In recent years, the percentage of adults seeking dental treatment has been on the rise. Among these patients, aesthetic demands and oral conditions complicate treatment. A multidisciplinary approach with a view to conducting more conservative treatments that avoid sacrificing healthy teeth is one of the goals for these patients. Using methods such as interproximal tooth wear is a preventative and therapeutic alternative that, when executed with care and knowledge, does not damage teeth or periodontal tissues, helps correct crowding, and improves tooth shape and black triangles. Furthermore, it provides more stable, functional and aesthetic results for patients.

 Frecuencia de los trastornos pulpares y periapicales antes del tratamiento de ortodoncia Introduction and objective: Orthodontic forces can aggravate a pre-existent pulpal condition. The aim of the present study was to determine the frequency of pulpal disorders in patients prior to orthodontic treatment. Materials and methods: Transversal study.  37 patients (19 female, 18 male) who met the following criteria were included: Patients with permanent dentition (including second molars) with full root formation, with a complete set of periapical radiographs, and no previous orthodontic treatment.  Patients using pacemakers or with history of previous orthodontic treatment were excluded.  Clinical testing of pulpal vitality and sensitivity, as well as periapical condition, was performed. Relative and absolute frequencies for pulpal and periapical diagnoses were described. Also, stratification by gender, age, arch, and area was implemented.   Results: 981 teeth were analyzed, 48.6% of the teeth showed pulpal or periapical disorders (477/981). Pulpless teeth were found mostly in female patients (72.2%), patients with 41 years of age on average (26%), and patients exhibiting three or more restorations (2.8%). 20.5% teeth were affected with periapical conditions (39/942). The first left maxillary molar showed the highest frequency of pulpal and periapical disorders. 73.5% exhibited poorly-performed obturation or condensation techniques from the 34 affected teeth (25/34). 74.3% of affected teeth were in the maxilla and 64.1% were in the posterior area of the mouth. Conclusion: A detail clinical and radiological examination of pulpal and periapical status should be performed before the onset of orthodontic treatment.