Purpose
This study aimed to evaluate changes of the alveolar bone and interdental bone septum of the mandibular incisors through cone-beam computed tomography (CBCT) after orthodontic treatment of mandibular dental crowding without dental extraction.
Materials and Methods
The sample consisted of 64 CBCT images (32 pre-treatment and 32 post-treatment) from 32 adult patients with class I malocclusion and an average age of 23.0±3.9 years. The width and height of the alveolar bone and interdental septum, the distance between the cementoenamel junction (CEJ) and the facial and lingual bone crests, and the inclination of the mandibular incisors were measured.
Results
The distance between the CEJ and the marginal bone crest on the facial side increased significantly (
P
<0.05). An increased distance between the CEJ and the bone crest on the facial and lingual sides showed a correlation with the irregularity index (
P
<0.05); however, no significant association was observed with increasing mandibular incisor inclination (
P
>0.05). The change in the distance between the CEJ and the marginal bone crest on the facial side was correlated significantly with bone septum height (
P
<0.05).
Conclusion
Bone dehiscence developed during the treatment of crowding without extraction only on the incisors' facial side. Increasing proclination of the mandibular incisor was not correlated with bone dehiscence. The degree of dental crowding assessed through the irregularity index was associated with the risk of developing bone dehiscence. The interdental septum reflected facial marginal bone loss in the mandibular incisors.
The aim was to report on a case of ossifying fibroma, consisting of a benign fibro-osseous lesion characterized by slow growth and proliferation of fibrous cellular tissue, bone, cement or a combination.A 29-year-old male patient was attended at a hospital, after he had suffered a car accident. During the clinical examination, increased volume in the region of the right side of the mandible was observed, and a fracture in the middle third of the face was suspected. The tomographic examination showed an image suggestive of fracturing of the left-side zygomatic complex, without displacement, and with a well-delimited radiopaque image of the mandible. The patient was sent to a hospital where panoramic radiography, posteroanterior radiography of the face and teleradiography were performed in order to better document the case. An incisional biopsy was performed. Histopathological examination showed the presence of a benign bone lesion suggestive of ossifying fibroma. Surgery was performed in order to completely remove the lesion, with fixation using a reconstruction plate. A new anatomopathological examination confirmed the diagnosis.
IntroduçãoA amelogênese imperfeita (AI) é uma má formação do esmalte dental e pode afetar tanto a dentição decídua quanto a permanente 1 . O defeito estrutural do dente está limitado ao esmalte, sendo que a dentina apresenta-se normal, assim como a câmara pulpar e a morfologia radicular. A AI é considerada um defeito hereditário 2 e ocorre durante a odontogênese 3 . Na odontogênese temos duas fases na formação do esmalte: formação ou aposição da matriz do esmalte e mineralização. A produção de matriz do esmalte inicia-se a nível de cúspides ou das bordas incisais e progride em direção cervical. Os distúrbios na formação da matriz do esmalte poderão causar hipoplasia. A mineralização do esmalte faz-se em duas etapas. Logo que a matriz orgânica é depositada, ocorre uma mineralização parcial imediata, pela deposição de cristais de hidroxiapatita. A segunda etapa é denominada maturação e corresponde à mineralização gradual e completa do esmalte. Se ocorrer alguma deficiência nessa fase, teremos um esmalte hipocalcificado ou hipomaturado 3 . A AI pode ser dividida em três tipos: hipoplásica, hipocalcificada e hipomaturada. Na AI hipoplásica a matriz do esmalte parece ser imperfeitamente formada, com falhas na fase de aposição. Embora a calcificação da matriz ocorra posteriormente e o esmal-
PurposeIn the present study, we coined the term 'alveolar dome' and aimed to demonstrate the prevalence of alveolar domes through digital periapical radiographs.Materials and MethodsThis study examined 800 digital periapical radiographs in regard to the presence of alveolar domes. The periapical radiographs were acquired by a digital system using a photostimulable phosphor (PSP) plate. The χ2 test, with a significance level of 5%, was used to compare the prevalence of alveolar domes in the maxillary posterior teeth and, considering the same teeth, to verify the difference in the prevalence of dome-shaped phenomena between the roots.ResultsThe prevalence of alveolar domes present in the first pre-molars was statistically lower as compared to the other maxillary posterior teeth (p<0.05). No statistically significant difference was observed in the prevalence of alveolar domes between the maxillary first and second molars. Considering the maxillary first and second molars, it was observed that the palatal root presented a lower prevalence of alveolar domes when compared to the distobuccal and mesiobuccal roots (p<0.05).ConclusionThe present study coined the term 'alveolar dome', referring to the anatomical projection of the root into the floor of the maxillary sinus. The maxillary first and second molars presented a greater prevalence of alveolar domes, especially in the buccal roots, followed by the third molars and second pre-molars. Although the periapical radiograph is a two-dimensional method, it can provide dentists with the auxiliary information necessary to identify alveolar domes, thus improving diagnosis, planning, and treatment.
Some complications can arise with the usage of local anesthesia for dental procedures, including the fracture of needles in the patient. This is a rare incident, usually caused by the patient's sudden movements during anesthetic block. Its complications are not common, but can include pain, trismus, inflammation in the region, difficulty in swallowing, and migration of the object, which is the least common but has the ability to cause more serious damage to the patient. This report describes a case in which, after the fracture of the anesthetic needle used during alveolar nerve block for exodontia of the left mandibular third molar, the fragment moved significantly in the first 2 months, before stabilizing after the third month of radiographic monitoring.
Coronoid Process Hyperplasia is a rare condition characterized by the increase in size of a histologically normal bone. It can be confused with Temporomandibular Joint Dysfunction, due to the presence of major signs/symptoms, including the limitation of mouth opening, pain, and facial asymmetry. Although several theories have been proposed, the etiology remains unknown. The recommended treatment is mandibular coronoidectomy. In the present study, the importance of computed tomography to reach the proper diagnosis and the surgical treatment plan is demonstrated.
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