RESUMEN Los caninos se pueden encontrar en situación heterotópica: fosas nasales, seno maxilar, sínfisis mentoniana, o ectópicamente cerca de su asiento normal, pero en diferentes posiciones. Lo más frecuente es que presenten su eje oblicuo hacia mesial, generalmente en palatino o vestibular en el caso de los inferiores, y relativamente frecuente bilateral. La sintomatología es nula en la inclusión y el diente se diagnostica por otros hechos o existe apariencia clínica en el caso de enclavamiento. El abordaje ortoquirúrgico de caninos retenidos ha avanzado con los miniimplantes; esto ha llevado a realizar ajustes en las técnicas quirúrgicas, priorizando la tracción mediante la técnica VISTA para un posicionamiento adecuado en la arcada. Los miniimplantes mejoran la eficacia y precisión, destacando su relevancia en ortodoncia en conjunto con la cirugía oral. Anteriormente se llevaban a cabo diferentes técnicas; a nivel vestibular, se realizaban colgajos con reposición apical o técnicas poco recomendables, como la fenestración mucosa, pues esta podría producir problemas periodontales; por otra parte, a nivel palatino, se realizaba la descubierta de los caninos incluidos mediante un colgajo mucoperióstico (técnica de ventana quirúrgica), en el que se realiza una alveolotomía conductora. Por todo ello, ha de tenerse en cuenta que la apa-ratología fija ortodóntica proporciona una alternativa que evita la extracción de órganos dentales retenidos, a través de técnicas quirúrgicas mínimamente invasivas, que permiten mantener los caninos en la arcada dental y, por tanto, la armonía de las arcadas dentales.

ABSTRACT Canines can be found in heterotopic situation: nostrils, maxillary sinus, mentonian symphysis, or ectopically near their normal seat, but in different positions. Most frequently it presents its axis obliquely towards mesial, generally in palatine or vestibular in the case of the inferior ones, and relatively frequently bilateral. Symptomatology is null in the inclusion and the tooth is diagnosed by other facts or there is clinical appearance in the case of interlocking. The orthosurgical approach to retained canines has advanced with mini-implants; which has led to adjustments in surgical techniques, prioritizing traction using the VISTA technique for adequate positioning in the arch. Mini-implants improve efficiency and precision, highlighting their relevance in orthodontics in conjunction with oral surgery. Previously, different techniques were carried out: at the vestibular level, flaps with apical repositioning or techniques that were not recommended, such as mucosal fenestration, which could cause periodontal problems; on the other hand, at the palatal level, the included canines were uncovered by means of a mucoperiosteal flap (surgical window technique), in which a conductive alveolotomy was performed. Therefore, it should be taken into account that fixed orthodontic appliances provide an alternative that avoids the extraction of retained dental organs through minimally invasive surgical techniques.

ABSTRACT Introduction: The long pathway that the canines take as they emerge into the maxillary arch makes them vulnerable to disruption during their natural emergence time. The process of planning treatment for impacted maxillary canine (IMC) presents significant challenges, underscoring the need for careful consideration and expertise. Objective: The aim of this article was to shed light on these complexities by discussing clinical case studies involving IMC, providing insights into the intricacies of their management. Conclusions: The management of IMC within orthodontics presents a multifaceted challenge that include the necessity for precise diagnostic processes, prudent use of cone beam computed tomography (CBCT), the strategic selection between open and closed exposure techniques, a in-depth understanding of the specific orthodontic biomechanics involved, and a keen awareness of potential adverse outcomes such as ankylosis, prolonged treatment times, root resorption, and additional complications. Introduction time (IMC challenges expertise Objective Conclusions processes CBCT, CBCT , (CBCT) techniques indepth in depth involved ankylosis times resorption complications (CBCT

RESUMO Introdução: O longo caminho que os caninos percorrem até irromper na arcada superior os torna vulneráveis a interrupções durante a erupção fisiológica. A etapa de planejamento do tratamento para caninos superiores impactados (CSI) apresenta desafios significativos, destacando a necessidade de consideração cuidadosa e expertise. Objetivo: O objetivo do presente artigo é esclarecer esses aspectos, discutindo relatos de casos clínicos envolvendo CSI, fornecendo percepções sobre a complexidade de seu manejo. Conclusões: O manejo do CSI na Ortodontia apresenta um desafio multifacetado, que inclui a necessidade de um diagnóstico preciso, o uso prudente de tomografia computadorizada de feixe cônico (TCFC), a seleção estratégica entre as técnicas de exposição aberta ou fechada, uma compreensão aprofundada da biomecânica ortodôntica específica envolvida, e uma consciência ampla dos possíveis resultados adversos, como anquilose, tempo de tratamento prolongado, reabsorção radicular e complicações adicionais. Introdução fisiológica (CSI significativos expertise Objetivo aspectos Conclusões multifacetado preciso TCFC, TCFC , (TCFC) fechada envolvida adversos anquilose prolongado adicionais (TCFC

RESUMO Objetivo: Este estudo teve como objetivo avaliar o volume radicular de caninos e incisivos laterais superiores em pacientes com impacção unilateral de caninos superiores. Métodos: Esse estudo transversal foi realizado em tomografias computadorizadas de feixe cônico (TCFC) de 100 pacientes (49 mulheres e 51 homens) com impacção unilateral de caninos superiores. As imagens foram abertas no Planmeca Romexis Viewer e a raiz foi reconstruída em camadas desde a junção amelocementária até o ápice radicular, em intervalos de 600 µm. Em cada camada foi marcado o limite da raiz e, então, o volume da raiz foi calculado multiplicando-se a área das camadas pela espessura de 600 µm. O tamanho da raiz dos caninos e incisivos laterais foi comparado entre os lados com impacção e sem impacção. Resultados: Sessenta e dois pacientes apresentaram impacção de caninos por vestibular e 38 apresentaram impacção por palatino. O volume médio da raiz dos caninos no lado da impacção foi significativamente maior do que no lado sem impacção; independentemente de o dente estar impactado por vestibular ou palatino (p<0,001). Os incisivos laterais vizinhos dos caninos impactados por vestibular apresentaram volume radicular significativamente menor do que os do lado contralateral (p<0,001). No entanto, não houve diferença significativa no tamanho da raiz dos incisivos laterais entre os dois lados, nos casos com impacção dos caninos por palatino (p=0,177). Conclusão: A diferença no volume da raiz dos caninos entre os dois lados pode servir como um indicador da impacção do canino. A redução no tamanho da raiz do incisivo lateral vizinho ao canino impactado por vestibular pode ser causada pela reabsorção radicular criada pela pressão da coroa do canino. Objetivo Métodos TCFC (TCFC 10 49 (4 5 homens 60 µm então multiplicandose multiplicando se Resultados 3 p<0,001. p0001 p p<0,001 . 0 001 (p<0,001) entanto p=0,177. p0177 p=0,177 177 (p=0,177) Conclusão 1 4 ( 6 p000 p<0,00 00 (p<0,001 p017 p=0,17 17 (p=0,177 p00 p<0,0 (p<0,00 p01 p=0,1 (p=0,17 p0 p<0, (p<0,0 p=0, (p=0,1 p<0 (p<0, p=0 (p=0, p< (p<0 p= (p=0 (p< (p= (p

ABSTRACT Objective: This study aimed to assess root volumes of maxillary canines and adjacent lateral incisors in patients with unilateral maxillary canine impaction. Methods: This cross-sectional study was performed on cone-beam computed tomography (CBCT) scans of 100 patients (49 females and 51 males) with unilateral maxillary canine impaction. The images were loaded in Planmeca Romexis Viewer, and root layers between the cementoenamel junction and apex were reconstructed at 600-µm intervals. At each layer, the root boundary was marked, and finally, the root volume was calculated by multiplying the layers’ area by the thickness of 600 µm. The root size of canines and lateral incisors was compared between the impaction and normal eruption sides. Results: Sixty-two patients showed buccal canine impaction, and 38 presented palatal impaction. The mean root volume of canines on the impaction side was significantly greater than that on the normal eruption side; either the tooth was buccally or palatally impacted (p<0.001). The lateral incisors on the side of buccally-impacted canines showed a significantly smaller root volume than that of the contralateral side (p<0.001). However, there was no significant difference in the root size of lateral incisors between the two sides in cases presenting palatal canine impaction (p=0.177). Conclusion: The difference in root volume of canines between the two sides can serve as an indicator of canine impaction. The reduction in the root size of the lateral incisor on the side of the buccally impacted canine may be due to root resorption created by pressure from the canine’s crown. Objective Methods crosssectional cross sectional conebeam cone beam CBCT (CBCT 10 49 (4 5 males Viewer 600µm µm intervals layer marked finally 60 Results Sixtytwo Sixty 3 p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) buccallyimpacted However p=0.177. p0177 p=0.177 177 (p=0.177) Conclusion s crown 1 4 ( 6 p000 p<0.00 00 (p<0.001 p017 p=0.17 17 (p=0.177 p00 p<0.0 (p<0.00 p01 p=0.1 (p=0.17 p0 p<0. (p<0.0 p=0. (p=0.1 p<0 (p<0. p=0 (p=0. p< (p<0 p= (p=0 (p< (p= (p

ABSTRACT Introduction: We report findings that allow us to observe the impacted maxillary canine as an entity of important prevalence. In the province of Ciego de Avila there is little research published on this eruptive alteration. Objectives: To describe epidemiological and clinical variables and to identify the local factors present in pediatric patients with retained maxillary canines in the municipality of Ciego de Avila between October 2019 and June 2020. Methods: An analytical observational research of cases and controls was carried out to determine the local factors associated to maxillary canine retention. The study population consisted of 388 schoolchildren between the ages of 11 and 17 years old, belonging to the health area of the Dr. Luis Páez Alfonso Stomatological Teaching Clinic in the municipality of Ciego de Avila, during the study period. Results: 56.9% of the participants belonged to the female sex; the group of 11 to 13 years old prevailed with 70.7 % and the skin color was white (74.1%). A total of 56.9 % of the patients had bilateral retention and the highest percentage (60.4%) was located in the vestibular region. Negative bone-tooth discrepancy, transverse micrognathism (OR of 6.3) and premature loss of primary teeth (OR was 6.1) showed significant statistical significance. Conclusions: Maxillary canine retention predominated in the female sex, in the 11 to 13 years age group, and in white-skinned pediatric patients. Bilateral retention and vestibular location of the canines occurred more frequently. The association between maxillary canine retention and the local factors negative bone-tooth discrepancy, transverse micrognathism and premature loss of primary teeth was found.

RESUMEN Introducción: Se reportan hallazgos que permiten observar al canino maxilar impactado como una entidad de importante prevalencia. En la provincia de Ciego de Ávila son escasas las investigaciones publicadas sobre la alteración eruptiva. Objetivos: Describir variables epidemiológicas y clínicas e identificar los factores locales presentes en pacientes pediátricos con retención de caninos maxilares del municipio Ciego de Ávila en el período comprendido entre octubre de 2019 y junio de 2020. Métodos: Se realizó una investigación observacional analítica de casos y controles donde se determinaron los factores locales asociados a la retención de caninos maxilares. La población de estudio se constituyó por 388 escolares, en las edades de 11 y 17 años, pertenecientes al área de salud de la clínica estomatológica docente Dr. Luis Páez Alfonso del municipio Ciego de Ávila, en el período de estudio. Resultados: El 56,9 % de los participantes pertenecían al sexo femenino; prevaleció el grupo de 11 a 13 años con el 70,7 % y el color de piel blanca (74,1 %). El 56,9 % de los pacientes presentaban retención bilateral y el mayor porciento (60,4 %) se ubicó por vestibular. La discrepancia hueso diente negativa, el micrognatismo transversal (OR de 6,3) y la pérdida prematura de dientes temporales (OR fue de 6,1) mostraron una importante significación estadística. Conclusiones: La retención de los caninos maxilares predominó en el sexo femenino, en el grupo etario de 11 a 13 años y en los pacientes pediátricos de piel blanca. La retención bilateral y la localización por vestibular de los caninos se presentaron con mayor frecuencia. Se constató la asociación entre la retención de caninos maxilares y los factores locales discrepancia hueso diente negativa, micrognatismo transversal y pérdida prematura de dientes temporales.

ABSTRACT Introduction: Canines are dental pieces considered as important in the stomatognathic system. Currently, there is a large number of patients with impacted canines in Mexico, and treatment is challenging from a diagnostic and therapeutic perspective for specialists. Orthodontic-surgical treatment has become the preferred method by clinicians, both orthodontics specialists and maxillofacial surgeons. Objective: To determine the degree of agreement in the criteria for the surgical management of impacted/retained canines. Materials and methods: It was a descriptive and analytical observational study. A questionnaire consisting of 29 questions was applied with a sample size of 30 orthodontists and 30 maxillofacial surgeons. Results: This study found on average a moderate level of agreement (54 %) in the management of retained canines between maxillofacial surgeons and orthodontists. Conclusions: Our results indicate that, although there is some alignment in management practices between these two professional groups, there is also considerable variability. This may reflect differences in training, experience, and individual preferences. Despite the limitation of a small sample, these findings suggest the need for clearer clinical guidelines and/or additional training to improve consistency in the management of retained canines.

RESUMEN Introducción: Los caninos son piezas dentarias consideradas como importantes en el sistema estomatognático. En la actualidad existe una gran cantidad de pacientes con caninos impactados en México y el tratamiento es desafiante desde una perspectiva diagnóstica y terapéutica para los especialistas. El tratamiento ortodóntico-quirúrgico se ha vuelto el método preferido por los clínicos tanto especialistas en ortodoncia como cirujanos maxilofaciales. Objetivo: Determinar el grado de coincidencia en los criterios para el manejo quirúrgico de caninos impactados/ retenidos. Material y métodos: Fue un estudio observacional descriptivo y analítico. Se aplicó un cuestionario que consistió de 29 preguntas con un tamaño de muestra de 30 ortodoncistas y 30 cirujanos maxilofaciales. Resultados: Este estudio encontró en promedio un nivel moderado de concordancia (54 %) en el manejo de los caninos retenidos entre cirujanos maxilofaciales y ortodoncistas. Conclusiones: Nuestros resultados indican que, aunque existe alguna alineación en las prácticas de manejo entre estos dos grupos profesionales, también hay una considerable variabilidad. Esto puede reflejar diferencias en la formación, experiencia y preferencias individuales. A pesar de la limitación de una muestra pequeña, estos hallazgos sugieren la necesidad de directrices clínicas más claras y/o formación adicional para mejorar la coherencia en el manejo de los caninos retenidos.

ABSTRACT Permanent canines are essential for the preservation of the stomatognathic system, as they are part of the occlusal and aesthetic function and balance. During the normal development of occlusion, canines follow a long and complex trajectory until their eruption, that is, they are more likely to suffer disturbances during this process. Removal of the permanent canine should only be considered in extreme cases, where the canine itself is not susceptible to orthodontic traction. Orthodontic traction is the most indicated treatment due to the high morphofunctional and aesthetic value of the permanent canine. The aim of this study is to report a clinical case of traction surgery of the superior permanent canine included in the maxilla. A 13-year-old female patient attended the dental clinic at the Nilton Lins University accompanied by her guardian, referred by an orthodontistfor canine traction surgery. during the examIn the clinical analysis, tooth 13 was absent from the dental arch. The patient had a computed tomography scan, where it was possible to verify the actual position of the toothimpacted with the partially erupted crown on the alveolar ridge. After planning, surgery was performed to install an orthodontic button and adapt the ligature with a 0.30 mm wire. After the 10-month follow-up period, the presence of the tooth in arch, completely erupted, was observed, showing effectiveness in the proposed treatment. Therefore, the procedure for bonding the orthodontic device was performed satisfactorily without complications or intercurrences, making it possible to continue the orthodontic treatment. The patient remains under follow-up. system balance occlusion eruption process cases maxilla 13yearold yearold year old guardian analysis 1 arch scan ridge planning 030 0 30 0.3 wire 10month month 10 followup up period observed Therefore intercurrences followup. up. 03 3 0.

RESUMO Os caninos permanentes são essenciais para a preservação do sistema estomatognático, visto que, fazem parte da função e equilíbrio oclusal e estético. Durante o desenvolvimento normal da oclusão, os caninos seguem uma longa e complexa trajetória até seu irrompimento, ou seja, estão mais propensos a sofrerem distúrbios no decorrer desse processo. A extração do canino permanente só deve ser considerada em casos extremos, onde o próprio não se encontra suscetível à tração ortodôntica. O tracionamento ortodôntico é o tratamento mais indicado devido ao alto valor morfofuncional e estético do canino permanente. Sendo assim, o objetivo deste estudo é relatar um caso clínico de cirurgia de tracionamento de canino permanente superior incluso em maxila. Paciente de 13 anos, gênero feminino, compareceu a clínica odontológica da Universidade Nilton Lins acompanhado de seu responsável, encaminhada por um ortodontista para cirurgia de tracionamento de canino. Durante o exame clínico observou-se ausência do dente 13 na arcada dentária. A paciente apresentou a tomografia computadorizada, onde foi possível verificar o real posicionamento do dente impactado com a coroa parcialmente irrompida no rebordo alveolar. Após o planejamento, realizou-se a cirurgia destinada a instalação de botão ortodôntico e adaptação da amarrilha com fio 0,30 mm. Posteriormente ao período de acompanhamento de 10 meses, observou-se a presença do dente em arco, totalmente erupcionado, mostrando efetividade no tratamento proposto. Portando, o procedimento de colagem de dispositivo ortodôntico ocorreu de forma satisfatória sem complicações ou intercorrências, tornando possível a continuidade do tratamento ortodôntico. A paciente permanece em acompanhamento. estomatognático que oclusão irrompimento seja processo extremos ortodôntica assim maxila 1 anos feminino responsável observouse observou dentária computadorizada alveolar planejamento realizouse realizou 030 0 30 0,3 mm meses arco erupcionado proposto Portando intercorrências 03 3 0,

ABSTRACT: The permanent maxillary canine (PMC) is the second most frequently impacted tooth due to its long intraosseous descent and eruption chronology. The objective of this study was to evaluate the degree of dental development and position of the PMC between the ages of 8 and 11 years 11 months in order to suggest an optimal chronological age for their early evaluation in panoramic radiography. A retrospective study was carried out, where 239 panoramic radiographs of children aged 8 to 11 years were analyzed. They were grouped according to age, gender and apical area; Then, the degree of dental development and position of the left PMC apex were analyzed. The results show that there are no significant differences in the position of the PMC with respect to chronological age. Furthermore, between eight years six months and nine years six months, 61% of the canines had more than half of the root formed. In conclusion, the early evaluation with panoramic radiography of the PMC is suggested from eight years six months to nine years six months, to alert the clinician in cases where the eruptive path is deviated.

RESUMEN: El canino maxilar permanente (CMP) es el segundo diente con mayor frecuencia de impactación debido a su largo descenso intraóseo y cronología de erupción. El objetivo de este estudio fue evaluar el grado de desarrollo dentario y posición del CMP entre los 8 años y los 11 años 11 meses con el fin de sugerir una edad cronológica óptima para su evaluación temprana en radiografía panorámica. Se realizó un estudio retrospectivo, en donde se analizaron 239 radiografías panorámicas de niños de 8 a 11 años. Éstas se agruparon según edad, género y área apical; luego se analizó el grado de desarrollo dentario y posición del vértice CMP izquierdo. En los resultados se observó que no existen diferencias significativas de la posición del CMP respecto a la edad cronológica. Además, entre los ocho años seis meses y nueve años seis meses un 61% de los caninos tuvieron más de la mitad de formación radicular. En conclusión, la evaluación temprana con radiografía panorámica del CMP se sugiere desde los ocho años seis meses a los nueve años seis meses, para alertar al clínico en casos donde el trayecto eruptivo se encuentre desviado.

RESUMO Objetivo: Destacar a importância do diagnóstico e discutir as abordagens terapêuticas que podem ser utilizadas no tratamento ortodôntico da má oclusão de Classe I associada a dois caninos superiores impactados. Relato de caso: A abertura de espaço para tracionar esses dentes por meio de expansão rápida da maxila ou exodontia de pré-molares superiores era contraindicada no caso relatado. Portanto, decidiu-se abrir espaço por meio da projeção dos incisivos. Resultados: Os resultados obtidos foram satisfatórios, pois obteve-se uma boa oclusão, com guias funcionais adequadas, além da melhoria no aspecto facial. Conclusão: A projeção dos incisivos prévia ao tracionamento dos caninos superiores impactados mostrou-se uma opção válida no caso descrito. Dez anos após a finalização do tratamento, o caso apresenta-se estável, mantendo a saúde periodontal.

ABSTRACT Objective: To emphasize the importance of diagnosis and discuss the therapeutic approaches that can be used in the orthodontic treatment of Class I malocclusion associated with two impacted maxillary canines. The opening of spaces for traction of these teeth by means of rapid maxillary expansion or extraction of maxillary premolars was contraindicated in the case reported. Therefore, it was decided to open spaces with projection of incisors. Results: The obtained results were satisfactory, as a good occlusion was obtained, with adequate functional guides, as well as an improvement in the facial appearance. Conclusion: The projection of the incisors prior to traction of the impacted maxillary canines proved to be a valid option in the case described. Ten years after completion of treatment, the case is stable, maintaining periodontal health.

Abstract This systematic review aimed to investigate if there is a better interceptive treatment for palatally displaced canines (PDC) in the mixed dentition stage. The PubMed/MEDLINE, CENTRAL, Scopus, and EMBASE databases were searched for randomized clinical trials related to the research topic. The gray literature and reference lists were also assessed. Network meta-analysis was conducted to analyze the effects of different approaches on PDC eruption. The surface under the cumulative ranking area was calculated to rank the treatments. The certainty of the evidence was evaluated using the GRADE approach. Of the 892 eligible studies, 18 were selected for full-text analysis and 9 for meta-analysis, involving 506 participants and 730 PDC, to compare 9 approaches. The proportion of erupted PDC was significantly higher for all interceptive treatments compared with control (no intervention). Furthermore, the proportion of erupted PDC was higher in patients subjected to rapid maxillary expansion (RME) than those who underwent double extraction of primary canine and primary molar (relative risk (RR) = 2.68 ICr95%: 1.12–9.35). A higher proportion of erupted PDC was found for RME (RR = 3.07 ICr95%: 1.31–10.67), RME plus use of transpalatal arch (TA) plus extraction of primary canine(s) (EC) (RR = 1.43 ICr95%: 1.09–1.95), EC plus use of cervical pull headgear (RR = 1.38 ICr95%: 1.11–1.79), and EC plus use of TA (RR = 1.36 ICr95%: 1.00–1.9) than for EC. RME was most likely to be considered as the best interceptive treatment. Overall, the certainty of the evidence was considered low due to imprecision and indirectness. In conclusion, no intervention in the mixed dentition stage is the worst choice for PDC. (PDC PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE CENTRAL Scopus topic assessed metaanalysis meta eruption approach 89 studies 1 fulltext full text metaanalysis, analysis, 50 73 intervention. . intervention) Furthermore (RME relative RR 268 2 68 2.6 ICr95% ICr95 ICr 1.12–9.35. 112935 1.12–9.35 12 35 1.12–9.35) 307 3 07 3.0 1.31–10.67, 1311067 1.31–10.67 , 31 10 67 1.31–10.67) (TA s canine(s (EC 143 43 1.4 1.09–1.95, 109195 1.09–1.95 09 95 1.09–1.95) 138 38 1.3 1.11–1.79, 111179 1.11–1.79 11 79 1.11–1.79) 136 36 1.00–1.9 10019 00 Overall indirectness conclusion 8 5 7 26 6 2. ICr9 11293 1.12–9.3 30 0 3. 131106 1.31–10.6 14 4 1. 10919 1.09–1.9 13 11117 1.11–1.7 1.00–1. 1001 1129 1.12–9. 13110 1.31–10. 1091 1.09–1. 1111 1.11–1. 1.00–1 100 112 1.12–9 1311 1.31–10 109 1.09–1 111 1.11–1 1.00– 1.12– 131 1.31–1 1.09– 1.11– 1.00 1.12 1.31– 1.09 1.11 1.0 1.1 1.31

ABSTRACT Introduction: If an impacted canine tooth crosses the midline towards the opposite side, it is considered as dental transmigration. It is a rare condition with low ranges of prevalence. The surgical-orthodontic treatment is one of the therapeutic options. Objective: To describe the orthodontic-surgical treatment results, in a patient, with transmigrated lower right canine. Case report: An 11-year-old male patient attended the general practitioner for dental evaluation, his chief complaint was the absence of one deciduous tooth and the permanent still un-erupted and the tipping of the upper incisors. During the orthodontic examination was noted insufficient space to tooth 43 in the arch. The patient was diagnosed with Moyers’ class II malocclusion division 1 syndrome. The radiographic examination confirmed the diagnosis of impacted and transmigrated lower right canine, mesioangular position across the midline within the chin area. Orthodontic-surgical treatment was carried out to bring the canine tooth to its functional position. Conclusions: Orthodontic-surgical treatment restored the function and aesthetics to the patient, through the right positioning of the canine in the arch. It could be considered as a therapeutic alternative in the case of transmigrated mandibular canine with type 1 pattern.

RESUMEN Introducción: Si un canino impactado cruza la línea media desde su posición normal al lado contrario, se denomina transmigración. Esta presenta bajos rangos de prevalencia por lo que se le considera una condición rara. El tratamiento ortodóncico quirúrgico es una de sus opciones terapéuticas. Objetivo: Describir los resultados del tratamientoortodóncico quirúrgico en un pacientecon canino inferior derecho transmigrado. Caso clínico: Paciente masculino de 11 años de edad con antecedentes de salud que acudió a consulta de Estomatología General Integral por tener los dientes botados y por la falta de uno que mudó y el sucesor aún no ha brotado. El caso se refiere al servicio de Ortodoncia. Al examen bucal destacó la ausencia clínica del 43, sin espacio necesario para su ubicación en la arcada. El paciente clasificó como síndrome de clase II división 1 de Moyers. Se indicó estudio radiográfico y se confirmó el diagnóstico de canino incluido, transmigrado y mesioangular en región mentoniana. Se decidió realizar tratamiento ortodóncico quirúrgico para colocar el canino en su posición. Conclusiones: El tratamiento ortodóncico quirúrgico devolvió al paciente la función y la estética, mediante la correcta ubicación del canino en la arcada. Este puede ser considerado como una alternativa terapéutica en el caso de canino mandibular transmigrado que presenta patrón tipo 1.

ABSTRACT Introduction: Orthodontic surgical treatment could be a therapy of choice for the impacted canines, as they should be kept in the dental arches for their functional and aesthetic benefits. The bilateral impaction of these in the maxillary bone is less frequent and their treatment is more complex. Objective: To describe the results of the orthodontic surgical treatment in a female patient with bilateral impaction of upper canines. Case report: A 16-year-old female patient with a health history was assisted by a general dentist in the company of the mother, because she was worried about the aspect of her cupids which were whiter and littler. The oral examination showed the presence of a permanent and complete dentition with the exception of the upper canines, in their place, were teeth number 53 and 63. It was also found an abnormal relief in the anterior zone of the hard palate with a slight increase of volume at palpation. It was taken panoramic and periapical X-ray and it was confirmed the presence of both impacted teeth. It was made orthodontic surgical treatment. Conclusions: Orthodontic surgical treatment gave back the patient the function and aesthetic by means of the correct location of both teeth in the dental arches.

RESUMEN Introducción: El tratamiento ortodóncico quirúrgico puede ser una terapia de elección para los caninos impactados, ya que estos deben conservarse en las arcadas por sus beneficios estéticos y funcionales. La inclusión bilateral de estos en el maxilar es menos frecuente y su tratamiento más complejo. Objetivo: Describir los resultados del tratamiento ortodóncico quirúrgico, en una paciente con inclusión bilateral de caninos superiores. Caso clínico: Paciente femenina de 16 años con antecedentes de salud, que acudió a consulta de Estomatología General Integral en compañía de la madre, preocupada por el aspecto de sus colmillos más blancos y pequeños. Al examen bucal, se observó una completa dentición permanente, excepto los caninos que, en su lugar, se encontraban los dientes 53 y 63. Presentó relieve anormal de la zona anterior de la mucosa palatina, con ligero aumento de volumen a la palpación. Se realizó radiografía panorámica y periapicales y se confirmó la presencia de ambos dientes impactados. Se realizó tratamiento ortodóncico quirúrgico. Conclusiones: El tratamiento ortodóncico quirúrgico devolvió a la paciente la función y la estética, mediante la correcta ubicación de ambos caninos en las arcadas.

ABSTRACT Background: preventing the premature loss of permanent teeth is the fundamental objective of the dental surgeon. External reabsorption can be a cause of tooth loss. Objective: to present the surgical management of a case of external root reabsorption of a central and left lateral incisor, caused by a retained upper canine. Case report: 16-year-old female patient who comes to the office because she feels mobility of her incisors; the intra-oral clinical examination showed the absence in the mouth of the upper left canine and Miller's degree 1 mobility of the central and lateral incisors is observed on the same side. The radiographic and tomographic evaluation is done, and the presence of root reabsorption of the incisors is evidenced. Surgical removal of the canine accompanied by bone regeneration is proposed, to prevent external reabsorption from progressing. It is evaluated radiographically at 6 months after surgery, showing that there is no progression of reabsorption and there is a good stability of the compromised incisors. Conclusions: with the removal of the impacted canine and bone regeneration, the patient was able to prevent the external reabsorption from progressing and recover the stability of his incisors.

RESUMEN Fundamento: prevenir la pérdida prematura de dientes permanentes es el objetivo fundamental del cirujano dentista. La reabsorción externa puede ser una causa de la pérdida dentaria. Objetivo: presentar el manejo quirúrgico de un caso de reabsorción radicular externa de un incisivo central y lateral superior izquierdo, ocasionada por un canino superior retenido. Presentación del caso: paciente femenino, de 16 años de edad que acudió a consulta porque sintió movilidad de sus incisivos, al examen clínico intra bucal se apreció la ausencia en boca del canino superior izquierdo y se constata movilidad grado I de Miller de los incisivos central y lateral del mismo lado. Se hizo la evaluación radiográfica y tomográfica, se evidenció la presencia de reabsorción radicular de los dos incisivos. Se planteó la extracción quirúrgica del canino acompañado de regeneración ósea, para prevenir que la reabsorción externa siga en progreso. Se evaluó por radiografía a los seis meses post cirugía, donde se evidenció que ya no existe progresión de la reabsorción y hay una buena estabilidad de los incisivos comprometidos. Conclusiones: con la extracción del canino retenido y la regeneración ósea, el paciente pudo prevenir que la reabsorción externa siga en progreso y recuperar la estabilidad de sus incisivos.

ABSTRACT Health education and training of primary health care (PHC) professionals are highly recommended to reduce the occurrence and lethality of visceral leishmaniasis (VL). This study assessed the impact of an educational intervention on the basic knowledge about visceral leishmaniasis (VL) among PHC professionals from the Brazilian municipality of Rondonopolis, an important endemic area for VL. Responses provided by physicians, nurses, nursing technicians and community health agents from 12 PHC facilities were recorded through the application of self-completed and semi-structured questionnaires before (n=92) and after (n=64) an in-person health training course covering various aspects of VL. Closed- and open-ended responses were compared by the chi-square test and analyses of word clouds, respectively. The proportion of professionals aware of the correct etiological agent (p<0.001) and transmission route (p<0.001) of VL increased post-intervention. In addition, they increased their ability to recognize fever (p<0.001), weakness (p<0.001), weight loss (p<0.001), pallor (p<0.001) and abdominal distention (p=0.013) as clinical manifestations of human VL, and weakness (p<0.001), alopecia (p<0.001) and weight loss (p=0.019) as signs of canine VL. Analyses of word clouds suggested that the participants became more aware of the role of dogs in VL transmission and the role of environmental management in the prevention of VL. In conclusion, the intervention positively impacted the baseline knowledge concerning VL among the professionals. This can support the planning of educational activities for the PHC team regarding early case detection, prevention and control of VL in endemic areas.

RESUMO Introdução: Muitas vezes, a erupção falha, e ocorrem situações que impedem que os caninos cheguem até o plano oclusal. Objetivos: Discorrer sobre quais as três situações nas quais o canino não chega até o plano oclusal, permanecendo não irrompido e, ao mesmo tempo, destacar como se diagnosticar com segurança uma dessas três causas, a anquilose alveolodentária, a partir da tomografia. Conclusões: A anquilose em dentes não irrompidos ocorre pela atrofia do ligamento periodontal, incluindo os Restos Epiteliais de Malassez. Os sinais tomográficos de uma anquilose alveolodentária em caninos não irrompidos são a interrupção do espaço periodontal hipodenso, a descontinuidade da lâmina dura e a sua continuidade com a superfície radicular, que, gradativamente, perde sua regularidade.

ABSTRACT Introduction: Teeth frequently fail to erupt and situations arise that prevent the canines from reaching the occlusal plane. Objective: Discourse about the three situations in which the canine does not reach the occlusal plane, and remains unerupted; and at the same time, point how to make a safe diagnosis of alveolodental ankylosis - one of the three causes -, based on tomography. Conclusions: Ankylosis occurs in impacted teeth by atrophy of the periodontal ligament, including the epithelial rests of Malassez. The tomographic signs of alveolodental ankylosis in unerupted canines are the interruption of hypodense periodontal space, discontinuity of the lamina dura and its continuity with the root surface, which gradually loses its regular shape.

ABSTRACT: One of the problems with greatest aesthetic and functional consequences in orthodontics is the Impaction of Maxillary Canines (ICM) being the main reason for root resorption of the adjacent teeth. Currently there are no studies describing root resorption by ICM through cone beam computed tomography (CBCT) in the Chilean population. The main objective of the study was to describe patients between 8 and 18 years old, who presented with ICM (or risk thereof), with the characteristics of canine impaction as well as root resorption presented in lateral incisors (IL) and in other adjacent teeth. In this retrospective study, 135 CBCT subjects were selected for convenience, of which 181 canines presented ICM. The variables were analyzed: age, sex, type of ICM (unilateral or bilateral), buccolingual location (vestibular or palatal), side of impaction (right or left), root resorption in the lateral incisor and registration of adjacent teeth affected by resorption radicular (central incisor and/or premolars). In addition, when reabsorption of IL was observed, three-dimensional analysis was made using the Three-Dimensional Leeds Orthodontic Root Resorption Target Scale (3D-LORTS). The ICM in the selected sample had an average age of 12 years, a ratio by sex of women:men of 1.5:1, frequently of unilateral type, on the right side and with palatine buccolingual location (64.1 %) above the vestibular (35.9 %). Root resorption reached 35.9 %, of which 27.6 % presented in the IL and 8.3 % in adjacent teeth. Regarding the three-dimensional distribution of root resorption, the most frequent involved the apical third (60 %), with pulpal or severe damage (40 %), in only one location, the palatine (54 %). None of the above variables considered showed statistical differences with the root resorption of lateral incisors.

RESUMEN: Uno de los problemas con mayores consecuencias tanto estéticas como funcionales en ortodoncia es la impactación de caninos maxilares (ICM) siendo principal motivo de reabsorciones radiculares de dientes adyacentes. Actualmente se carece de estudios que describan la reabsorción radicular por ICM a través de tomografía computarizada conebeam (TCCB) en la población chilena. El objetivo del estudio fue describir a pacientes entre 8 a 18 años, que presentan ICM (o riesgo de ella), tanto en las características de la impactación canina como en la reabsorción radicular presentada en incisivos laterales (IL) y en otros dientes adyacentes. En este estudio retrospectivo, 135 datos de TCCB fueron seleccionados por conveniencia, de los cuales 181 caninos presentaron ICM. Fueron analizadas las variables edad, sexo, tipo de ICM (unilateral o bilateral), localización bucolingual (vestibular o palatino), lado de impactación (derecho o izquierdo), reabsorción radicular en el incisivo lateral y registro de el o los dientes anexos afectados por reabsorción radicular (incisivo central y/o premolares). Además en el caso de reabsorción de IL fue analizada la reabsorción tridimensionalmente a través de la ThreeDimensional Leeds Orthodontic Root Resorption Target Scale (3D-LORTS). La ICM en la muestra seleccionada tuvo una edad promedio de 12 años, una relación por sexo mujeres:hombres de 1,5:1, frecuentemente de tipo unilateral, en el lado derecho y una localización bucolingual palatina (64,1 %) por sobre la vestibular (35,9 %). La reabsorción radicular alcanzó un 35,9 %, de la cual un 27,6 % involucró a IL y un 8,3 % en dientes anexos adyacentes. En cuanto a la distribución tridimensional de la reabsorción radicular, la más frecuente involucró el tercio apical (60 %), con compromiso pulpar o severo (40 %), involucrando solo una cara, la palatina (54 %). Ninguna de las variables anteriores consideradas, demostró diferencias estadísticas con la reabsorción radicular de incisivos laterales.