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      Ankylosis of Permanent First Molar: Diagnosis by Cone Beam Computed Tomography Translated title: Anquilosis del Primer Molar Permanente: Diagnóstico por Tomografía Computarizada con Haz Cónico

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          Abstract

          ABSTRACT: Ankylosis is an anomaly of tooth eruption characterized by the fusion of cementum and alveolar bone, and may affect from small regions to the entire root surface. Clinical assessment combined with imaging exams can aid diagnosis. Radiographic testing enables assessing only proximal regions of possibly affected roots. Whereas cone beam computed tomography (CBCT) allows a three-dimensional assessment of axial, coronal, and sagittal planes of all dental extension, eliminating thus overlapping images and helping to confirm the correct diagnosis. The present study contains a case report of a male patient with ankylosis in tooth 16 diagnosed by CBCT, aiming at providing information for dentists about this anomaly, its characteristics and situations in which CBCT should be indicated.

          Translated abstract

          RESUMEN: La anquilosis es una anomalía de la erupción del diente caracterizada por la fusión de cemento y hueso alveolar, y puede afectar desde pequeñas regiones hasta toda la superficie de la raíz. La evaluación clínica combinada con los exámenes de imagen puede ayudar a diagnosticar esta anomalía. Las pruebas radiográficas permiten evaluar sólo las regiones proximales de las raíces posiblemente afectadas. La tomografía computarizada de haz de cono (CBCT) permite una evaluación tridimensional de los planos axial, coronal y sagital de toda la extensión dental, eliminando así las imágenes superpuestas y ayudando a confirmar el diagnóstico correcto. En el presente estudio se presenta un reporte de caso de un paciente con anquilosis en el diente 16 diagnosticado por CBCT, con el objetivo de proporcionar información para los dentistas sobre esta anomalía, sus características y situaciones en las que debe indicarse la CBCT.

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          Most cited references29

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          Impaction and retention of second molars: diagnosis, treatment and outcome. A retrospective follow-up study.

          To evaluate treatment outcome in patients with second molar impaction and retention. A total of 135 second molars, 65 in the maxilla and 70 in the mandible were collected from 87 patients (45 girls and 42 boys) with a mean age of 15 years (range: 11- 19 years). Available patient records, x-rays, study casts, and photos were studied. The mean follow-up period was 22 months (range: 4-106 months). A total of 166 second molars were diagnosed as impacted, 24 as primary and 5 as secondarily retained; 80% of the second molars were orthodontically or surgically treated. In more than half of the treated patients the second molars failed to erupt into a proper position. Surgical exposure of the retained or impacted second molar was the treatment found most successful (71%). The least successful treatment (11%) used the third molar to replace the second molar after the second molar was extracted. No clear difference in treatment outcome could be detected between the impacted and the primary or secondary retained teeth. However, a clear difference was found between the impacted and the primary retained second molars regarding treatment strategy: 9% of the impacted and 67% of the primary retained teeth were left untreated. Dental crowding was found in 70% of the patients. In more than half of the treated patients the second molars failed to erupt into a proper position. The most common treatment given (extraction of the second molar) was the least successful.
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            Primary failure of eruption: further characterization of a rare eruption disorder.

            Posterior open bite has several possible causes, including primary failure of eruption (PFE) that affects all teeth distal to the most mesial involved tooth, mechanical failure of eruption (MFE) (primarily ankylosis) that affects only the involved tooth or teeth, and soft-tissue interferences with eruption (other). Radiographs and other clinical records for 97 cases of failure of posterior eruption submitted for consultation were analyzed to further characterize PFE and distinguish it from MFE. Of the 97 cases, 38 were judged to be clear-cut PFE; 19 were diagnosed as MFE; 32 were classified as indeterminate failure because they were too young to be certain of the distinction between PFE and MFE; and 8 were placed in the "other" category. Two subtypes of PFE were observed. In type 1, eruption failure occurred at or near the same time for all teeth in an affected quadrant. In type 2, a gradient of the time of failure was present, so that some further development of the teeth posterior to the most mesial affected tooth was observed before eruption failure. A family history of eruption problems was noted in 10 of the 38 PFE subjects (26%), and a pedigree analysis was done for 4 families. This was consistent with autosomal dominant transmission. The distinction between PFE and MFE is clinically important because it determines whether all posterior teeth, or only individual affected teeth, will not respond to orthodontic force. Certain diagnosis often requires progress radiographs so that the pattern of eruption of teeth distal to the most mesial affected tooth can be observed.
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              Cone-beam computed tomography in orthodontics: benefits and limitations.

              In order to obtain an overlay-free assessment of dental structures for resorption and ankylosis diagnostics, conebeam computed tomography (CBCT) is being employed more and more often in orthodontics alongside dental CT.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                ijodontos
                International journal of odontostomatology
                Int. J. Odontostomat.
                Universidad de La Frontera. Facultad de Medicina (Temuco, , Chile )
                0718-381X
                September 2017
                : 11
                : 3
                : 319-325
                Affiliations
                [3] Juiz de Fora Minas Gerais orgnameFederal University of Juiz de Fora orgdiv1Department of Dentistry orgdiv2Division of Endodontic Brazil
                [2] Juiz de Fora Minas Gerais orgnameFederal University of Juiz de Fora orgdiv1Department of Dentistry orgdiv2Division of Oral Radiology Brazil
                [1] Piracicaba São Paulo orgnameState University of Campinas orgdiv1Piracicaba Dental School orgdiv2Department of Oral Diagnosis Brazil
                [4] Piracicaba São Paulo orgnameState University of Campinas orgdiv1Piracicaba Dental School orgdiv2Department of Social Dentistry Brazil
                Article
                S0718-381X2017000300319
                c291c2bf-c78b-477c-8e36-6d5a509304c9

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 21 April 2017
                : 19 June 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
                Product

                SciELO Chile


                anquilosis dental,diagnóstico,tomografía computarizada de haz cónico,dental ankylosis,diagnosis,cone beam computed tomography

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