Objective. To investigate the accuracy of dies obtained from single-step and 2-step double-mix impressions. Material and Methods. Impressions (n = 10) of a stainless steel die simulating a complete crown preparation were...Objective. To investigate the accuracy of dies obtained from single-step and 2-step double-mix impressions. Material and Methods. Impressions (n = 10) of a stainless steel die simulating a complete crown preparation were performed using a polyether (Impregum Soft Heavy and Light body) and a vinyl polysiloxane (Perfectim Blue Velvet and Flexi-Velvet) in two consistencies, in one or two (without relief) steps. Accuracy of the stone dies was accessed at a measuring microscope, using a metallic crown with perfect fit to the reference crown preparation. Data were submitted to 2-way ANOVA and Tukey test (α = 0.05). Results. The single-step technique resulted in slightly larger dies, while the 2-step technique without relief produced significantly smaller dies, when compared to the original stainless steel die. Stone dies obtained from 2-step polyether impressions were significantly smaller when compared to dies obtained from 2-step vinyl polysiloxane impressions (Impregum 2-step: -290.94 ± 71.64 μm; Perfectim 2-step: -201.86 ± 28.58 μm). No significant differences were observed in dies obtained from either polyether or vinyl polysiloxane with the single-step technique (Impregum single-step: 63.52 ± 16.60 μm; Perfectim single-step: 79.40 ± 14.11 μm). Conclusion. Higher discrepancies were detected for the 2-step impression technique without relief for the investigated materials.
Cherubism is a rare autosomal-dominant inherited syndrome and is usually self-limiting; it starts in early childhood and involutes by puberty. It is a benign fibroosseous disease, characterized by excessive bone degradat...Cherubism is a rare autosomal-dominant inherited syndrome and is usually self-limiting; it starts in early childhood and involutes by puberty. It is a benign fibroosseous disease, characterized by excessive bone degradation of the upper and lower jaws followed by development of fibrous tissue masses. The purpose of this clinical report is to describe a rare and aggressive form of cherubism on an adult female patient that has been treated in our Bioscience Center for Special Health Care Needs-CEBAPE. The patient was firstly submitted to the surgical procedure with partial curettage of the lesion, and the cavity was filled with autogenous cancellous bone and bone marrow grafts. Furthermore, the support treatment used was the administration of salmon calcitonin by nasal spray during the first year after the preconized procedure. At 4-year followup, we confirmed the stomatognathic system improvement and esthetic rehabilitation, which led to a significant increase in the patient's quality of life.
Dental ectopia is a rare clinical finding characterized by a change in the normal tooth eruption pathway. In more severe cases, nontreated ectopia may develop into either partial or total transposition. The early diagnos...Dental ectopia is a rare clinical finding characterized by a change in the normal tooth eruption pathway. In more severe cases, nontreated ectopia may develop into either partial or total transposition. The early diagnosis is of crucial importance for establishing a treatment planning correctly. Therefore, the present paper is aimed at reporting an unusual case of a 11-year-old boy with ectopic eruption and partial transposition of mandibular permanent lateral incisors as well as the diagnosis and therapeutic outcomes involving such an anomaly.
Objective. To compare the amounts of anchorage loss in the upper first molar (U6) and of retraction of the upper central incisor (U1) in cases with Class I malocclusion between orthodontic mini-implants (OMIs) and conven...Objective. To compare the amounts of anchorage loss in the upper first molar (U6) and of retraction of the upper central incisor (U1) in cases with Class I malocclusion between orthodontic mini-implants (OMIs) and conventional anchorage reinforcements (CARs). Methods. The subjects were 40 female adult patients with Class I malocclusion who were treated with extraction of the first premolars and sliding mechanics. The subjects were divided into Groups 1 (N = 20, CAR) and 2 (N = 20, OMI) according to anchorage method. Lateral cephalograms were taken before (T0) and after treatment (T1). Seven skeletal and dental variables and ten anchorage variables were measured. Mann-Whitney test was used for statistical analysis. Results. Group 2 showed significantly larger retraction of U1 (U1E-sag, 9.5 mm : 7.1 mm, P < .05) and less anchorage loss of U6 (U6M-sag, 0.2 mm : 2.2 mm, P < .05; U6A-sag, 0.3 mm versus 2.4 mm, P < .01) than Group 1. There was opposite vertical movement in U1 and U6 between Groups 1 and 2 (U1E-ver, 0.9 mm intrusion : 0.7 mm extrusion; U6F-ver, 1.0 mm intrusion : 0.9 mm extrusion, P < .05). Conclusion. Although OMI could not reduce the treatment duration, it could provide better maximum anchorage of U6, greater retraction of U1, intrusion of U1 and U6 than CAR.
Single tooth anterior dental crossbite is the commonly encountered malocclusion during the development of occlusion in children. Various treatment options such as removable and fixed appliances have been suggested by dif...Single tooth anterior dental crossbite is the commonly encountered malocclusion during the development of occlusion in children. Various treatment options such as removable and fixed appliances have been suggested by different authors in the past literature. This paper presents two cases of anterior crossbite corrected using the standard Catlan's appliance (Lower Inclined Bite Plane) in a short period of three weeks without any damage to the tooth or the periodontium. This fixed appliance is a simple and traditional method which does not depend on patient cooperation to reverse the bite.
Dentoalveolar traumatic injuries are among the clinical conditions most frequently treated in dental practice. However, few studies so far have addressed the biomechanical aspects of these events, probably as a result of...Dentoalveolar traumatic injuries are among the clinical conditions most frequently treated in dental practice. However, few studies so far have addressed the biomechanical aspects of these events, probably as a result of difficulties in carrying out satisfactory experimental and clinical studies as well as the unavailability of truly scientific methodologies. The aim of this paper was to describe the use of finite element analysis applied to the biomechanical evaluation of dentoalveolar trauma. For didactic purposes, the methodological process was divided into steps that go from the creation of a geometric model to the evaluation of final results, always with a focus on methodological characteristics, advantages, and disadvantages, so as to allow the reader to customize the methodology according to specific needs. Our description shows that the finite element method can faithfully reproduce dentoalveolar trauma, provided the methodology is closely followed and thoroughly evaluated.
Objectives. The aim of this study was to evaluate the influence of operator skill on microleakage in class V composite restorations. Materials and Methods. A total of 16 dentists and 25 dental students were enrolled, and...Objectives. The aim of this study was to evaluate the influence of operator skill on microleakage in class V composite restorations. Materials and Methods. A total of 16 dentists and 25 dental students were enrolled, and 123 extracted teeth were allocated according to the adhesive being tested: Scotchbond Multipurpose, Adper Scotchbond 1 XT, and AdheSE. Each operator was asked to restore one tooth from each experimental group: two class V cavities were cut on each tooth and each adhesive was used on the same tooth before and after instructions for its use. After filling cavities with composite (Z100), the teeth were thermocycled. Results. For all of the tested adhesives, the mean microleakage score was lower for the dentists than for the students. The mean scores for the three tested adhesives were statistically similar before and after instructions for use. Conclusion. Our results indicate that the skill of the operator has a significant influence on microleakage.
The aim of this study was to present a case report of the surgical removal of hyperplasia in the oral cavity, using carbon dioxide (CO(2)) laser radiation and rehabilitation with a complete denture. Epulis fissuratum occ...The aim of this study was to present a case report of the surgical removal of hyperplasia in the oral cavity, using carbon dioxide (CO(2)) laser radiation and rehabilitation with a complete denture. Epulis fissuratum occurs in complete denture patients, because a constant irritative action induces the mucosa to grow under poorly fitting dentures. These lesions must be removed, and to avoid a relapse, new complete dentures should be made to maintain healthy surgical tissues. The clinical sequence presented in this case shows a completely edentulous patient with epulis fissuratum on the lower alveolar ridge extending to the vestibular sulcus of the anterior region of mandible. Immediate complete dentures were made prior to the lesion removal with CO(2) laser radiation, providing satisfactory results in oral function and tissue health.
Dens invaginatus is a developmental dental anomaly clinically characterized by a palatine furrow that can be limited to the coronal pulp or may extend to the radicular apex. The purpose of this paper was to present a cli...Dens invaginatus is a developmental dental anomaly clinically characterized by a palatine furrow that can be limited to the coronal pulp or may extend to the radicular apex. The purpose of this paper was to present a clinical case of type III dens invaginatus, identified on the maxillary right central incisor in anterior periapical radiographs, in which the tooth was submitted to conventional endodontic treatment. The results obtained after five years of clinical and radiographic followup demonstrated that conventional endodontic treatment is a clinically viable alternative in cases of type III dens invaginatus.
Objective. Patients with hypodontia are relatively common in clinical dentistry. This study was performed to determine the prevalence of hypodontia of permanent teeth in Korean orthodontic patients and whether such preva...Objective. Patients with hypodontia are relatively common in clinical dentistry. This study was performed to determine the prevalence of hypodontia of permanent teeth in Korean orthodontic patients and whether such prevalence is associated with the type of dental clinic, patient gender, or the type of malocclusion. Materials and Methods. Over a five-year period, we evaluated 3,055 patients (mean age, 15.1 years; range 9~30) from two geographically separated orthodontic clinics: 1,479 from University Hospital and 1,576 from a private clinic. Hypodontia was diagnosed using panoramic radiographs, clinical examination, and dental casts. Results. The overall prevalence of hypodontia, excluding the third molars, was 11.3%, and there was no statistically significant association with the type of dental clinic, gender, or malocclusion patterns. The most commonly missing teeth were the mandibular second premolars (44.2%), followed by the mandibular lateral incisors (36.6%), and the maxillary second premolars (34.0%). In both sexes, 86.0% of patients with hypodontia were missing one or two teeth. Conclusion. The relatively high prevalence of hypodontia emphasizes the importance of dental examination in early childhood with radiographic screening for hypodontia as standard public oral health policy and warrants further investigation of the orthodontic treatment strategies to prevent resultant oral health impairments of hypodontia.
Introduction. Dental treatment performed in patients receiving continuous oral anticoagulant drug therapy is becoming increasingly common in dental offices. For these patients it is imperative to carry out careful anamne...Introduction. Dental treatment performed in patients receiving continuous oral anticoagulant drug therapy is becoming increasingly common in dental offices. For these patients it is imperative to carry out careful anamnesis, as well as a multiprofessional clinical evaluation with regard to the risk and control of hemorrhagic or thromboembolic episodes. Objectives and Material and Methods. The aim is to evaluate postextraction hemorrhagic or thromboembolic episodes in patients who have been on anticoagulant medications for an uninterrupted period of 48 months. Results. Among the 108 patients evaluated, 215 extractions were performed in which there was only one case of postoperative bleeding. Warfarin was used by 98 patients; Warfarin associated with salicylic acetic acid by 9 patients and salicylic acetic acid in only 1 patient. As regards the serologic tests performed, International Normalized Ratio (INR) ranged from 0.8 to 4.9, with a mean of 3.15. Conclusion. Extractions in patients on oral anticoagulants must be performed in the least traumatic manner possible. It is not necessary to stop anticoagulant therapy to perform extractions. Local hemostasis techniques, such as obliterative sutures alone are sufficient to prevent hemorrhagic complications.
Objectives. To compare the efficacy of three placement techniques in marginal sealing of Class V composite restorations extending onto the root. Materials and Methods. Class V cavities were prepared on buccal surfaces of...Objectives. To compare the efficacy of three placement techniques in marginal sealing of Class V composite restorations extending onto the root. Materials and Methods. Class V cavities were prepared on buccal surfaces of 30 extracted human molars, with gingival margins 1.5 mm on the root. Prepared teeth were randomly assigned into 3 groups of 10 each and restored with Single Bond/Filtek Supreme using following techniques; Group I: oblique; Group II: occlusogingival; and Group III: split-increment. After restoration finishing, teeth were thermocycled, and immersed in 2% methylene blue dye for 24 h. Teeth were sectioned buccolingually. Digital photographs were made of sectioned surfaces using digital camera fitted on stereomicroscope. Microleakage was scored at occlusal and gingival margins using 0-3 scale. Dye penetration depth (DPD) at both margins was also measured using AnalySIS software. Data were analyzed using one-way ANOVA and Bonferroni multiple comparison test. Results. 5% of occlusal margins in Groups I and III had 50 μm average (DPD). In Group II, only 10% of occlusal margins showed dye penetration, with 60 μm average depth. For gingival margins, Groups I and III presented dye penetration in 55% of specimens, with 220 and 150 μm average (DPD), respectively. Group II had 60% of gingival margins, with 230 μm average (DPD). There was no significant difference in microleakage at occlusal and gingival margins in all groups. Dye penetration was larger at gingival than at occlusal margins (P < .001). Conclusion. None of placement techniques produced gap-free margins. Oblique and occlusogingival techniques exhibited higher degrees of microleakage at occlusal and gingival margins, as compared to that of split-increment technique. Splitting flat composite increment by diagonal cut, prior to light-curing, preserved bonded gingival margin integrity and reduced microleakage.
Cerebral palsy (CP) is one of the most severe childhood disabilities due to a lesion in the developing brain. Oral conditions often observed in this pathogenic are a tendency for the delayed eruption of permanent molars,...Cerebral palsy (CP) is one of the most severe childhood disabilities due to a lesion in the developing brain. Oral conditions often observed in this pathogenic are a tendency for the delayed eruption of permanent molars, higher percentages of malocclusion and parafunctional habits, including bruxism. The significance of oral conditions observed in CP patients demonstrates the need for intensive home and professional care for these individuals. This paper presents a 7-year-old boy, with cerebral palsy, severe mental retardation, who had high abrasion wear of the primary teeth related to bruxism. Dental care was carried out under oxide-induced sedation, and management of the bruxism was achieved after the use of a resin acrylic protective appliance fixed on both sides of the mandibula. The treatment performed offered efficiency advantages, was clinically viable, and should be a valuable option to practitioners considering appliance therapy to control parafunctional behavior.
Nickel-titanium (NiTi) shape-memory alloys (SMAs) have been used in the manufacture of orthodontic wires due to their shape memory properties, super-elasticity, high ductility, and resistance to corrosion. SMAs have grea...Nickel-titanium (NiTi) shape-memory alloys (SMAs) have been used in the manufacture of orthodontic wires due to their shape memory properties, super-elasticity, high ductility, and resistance to corrosion. SMAs have greater strength and lower modulus of elasticity when compared with stainless steel alloys. The pseudoelastic behavior of NiTi wires means that on unloading they return to their original shape by delivering light continuous forces over a wider range of deformation which is claimed to allow dental displacements. The aim of this paper is to discuss the physical, metallurgical, and mechanical properties of NiTi used in Orthodontics in order to analyze the shape memory properties, super-elasticity, and thermomechanical characteristics of SMA.
Purpose. To analyze the stress distribution in an endodontically treated maxillary central incisor restored with various post-core systems and assess the benefit of ferrule using finite element analysis. Material and Met...Purpose. To analyze the stress distribution in an endodontically treated maxillary central incisor restored with various post-core systems and assess the benefit of ferrule using finite element analysis. Material and Methods. Twelve models with metal ceramic crown were created based on the combination of three types of post-core systems (titanium post-composite resin core, nickel-chromium post-core, and fiber reinforced composite resin post-composite resin core), two varieties of posts (tapered, parallel), and with or without ferrule. 100 N load was applied in three directions and the von Mises stress was compared. Results. Ferrule made no difference in stress distribution for the titanium and nickel-chromium posts, though it showed some stress reduction in fiber-reinforced composite resin posts. Nickel-chromium cast post-core transmitted the least amount of stresses to the dentin despite producing the maximum stress. Conclusion. Incorporation of ferrule offered some degree of stress reduction in nonmetal post, and it increased the stresses within cervical dentin.
Although it has been established that nifedipine is associated with gingival overgrowth (GO), there is little information on the prevalence and severity of this condition in the Brazilian population. The aim of this stud...Although it has been established that nifedipine is associated with gingival overgrowth (GO), there is little information on the prevalence and severity of this condition in the Brazilian population. The aim of this study was to assess the occurrence of nifedipine-induced GO in Brazilian patients and the risk factors associated using a Clinical Index for Drug Induced Gingival Overgrowth (Clinical Index DIGO). The study was carried out on 35 patients under treatment with nifedipine (test group) and 35 patients without treatment (control group). Variables such as demographic (age, gender), pharmacological (dose, time of use), periodontal (plaque index, gingival index, probing depth, clinical insertion level, and bleeding on probing), and GO were assessed. Statistical analysis showed no association between GO and demographic or pharmacological variables. However, there was an association between GO and periodontal variables, except for plaque index. According to our study, the Clinical Index DIGO can be used as a parameter to evaluate GO. Therefore, we conclude that the presence of gingival inflammation was the main risk factor for the occurrence of nifedipine-induced GO.
Caries is a multifactorial disease, and studies aiming to unravel the factors modulating its etiology must consider all known predisposing factors. One major factor is bacterial colonization, and Streptococcus mutans is...Caries is a multifactorial disease, and studies aiming to unravel the factors modulating its etiology must consider all known predisposing factors. One major factor is bacterial colonization, and Streptococcus mutans is the main microorganism associated with the initiation of the disease. In our studies, we have access to DNA samples extracted from human saliva and blood. In this report, we tested a real-time PCR assay developed to detect copies of genomic DNA from Streptococcus mutans in 1,424 DNA samples from humans. Our results suggest that we can determine the presence of genomic DNA copies of Streptococcus mutans in both DNA samples from caries-free and caries-affected individuals. However, we were not able to detect the presence of genomic DNA copies of Streptococcus mutans in any DNA samples extracted from peripheral blood, which suggests the assay may not be sensitive enough for this goal. Values of the threshold cycle of the real-time PCR reaction correlate with higher levels of caries experience in children, but this correlation could not be detected for adults.