IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 190 IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANA, BRAZIL PREVALÊNCIA DE DENTES RETIDOS NA CIDADE DE CURITIBA, PARANÁ, BRASIL Rodrigo SANDRIN ** Daniel Luiz Gaertner ZORZETTO *** Clóvis MARZOLA **** João Lopes TOLEDO-FILHO ***** José Lucas BARBOSA ****** Ivonete Barreto HAAGSMA ******* _________________________________________ * Monograph presented for conclusion of Specialization Course in Oral and Traummatology Maxillofacial Surgery in 2008. ** Ex Resident of the Course in Oral and Traummatology Maxillofacial Surgery by the Brazilian College of Buco Maxillofacial Surgery and Traummatology and Base Hospital of Bauru, São Paulo State, Brazil. Student that concluded the Specialization Course in Oral and Traummatology BMF Surgery APCD - Bauru, 2007 and author of the monograph. *** Professor of the Specialization Course of Oral and Traummatology Buco Maxillofacial Surgery, APCD – Bauru, São Paulo State, Brazil. Effective member of the Base Hospital of Bauru, São Paulo, Brazil. Titular member of the Brazilian College of Buco Maxillofacial Surgery and Traummatology. **** Retired Titular Professor of Surgery of School of Dentistry of the University of São Paulo – FOB – USP. Professor of the Specialization Course of Oral and Traummatology Buco Maxillofacial Surgery, APCD – Bauru, São Paulo State, Brazil. Effective member of the Base Hospital of Bauru, São Paulo, Brazil. Titular member of the Brazilian College of Buco Maxillofacial Surgery and Traummatology. Credenciated Professor of the Albert Einstein Israelite Hospital, São Paulo, SP, Brazil. Co-adviser of this report. ***** Titular Professor of Anatomy of School of Dentistry of the University of São Paulo – FOB USP. Professor of the Specialization Course of Oral and Traummatology Buco Maxillofacial Surgery, APCD – Bauru, São Paulo State, Brazil. Effective member of the Base Hospital of Bauru, São Paulo, Brazil. Titular member of the Brazilian College of Buco Maxillofacial Surgery and Traummatology. ****** Specialist in Radiology and Orthodonty and proprietor of the “All Doc Radiology Clinic” in the Curitiba City, in Paraná state in Brazil. ******* Specialist in Radiology and proprietor of the “All Doc Radiology Clinic” in the Curitiba City, in Paraná state in Brazil. IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 191 ABSTRACT This research reports a radiographic review of 9028 panoramic radiographs from the digital archives of a Radiologic Institute of Curitiba city, state of Paraná, “ALL DOC” with the purpose of evaluating the prevalence of dental retention and their characteristics such as gender, location, age group and teeth more frequently found retained. Three thousand and six hundred and thirty six (3636) (40,27%) panoramic radiographs were found with retained teeth, being female gender more affected (58,22%). The age group researched was from 13 to 95 years old. The posterior region of right mandible presented the major number of retention cases (28,64%) and the teeth more frequently found retained were lower third molars (54,65%), followed by upper third molars (40,09%) and upper canines (1,61%). RESUMO Esta pesquisa apresenta uma revisão de 9028 radiografias panorâmicas do arquivo digital do instituto de radiologia da cidade de Curitiba, estado do Paraná, “ALL DOC” com a finalidade de avaliar a prevalência de dentes retidos e suas características quanto ao gênero, localização, faixa etária e dentes mais freqüentemente encontrados retidos. Foram encontradas 3636 (40,27%) radiografias panorâmicas com dentes retidos, sendo o gênero feminino o mais acometido (58,22%). A faixa etária pesquisada variou dos 13 aos 95 anos. A região posterior da mandíbula direita foi a que mais apresentou casos de retenção (28,64%) e, os dentes mais freqüentemente encontrados retidos foram os terceiros molares inferiores (54,65%), seguidos pelos terceiros molares superiores (40,09%) e, caninos superiores (1,61%). Uniterms: Dental retention; retained third molars; prevalence. Unitermos: Retenção dental; terceiros molares retidos; prevalência. INTRODUCTION Impacted teeth are defined when a tooth is embedded totally or partly inside the bone by the time of normal eruption, with or without maintenance of follicular sac integrity. (MARZOLA, 1995 e 2005). Impaction can occur with any type of teeth, nevertheless impaction of third molars and maxillary canines seem to occur more frequently than for other type of teeth. (MARZOLA; MADEIRA; CASTRO, 1968). One of the reasons for the higher impacted third molar frequency is the fact of being the last tooth to erupt (OLASOJI; ODUSANYA, 2000). As to this line of thought, it has been said that the higher prevalence of mandibular third molar impaction is due to mandibular bone thickness and compact tissue and either for the space for this teeth were limited by one side for the mandibular second molar and at the other for the ascending ramus IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 192 of mandible, acting both as an obstacle for its eruption (MARTINHÃO; BARROS; CAMPOS et al., 1992). Impacted teeth are potentially related to periodontal disease, pericoronitis, caries and adjacent tooth reabsorption (NICODEMO; RANGEL; BAZZARELLA, 1982). Those facts justify the value of this study, emphasizing the early diagnose and treatment planning for these anomalies that if left untreated may cause patient health issues. With this purpose, we propose to evaluate the prevalence of impacted teeth in the City of Curitiba, the gender prevalence and the teeth more founded in this condition. LITERATURE REVIEW There are two forms of dental impaction: teeth completely bone embedded (endosseous impaction) or partly or totally gingival mucosa embedded (subgingival impaction). It can be partly impacted with rupture of follicular sac (semi-impaction) (MARZOLA, 1995 e 2005). The frequency of dental impaction hasn’t been addressed until recent years. BLUM (1923) was the first to report mandibular third molars (86%), maxillary canines (51%) and maxillary third molars (33%) as the most frequently impacted teeth. In a study of 6389 cases, 1432 of them with full mouth radiographs, MEAD (apud MARZOLA, 2005) reported that 461 of 581 impacted teeth (nearly 80%) were third molars, being 248 mandibular and 213 maxillary; another teeth reported with high frequency was the maxillary canine(23). FONSECA (1956) evaluated 1000 patients clinic and radiographically, finding 174 (17,4%) patients with impacted teeth, 93 (18,6%) male e 81 (15,4%) female. The author could prove the higher prevalence of impacted mandibular third molars (66,6%), followed by maxillary third molars (33,3%), maxillary canines (14,3%), mandibular premolars (2,8%), mandibular canines (1,7%); supernumerary teeth (1,4%, 8 maxillary fourth molar and 1 mandibular) and two cases of mesiodens (0,2%). In a study with 3874 radiographs, the prevalence of at least one impacted teeth was 16,7%. The most frequently impacted teeth were maxillary third molars (21,9%) and mandibular ones (17,5%), followed by maxillary canines and mandibular premolars. No significant statisticcal difference was found by gender to third molar impaction. Nevertheless, maxillary canine impaction was more frequent in female (1,17% versus 0,51% male) (DACHI; HOWELL, 1961). In the City of Ribeirão Preto (SP, Brazil) it was noticed 1000 radiographs, with 63 (6,3%) showing 99 impacted teeth, among them mandibular third molars with high prevalence (34,3%); maxillary canines (18,2%); maxillary third molars (17,2%); mandibular second premolars (10,1%); mandibular first premolars (4%); maxillary second premolars (4%); maxillary central incisor (3%); supernumerary (3%); mandibular canines (2%); maxillary lateral incisor (1%) and mandibular first and second molars (1% each). By gender: 6.6% female and 5.9% male (GRANDINI; VERRI; STIVANIN, 1966). IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 193 In a study with 1760 patients in the city of Araçatuba (SP, Brazil) it was observed that impaction was present in 17.9% of the patients and agenesis occurred in 7.6%. Mandibular and maxillary third molars were the most impaction-affected teeth (49.35 % each). Maxillary canine’s impaction was seen in 1.4% of cases. Thus, in gender, the prevalence was similar (45.3% male and 41.1% female) (MARZOLA; MADEIRA; CASTRO, 1968). It was found 6.4% prevalence of impacted teeth in 1000 patients evaluated clinically and radiographically, 6,68% female and 6,05% male. Nevertheless, supernumerary teeth suffered more impaction (26,02%); although difference between them and mandibular third molars was lower (23,29%). Other teeth suffering from impaction were maxillary canines (24,66%); maxillary third molars (9,59%); mandibular canines (5,48%); maxillary second premolars (4,11%); maxillary central incisor (4,11%); mandibular second premolars (1,37%) and mandibular first premolars (1,37%). Of supernumerary teeth, all were maxillary, 57,90% posterior and 42,10% anterior (5 mesiodens) (SALOMÃO; SENI, 1970). A study at Harlem Hospital (USA) where 95% of the patients were afro-Americans, evaluated 3745 panoramic radiographies. The authors reported 18,20% patients with one or more impaction, male and female with equal prevalence. Maxillary third molars were most frequently impacted than mandibular (58,87% and 41,13% respectively). Other impaction reported was canine (3,94%); second molar (0,67%); first and second premolar (0,49% each); first molar (0,25%) e lateral incisor (0,08%) (KRAMER; WILLIAMS, 1970). Following the same line of research, a radiograph evaluation was performed with 3000 patients. In 245 (8,16%) of 3000 patients it was found 360 impacted teeth: mandibular third molar (37,78%); maxillary third molar (20,28%); maxillary canine (16,94%); supernumerary (11,39%) and different teeth with lower percentage. Impaction were more frequent in female (8,26%) than male (8,06%) (VERRI; OLIVEIRA; GRANDINI et al., 1973). A research conducted among Dentistry students in the City of São José dos Campos between 18 and 23 years old showed that 40% of the sample with third molar impaction, 45,2% female and 31.2% male. Impaction prevalence in decreasing order was: right mandibular third molar (39 cases); left mandibular third molar (34 cases); right maxillary third molar (33 cases) and left maxillary third molar (31 cases) (NICODEMO; RANGEL; BAZZARELLA, 1982). Prevalence and distribution of impacted teeth in 1895 radiographs was 583 (30,8%) with one or more impaction at the following order: mandibular third molar (48,1%); maxillary third molar (29,6%); maxillary canine (11,9%); mandibular canine (3,5%); mandibular second premolar (3,3%); maxillary second premolar (2,2%); maxillary second molar (0,5%); mandibular first premolar (0,4%); maxillary central incisors (0,2%); mandibular second molar (0,1%); maxillary first premolar (0,1%); other (0,3%). There was no significant statisticcal difference in gender (BROWN; BERKMAN; COHEN et al., 1982). Swedish student’s radiographs were evaluated for prevalence of impaction of third molars. Analyzing 113 female and 144 male, it was reported that 33% of the sample showed one or more third molars impacted. The prevalence of third molar impaction was higher in mandible (66%) than in maxillae (34%) (SCHERSTÉN; LYSELL; ROHLIN, 1989). IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 194 A study of 334 panoramic radiographies in the City of Maringa (PR) showed 58 third molars impacted in 36 (10,78%) radiographies. The minimal age criteria of inclusion in this study were 25 years old. 34 mandibular third molars were observed (58,6%) and 24 maxillary third molars (41,4%). Distribution of impacted teeth ranged from 67,2% female to 32,8% male (MARTINHÃO; BARROS; CAMPOS et al., 1992). A study of dental anomalies was designed through the analysis of 934 panoramic radiographies of patients aging from 3 to 80 years old. It was found some kind of anomaly in 550 (58,9%) of the radiographs, such as impacted teeth (21,2%) and supernumerary teeth (2,3%) (CARVALHO; SIMI; ABDALLA et al., 1997). A comparison between the prevalence in third molar impaction in an urban population (city of Lagos, Nigeria) and a rural one was made. Evaluating 1200 patients clinically and radiographically in each group, a higher prevalence was observed in the urban population (22.8%) than in the rural one (3.1%). Mandibular third molar impaction was numbered in 15,1% of impaction in urban cases versus 1.9% at rural population, as for maxillary third molar, 6.2% were urban versus 0.3% rural. Authors reported that the difference in impacted teeth may be due to changes in eating habits occurred in the urban population, such as the addition of less rigid food, therefore demanding less maxillary function. It was also reported that dental friction during mastigatory movements of rigid food requires a high muscle activity stimulating mandibular growth (OLASOJI; ODUSANYA, 2000). In the years 2001 and 2002 the impaction prevalence in 88 panoramic radiographies of surgery attending patient’s of the Dentistry school of the City of Feira de Santana (BA) was evaluated. As a result 59,1% of the sample was female and 40.9% male. It was reported that the majority of impacted teeth were mandibular third molars (49,3%), followed by maxillary third molars (36,9%); supernumerary (6,7%); maxillary canines (3,8%); incisors (1,9%) and mandibular premolars (1,4%) (FARIAS; SANTOS; CAMPOS et al., 2003). A research designed in Singapore, China, with 1000 panoramic radiographies of patients ranging from 20 to 40 years old found out 68,6% of the population researched with impacted third molar teeth. It was observed higher prevalence in mandible (90%) than maxillae (28%) and female suffered in higher number (56%) than male (44%) (QUEK; TAY; TAY et al., 2003). Aiming to analyze third molar position prevalence in private practice patients in the Cities of Cunha Porã, Maravilha and Palmitos (SC, Brazil), 585 panoramic radiographies were observed, being 210 male and 375 female. 1815 impacted third molars were recorded, 465 teeth number 28; 453 teeth number 38; 450 teeth number 18 and 447 teeth number 48 (MARZOLA; COMPARIN; TOLEDO-FILHO, 2006). 2651 panoramic radiographies of a digital data center in the City of Curitiba (PR) were analyzed for the prevalence of impacted teeth (third molar, molar, premolar, canine and incisor). 425 radiographies showed impacted teeth, 185 male (43,53%) and 240 female (56,47%), ages ranging from 15 to 88 years. 971 impacted teeth were observed: 267 (teeth number 38); 242 (teeth number 48); 217 (teeth number 18); 187 (teeth number 28); 14 (teeth number 23); 12 (teeth number 13) and other in lower percentage (TOLEDO, 2007). IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 195 At the same digital data center, 3000 panoramic radiographies were also evaluated for the prevalence of impacted canines finding 2,23% of impaction. Higher prevalence in female (58,2%) than male (41,8%) was observed. The frequency of impaction was: teeth number 23 (44,8%); teeth number 13 (41,8%); teeth number 33 (7,4%) and teeth number 43 (6%) (OLIVEIRA, 2007). Authors studying 848 panoramic radiographies found 64 supernumerary impacted teeth, most of them in permanent dentition. As to location, the maxilla anterior region had the most occurrences, with 57,8%. Other regions in maxilla were molar (10,9%); premolar (9,4%); canine (7,8%). Mandible: premolar (9,4%). Other areas, 4,8%. In gender, there was higher prevalence in male (8,4%) then female (5,2%) (CUNHA-FILHO; PURICELLI; HENNIGEN et al., 2002). It was also observed that in supernumerary teeth the most common was mesiodens, being related one case of a 5 year-old male, with 2 impacted palatal mesiodens, one of them inverted (ABREU-E-LIMA; MOTISUKI; BORDIN, 2002). MATERIAL AND METHOD 9028 panoramic radiographies were examined from a radiological digital institute arquive called “ALL DOC” in the city of Curitiba, PR, Brazil, taken for different therapeutic reasons. The study protocol was evaluated by the ‘Hospital de Reabilitação de Anomalias Craniofaciais’ of São Paulo University, Bauru, Brazil ethical committee. The required inclusion criteria were based on permanent tooth, discarding those with deciduous dentition and permanentdeciduous dentition. Minimal age consider for inclusion was 13 years, due to the fact that at this age maxillary canines have already erupted and because at this phase, we can predict the impaction or not of third molars. Radiographies researched in this study were from both male and female patients and age ranged from 13 to 95 years. Prior to the beginning of collect data, the examiner was adjusted. Digital radiographies were analyzed clockwise counting impacted teeth after careful anatomic region consideration. Images were analyzing using a LG 17” monitor and desktop computer; light in the room was adequate, during one hour daily for about four months, by a buco-maxillo-facial surgery specialized dentist. Data were manually classified in proper cards in the end of each evaluation. In the final evaluation stage these info were condensed in a computer file using Microsoft Excel® software in order to facilitate percentage study of the data collected. RESULTS From 9028 panoramic radiographies, 3685 (40,82%) were male and 5343 (59,18%) female. Age ranged from 13 to 95 years. From this amount, 3636 (40,27%) radiographies showed impacted teeth and 59,73% did not showed any signals of impaction (Graph 1). IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 196 40,27% impacted teeth no impacted teeth 59,73% Graph 1 – Prevalence of impacted teeth in the population studied. From the total of impacted teeth, 2117 (58,22%) were female and 1519 (41,78%) male (Graph 2). 41,78% male female 58,22% Graph 2 – Prevalence of impacted teeth according to genre. IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 197 Most frequently impacted teeth was 48 (27,79%); 38 (26,86%); 28 (20,18%); 18 (19,91%); 13 (0,81%) and 23 (0,80%). Other type’s equals 3,65% (Graph 3). 30,00% 27,79% 26,86% 25,00% 20,18% 19,91% 20,00% 15,00% 10,00% 3,65% 5,00% 0,81% 0,80% Teeth 13 Teeth 23 0,00% Teeth 48 Teeth 38 Teeth 28 Teeth 18 Other tooth Graph 3 – Prevalence according to the frequency of impacted teeth type. There were 65 impacted supernumerary cases (0,65%), maxillary fourth molars (0,43%) in higher range, followed by mandibular premolars (0,12%); mandibular fourth molars (0,05%); maxillary premolars (0,02%); maxillary incisor (0,02%) and mesiodens (0,01%) (Graph 4). 0,01% 0,02% 4º MS 0,02% PMI 0,05% 4º MI 0,12% PMS IS 0,43% Graph 4 – Supernumerary prevalence. Mesiodens IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 198 DISCUSSION The dental impaction theme has been reckoned by several authors throughout the years. The amount of impacted teeth found in this study seem to correspond to those reported before (NICODEMO; RANGEL; BAZZARELLA, 1982 (40%); BROWN; BERKMAN; COHEN et al., 1982 (30,8%) and SCHERSTÉN; LYSELL; ROHLIN 1989 (33%)), opposing from other outcomes (FONSECA, 1956 (17,4%); DACHI; HOWELL, 1961 (16,7%); GRANDINI; VERRI; STIVANIN, 1966 (6,3%); MARZOLA; MADEIRA; CASTRO, 1968 (17,9%); SALOMÃO; SENI, 1970 (6,4%); KRAMER; WILLIAMS, 1970 (18,20%); VERRI; OLIVEIRA; GRANDINI et al., 1973 (8,16%); MARTINHÃO; BARROS; CAMPOS et al., 1992 (10,78%); CARVALHO; SIMI; ABDALLA et al., 1997 (21,2%); OLASOJI; ODUSANYA, 2000 (22,8% and 3,1% in two different population); QUEK; TAY; TAY et al., 2003 (68,6%); TOLEDO, 2007 (16,03%) and OLIVEIRA, 2007 (2,23%) (Fig. 1). Regarding the most frequent gender affected by impacted teeth, some authors described higher prevalence in females, (GRANDINI; VERRI; STIVANIN, 1966; SALOMÃO; SENI, 1970; VERRI; OLIVEIRA; GRANDINI et al., 1973; NICODEMO; RANGEL; BAZZARELLA, 1982; MARTINHÃO; BARROS; CAMPOS et al., 1992; FARIAS; SANTOS; CAMPOS et al., 2003; QUEK; TAY; TAY et al., 2003; MARZOLA; COMPARIN; TOLEDO-FILHO, 2006; TOLEDO, 2007 and OLIVEIRA, 2007), this was also seen in this study. Others may disagree describing males with better prevalence (FONSECA, 1956; MARZOLA; MADEIRA; CASTRO, 1968; SCHERSTÉN; LYSELL; ROHLIN, 1989 and CUNHA-FILHO; PURICELLI; HENNIGEN et al., 2002). Nevertheless, researches showed similar prevalence in both gender (DACHI; HOWELL, 1961; KRAMER; WILLIAMS, 1970 and BROWN; BERKMAN; COHEN et al., 1982). For the most impacted tooth type findings, present investigation outcome are in agreement with several authors (BLUM, 1923; MEAD apud MARZOLA, 2005; FONSECA, 1956; GRANDINI; VERRI; STIVANIN, 1966; VERRI; OLIVEIRA; GRANDINI et al., 1973; NICODEMO; RANGEL; BAZZARELLA, 1982; BROWN; BERKMAN; COHEN et al., 1982; SCHERSTÉN; LYSELL; ROHLIN, 1989; MARTINHÃO; BARROS; CAMPOS et al., 1992; OLASOJI; ODUSANYA, 2000; FARIAS; SANTOS; CAMPOS et al., 2003; QUEK; TAY; TAY et al., 2003 and TOLEDO, 2007), who reported mandibular third molars with high prevalence than other teeth. Some studies showed lower prevalence of mandibular third molars when compared with other teeth (DACHI; HOWELL; 1961; SALOMÃO; SENI, 1970; KRAMER; WILLIAMS, 1970 e MARZOLA; COMPARIN; TOLEDO-FILHO, 2006). Approaching impacted maxillary canine, the outcome was similar to other authors (MARZOLA; MADEIRA; CASTRO, 1968; KRAMER; WILLIAMS, 1970; FARIAS; SANTOS; CAMPOS et al., 2003; TOLEDO, 2007 and OLIVEIRA, 2007), opposing to contemporaneous and previous researches (BLUM 1923; FONSECA, 1956; GRANDINI; VERRI; IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL 199 STIVANIN, 1966; SALOMÃO; SENI, 1970; VERRI; OLIVEIRA; GRANDINI et al., 1973 and BROWN; BERKMAN; COHEN et al., 1982). The supernumerary prevalence was similar to several studies (FONSECA, 1956; GRANDINI; VERRI; STIVANIN, 1966 and CARVALHO; SIMI; ABDALLA et al., 1997). However, different of some studies (SALOMÃO; SENI, 1970; VERRI; OLIVEIRA; GRANDINI et al., 1973 and FARIAS; SANTOS; CAMPOS et al., 2003), where the supernumerary prevalence was higher. Maxillary fourth molars were the most common finding among supernumerary teeth, despite the statement of most common being mesiodens (ABREU-E-LIMA; MOTISUKI; BORDIN, 2002), appearing just one case at the present study, as in other researches (FONSECA, 1956 and MARZOLA; FREITAS; ALVAREZ et al., 1968). Discussing location of supernumerary teeth the outcome of the this study does not agree with some of the literature (CUNHA-FILHO; PURICELLI; HENNIGEN et al., 2002) where the anterior maxillae had more prevalence opposing to posterior maxillae, as showed at the present study and other (SALOMÃO; SENI, 1970). Great part of supernumerary teeth occurence was in patients with multiple impacted supernumerary teeth (MARZOLA, 1995 and 2005). CONCLUSIONS Within the analysis of 9028 radiographies in this study: 1. Impacted teeth prevalence in Curitiba, PR, Brazil was 40,27%. 2. Gender prevalence showed that female are most likely in 58,22% to present dental impaction. 3. Mandibular third molars has the higher impaction rate (54,65%), followed by maxillary third molars (40,09%) and maxillary canines (1,61%). Fig. 1 – Some factors prevalence research about impacted teeth. Authors Impaction Prevalence BLUM, 1923 ---------------- MEAD apud MARZOLA, 2005 ---------------- --------------- 248 213 23 17,4% 16,7% Male 18,6% --------------- 66,6% 17,5% 33,3% 21,9% 14,3% ------------- 34,3% 17,2% 18,2% 49,3% 49,3% 1,4% 23,29% 9,59% 24,66% FONSECA, 1956 DACHI; HOWELL, 1961 GRANDINI; VERRI; STIVANIN, 1966 MARZOLA; MADEIRA; CASTRO, 1968 SALOMÃO; SENI, 1970 6,3% 17,9% 6,4% Gender Third Lower Third Upper Molar Molar Prevalence Prevalence --------------86% 33% - Female 6,6% Male 45,3% Female 6,68% Upper Canine Prevalence 51% IMPACTED TEETH PREVALENCE IN THE CITY OF CURITIBA, PARANÁ, BRAZIL KRAMER; WILLIANS, 1970 AITASALO; LEHTINEN; OKSALA apud MARZOLA, 2005 VERRI; OLIVEIRA; GRANDINI et al., 1973 NICODEMO; RANGEL; BAZZARELLA, 1982 BROWN; BERKMAN; COHEN et al., 1982 SCHERSTÉN; LYSELL; ROHLIN, 1989 200 18,20% --------------- 41,13% 58,87% -------------- --------------- --------------- 39,2% 36,9% ------------- 8,16% Female 8,26% 37,78% 20,28% 16,94% 40% Female 45,2% 73 64 -------------- 48,1% 29,6% 11,9% 66% 34% ------------ 33% --------------Male 56,03% -------------- Feminino 60,6% ------------- -------------- -------------- 10,78% Female 67,2% 58,6% 41,4% ------------- ---------------- Female 56% 417 601 --------------- 21,2% -------------- --------------- ------------- --------------- 22,8%/3,1% --------------- 15,1%/1,9% 6,2%/0,3% -------------- --------------- Female 59,1% 49,3% 36,9% 3,8% 68,6% Female 56% 90% 28% --------------- --------------- Female 375 900 915 --------------- TOLEDO, 2007 16,03% Female 56,47% 509 404 26 OLIVEIRA, 2007 --------------- Female 58,2% ---------------- ----------------- 54,65% 40,09% MARZOLA; NARYFILHO; KAWAKAMI et al., 1990 MARTINHÃO; BARROS; CAMPOS et al., 1992 OLIVEIRA; SPOHR; ZENI et al., 1996 CARVALHO; SIMI; ABDALLA et al., 1997 OLASOJI; ODUSANYA, 2000 FARIAS; SANTOS; CAMPOS et al., 2003 QUEK; TAY; TAY et al., 2003 MARZOLA; COMPARIN; TOLEDO-FILHO, 2006 PRESENT RESEARCH 30,8% 40, 27% Female 58,22% 2,23% 1,61% REFERENCES * ABREU-E-LIMA; F.; MOTISUKI, C.; BORDIN, M. 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