RESUMO Objetivo: Avaliar a frequência dos forames linguais mediais presentes na cortical da mandíbula por meio da tomografia computadorizada de feixe cônico (TCFC). Métodos: Um total de 953 exames de TCFC da mandíbula foram avaliados para determinar a presença de canais na linha média mandibular, localização do canal em relação ao tubérculo geniano, diâmetro do canal, distância à base e crista alveolar da mandíbula, trajetória da canal e medidas de coincidência da imagem panorâmica contendo a localização do canal em relação ao tubérculo geniano. Resultados: Os forames localizaram-se em três posições: acima do tubérculo (FSS) 89,2%, abaixo do tubérculo (FIS) 67,9% e outras posições (FOP) 21,3%. Indivíduos não edêntulos apresentaram um número significativamente maior de FSS do que indivíduos edêntulos (P <0,001). Indivíduos do sexo masculino apresentaram distâncias significativamente maior do FSS (P = 0,001), FIS (P = 0,045) e FOP (p = 0,002) até a base da mandíbula do que indivíduos do sexo feminino. Os indivíduos mais jovens apresentaram uma distância significativamente maior do FSS (P = 0,001) e FIS (P = 0,001) até a crista alveolar da mandíbula. Indivíduos do sexo masculino tiveram um diâmetro de FIS (P = 0,002) e FOP (P = 0,001) significativamente maior do que indivíduos do sexo feminino. Indivíduos do sexo masculino tiveram um número significativamente maior de bifurcações no FOP do que indivíduos do sexo feminino (P = 0,017). Conclusão: a TCFC fornece ao profissional uma avaliação detalhada dos forames e canais, o que melhora a qualidade do planejamento cirúrgico e diminui as chances de intercorrências.

ABSTRACT Objective: To evaluate the frequency of medial lingual foramina present in the cortex of the mandible using cone beam computed tomography (CBCT). Methods: A total of 953 CBTC exams of the mandible were evaluated to determine the presence of canals in the mandibular midline, canal location in relation to the mental spine, canal diameter, distance to the base and alveolar crest of the mandible, trajectory of the canal, and coincidence measurements of the panoramic image containing the location of the canal in relation to the mental spine. Results: Foramina were located in three positions: above the mental spine (FSS) 89.2%, below the mental spine (FIS) 67.9%, and other positions (FOP) 21.3%. Non-edentulous individuals had a significantly higher number of FSS than did edentulous individuals (P<0.001). Male individuals presented a significantly greater distance from the FSS (P=0.001), FIS (P=0.045) and FOP (p=0.002) to the base of the mandible than female individuals. Younger individuals presented a significantly higher distance from the FSS (P=0.001) and FIS (P=0.001) to the alveolar crest of the mandible. Male individuals had a significantly greater FIS (P=0.002) and FOP (P=0.001) diameter than female individuals. Male individuals had a significantly higher number of bifurcations in FOP than female individuals (P=0.017). Conclusion: CBCT supplies the provider with a detailed assessment of the foramina and canals, which improves the quality of surgical planning and mitigates the chances of surgical intercurrences.

Abstract The present study aimed to evaluate the frequency of immediate care seeking after traumatic dental injury (TDI) in primary dentition and its association with the children’s characteristics, socioeconomic status, and TDI characteristics. This was a cross-sectional study with dental records of children aged 9 months to 6 years who attended a reference center in TDI in primary dentition between 2007 and 2018. Immediate care seeking after TDI, child’s characteristics, sociodemographic conditions and TDI characteristics were collected. Descriptive statistics and Poisson regression analysis with robust variance were performed (p < 0.05; 95%CI). Among the 493 dental records, 61.1% (n = 301) were of males and 50.5% (n = 249) were from children aged 2 years or less. More than one third of the sample (36.9%; n = 182) sought immediate care after TDI. Among the types of TDI, the prevalence of soft tissue injuries was 59.0% (n = 291), while 51.7% (n = 255) were hard tissue injuries and 54.0% (n = 266) were supporting tissue injuries. Immediate care seeking after TDI was higher in children who needed suture (PR: 1.39; 95%CI: 1.01–1.92. p = 0.039), had luxation (lateral, intrusion, or extrusion) (PR: 2.36; 95%CI: 1.36–4.08. p = 0.002) or avulsion (PR: 2.18; 95%CI: 1.28–3.70. p = 0.004). The need for suture, luxation (lateral, intrusion and extrusion), and avulsion were determinant factors for the immediate care seeking after TDI, regardless of the child’s characteristics and socioeconomic status.

RESUMO Exostoses ou hiperostoses são crescimentos ósseos benignos originados da cortical óssea e dependem de sua localização para uma denominação mais precisa. Os tipos mais comuns encontrados na cavidade oral são o Tórus Palatino e o Tórus Mandibular. Exostoses bucais e palatais acometem a face vestibular do processo alveolar na maxila e/ou na mandíbula (comumente na região de molares e pré-molares) e a superfície do processo alveolar posterior (usualmente na área da tuberosidade maxilar), respectivamente. A etiologia das exostoses ainda não foi esclarecida, mas acredita-se em uma interação entre fatores ambientais e genéticos. São usualmente assintomáticas, a não ser que a mucosa se torne ulcerada. A frequência aumenta com a idade, tendo sua maior prevalência a partir de 60 anos de idade, sendo mais comuns em homens e sofrendo influências étnicas. É importante uma avaliação minuciosa para o correto diagnóstico, visto que outras lesões, como os osteomas, possuem características clínicas semelhantes às das exostoses. A maior parte das exostoses é diagnosticada clinicamente em conjunto com interpretações radiográficas, tornando a biópsia dispensável e o tratamento é usualmente desnecessário. O objetivo deste artigo foi relatar um caso clínico de exostose maxilar bilateral, incomum, em uma paciente do sexo feminino. Se uma quantidade excessiva de osso está presente, as exostoses podem mostrar uma relativa radiopacidade nas radiografias dentárias. Inicialmente foram realizadas radiografias periapicais e radiografia panorâmica para avaliar as alterações. Devido ao tamanho das exostoses, realizou-se uma Tomografia Computadorizada de Feixe Cônico, para confirmação do diagnóstico. A paciente encontra-se em acompanhamento.

ABSTRACT Exostoses or hyperostoses are benign bony outgrowths originating from the cortical bone and depend on their location for a more precise designation. The most common types found in the oral cavity are the torus palatinus and the torus mandibularis. Buccal and palatal exostoses are located along the buccal aspect of the maxilla and/or the mandible (commonly in the premolar and molar areas) and on the palatal aspect of the maxilla (usually in the tuberosity area), respectively. The etiology of exostoses still hasn’t been enlightened but an interaction between environmental and genetic factors is accredited. They are usually asymptomatic, unless the mucosa becomes ulcerated. The frequency of exostoses increases with age, having their biggest prevalence from 60 years old, being more common in men and suffering ethnic influences. A thorough evaluation is important for the correct diagnosis since other lesions have similar clinical characteristics to the exostoses such as osteomas. The majority of exostoses are diagnosed clinically along with radiographic interpretations, making the biopsy dispensable and the treatment is usually unnecessary. The aim of this article was to describe a case report of bilateral maxillary exostosis, unusual, in a female patient. If an excessive amount of bone is present the exostoses may exhibit a relative radiopacity on dental radiographs. Initially, periapical and panoramic radiographs were performed to evaluate the alterations. Due to the size of the exostoses a concomitant Cone Beam Computed Tomography was performed to confirm the diagnosis. The patient is in follow-up.

Abstract The present study aimed to evaluate the performance of cone beam computed tomography (CBCT) and digital periapical radiographs (PR) in diagnosing external root resorption (ERR) in human permanent teeth replanted after traumatic avulsion. The samples comprised 39 permanent maxillary incisors replanted after traumatic avulsion. Digital PR and CBCT images were taken from each tooth and independently examined by 2 calibrated examiners to assess the ERR activity regarding type and extension. The degrees of agreement between both imaging examinations were determined by the mean global agreement index using SPSS software. The two imaging examinations diverged greatly in the diagnosis of the type of ERR since CBCT identified more cases as inflammatory ERR and PR as replacement ERR. A discordance level of 69.2% was observed between the two methods in the diagnosis of the type of ERR when CBCT for mesial and distal (MD) surfaces was considered and 61.5% when CBCT for mesial, distal, buccal and lingual (MD/BL) was considered. Likewise, CBCT and PR differed regarding the ERR index. PR examinations classified most cases as moderate or severe (69.2%), while CBCT examinations classified more cases as mild either in the MD surfaces analysis (41.4%) or in the analysis of the MD-BL surfaces (51.3%). In conclusion, the present results highlight a discrepancy between CBCT and digital PR performance in the diagnosis of different types and extent of ERR in replanted teeth.

RESUMO A displasia cemento-óssea florida é um subtipo de lesão fibro-óssea que geralmente aparece nos ossos gnáticos de mulheres negras de meia idade. Clinicamente a displasia cemento-óssea florida é assintomática. Os aspectos radiográficos mostram uma área radiolucente com várias massas de estruturas radiopacas, tipicamente encontradas próximas às raízes dos dentes. O tratamento é requerido quando ocorre infecção devido à exposição da lesão na cavidade oral. Em casos mais severos, dor e deformidade podem estar presentes. Concomitante a higiene oral, visitas de rotina ao dentista são recomendadas ao indivíduo afetado. O objetivo deste estudo foi apresentar o caso clínico de uma mulher de 24 anos de idade, cor da pele branca com diagnóstico de displasia cemento-óssea florida com acompanhamento de 13 anos. Algumas alterações no padrão radiográfico foram observadas, como a mineralização progressiva da lesão. Tratamento ortodôntico foi realizado em um serviço privado. Não foi realizado exodontia. Esta alteração era esperada, pois a displasia cemento-óssea florida tem diferentes estágios de desenvolvimento. É sugerido, portanto, que a presença da displasia cemento-óssea florida não impediu o sucesso do tratamento ortodôntico.

ABSTRACT Florid cemento-osseous dysplasia is a subtype of fibrous-osseous lesion that commonly appears in the jaws of middle-aged black women. Clinically, the florid cemento-osseous dysplasia is asymptomatic. The radiographic aspect shows a radiolucent area with several masses of radiopaque structures, typically found in the toothbearing areas. Usually, the diagnosis is made during routine radiographic examination. The treatment is required when infection occurs due to exposure of the lesion in the oral cavity. In these severe cases, pain and facial deformity may be present. Commitment oral hygiene and routine dental visits for check-up are recommended for individuals affected. The objective of this study was to present a clinical case of a 24-year-old white woman with florid cemento-osseous dysplasia, who had been under surveillance for 13 years. Some changes in the radiographic pattern were observed as the orthodontic treatment was carried out in a private service. No tooth extraction was performed. This change is expected because florid cemento-osseous dysplasia has different radiographic aspects that correspond to the different developmental stages of the lesion. It is suggested, however, that the presence of florid cemento-osseous dysplasia did not preclude the success of the orthodontic treatment.