Maria Augusta Portella Guedes Visconti

Utility of panoramic radiography for identification of the pubertal growth period

INTRODUCTION Our aim in this study was to investigate the association between dental mineralization stages and the periods of the pubertal growth spurt (PGS). METHODS The sample included panoramic and hand-wrist radiographs from 491 subjects (222 boys, 269 girls) aged 7 to 17 years. Dental development was rated, and skeletal maturation was evaluated. The relevant associations were investigated by analysis of ordinal multinomial logistic regression. RESULTS The second molar (odds ratio [OR] = 4.34) and the first premolar (OR = 2.45) were the best growth predictors for girls. For boys, the second molar (OR = 6.80), second premolar (OR = 2.41), and canine (OR = 3.21) proved to be the best predictors. Stages D and E of the second molar for girls, and stages E and F for boys, corresponded to the onset of the accelerated growth spurt. Stage F of the second molar for girls and stage G for boys corresponded to the peak of the PGS. At the end of the PGS, most teeth had already attained apical closure. In girls, however, most second molars were found at stage G. CONCLUSIONS An association exists between the dental mineralization stages and the periods of the PGS, especially for second molars. Panoramic radiographs can be used as the first diagnostic tool to estimate the pubertal growth period.

Tomografía Computarizada de Haz Cónico como Instrumento Complementario de Diagnóstico y Planeamiento Quirúrgico de Quiste Dentígero: Reporte de un Caso

El quiste dentigero es una de las patologias oseas que mas frecuentes en el maxilar y la mandibula. Se evidencia radiograficamente como una imagen radiolucida y unilocular en la mayoria de los casos. Generalmente es detectado en examenes de rutina o cuando se investiga la presencia de dientes no erupcionados. El quiste dentigero aparece principalmente en las tres primeras decadas de vida, con crecimiento lento y asintomatico. Los terceros molares,asi como dientes supernumerarios, pueden estar relacionados con su formacion, sin embargo, su etiopatologia no es totalmente conocida. La descompresion, marsupializacion y la enucleacion son las principales formas de tratamiento, pero algunos criterios deben ser considerados, como tamano del quiste, edad del paciente, proximidad con estructuras anatomicas nobles e importancia clinica del diente involucrado. Para que se establezca un correcto diagnostico y plan de tratamiento es esencial la utilizacion de examenes complementarios de calidad, siendo, actualmente, la tomografia computarizada de haz conico el mas completo y preciso metodo de diagnostico por imagen empleado en estas lesiones. El objetivo de este estudio fue resaltar, por medio de la presentacion de un caso clinico, la importancia de la tomografia computarizada de haz conico en el diagnostico y planeamiento quirurgico de un quiste dentigero asociado a un diente no erupcionado.

Development of estimation models of bone height considering the potential presence of anterior extension of the mandibular canal.

Purpose:To evaluate the presence of the anterior extension (AE) of the mandibular canal and to measure the bone height (BH) at different points along the extension. Materials and Methods:Cone-beam computed tomography examinations of 108 patients were bilaterally evaluated regarding the presence of the AE, and linear measurements of the AE and BH were obtained. For comparisons between sides and genders, Student t test was applied. Variations in BH measurements were assessed by a 2-way analysis of variance. Through a simple linear regression analysis, formulas were determined for calculations of the BH in the AE. Results:A right AE was detected in 76.9% and left AE in 77.8% of the samples. In the majority of the cases, the extension was of the rectilinear type. The mean length of the AE was 8.5 mm, and there was no statistically significant difference observed in relation to gender or side. It was observed that the BH increases as it approaches the midline. Conclusion:The AE of the mandibular canal must be evaluated during presurgical planning. The formulae presented in this study provide a method to calculate BH values in the interforaminal region and can be used to assist in presurgical planning, especially in the cases in which the identification of the hipodense site, which corresponds to the AE, is not evident.