6º FICHAMENTO
Autor: Anni Odonto | Publicado: 2011-06-05T16:46:00-07:00

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 <![endif]-->  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 6º FICHAMENTO
RECURSOS ORTODONTICOS COM O INTUITO DE TRATAR AS AGENESIAS DE INCISIVOS LATERAIS SUPERIORES.
Alexander Macedo,&nbsp;Andréia Cotrim-Ferreira, Daniela Gamba Garib e Renato Rodrigues de Almeida
“A agenesia dentária também pode ser denominada de anodontia parcial, hipodontia ou oligodontia, caracterizando-se pela ausência de um ou mais dentes.”
“Segundo Daniela G. Garib, professora associada de Ortodontia da USP, a etiologia das agenesias dentárias apresenta um caráter predominantemente genético. “O papel da Genética na etiologia das agenesias foi evidenciada mediante estudos em famílias, em gêmeos homozigóticos, e em pacientes com certas síndromes genéticas. Estudos mais recentes, em Biologia Molecular, já identificaram alguns genes envolvidos na determinação das agenesias como o MSX1 do cromossomo 4”, informa.”
“A ausência congênita de um ou mais dentes na espécie humana tem sido observada desde o período Paleolítico.”
“A agenesia dentária constitui anomalia de desenvolvimento mais comum da dentição humana, ocorrendo em aproximadamente 25% da população. O terceiro molar representa o dente mais afetado por esta anomalia, exibindo uma prevalência de 20%.”
“As agenesias dentárias geralmente apresentam-se simétricas, ocorrendo, portanto, bilateralmente. Observa-se uma exceção em relação aos incisivos laterais superiores que, freqüentemente, estão ausentes unilateralmente, sendo que o do lado esquerdo é mais afetado que o direito (Bailit, 1975).”
“Em caso de ausência de incisivos laterais superiores, a conduta terapêutica pode seguir duas formas básicas:
1. A manutenção do espaço para reabilitação com prótese/implante, ou
2. O fechamento do espaço mediante o movimento para mesial dos dentes posteriores.”
“Dessa forma, o tratamento de pacientes com agenesia de incisivos laterais superiores, uni ou bilateral deve ser multidisciplinar, envolvendo as áreas da Ortodontia, Dentística, Implantodontia e Prótese.”
“Quando a agenesia é unilateral e o incisivo lateral oposto é conóide, o tratamento preferencial é a extração do dente anômalo e o fechamento dos espaços remanescentes para posterior transformação de caninos em incisivos laterais, com melhor simetria de tamanho, cor e estabilidade.”
“Por outro lado, se há relação inter-arcos de Classe I, perfil facial de Classe I (reto), ausência de overjet, sobra significativa de espaço intra-arco, arco inferior bem alinhado e sorriso médio/baixo, a preferência é a abertura de espaços para posterior colocação de implante de comum acordo com o paciente”, enumera Renato.”
“Conforme Daniela, minimizar a mecânica e o tempo de tratamento ortodôntico nos casos em que o paciente apresenta relação ântero-posterior normal entre os arcos dentários é a única vantagem da opção pela reabertura de espaço.”
“Ao final, a oclusão de um paciente com agenesia de incisivos laterais tratados ortodonticamente com mesialização dos dentes posteriores é satisfatória do ponto de vista estético e funcional.”