Accuracy of cone-beam computed tomography in determining gingival thickness: a systematic review and meta-analysis.

OBJECTIVE: To assess the accuracy of cone-beam computed tomography (CBCT) for determining gingival thickness. MATERIAL AND METHODS: Searches were undertaken in PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, LIVIVO, and gray literature (Google Scholar and ProQuest) for studies considered eligible according to the following criteria: cross-sectional observational studies, which compared CBCT accuracy with that of transgingival probing when determining gingival thickness, in adult patients with good periodontal health. No language or time restrictions were applied in this systematic review. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for analytical cross-sectional studies. RESULTS: Six articles were included for qualitative synthesis, involving a pooled sample of 132 patients with a mean age of 29 years (18-51 years). Of these 6 studies, 5 were eligible for quantitative analysis. The meta-analysis showed no statistically significant difference between CBCT and transgingival probing measures of gingival tissue (mean difference of 0.10 (95% CI-0.17-0.38). No significant level of heterogeneity was detected (Tau2-P = 0.0662; I2 = 0%; H2-P = 1.000; Q-P = 1.134). According to the GRADE criterion, confidence in the cumulative evidence was considered low. CONCLUSIONS: CBCT is an accurate method for determining gingival tissue thickness, comparable to the reference standard (transgingival probing). CLINICAL RELEVANCE: CBCT could be considered for gingival thickness measurement when bone thickness is also needed, and thereby aid in the assessment of gingival biotype without the discomfort and anesthesia needed in transgingival probing. TRIAL REGISTRATION: This protocol was registered at the PROSPERO database (International Prospective Register of Systematic Review) under registration number CRD42022326970. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022326970 .

Impact of Fracture Line Width on Radiographic Diagnosis of Vertical Root Fractures: Analysis of the Generalised Estimating Equation Model.

OBJECTIVE: To undertake a joint analysis of the influence of fracture width, dental thickness and distance of the fracture from the cortical bone on the radiographic diagnosis of vertical root fractures. METHODS: Thirty-six uniradicular bovine teeth were endodontically treated and distributed into three groups according to the remaining root dentine thickness: 1.2 mm, 1.5 mm and 1.8 mm. Each group comprised 12 teeth, six with vertical root fracture and six without. Scanning electron microscopy (SEM) images of the fractured tooth groups were obtained and the fracture lines were measured. All specimens were inserted into bone defects created in bovine ribs, at different distances from the external cortical bone. Digital periapical radiographs were randomly evaluated by three blinded examiners (presence or absence of fractures). RESULTS: The specificity for periapical radiography was found to be 89% and the accuracy rate was 57.4%. The mixed-model regression using the generalised estimating equation (GEE) model showed that the width of the fracture line and the thickness of the dental remnant play an important role in radiographic detection of vertical root fractures. There is a lower chance of correct diagnosis with fracture line widths < 0.2 mm (odds ratio [OR] 0.294, 95% confidence interval [CI] 0.103 to 0.836; P = 0.022) and tooth thicknesses < 1.2 mm (OR 0.342, 95% CI 0.157 to 0.747; P = 0.007). CONCLUSION: Fracture line widths < 0.2 mm and smaller root thicknesses lead to a less accurate diagnosis of vertical root fractures on periapical radiographs.

Surface Topography, Gloss and Flexural Strength of Pressable Ceramic After Finishing-Polishing Protocols.

This study evaluated the effect of different finishing-polishing protocols on surface roughness, gloss, morphology and biaxial flexural strength of pressable fluorapatite glass ceramic. Thirty ceramic discs (12x1 mm) were produced and divided into five groups (n=6): CT: control (glaze); DA: fine grit diamond bur; DG: DA + new glaze layer; DP: DA + felt disk with fine grit diamond paste; DK: DA+ sequential polishing with silicon abrasive instruments, goat hair brush and cotton wheel. The specimens were analyzed for surface roughness (Ra) under profilometry and atomic force microscopy (AFM). Gloss was measured with spectrophotometry and micromorphology with scanning electron microscopy (SEM). Flexural strength was assessed by biaxial flexural strength test. Data were analyzed using one-way ANOVA and Tukey's post hoc test (a=0.05). DK showed the lowest surface roughness values and DA presented the highest in the perfilometer analysis. No significant differences were observed in the AFM for the CT, DG and DK groups, which presented the lower surface roughness; DA and DP had the higher Ra values. The DA, DP and CT showed the lowest surface gloss values, and the reflectance was significantly different from those observed for DK and DG groups. SEM analysis revealed the smoothest surface for DK group, followed by DG and CT groups; DA and DP groups exhibited variable degrees of surface irregularities. No significant differences were observed among groups for the biaxial flexural strength. The polishing protocol used in DK group can be a good alternative for chairside finishing of adjusted pressable fluorapatite glass ceramic surfaces.

A diet including xanthan gum triggers a pro-inflammatory response in Wistar rats inoculated with Walker 256 cells.

OBJECTIVE: The aim of this study was to evaluate the effect of adding xanthan gum to the diet of rats on the production of cytokines and pro-inflammatory factors and on tumor development in rats inoculated with Walker 256 tumor cells. METHODS: Fifty-six rats were divided into 4 groups: control diet (C), control diet with tumor (TC), xanthan gum diet (XG), xanthan gum diet with tumor (TXG). RESULTS: The ingestion of xanthan gum promotes changes in cytokine content: increasing IL-6 TNF-α and IL-10 in retroperitoneal adipose tissue compared to the control group; and increasing TNF-α in the mesenteric adipose tissue compared to the C and TXG groups. On the contrary, the addition of xanthan gum to the diet did not affect the development of Walker 256 tumors in rats. CONCLUSION: The continuous use of xanthan gum triggered a pro-inflammatory response, promoting an increase in pro-inflammatory cytokines in the adipose tissue, but it did not have an effect on the tumor development in the animals inoculated with Walker 256 tumor cells.

Clinical tools designed to assess motor abilities in children with cerebral palsy.

OBJECTIVE: This systematic review aimed to list the tools used by rehabilitation professionals to test motor abilities in children with cerebral palsy (CP), to determine if these tools have psychometric properties specifically measured for CP, and to identify the main characteristics of these tools. METHOD: Web of Science, PEDro, PubMed/MEDLINE, Science Direct, and SciELO databases were searched to identify the tools. PubMed/MEDLINE was then searched to identify the studies assessing those tools' psychometric properties. The agreement-based standards for the selection of health measurement tools and the Terwee criteria were used to assess the quality and the results of each included study, respectively. RESULTS: Eighteen tools were identified. The psychometric properties of many of the tools used with children with CP have not been evaluated for this population. CONCLUSION: The psychometric properties evaluated often have a poor methodological quality of measurement. Overall, we suggest the tools with most empirical support to evaluate children with CP.

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions.

Great attention has been given to the study of radiolucent periapical lesions to avert possible misdiagnosis of apical periodontitis associated with certain radiolucent non-endodontic lesions. However, there are a significant number of radiopaque lesions found in the periapical region, which could be equally relevant to endodontic practice. The diagnosis and management of these radiopaque/hyperdense lesions could be challenging to the endodontist. These bone alterations could be neoplastic, dysplastic or of metabolic origin. In the context of the more widespread use of cone-beam CT, a detailed review of radiopaque inflammatory and non-inflammatory lesions is timely and may aid clinicians perform a differential diagnosis of these lesions. Distinguishing between inflammatory and non-inflammatory lesions simplifies diagnosis and consequently aids in choosing the correct therapeutic regimen. This review discusses the literature regarding the clinical, radiographic, histological and management aspects of radiopaque/hyperdense lesions, and illustrates the differential diagnoses of these lesions.

Stem Cell Marker Expression in Persistent Apical Periodontitis.

INTRODUCTION: This study evaluated the expression of CD90 (mesenchymal stem cell) and Sox2 (progenitor stem cell) markers in persistent apical periodontitis (PAP) (n = 16) and primary periapical lesions (PPLs) (n = 10). METHODS: All samples were classified histologically according to the intensity of inflammatory cell infiltrate in the periapical lesion. Immunohistochemistry was used to detect CD90 and Sox2 in PAP and PPLs. The Spearman correlation coefficient and the Mann-Whitney U test were used to analyze data at the 5% significance level. RESULTS: CD90 expression was found in mesenchymal cells and vascular endothelial cells of 68.5% of all cases of PAP. There was no correlation between CD90 expression and histopathological diagnosis (P = .053) or inflammatory cell infiltrate intensity (P = .112). CD90 staining was predominantly found in the vascular endothelial cells of 30% (n = 3) of PPLs. CD90 expression was significantly higher in PAP than in PPLs (Mann-Whitney U test, P < .05). Sox2 expression was found in all cases of PAP. Eventually, all mesenchymal and chronic inflammatory cells exhibited Sox2 expression. There was no correlation between Sox2 expression and histopathological diagnoses (P = .749), inflammatory cell infiltrate intensity (P = .510), or acute or chronic inflammatory cell infiltrate (P = .256). Sox2 expression was found in 100% of PPLs. There was no difference in Sox2 expression between PAP and PPLs (P = .477). CONCLUSIONS: Mesenchymal stem cells may contribute to the immunosuppressive environment in PAP. Additionally, distinct stem cell sources may be associated with the chronic nature of PAP as well as with the development of PPLs.

Does the moment of fiber post cutting influence on the retention to root dentin?

Despite several advantages associated with pre-fabricated glass-fiber posts, the coronal portion of these posts must be cut to allow their use in various clinical situations. However, cutting the cemented post can generate stress on the bonding interface and affect the bond strength. The aim of this study was to investigate the effect the of fiber post cutting on the bond strength of root canals. Sixty bovine incisor roots were included in resin cylinders with simulated periodontal ligaments. Glass-fiber posts were luted using regular resin cement RelyX ARC (3M ESPE) or self-adhesive cement RelyX Unicem (3M ESPE). The posts were cut prior to cementation, immediately after luting or after building up the core (n=10). After storage for 24 h, the samples were cut and subject to push-out testing using a mechanical testing machine (EMIC DL 2000). Data were analyzed using two-way ANOVA (resin cement x moment of post cutting) and Tukey's post hoc test (α=0.05). The moment of fiber post cutting did not affect the bond strength when Unicem was used. However, the bond strength was reduced when ARC was used and when the post was cut immediately. In conclusion, the moment of fiber post cutting may affect the retention of root canal posts when a regular resin cement is used.

Green Tea Extract Rich in Epigallocatechin-3-Gallate Prevents Fatty Liver by AMPK Activation via LKB1 in Mice Fed a High-Fat Diet.

Supplementation with epigallocatechin-3-gallate has been determined to aid in the prevention of obesity. Decaffeinated green tea extract appears to restore a normal hepatic metabolic profile and attenuate high-fat diet (HFD)-induced effects, thereby preventing non-alcoholic fatty liver disease in mice. Mice were maintained on either a control diet (CD) or HFD for 16 weeks and supplemented with either water or green tea extract (50 mg/kg/day). The body mass increase, serum adiponectin level, and lipid profile were measured over the course of the treatment. Furthermore, the AMPK pathway protein expression in the liver was measured. From the fourth week, the weight gain in the CD + green tea extract (CE) group was lower than that in the CD + water (CW) group. From the eighth week, the weight gain in the HFD + water (HFW) group was found to be higher than that in the CW group. Moreover, the weight gain in the HFD + green tea extract (HFE) group was found to be lower than that in the HFW group. Carcass lipid content was found to be higher in the HFW group than that in the CW and HFE groups. Serum analysis showed reduced non-esterified fatty acid level in the CE and HFE groups as compared with their corresponding placebo groups. Increased adiponectin level was observed in the same groups. Increased VLDL-TG secretion was observed in the HFW group as compared with the CW and HFE groups. Increased protein expression of AdipoR2, SIRT1, pLKB1, and pAMPK was observed in the HFE group, which explained the reduced expression of ACC, FAS, SREBP-1, and ChREBP in this group. These results indicate that the effects of decaffeinated green tea extract may be related to the activation of AMPK via LKB1 in the liver of HFD-fed mice.

Surface topography, gloss and flexural strength of pressable ceramic after finishing-polishing protocols

Abstract This study evaluated the effect of different finishing-polishing protocols on surface roughness, gloss, morphology and biaxial flexural strength of pressable fluorapatite glass ceramic. Thirty ceramic discs (12x1 mm) were produced and divided into five groups (n=6): CT: control (glaze); DA: fine grit diamond bur; DG: DA + new glaze layer; DP: DA + felt disk with fine grit diamond paste; DK: DA+ sequential polishing with silicon abrasive instruments, goat hair brush and cotton wheel. The specimens were analyzed for surface roughness (Ra) under profilometry and atomic force microscopy (AFM). Gloss was measured with spectrophotometry and micromorphology with scanning electron microscopy (SEM). Flexural strength was assessed by biaxial flexural strength test. Data were analyzed using one-way ANOVA and Tukey's post hoc test (a=0.05). DK showed the lowest surface roughness values and DA presented the highest in the perfilometer analysis. No significant differences were observed in the AFM for the CT, DG and DK groups, which presented the lower surface roughness; DA and DP had the higher Ra values. The DA, DP and CT showed the lowest surface gloss values, and the reflectance was significantly different from those observed for DK and DG groups. SEM analysis revealed the smoothest surface for DK group, followed by DG and CT groups; DA and DP groups exhibited variable degrees of surface irregularities. No significant differences were observed among groups for the biaxial flexural strength. The polishing protocol used in DK group can be a good alternative for chairside finishing of adjusted pressable fluorapatite glass ceramic surfaces.

Resumo O objetivo deste estudo foi avaliar o efeito de diferentes protocolos de acabamento e polimento na rugosidade da superfície, brilho, resistência à flexão biaxial e morfologia de cerâmica prensada. Trinta discos de cerâmica (12x1 mm) foram produzidos e divididos em cinco grupos (n=6): CT- controle (glaze); DA- ponta diamantada de granulação fina; DG: DA + nova camada de glaze; DP: DA + disco de feltro com pasta de diamante de granulo fino; DK: DA + polimento sequencial com instrumentos abrasivos de silício, escova de cabra e roda de algodão. Os espécimes foram analisados quanto à rugosidade da superfície (Ra) sob profilometria e microscopia de força atômica (AFM). O brilho foi medido com espectrofotometria e a micromorfologia com microscopia eletrônica de varredura (SEM). A resistência à flexão foi avaliada pelo teste de resistência à flexão biaxial. Os dados foram analisados ​​usando ANOVA um fator e teste post hoc de Tukey (a=0,05). DK mostrou mais baixos valores de rugosidade da superfície e DA apresentou o maior na análise do perfilômetro. Não foram observadas diferenças significativas no AFM para os grupos CT, DG e DK, que apresentaram a menor rugosidade de superfície; DA e DP apresentaram os maiores valores Ra. O DA, DP e CT mostraram valores de brilho superficial mais baixos, e a reflectância foi significativamente diferente da observada para os grupos DK e DG. A análise de SEM revelou a superfície mais homogênea para o grupo DK, seguido de grupos DG e CT; Os grupos DA e DP exibiram graus variáveis de irregularidades da superfície. Não foram observadas diferenças significativas entre os grupos quanto à resistência à flexão biaxial. O protocolo de polimento utilizado no grupo DK pode ser uma boa alternativa para o acabamento em consultório das superfícies de cerâmicas prensadas após ajustes.

Ultrastructural and immunohistochemical study of early repair of alveolar sockets after the extraction of molars from alendronate-treated rats.

The aim of the present research was to analyze ultrastructural and immunohistochemical aspects of the alveolar repair after the extraction of molars of alendronate (ALN)-treated rats. Wistar rats received 2.5mg/kg body wt/day of ALN during 14 days previously and 7, 14 and 21 days after the extraction of the second mandibular molar. Specimens were fixed in 2% glutaraldehyde + 2.5% formaldehyde under microwave irradiation, decalcified in 4.13% EDTA and paraffin embedded for TRAP histochemistry and immunohistochemistry for OPN, BSP and endoglin, or embedded in Spurr epoxy resin for TEM analysis. Additional specimens had their soft tissues removed and were processed for scanning electron microscopy. The ALN group presented latent TRAP-positive osteoclasts and nonresorbed alveolar crests with bacterial infection. Mild bone necrosis signs were observed at all time points studied. Ultrastructurally, empty osteocyte lacunae were observed and bone trabeculae surface presented hyalinized aspect. A significant delay in alveolar repair occurred, as well as decreased angiogenesis. ALN treatment provoked mild signs of bone necrosis, despite the high dose employed. The present findings add new information about the ultrastructural aspect of the early repair of rats under ALN treatment and highlight for giving attention when oral surgeries are performed in patients using this drug.

Differential diagnosis and clinical management of periapical radiopaque/hyperdense jaw lesions

Abstract Great attention has been given to the study of radiolucent periapical lesions to avert possible misdiagnosis of apical periodontitis associated with certain radiolucent non-endodontic lesions. However, there are a significant number of radiopaque lesions found in the periapical region, which could be equally relevant to endodontic practice. The diagnosis and management of these radiopaque/hyperdense lesions could be challenging to the endodontist. These bone alterations could be neoplastic, dysplastic or of metabolic origin. In the context of the more widespread use of cone-beam CT, a detailed review of radiopaque inflammatory and non-inflammatory lesions is timely and may aid clinicians perform a differential diagnosis of these lesions. Distinguishing between inflammatory and non-inflammatory lesions simplifies diagnosis and consequently aids in choosing the correct therapeutic regimen. This review discusses the literature regarding the clinical, radiographic, histological and management aspects of radiopaque/hyperdense lesions, and illustrates the differential diagnoses of these lesions.

Can size and rigidity of objects influence infant's proximal and distal adjustments of reaching?

BACKGROUND: It has been found that objects influence the adjustments to reaching of breastfeeding infants, however, it has not been investigated whether these adjustments change in older infants. OBJECTIVES: The aim of this study was to determine whether the size and rigidity of objects influence the proximal and distal adjustments to reaching of infants of 6, 7, 8 and 36 months of age. METHODS: Nine healthy infants were presented with: one large rigid, one small rigid, one large malleable and one small malleable object. The movements were videotaped and later analyzed qualitatively with regard to proximal (unimanual and bimanual reaching) and distal adjustments (horizontal, vertical and oblique hand orientation, opened, half-open and closed hand) and with regard to grasping of these objects (with and without). Friedman test and Dunn multiple comparisons were applied and 0.05 was considered as a significant difference. RESULTS: Infants of 36 months of age performed more unimanual reaching than younger infants. Additionally, at all ages, unimanual reaching was particularly performed for small objects. At 36 months of age infants guided the hand horizontally to touch and grasp the objects, while at 6 and 7 months the hand orientation was oblique to touch and vertical to grasp the objects, regardless of the object's properties. Over the months, both at the beginning and at the end of reaching, the hands became more open, especially to touch the large rigid object, and infants increasingly performed reaching with successful grasping, especially for malleable or small objects. CONCLUSIONS: From 6 to 36 months of age, the reaching became more refined and the infants adjusted to the different properties of the objects which were observed through changes in the proximal and distal adjustments.

Reabilitação estética do sorriso por meio de procedimento restaurador direto com resina composta nanoparticulada: relato de caso / Esthetic smile rehabilitation throught direct restorative procedure with nanoparticulate composite resin: a case report

Pacientes acometidos por traumas em dentes anteriores são comumente encontrados na prática clínica. Estes traumas ocasionam diversas complicações, que podem prejudicar a função como fonética, estética e em casos mais graves, até resultar em perda do elemento dentário. Na ocorrência de fraturas dentárias, uma das alternativas de reabilitação é o procedimento restaurador por meio de técnica direta, com utilização de resina composta. Tais materiais possuem facilidade na execução da técnica, apresentam baixo custo, quando comparado às restaurações indiretas e ainda possuem propriedades físicas e mecânicas que são semelhantes à estrutura dentinária, funcionando de forma a biomimetizar a estrutura perdida do elemento dentário. O presente caso clínico relata reabilitação funcional e estética do sorriso de um paciente jovem, por meio de procedimento restaurador direto, o qual foi possível devolver aspecto de naturalidade aos dentes e harmonia do sorriso.

Patients affected by injuries in anterior teeth are commonly encountered in clinical practice. These cause a variety of complications, which may impair the function as phonetics, esthetics and in more severe cases, even result in dental element loss. On dental fractures occurrence, one of the rehabilitation alternatives is the restorative procedure through direct technique, using composite resin. Such materials have ease in execution of the technique, feature low cost, when compared to the indirect restorations and still possess physical and mechanical properties, which are similar to dentin structure, working in order to resemble the lost dental element structure. The present clinical case reports functional and esthetic smile rehabilitation of a young patient, through direct restorative procedure, which was possible return aspect of naturalness to the teeth and the smile harmony.

Reabilitação estética do sorriso com laminados cerâmicos: Relato de caso clínico / Aesthetic Restabilishment with laminates venners: Case report

Resumo: A busca por um sorriso harmônico eleva o nível de exigência e a expectativa dos pacientes. Esse fato propicia o desenvolvimento de novos materiais e técnicas odontológicas que visam procedimentos conservadores e resultados mais previsíveis. As cerâmicas têm se tornado alternativa para essas reabilitações de alta exigência estética, uma vez que possuem propriedades como biocompatibilidade, estabilidade de cor, longevidade e resistência, ou seja, apresentam biomimetismo com esmalte. Dessa forma, esse relato de caso tem como objetivo descrever a sequência clínica de uma reabilitação estética dos dentes 11, 12, 21 e 22 empregando laminados de cerâmica vítrea a reforçadas de dissilicato de lítio, proporcionando a reprodução das características naturais dos dentes. Os laminados cerâmicos promoveram excelentes resultados estéticos, sendo que o conhecimento da técnica operatória e dos materiais restauradores e qualidade do trabalho protético são essenciais parao planejamento e execução de restaurações estéticas.

The search for a harmonious smile raises the level of demand and the expectations of patients. This fact enables the development of new dental materials and techniques to conservative procedures and more predictable results. The ceramic has become an alternative to these highly demanding aesthetic restorations since they possess properties such as biocompatibility, color stability, durability and resilience, ie with the present biomimetism tooth structure. Thus, this case report aims to describe the clinical sequence of an aesthetic rehabilitation of the teeth 11, 12, 21 and 22 using laminated glass-ceramic reinforced of lithium di-silicate, providing playback of the natural characteristics of the teeth. The ceramic laminates promoted excellent aesthetic results, and the knowledge of the surgical technique and restorative materials and quality of the prosthetic work areessential for planning and execution of esthetic restorations.

Does the Moment of Fiber Post Cutting Influence on the Retention to Root Dentin?

Despite several advantages associated with pre-fabricated glass-fiber posts, the coronal portion of these posts must be cut to allow their use in various clinical situations. However, cutting the cemented post can generate stress on the bonding interface and affect the bond strength. The aim of this study was to investigate the effect the of fiber post cutting on the bond strength of root canals. Sixty bovine incisor roots were included in resin cylinders with simulated periodontal ligaments. Glass-fiber posts were luted using regular resin cement RelyX ARC (3M ESPE) or self-adhesive cement RelyX Unicem (3M ESPE). The posts were cut prior to cementation, immediately after luting or after building up the core (n=10). After storage for 24 h, the samples were cut and subject to push-out testing using a mechanical testing machine (EMIC DL 2000). Data were analyzed using two-way ANOVA (resin cement x moment of post cutting) and Tukey's post hoc test (α=0.05). The moment of fiber post cutting did not affect the bond strength when Unicem was used. However, the bond strength was reduced when ARC was used and when the post was cut immediately. In conclusion, the moment of fiber post cutting may affect the retention of root canal posts when a regular resin cement is used.

Apesar das diversas vantagens associadas aos pinos de fibra de vidro pré-fabricados, o corte da sua porção coronária deve ser realizado para permitir seu uso em algumas situações clínicas. Entretanto, o corte do pino cimentado pode gerar tensões na interface adesiva e afetar a resistência de união. O objetivo deste estudo foi avaliar o efeito do momento do corte do pino na resistência de união ao canal radicular. Sessenta raízes de incisivos bovinos foram incluídas em cilindros de resina com simulação do ligamento periodontal. Pinos de fibra de vidro foram cimentados utilizando um cimento resinoso convencional RelyX ARC (3M ESPE) ou autoadesivo RelyX Unicem (3M ESPE). Os pinos foram cortados previamente à cimentação, imediatamente após a cimentação, ou após a reconstrução do núcleo de preenchimento (n=10). Após o armazenamento por 24 h, as amostras foram seccionadas e submetidas ao ensaio de cisalhamento por extrusão utilizando máquina de ensaio mecânico (EMIC DL 2000). Os dados foram analisados por ANOVA dois fatores (cimento resinoso x momento do corte do pino) e teste de Tukey (=0,05). O momento do corte do pino de fibra de vidro não afetou a resistência de união quando o RelyX Unicem foi utilizado. No entanto, o corte do pino imediatamente após a cimentação reduziu os valores de resistência de união quando o RelyX ARC foi utilizado. Em conclusão, o momento do corte do pino pode afetar a resistência de união ao canal radicular quando o cimento resinoso convencional for utilizado.

Osteonecrose dos maxilares associada ao uso de bisfosfonatos: recidiva após radioterapia de cabeça e pescoço / Bisphosphonates osteonecrosis of the jaws: Recurrence after head and neck radiotherapy

O processo natural de remodelação óssea ocorre através de atividadescelulares, mediada principalmente por osteoblastos e osteoclastos.A interrupção desse processo pode levar a ocorrência de alterações como a osteonecrose. A osteonecrose é causada por diversos fatores, dentre eles locais e sistêmicos, destacando-se o uso de medicamentos e radioterapia. A osteonecrose dos maxilares associada ao uso de bisfosfonatos (ONB) é caracterizada pela presença de um osso necrótico exposto na cavidade bucal, por mais de 8 semanas, em pacientes tratados com este medicamento, sem o histórico de terem sido submetidos à radioterapia de cabeça e pescoço. Já osteorradionecrose (ORN), em conseqüência da radioterapia para tratamento de neoplasias malignas, reduz o potencial de vascularização do tecido ósseo, afetando a atividadecelular, a formação de colágeno e a capacidade de reparo do tecido, podendo levar à necrose. A ONB e ONR apresentam como principais sinais e sintomas: dor intensa, edema, parestesia, infecções, ulceração dos tecidos moles e alterações radiográficas. Por apresentarem características semelhantes, clinicamente a diferenciação entre a ONB e ORN se dá apenas pela história de uso ou não de bisfosfonatos. Este trabalho teve como objetivo abordar um caso sem precedentes, em que descreveu-se a recidiva de uma osteonecrose mandibular, após o debridamento cirúrgico e a infusão de PRP, em uma paciente que posteriormente foi submetida à radioterapia de cabeça e pescoço para tratamento de um caso de reincidência de um mieloma múltiplo (MM).

The natural bone remodeling process occurs mediated by osteoblasts and osteoclasts. Disturbances in this process may lead to osseous changes as osteonecrosis. Osteonecrosis is caused by several factors, including local and systemic factors, highlighting the use of drugs or radiation. The Bisphonates related osteonecrosis of the jaw (BRONJ) is characterized by the presence of an exposed necrotic bone in the oral cavity for more than 8 weeks in patients treated with this drug, with no history of being subjected to radiotherapy. Osteoradionecrosis (ORN), as a result of radiotherapy, reduces the vascularization potencial of bone, affectingcellular activity, the collagen formation and the capacity of tissue repair, leading to necrosis. As signs and symptoms of BRONJ and ONR is described: intense pain, edema, paresthesia, infection, ulceration, soft tissue and radiographic changes. Because they have similar characteristics, clinical differentiation between the BRONJ and ORN is given only by the history of bisphosphonates intake. This study aimed to discuss an unprecedented case in which was described an mandibular osteonecrosis relapse, after surgical debridement and the PRP infusion, in a patient who has subsequently submitted to radiotherapy for the treatment of a recurrence of multiple myeloma (MM) in head and neck region.

Acabamento e polimento em resina composta: reprodução do natural / Polishing composite resin: reproduction of natural

As restaurações diretas em resina composta em dentes anterioresconstituem tratamento estético, entretanto, dependendo da composição e do uso inadequado destes compósitos resinosos, podem resultar em restaurações insatisfatórias provenientes da inadequada rugosidade superficial, porosidade, ausência de brilho e alteração de cor. Estas características podem ser evitadas ao se realizar adequado acabamento e polimento. Diante deste quadro, este artigo tem como objetivo apresentar uma técnica de acabamento e polimento para restaurações em resina composta. O acabamento e polimento é uma etapa imprescindível para a harmonia do sorriso e sucesso das reabilitações com resina composta.

Direct composite resin restorations in anterior teeth are aesthetic treatment, however, the some composition and the inappropriate use of these resin composites can be result in unsatisfactory restorations from inadequate surface roughness, porosity, lack luster and color change. These characteristics can avoid when management correct finishing and polishing. The aim of this article was to describe finishing and polishing techniques in composite resin restorations. The finishing and polishing is essential to smile harmony and success of restorations with composite resin step.

Tamanho e rigidez dos objetos influenciam os ajustes proximais e distais do alcance de crianças? / Can size and rigidity of objects influence infant's proximal and distal adjustments of reaching?

CONTEXTUALIZAÇÃO: Objetos influenciam nos ajustes do alcance de lactentes, no entanto ainda não se investigou se esses ajustes se modificam em crianças com mais idade. OBJETIVOS: Verificar se o tamanho e a rigidez dos objetos influenciam os ajustes proximais e distais do alcance dos 6 aos 8 meses e aos 36 meses de idade. MÉTODOS: A nove crianças saudáveis foram apresentados: um objeto rígido grande, um rígido pequeno, um maleável grande e um maleável pequeno. Os alcances foram filmados e posteriormente analisados qualitativamente quanto aos ajustes proximais (alcance uni e bimanual) e distais (orientação da mão horizontalizada, verticalizada e oblíqua; mão aberta, semiaberta e fechada) e a preensão desses objetos (com e sem). Foram aplicados o Teste de Friedman e as comparações múltiplas de Dunn, considerando-se 0,05 como diferença significativa. RESULTADOS: Constatou-se que, aos 36 meses, houve mais alcances unimanuais do que nas idades anteriores e, em todas as idades, os alcances unimanuais foram realizados principalmente para os objetos pequenos. Aos 36 meses, as crianças orientaram a mão horizontalizada para tocar e apreender os objetos, enquanto que, aos 6 e 7 meses, a orientação foi oblíqua para tocar e verticalizada para apreendê-los, independentemente das propriedades dos objetos. No decorrer dos meses, tanto no início quanto no final do alcance, as mãos tornaram-se mais abertas, principalmente para tocar o objeto rígido grande, e as crianças realizaram cada vez mais alcances com preensão, principalmente para os objetos maleáveis ou objetos pequenos. CONCLUSÕES: De 6 a 36 meses, os alcances tornaram-se mais refinados e ajustados às propriedades mais discrepantes dos objetos apresentados, o que se observou pelas modificações nos ajustes proximais e distais.

BACKGROUND: It has been found that objects influence the adjustments to reaching of breastfeeding infants, however, it has not been investigated whether these adjustments change in older infants. OBJECTIVES: The aim of this study was to determine whether the size and rigidity of objects influence the proximal and distal adjustments to reaching of infants of 6, 7, 8 and 36 months of age. METHODS: Nine healthy infants were presented with: one large rigid, one small rigid, one large malleable and one small malleable object. The movements were videotaped and later analyzed qualitatively with regard to proximal (unimanual and bimanual reaching) and distal adjustments (horizontal, vertical and oblique hand orientation, opened, half-open and closed hand) and with regard to grasping of these objects (with and without). Friedman test and Dunn multiple comparisons were applied and 0.05 was considered as a significant difference. RESULTS: Infants of 36 months of age performed more unimanual reaching than younger infants. Additionally, at all ages, unimanual reaching was particularly performed for small objects. At 36 months of age infants guided the hand horizontally to touch and grasp the objects, while at 6 and 7 months the hand orientation was oblique to touch and vertical to grasp the objects, regardless of the object's properties. Over the months, both at the beginning and at the end of reaching, the hands became more open, especially to touch the large rigid object, and infants increasingly performed reaching with successful grasping, especially for malleable or small objects. CONCLUSIONS: From 6 to 36 months of age, the reaching became more refined and the infants adjusted to the different properties of the objects which were observed through changes in the proximal and distal adjustments.