RESUMO
En este informe de caso clínico se muestra el tratamiento exitoso de un paciente con anodoncia parcial de órganos dentales 13 y 23 debido a que fueron extraídos por presentar impactación y mal pronóstico de tracción. En este artículo se presenta un paciente masculino de 29 años clase I esquelética con un perfil convexo, maloclusión de clase III, overjet disminuido, ausencia de guías funcionales, discrepancia oseodentaria positiva en arcada superior y negativa en arcada inferior. El tratamiento se realizó con extracciones de los órganos dentales 34 y 44 para nivelar las discrepancias óseo dentarias interarcadas, se llevó a cabo mediante un cierre de espacios recíproco por medio de cadenas elásticas para ambas arcadas, con lo que se logró crear un overjet y overbite adecuados. La creación de las guías caninas funcionales se consiguió mediante el cambio de morfología de los órganos dentales 14 y 24, los cuales fueron llevados a la posición de los caninos ausentes. El tiempo total de tratamiento para este paciente fue de 24 meses. Se realizaron ameloplastias positivas, la aplicación de agregados de resina para mejorar la funcionalidad y proveer salud articular. Se sugiere que ante casos de anodoncia de caninos en la arcada superior, un tratamiento favorable se puede llevar a cabo mediante el cierre de espacios, la caracterización morfológica de los caninos ausentes mediante ameloplastias positivas en premolares (AU)
This case report shows the successful treatment of a patient with partial anodontia of dental organs 13 and 23 because they have been extracted due to present impactation and poor traction prognosis. This article presents a 29-year-old male class I skeletal patient with convex profile, class III malocclusion, overjet reduction, absence of functional guidance, positive bone-teeth discrepancy in the upper arch and negative in the lower arch. The treatment was carried out with the extractions of the dental organs 34 and 44 for correcting oral dental discrepancies between upper and lower arches; it was done using reciprocal closing of spaces by using elastic chains for both arches in order to achieve a suitable overjet and overbite. The creation of the canine guides was achieved by changing the morphology of the dental organs 14 and 24, which were taken to the position of the absent canines. The total treatment timing for this patient was 24 months. Positive ameloplasties were performed by application of resin aggregates to improve functionality and provide joint health. A favorable treatment for these kinds of cases of canine anodontics in the upper arch is carried out by closing spaces and the morphological characterization of the absent canines by positive in-premolar ameloplasties (AU)
Assuntos
Humanos , Masculino , Adulto , Extração Dentária/métodos , Dente Pré-Molar , Dente Canino/cirurgia , Esmalte Dentário/cirurgia , Anodontia/terapia , Faculdades de Odontologia , Técnicas de Movimentação Dentária/métodos , Braquetes Ortodônticos , Contenções Ortodônticas , Fechamento de Espaço Ortodôntico , Estética Dentária , Má Oclusão Classe III de Angle/terapia , Maxila , MéxicoRESUMO
A continuación se presenta un caso de un paciente de 12 años de edad, con antecedente de bruxismo, con biotipo mesofacial, tercio inferior dolicofacial, hipertonicidad muscular en maseteros, cierre labial forzado con incompetencia labial de 4 milímetros con dolor en sinoviales anteriores inferiores. Los objetivos de tratamiento consistieron en lograr relajación muscular y promover un posicionamiento condilar ortopédicamente funcional y estable, realizar control vertical para disminuir gap interlabial, alinear líneas medias, mantener clase I molar bilateral, clase I canina bilateral y clase I incisiva, crear overjet y overbite adecuados, con recuperación estética y función del segmento anterior. Debido a eventos adversos durante la etapa de cierre de espacios, la clase molar y canina I no se logró, pero se aseguró mediante ameloplastias positivas la función y estética adecuadas para tener un tratamiento de ortodoncia estable a largo plazo (AU)
The following is a case of a 12-year-old patient, with a history of bruxism, with a mesofacial biotype, lower third of the facial area, muscular hypertonicity in the masseters, a forced labial closure with a 4-millimeter labial incompetence with pain in inferior anterior synoviums. Treatment objectives consisted of achieving muscle relaxation and promoting orthopedically functional and stable condylar positioning, perform vertical control to decrease interlabial gap, align midlines, maintain bilateral molar class I, bilateral canine class I and incisive class I, create adequate overjet and overbite, with aesthetic recovery and function of the anterior segment. Due to adverse events during the closing phase of spaces, the molar and canine I class was not achieved, but positive function and aesthetics were ensured by positive ameloplasties in order to have a long-term stable orthodontic treatment (AU)
Assuntos
Humanos , Feminino , Criança , Ortodontia Corretiva , Bruxismo , Relação Central , Esmalte Dentário/cirurgia , Estética Dentária , Aparelhos Ortodônticos , Planejamento de Assistência ao Paciente , Placas Oclusais , Resinas Compostas , México , Relaxamento MuscularRESUMO
This study aimed to evaluate the use of antimicrobial photodynamic therapy (aPDT) as an adjunct for minimally invasive treatment (partial removal of carious tissue-PRCT) of deciduous carious tissue evaluating its efficacy in reducing microorganisms. For that, a clinical study was design including children with deciduous molars with active deep caries lesions (DCL). PRCT was performed and remaining dentin was treated with 100 µg mL-1 methylene blue solution (5 min) and than irradiated with a low power laser emitting red light (InGaAIP-indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 300 J cm-2 ; 90 s; 9 J). The colony forming units (CFU) count after PRCT and after PRCT + aPDT/mg of dentin were compared for total microorganisms, including Candida spp., the mutans streptococci group, Streptococcus spp. and Lactobacillus spp. The dentin was classified (color, consistency and humidity). The microbial reduction varied from 69.88% to 86.29% and was significantly observed for total microorganisms, mutans streptococci, Streptococcus spp. and Lactobacillus spp (P < 0.001). The dentin type did not influence reduction of microorganisms (P > 0.05). The aPDT presents a promising future for clinical use as an adjunct for the reduction of microorganisms in PRCT of DCL in all kinds of dentin.
Assuntos
Cárie Dentária/tratamento farmacológico , Azul de Metileno/administração & dosagem , Dente Molar/efeitos dos fármacos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Dente Decíduo/efeitos dos fármacos , Candida/efeitos dos fármacos , Candida/crescimento & desenvolvimento , Criança , Pré-Escolar , Cárie Dentária/microbiologia , Cárie Dentária/cirurgia , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/microbiologia , Esmalte Dentário/cirurgia , Dentina/efeitos dos fármacos , Dentina/microbiologia , Dentina/cirurgia , Feminino , Humanos , Lactobacillus/efeitos dos fármacos , Lactobacillus/crescimento & desenvolvimento , Lasers , Luz , Masculino , Azul de Metileno/metabolismo , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Dente Molar/microbiologia , Dente Molar/cirurgia , Fármacos Fotossensibilizantes/metabolismo , Streptococcus/efeitos dos fármacos , Streptococcus/crescimento & desenvolvimento , Dente Decíduo/microbiologia , Dente Decíduo/cirurgia , Resultado do TratamentoRESUMO
Abstract The effect of a 4% titanium tetrafluoride (TiF 4 ) varnish on enamel demineralization was evaluated. Twelve volunteers participated in this double-blind, randomized crossover study. Six enamel specimens were positioned in intraoral appliances throughout four treatment stages: 4% TiF 4 varnish (experimental varnish), 5% sodium fluoride (NaF) varnish (Duraphat ® ), placebo varnish, and negative control (deionized water). After 24 h, the varnishes were removed and plaques were allowed to accumulate. A 20% sucrose solution was dripped onto enamel blocks (10x/day). Enamel alterations were analyzed by surface microhardness (SMH), percentage of surface loss (%SML), cross-sectional microhardness (CSMH), scanning electron microscopy (SEM), and energy dispersive X-ray spectrometry (EDS). Student's paired t-test was used for SMH analysis and repeated-measures analysis of variance (ANOVA) for %SML and CSMH (∆Z) analyses (p-value=0.05). The TiF 4 varnish group had lower %SML than the placebo and control groups (p=0.044 and p=0.003, respectively), thus showing its capacity to inhibit surface demineralization. TiF 4 and NaF varnishes demonstrated a protective effect against mineral loss on the enamel subsurface. Both were statistically different from the control group when CSMH was analyzed (p=0.000). A titanium dioxide film was observed on enamel surfaces of the TiF 4 group SEM images. EDS confirmed the presence of titanium in all TiF 4 samples. The 4% TiF 4 varnish is a promising compound capable of reacting with enamel to protect it against surface and subsurface demineralization.
Assuntos
Humanos , Adulto , Adulto Jovem , Fluoreto de Sódio/farmacologia , Titânio/farmacologia , Cariostáticos/farmacologia , Desmineralização do Dente/prevenção & controle , Esmalte Dentário/efeitos dos fármacos , Fluoretos/farmacologia , Espectrometria por Raios X , Propriedades de Superfície , Fatores de Tempo , Teste de Materiais , Microscopia Eletrônica de Varredura , Método Duplo-Cego , Fluoretos Tópicos/farmacologia , Reprodutibilidade dos Testes , Análise de Variância , Resultado do Tratamento , Estatísticas não Paramétricas , Estudos Cross-Over , Esmalte Dentário/cirurgia , Testes de DurezaRESUMO
UNLABELLED: Ideally projected to be applied on soft tissues, infrared lasers were improved by restorative dentistry to be used in hard dental tissues cavity preparations--namely enamel and dentin. This paper evidentiates the relevant aspects of infrared Erbium laser's action mechanism and its effects, and characterizes the different effects deriving from the laser's beams emission. The criteria for use and selection of optimal parameters for the correct application of laser systems and influence of supporting factors on the process, such as water amount and its presence in the ablation process, protection exerted by the plasma shielding and structural factors, which are indispensable in dental tissues cavity preparation related to restorative technique, are subordinated to optical modifications caused by the interaction of the energy dissipated by these laser light emission systems in the targeted tissue substrate. CLINICAL RELEVANCE: Differences in the action of infrared Erbium laser system in regard to the nature of the ablation process and variations on the morphological aspects observed in the superficial structure of the target tissue irradiated, may be correlated to the structural optical modifications of the substrate produced by an interaction of the energy propagated by laser systems.
Assuntos
Esmalte Dentário/ultraestrutura , Dentina/ultraestrutura , Terapia a Laser/métodos , Lasers de Estado Sólido/uso terapêutico , Absorção Fisico-Química , Cristalografia , Preparo da Cavidade Dentária/métodos , Esmalte Dentário/química , Esmalte Dentário/cirurgia , Dentina/química , Dentina/cirurgia , Radiação Eletromagnética , Humanos , Microscopia Eletrônica de Varredura , Gases em Plasma/química , Radiometria , Temperatura , Termodinâmica , Volatilização , Água/químicaRESUMO
OBJECTIVE: The objective of the present article is to describe procedures that can be performed to achieve excellence in orthodontic treatment finishing. The content is limited to microesthetics, which comprises the concept of ideal dental dimensions and proportions (white esthetics) and its correlation with the periodontium (pink esthetics). Standards of normality are described both in their real dimensions (dental height and width), and in those effectively perceived by the observer, the virtual dimensions. METHODS: The best scientific evidence was sought in the literature to support the clinical procedures that must guide the professional to obtain maximum esthetic quality on their treatments. Therefore, it is necessary to investigate what the other specialties in Dentistry expect from Orthodontics and, specially, what they have to offer. Clinical cases will be used to illustrate the dental movement that might maximize treatment outcome and to confront the ideal standards with the current state of the art. CONCLUSION: Treatment quality is directly related to the amount of procedures implemented by the orthodontist, associated with concepts and resources from Periodontics and Dental Prosthesis. Microesthetics cannot be seen in isolation, but rather as the key to establish a pleasant smile (miniesthetics) in addition to a harmonious face (macroesthetics) and a human being with high self-esteem (hyper-esthetics).
Assuntos
Estética Dentária , Ajuste Oclusal/métodos , Ortodontia Corretiva/métodos , Coroa do Dente/anatomia & histologia , Arco Dental/anatomia & histologia , Esmalte Dentário/cirurgia , Facetas Dentárias , Gengivectomia , Humanos , Incisivo/anatomia & histologia , Administração da Prática Odontológica , Qualidade da Assistência à Saúde , Valores de Referência , Autoimagem , SorrisoRESUMO
OBJECTIVE: The objective of the present article is to describe procedures that can be performed to achieve excellence in orthodontic treatment finishing. The content is limited to microesthetics, which comprises the concept of ideal dental dimensions and proportions (white esthetics) and its correlation with the periodontium (pink esthetics). Standards of normality are described both in their real dimensions (dental height and width), and in those effectively perceived by the observer, the virtual dimensions. METHODS: The best scientific evidence was sought in the literature to support the clinical procedures that must guide the professional to obtain maximum esthetic quality on their treatments. Therefore, it is necessary to investigate what the other specialties in Dentistry expect from Orthodontics and, specially, what they have to offer. Clinical cases will be used to illustrate the dental movement that might maximize treatment outcome and to confront the ideal standards with the current state of the art. CONCLUSION: Treatment quality is directly related to the amount of procedures implemented by the orthodontist, associated with concepts and resources from Periodontics and Dental Prosthesis. Microesthetics cannot be seen in isolation, but rather as the key to establish a pleasant smile (miniesthetics) in addition to a harmonious face (macroesthetics) and a human being with high self-esteem (hyper-esthetics).
OBJETIVO: o objetivo do presente artigo é descrever procedimentos que podem ser realizados para alcançar a excelência na finalização do tratamento ortodôntico. Delimita-se o assunto à micro-estética, que abrange o conceito das dimensões e proporções dentárias ideais (estética branca) e sua correlação com o periodonto (estética vermelha). Padrões de normalidade são descritos tanto em suas dimensões reais (altura e largura dentária), como naquelas efetivamente percebidas pelo observador, as dimensões virtuais. MÉTODOS: buscou-se na literatura a melhor evidência científica para embasar os procedimentos clínicos que devem nortear o profissional para obter a máxima qualidade estética nos tratamentos. E, para tanto, há necessidade de investigar o que as demais especialidades da Odontologia esperam da Ortodontia e, principalmente, o que têm a oferecer. Casos clínicos serão utilizados para ilustrar a movimentação dentária que pode maximizar o resultado final do tratamento, e para confrontar com os padrões ideais para o estado da arte atual. CONCLUSÃO: conclui-se que a qualidade do tratamento está diretamente relacionada à soma de procedimentos implementados pelo ortodontista, associados a conceitos e recursos da Periodontia e Prótese Dentária. A micro-estética não pode ser vista de forma isolada, mas sim como parte fundamental para se estabelecer um sorriso agradável (mini-estética), uma face harmoniosa (macro-estética) e um ser humano com autoestima elevada (hiper-estética).
Assuntos
Humanos , Estética Dentária , Ajuste Oclusal/métodos , Ortodontia Corretiva/métodos , Coroa do Dente/anatomia & histologia , Facetas Dentárias , Arco Dental/anatomia & histologia , Esmalte Dentário/cirurgia , Gengivectomia , Incisivo/anatomia & histologia , Administração da Prática Odontológica , Qualidade da Assistência à Saúde , Valores de Referência , Autoimagem , SorrisoRESUMO
Since about 40 years, laser-based surgical tools have been used in medicine and dentistry to improve clinical protocols. In dentistry, femtosecond lasers have been claimed to be a potential ablation tool. It would, however, be good to perform a more fundamental investigation to understand ablation interaction mechanisms and possible side effects, depending on different specific components of the target tissue. The goal of this study is to show the changes of ablation characteristics in the femtosecond regime at different levels of structural water within dental hard tissues. Thirty human teeth samples were split into three hydration groups and subdivided into dentin and enamel groups (n = 5). The specimens were irradiated using a 70-fs Ti:sapphire laser (with a 1-kHz repetition rate and a 801-nm wavelength output). Ablation was performed using five different power levels and three exposure times. The results clearly show an inversely proportional dependence of the ablation threshold to the hydration level of the tissues. A known mathematical model was adapted in order to include the influence of the changes on the relative fractional composition of dental hard tissues. This analysis was consistent with the experimental results regarding the ablation threshold. High thermal and mechanical damages were observed as a high repetition rate had been applied. Macroscopic images and scanning electron microscopy images were used to preliminarily analyze both the thermal and mechanical damage thresholds, and their variations according to the hydration level present. By manipulating the hydration states, the modifications in the proportions of the molecules that build dental hard tissues clearly shift, and therefore, the characteristics of a plasma-induced ablation change.
Assuntos
Esmalte Dentário/cirurgia , Dentina/cirurgia , Terapia a Laser/métodos , Esmalte Dentário/ultraestrutura , Dentina/ultraestrutura , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , ÁguaRESUMO
Anterior dental fractures often require a multidisciplinary approach. This article presents a case in which an extensive fracture with palatal biological width invasion was treated successfully through clinical crown lengthening with odontoplasty. This procedure was a simple direct technique that restored the tooth without damaging the dental esthetics, the gingival contour, or the papillae.
Assuntos
Aumento da Coroa Clínica/métodos , Estética Dentária , Incisivo/lesões , Fraturas dos Dentes/cirurgia , Adulto , Alveoloplastia , Resinas Compostas/química , Esmalte Dentário/lesões , Esmalte Dentário/cirurgia , Materiais Dentários/química , Restauração Dentária Permanente/métodos , Dentina/lesões , Dentina/cirurgia , Feminino , Seguimentos , Gengiva/patologia , Humanos , Incisivo/cirurgia , Tratamento do Canal Radicular , Clareamento Dental/métodos , Coroa do Dente/lesões , Coroa do Dente/cirurgia , Fraturas dos Dentes/terapiaRESUMO
This case report describes the orthodontic treatment of a patient with a deep-overbite Angle Class I malocclusion, agenesis of a mandibular central incisor, and 2 supernumerary teeth, which caused impaction of the mandibular first premolars. The 15-year-old patient also had a convex profile, maxillary dentoalveolar protrusion, and deficiency of space for the correct alignment of teeth. Therefore, treatment consisted of fixed appliance therapy, cervical headgear, extraction of the supernumeraries and the mandibular and maxillary first premolars, and mesiodistal reduction of the maxillary incisors to solve the arch perimeter discrepancy as much as possible with interproximal stripping. This method of treatment significantly improved the patient's facial and dental esthetics and provided a good functional occlusion, despite the absence of a mandibular incisor, which generally impairs achieving adequate incisal guidance.