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Objective: To evaluate the influence of mandibular third molars on relapse of mandibular anterior crowding in orthodontically treated patients.Material and Methods: Sample included orthodontic records of 108 patients: Group 1: 72 patients (39 female; 33 male) with third molars present in the postretention evaluation stage. Group 2: 36 patients (18 female; 18 male) who did not present the third molars in the postretention evaluation stage. Panoramic radiographs and dental models were evaluated at three different stages: pre-treatment; posttreatment and postretention. Panoramic radiographs showed the presence or absence of third molars in the 3 evaluated stages and on the dental models, overbite and mandibular anterior crowding was measured by the Little Irregularity Index. For intergroup comparisons, t-tests and a multifactorial regression analysis were used.Results: There was no statistically significant difference in the relapse of mandibular anterior crowding among the groups with and without mandibular third molars at the postretention stage.Conclusion: The presence or absence of mandibular third molars did not influence the relapse of mandibular anterior crowding in orthodontically treated patients.

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Resumen El objetivo del presente estudio es determinar la prevalencia del apiñamiento dental determinando el comportamiento y la prevalencia de esta anomalía en el ciclo de vida de las personas y el grupo dentario más afectado en la población que consulta los servicios de odontología de la CCSS. Se realizó un estudio descriptivo del 1 de enero al 30 de abril del 2017 en las áreas de salud del país donde se valoró la cantidad de pacientes sugeridos; para el examen clínico se usó como soporte la ficha de encuesta para la evaluación del estado de salud bucodental, elaborada con variables con base en las necesidades de esta investigación. Se recolecta una muestra de 104.691 datos de personas, en el que el muestreo estratificado por grupos de edad prefijados, es el siguiente: 9.652 niños de 0 a 5 años; 4.270 niños de 6 años; 10.477 niños de 7 a 9 años; 9.495 adolescentes de 10 a 12 años; 13.096 jóvenes de 13 a 19 años; 14.532 mujeres de 20 a 35 años; 7.586 mujeres de 36 a 45 años; 13.435 adultos de 20 a 45 años; 13.504 adultos de 46 a 59 años y 8.644 adultos mayores de 60 y más años, y esta información es procedente de las áreas de salud de las diferentes regiones del país. La prevalencia nacional del apiñamiento dental se estimó en 10% (0,0981 - 0,1018) IC95%, y la prevalencia de apiñamiento dental es menor del 1% en el grupo de 0-5 años, y empieza un aumento acelerado hasta 17% a la edad de 13-19 años, para luego disminuir hasta el 3% en el adulto mayor; que disminuye a partir del grupo de los 13 a 19, debido a que en estas edades comienza a incrementarse la pérdida de piezas dentales producto de la caries dental en que la prevalencia de pieza perdida dental de 5% en el grupo de 13 a 19 se incrementa hasta llegar al 75% en el adulto mayor y la pérdida de dientes por enfermedad periodontal de 0,08 en los adolescentes de 13 a 19 años para luego incrementarse paulatinamente hasta llegar al 18% en el adulto y luego aumentar abruptamente al 39% en el adulto mayor. El apiñamiento promueve dificultades para comer, hablar e incluso problemas bucodentales como consecuencia de la acumulación de placa, caries, enfermedad periodontal, disfunción de la articulación temporomandibular (ATM), además de repercutir en la estética del paciente, disminuyendo su autoestima, por lo que, realizar este tipo de investigaciones nos ayuda a conocer el impacto que tienen este tipo de patologías en la población y que por ser un problema de salud pública, es de especial interés para los tomadores de decisiones en salud, conocer a fondo dicha problemática.

Abstract The aim of this study is to estimate the prevalence of dental crowding, determining its behavior and presence of this anomaly through life, also the most affected population group that uses the dentistry services of CCSS. A descriptive study was made from January 1st through April 30, 2017, in different Costa Rican health services, the number of necessary patients was calculated; for the clinical exam a dental survey record chart was used to evaluate oral health conditions, this chart was specifically designed for the needs of this investigation A sample of 104.691 patients was documented, in which stratified sampling of previously selected age groups was designated as follows: 9.652 children from 0 to 5 years old; 4.270 children under 6 years, 10.477 children from 7 to 9 years old; 9.495 teenagers from 10 to 12 years old; 13.096 teenagers from 13 to 19 years of age; 14.532 women from 20 to 35 years old; 7.586 women from 36 to 45 years old; 13.435 adults from 20 to 45 years of age; 13.504 adults from 46 to 59 years old and 8.644 adults at age 60 or older, and this information proceeded from different regions of the country. The Crowding National Prevalence was estimated at 10% (0.0981 - 0.1018) IC95%, in the group from 0 to 5 years old crowding was lower than 1%, and started increasing quickly up to 17% at 13-19 years of age, after that it lowered down to 3% in the elderly group; crowding decreased in group 13 to 19 years old, possibly because at these ages tooth loss starts increasing due to dental cavities. Tooth loss at ages 13 to 19 had a prevalence of 5% and increased up to 75% in the elderly group. Tooth loss caused by periodontal disease in the age group 13 to 19 had a prevalence of 0.08 and gradually increased to 18% in adults and 39% in the elderly group. Crowding promotes difficulties for eating, speaking, increases oral problems as a consequence of biofilmbaccumulation, dental cavities, periodontal disease, TMD, as well as affecting the patient's esthetics lowering self-esteem, for these reasons this type of investigations helps to understand the impact of this pathology over the population, and since it is viewed as a public health issue, it is of special interest in the health program's decisión making process to comprehend such problematic.

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RESUMEN: Introducción: La relación entre terceros molares y el desarrollo o reincidencia de maloclusión y apiñamiento dental tras el tratamiento de ortodoncia, especialmente en el segmento anterior del arco dental, es un tema que ha sido discutido y presentado en la literatura, el cual aún permanece sin resolver. Métodos: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, preparamos tablas de resumen de los resultados utilizando el método GRADE. Resultados: Identificamos 7 revisiones sistemáticas que en conjunto incluyen 31 estudios primarios, de los cuales, 2 son ensayos aleatorizados. Conclusiones: El limitado desarrollo de estudios que relacionan los terceros molares con apiñamiento dental y el bajo nivel de evidencia de éstos no permiten tener claridad respecto a la posible asociación. Son necesarios nuevos estudios sobre el tema.

ABSTRACT: Introduction: The relationship between third molars and the development or recurrence of malocclusion and dental crowding after orthodontic treatment, especially in the anterior segment of the dental arch, is a subject that has been discussed and presented in the literature, which still remains unsolved. Methods: To answer this question we used Epistemonikos, the largest database of systematic health reviews, which combines searches in multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted the data from the identified reviews, reanalyzed them from the primary studies and prepared summary tables of the results using the GRADE method. Results: We identified 7 systematic reviews that together included 31 primary studies, 2 of which were randomized trials. Conclusion: The limited development of studies that relate third molars to dental crowding and their low level of evidence does not allow us to be certain about the possible association. New studies are necessary.

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ABSTRACT The teeth become very close to each other when they are crowded, but their structures remain individualized and, in this situation, the role of the epithelial rests of Malassez is fundamental to release the EGF. The concept of tensegrity is fundamental to understand the responses of tissues submitted to forces in body movements, including teeth and their stability in this process. The factors of tooth position stability in the arch - or dental tensegrity - should be considered when one plans and perform an orthodontic treatment. The direct causes of the mandibular anterior crowding are decisive to decide about the correct retainer indication: Should they be applied and indicated throughout life? Should they really be permanently used for lifetime? These aspects of the mandibular anterior crowding and their implication at the orthodontic practice will be discussed here to induct reflections and insights for new researches, as well as advances in knowledge and technology on this subject.

RESUMO Os dentes ficam muito próximos quando estão apinhados, mas suas estruturas permanecem individualizadas e, nessa situação, o papel dos restos epiteliais de Malassez é fundamental para liberar o EGF. A tensigridade é um conceito chave para compreender as respostas dos tecidos submetidos às forças nos movimentos corporais, incluindo os dentes e sua estabilidade nesse processo. Os fatores da estabilidade de posição de um dente na arcada dentária — ou tensigridade dentária — devem ser considerados quando se planeja e finaliza um caso na prática clínica ortodôntica. As causas diretas do apinhamento dentário anteroinferior são determinantes para se refletir se a contenção deve ser mesmo indicada e aplicada por toda a vida e se, necessariamente, deve ser usada de forma permanente. Esses aspectos do apinhamento dentário anteroinferior e suas implicações na prática clínica serão aqui abordados para induzir reflexões e insights de novas pesquisas, bem como avanços no conhecimento e tecnologia sobre esse assunto.

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OBJECTIVE: The aim of this longitudinal study, comprising young adults without orthodontic treatment, was to assess spontaneous changes in lower dental arch alignment and dimensions. METHODS: Twenty pairs of dental casts of the lower arch, obtained at different time intervals, were compared. Dental casts obtained at T1 (mean age = 20.25) and T2 (mean age = 31.2) were compared by means of paired t-test (p < 0.05). RESULTS: There was significant reduction in arch dimensions: 0.43 mm for intercanine (p = 0.0089) and intermolar (p = 0.022) widths, and 1.28 mm for diagonal arch length (p < 0.001). There was a mild increase of approximately 1 mm in the irregularity index used to assess anterior alignment (p < 0.001). However, regression analysis showed that changes in the irregularity index revealed no statistically significant association with changes in the dental arch dimensions (p > 0.05). Furthermore, incisors irregularity at T2 could not be predicted due to the severity of this variable at T1 (p = 0.5051). CONCLUSION: Findings suggest that post-growth maturation of the lower dental arch leads to a reduction of dental arch dimensions as well as to a mild, yet significant, increase in dental crowding, even in individuals without orthodontic treatment. Furthermore, dental alignment in the third decade of life cannot be predicted based on the severity of dental crowding at the end of the second decade of life. .

OBJETIVO: o objetivo deste trabalho foi avaliar, por meio de um estudo longitudinal em adultos jovens, sem tratamento ortodôntico, as alterações espontâneas do alinhamento da arcada dentária inferior e de suas dimensões. MÉTODOS: vinte pares de modelos de gesso da arcada inferior foram obtidos em dois tempos. No primeiro exame (T1), os indivíduos tinham, em média, 20,25 anos; enquanto no segundo exame (T2) a média de idade foi de 31,2 anos. Comparações entre os tempos T1 e T2 foram realizadas usando o teste t pareado (p < 0,05). RESULTADOS: houve uma redução significativa nas dimensões da arcada - de 0,43mm nas larguras intercaninos (p = 0,0089) e intermolares (p = 0,022) e de 1,28mm para o comprimento diagonal da arcada (p < 0,001). Foi observado um aumento suave, de aproximadamente 1mm, no índice de irregularidade anterior (p < 0,001). Entretanto, a análise de regressão mostrou que as mudanças no índice de irregularidade não revelaram uma associação estatisticamente significativa com as mudanças na arcada dentária (p > 0,05). Além disso, o índice de irregularidade dos incisivos em T2 não pode ser estimado, devido à severidade dessa variável em T1 (p = 0,5051). CONCLUSÃO: esses achados sugerem que a maturação da arcada dentária inferior, pós-crescimento, leva a uma redução das dimensões da arcada e um aumento suave, porém significativo, do apinhamento dentário, mesmo em indivíduos sem tratamento ortodôntico. Assim, o alinhamento dentário na terceira década de vida não pode ser previsto tendo como base a severidade do apinhamento dentário ao final da segunda década de vida. .

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Como propósito se ha tenido el determinar la prevalencia del apiñamiento dentario en adolescentes del área de salud Masó, en el curso escolar 2007-2008, identificar la prevalencia por sexos, precisar la arcada más afectada, clasificarlo y relacionarlo con la clasificación de Angle. Se realizó un estudio descriptivo-prospectivo en un universo de 987 adolescentes, seleccionando de forma aleatoria estratificada una muestra de 138; se examinaron en sus propios escenarios, con luz natural y se utilizaron depresores linguales, pie de rey y solución esterilizante. La frecuencia del apiñamiento dentario fue de 44,2%; según el sexo, el masculino mostró 49,2% y el femenino, 50,8%; el apiñamiento dentario en la mandíbula mostró 44,2%; en el maxilar, 23% y en ambos maxilares, 32,8%. Al clasificarlo, el apiñamiento ligero se observó en 52 adolescentes (64,2%) y es la clase I de Angle la que más se relacionó con el apiñamiento (57,4%). La frecuencia del apiñamiento dentario se presentó por encima de 40%, no existen diferencias significativas en cuanto al sexo. Apareció el apiñamiento más en la mandíbula y es el ligero, él que aportó mayor número de casos, es la Clase I la que se relacionó más con la patología en estudio.

To determine the prevalence of the dental crowding in adolescents of the Health Area Masó, in the schoolar course 2007-2008, identificate the prevalence by gender, select the most affected arcade, clasify and relate with Angle's classification. A descriptive-prospected study was made in an univrse of 987 adolescents, selecting the aleatory form stratificated in their own stages with natural lihght and lingual tonge pusher, dental vernier and sterilizer solution were used. The prevalence of the dental crowding was of the 44,2%; according to the gender, the masculine shows 44,2% and the female 50,8%. The dental crowding in the jaw showed 42,2%, in the maxilar 23%, in both maxilars 32,8%. At the moment of classify the crowding was observed in 52 adolescents (64,2%) and it is Class I of Angle the one that had most relation with the crowding (57,4%). The prevalence of the dental crowding was presented over the 40%, there aren't significant differences according to the gender. Appeared the dental crowding more in the jaw and it is the light the one that offered a greater number of cases, it is Class I of Angle the one most related with the patology in study.

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