métodos: Se realizó un estudio longitudinal, descriptivo, de corte transversal, en adolescentes del Instituto Preuniversitario "Rafael María de Mendive" de Santiago de Cuba durante el periodo comprendido entre enero del 2017 y marzo del 2020. Fueron empleadas dos muestras aleatorias de 21 estudiantes de 15-18 años y 29 profesionales de las ciencias de la salud. Se estudiaron variables como el sexo, color de la piel, localización, etapa de formación, espacio óseo posterior, angulación, diámetro mesiodistal, factores predictivos y tipo de brote de los terceros molares. Resultados: Predominó el tipo de brote anormal: 19,0 por ciento para la localización 1.8; 17,9 por ciento para la 2.8; 21,4 por ciento en la 3.8 y 20,2 por ciento en la posición 4.8. No existieron diferencias significativas entre las medidas promedios del espacio óseo posterior, angulación y diámetro mesiodistal con el estudio de referencia. La validación de modelo por criterio de expertos obtuvo una calificación global de concordancia entre ellos del 100 por ciento. Conclusiones: El modelo cefalométrico predictivo validado es viable en el proceso de predicción del brote de los terceros molares en la población(AU)

Introduction: Early intervention in the abnormal eruption of third molars could reduce the number of patients with associated discomfort and the appearance of alterations caused by dental retention. Objective: Validate the cephalometric prediction model for third molar eruption developed by González Espangler. Methods: A cross-sectional longitudinal descriptive study was conducted of adolescents from Rafael María de Mendive Senior High School in Santiago de Cuba from January 2017 to March 2020. The two random samples examined consisted of 21 students aged 15-18 years and 29 health sciences professionals. The variables considered were sex, skin color, location, training stage, posterior bony space, angulation, mesiodistal diameter, predictive factors and type of third molar eruption. Results: Abnormal eruption prevailed: 19.0 percent in location 1.8; 17.9 percent in 2.8; 21.4 percent in 3.8 and 20.2 percent in 4.8. Significant differences were not observed between average values for posterior bony space, angulation and mesiodistal diameter, and the study reference. Validation of the model by expert criteria obtained a global agreement score of 100 percent. Conclusions: The cephalometric prediction model validated in the study is viable for the prediction of third molar eruptions in the population(AU)

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OBJECTIVES: The aim of this study is to verify whether the diagnostic accuracy of cone beam computed tomography (CBCT) is superior to panoramic radiography (PR) in predicting inferior alveolar nerve (IAN) exposure during the lower third molar extraction. MATERIALS AND METHODS: Eight electronic databases were searched up to September 2020. Studies that evaluated the accuracy (sensitivity, specificity, positive-predictive value, and negative predictive value) of both imaging methods were included. The gold standard was the visualization of the IAN exposure during the extraction of lower third molars. The gray literature was also used to include any other paper that might meet the eligibility criteria. The meta-analysis was performed with OpenMeta-Analyst and ReviewManager v.5.3 software. The methodology of the studies was evaluated using QUADAS-2. RESULTS: Among the search, three studies met all the eligibility criteria and were included in the qualitative and quantitative synthesis. The meta-analysis was conducted with all included studies. Accuracy values for CBCT were 95.1% for sensitivity (p=0.666) and 64.4% for specificity (p<0.001). For PR sensitivity and specificity, we observed 73.9% (p=0.101) and 24.8% (p<0.001), respectively. CONCLUSIONS: Both exams were reliable for detecting positive cases of exposure of the IAN. However, CBCT had a better performance compared to PT in predicting IAN exposure during surgery. CLINICAL RELEVANCE: To better understand the CBCT accuracy in predicting the IAN exposure during surgery, since this event can increase the likelihood of IAN injury and, consequently, cause neurosensory disturbances.

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The present study correlated the mineralization of third molars to chronological age using a modified classification based on Demirjian's stages in a Brazilian subpopulation and compared with the original classification. A total of 1082 patients with age ranging from 6 to 26 years were included in the sample, with at least one third molar on panoramic radiographs. The third molars were classified according to the original Demirjian classification (8 stages) and a new model based on the Demirjian method, where the original stages were grouped into four stages: AB-enamel mineralization; CD-crown dentin mineralization; EFG-root formation; and H-complete development. Statistical analyses were performed by Kruskal-Wallis/Dunn tests (α = 0.05) and the multinomial logistic regression model. Data were analyzed according to percentiles for the probability of an individual being over 18 years old. The mean ages of the stages in both classifications did not present a significant difference between superior and inferior arches (p < 0.05). The differences in mean ages between all the stages of mineralization were statistically significant (p < 0.001) only for the 4-stage classification. Males attained root formation and complete formation earlier than females (p < 0.05) in the 4-stage classification. The modified classification system showed dependence between chronological age and mineralization stages of third molars, simplifying the age estimation process. At stage H, females present a 95.7% chance of being over 18, while for males, this probability is 89.6%. This modified classification system simplifies the dental age estimation process based on third molars and can be used as a reference for future studies.

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ABSTRACT Introduction: The third molars are forgotten because they are the last in the dental arch, they do not directly influence the smile and they appear only in adolescence, when they do. Objectives: 1) to provide the clinician with a "checklist" to assess and diagnose changes to be screened in the third molar region in new patients; 2) to reveal the importance of not discharging the patient submitted to any dental treatment without first analyzing the third molars region clinically and on imaging examinations, since many diseases are associated to them. Result: A list of 10 situations that cover all diagnostic possibilities involving the third molars is presented. Conclusion: Adopting this protocol is a matter of habit, since the need is fundamental. The next professional assisting your patient may ask: "Did he not request examinations for the third molars?".

RESUMO Introdução: Os terceiros molares são esquecidos por serem os últimos dentes na arcada dentária, por não influenciarem diretamente no sorriso e por aparecerem apenas na adolescência - quando aparecem. Objetivos: 1) Fornecer ao clínico um checklist de conferência e diagnóstico de alterações a serem checadas na região dos terceiros molares em novos pacientes; e 2) Destacar a importância de não dar alta ao paciente submetido a qualquer tratamento odontológico sem antes analisar, clínica e imagiologicamente, a região dos terceiros molares, pois muitas doenças estão a eles associadas. Resultado: Criou-se uma lista de 10 situações que englobam todas as possibilidades diagnósticas envolvendo os terceiros molares. Conclusão: Adotar esse protocolo é uma questão de hábito, pois a necessidade é imperiosa. O próximo profissional a atender o seu paciente vai perguntar: "Ele não solicitou exames para os terceiros molares?".

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Los terceros molares tienen un patrón de erupción inusual. Estudios sugieren que, debido a la posición y angulación de estos, se pueden presentar diversas patologías en los molares adyacentes, tales como problemas periodontales y aparición de caries distales. El objetivo de este trabajo es describir el estado periodontal de los segundos molares mandibulares adyacentes a terceros molares mandibulares. Para ello se realizó un estudio descriptivo transversal. Se trabajó con una muestra de 277 pacientes que acudieron a la clínica odontológica de la UCSG para realizarse extracciones de terceros molares en el período A-2018. Se realizó un examen clínico intraoral en donde se observaron las siguientes variables: profundidad de sondaje, estado gingival y presencia de caries en segundos molares mandibulares. Además, se revisó las radiografías panorámicas de los pacientes para determinar la posición del tercer molar mandibular y el nivel de la cresta ósea distal de los segundos molares. Los resultados mostraron que la profundidad del sondaje por distal de los segundos molares mandibulares revisados fue normal (de 1 a 3mm) en el 31% de los casos, en tanto que en el 69% se encontraron profundidades mayores a 3mm. Con respecto a la presencia de pérdida ósea en estas piezas, en el 43% de los casos no hubo pérdida, en el 35% de los casos hubo pérdida leve, el 22% presentó pérdida moderada y solo un 1% tuvo pérdida severa. La presencia de terceros molares mandibulares afecta de forma significativa el estado periodontal del segundo molar adyacente, pudiendo generar bolsas periodontales, pérdidas óseas y caries en la zona distal de estos.

Third molars have an unusual eruption pattern. Studies suggest that, due to the positionand angulation of these, various pathologies could occur in the adjacent molars, such as periodontal problems and the appearance of distal caries. The objective of this work is to describe the periodontal status of mandibular second molars adjacent to mandibular third molars. For this, a descriptive transversal study was carried out. We worked with a sample of 277 patients that went to the Dental UCSG Clinic to have their third molars extracted in the period A-2018. An intraoral clinical examination was performed, and the following variables were observed: probing depth, gingival state, and presence of caries in mandibular second molars. In addition, panoramic x-rays of the patients were reviewed to determine the position of the third mandibular molar and the level of the distal bone crest of the second molars. The results showed that the depth of distal probing of the mandibular second molars were normal (from 1 to 3mm) in 31% of the cases, while in 69% depths greater than 3mm were found. Regarding the presence of bone loss, in 43% of the cases there was no loss, in 35% of the cases there was a slight loss, 22% presented moderate loss and only 1% had severe loss. The presence of mandibular third molars significantly affects the periodontal status of theadjacent second molar, which can lead to periodontal pockets, bone loss and caries in their distal area.

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INTRODUCCIÓN: La coronectomía se considera una alternativa a la extracción total en los casos donde las raíces de los terceros molares inferiores están en íntimo contacto con el nervio alveolar inferior. Existe incertidumbre sobre si la coronectomía disminuye la incidencia de parestesia en comparación a la extracción total. MÉTODOS: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un meta análisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos seis revisiones sistemáticas que en conjunto incluyeron 17 estudios primarios, de los cuales, dos corresponden a ensayos clínicos aleatorizados. Concluímos que la coronectomía en comparación a la extracción total de los terceros molares inferiores probablemente se asocia a un menor riesgo de parestesia. Además, no está claro si la coronectomía en comparación a la extracción total de terceros molares inferiores podría aumentar el riesgo de infección (certeza de la evidencia es muy baja).

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