Clinical and laboratorial performance of rehabilitation of endodontically treated teeth: A systematic review.

OBJECTIVE: This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. MATERIALS AND METHODS: A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. RESULTS: Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. CONCLUSION: Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. CLINICAL SIGNIFICANCE: This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation.

Association between sleep bruxism, use of antidepressants, and obstructive sleep apnea syndrome: A cross-sectional study.

BACKGROUND: Sleep bruxism (SB) is a condition regulated centrally, with a multifactorial etiology, which can occur secondary to systemic disorders and the use of certain medications. OBJECTIVE: The aim of this study was to identify associations between SB, obstructive sleep apnea, and hypopnea syndrome (OSAHS) and the use of antidepressants. MATERIAL AND METHODS: In this cross-sectional study, 240 individuals underwent full-night polysomnography for medical reasons. Anamnesis was performed to collect data about the use of antidepressants and general health conditions. Polysomnography was performed to analyse sleep data and assess respiratory-related events and apnea and hypopnea index (AHI). The polysomnographic assessment of SB was performed, from electrodes placed on masseter muscles and chin. SB was defined by the presence of more than two events of rhythmic masticatory muscles activity per hour of sleep. Statistical analyses were performed to compare the presence of SB and AHI, the severity of OSAHS, and the use of antidepressants. RESULTS: There were statistically significant differences between bruxers and non-bruxers when comparing AHI (48.28 ± 25.84; p = .001) and severity of OSAHS (p = .015). Regarding the use of antidepressants, comparative analyses did not show correlations with bruxism (p = .072). However, logistic regression suggests that the use of these medications may represent increased odds for SB development (OR =2.387; p = .005). CONCLUSION: The relationship between the use of antidepressants and SB remains inconclusive. SB is associated with OSAHS, mainly in its severe form. Therefore, identifying SB can raise the suspicion of the occurrence of other systemic disturbances.

Successful and stable orthodontic camouflage of a mandibular asymmetry with sliding jigs.

The purpose of this paper is to present and discuss a simple and low-cost clinical approach to correct an asymmetric skeletal Class III combined to an extensive dental open bite that significantly compromised the occlusal function and smile aesthetics of an adult male patient. The patient did not accept the idealistic surgical-orthodontic treatment option, neither the use of temporary anchorage devices to facilitate the camouflage of the asymmetrical skeletal Class III/open bite. Therefore, a very simple and inexpensive biomechanical approach using sliding jigs in the mandibular arch was implemented as the compensatory treatment of the malocclusion. Although minor enhancements in facial aesthetics were obtained, the occlusal function and dental aesthetics were significantly improved. Furthermore, the patient was very satisfied with his new smile appearance. Some advantages of this treatment option included the small invasiveness and the remarkably low financial costs involved. Moreover, the final results fulfilled all realistic treatment objectives and the patient's expectations. Results remained stable 5 years post-treatment demonstrating that excellent results can be obtained when simple and low cost, but well-controlled mechanics are conducted.

Tooth displacement in shortened dental arches: a three-dimensional finite element study.

STATEMENT OF PROBLEM: Some patients may opt for a prosthetic rehabilitation without replacing all missing teeth, finishing treatment with a reduced dental arch. This choice may be due to biologic reasons or financial restrictions. It is unclear if a reduced dental arch functions as well as a complete dental arch. PURPOSE: The purpose of this study was to analyze whether shortened dental arches could result in tooth displacement. MATERIAL AND METHODS: Four different 3-dimensional maxillary and mandibular arches with different levels of arch length reduction were created. In all models, anatomic structures that represent the temporomandibular joint, cortical and cancellous bone, enamel, dentin, and periodontal ligament were modeled. Mechanical properties were attributed to each anatomic component, and a total occlusal load of 100 N on masseter, temporal, and medial pterygoid muscles was simulated for each model. The MSC. Patran software was used for the preprocessing and postprocessing of the biomechanical analysis of the models. One complete dental arch was used as the control. RESULTS: The simulations showed that shortened dental arches presented greater tooth displacements than those found in a complete dental arch. The changes in mandibular tooth position were greater than those observed in the maxillary arches. In finite element models 1 and 2, the largest maxillary displacements were found for posterior teeth. CONCLUSIONS: Decreasing numbers of occlusal units resulted in increasing amounts of displacements of the remaining teeth, which may compromise dental stability in patients with shortened dental arches.

Interdisciplinary treatment of a class III patient with congenitally absent maxillary lateral incisors.

UNLABELLED: The purpose of this paper is to present a case report of an adult Class III patient presenting bilateral congenitally missing maxillary lateral incisors that compromised occlusal function as well as smile and facial esthetics. After the interdisciplinary diagnosis, spaces for prosthetic substitution were opened with the help of miniscrews. The orthodontic therapy achieved a better dental relationship, and the final interdisciplinary treatment results represented a significant improvement in function and both dental and facial esthetics. CLINICAL SIGNIFICANCE: The interdisciplinary treatment of orthodontics and restorative dentistry is very important because the two complement each other in search of the best for the patient. This case demonstrates very well that where orthodontics provided the best tooth position prior to implant placement and restorations.

Viability of Maxillary Single Crowns Supported by 4-mm Short Implants: A Finite Element Study.

PURPOSE: Short implants are increasingly being used in posterior regions to avoid grafting procedures and their related risks, costs, and morbidity. However, studies focusing on implants measuring less than 6 mm long remain scarce, and the literature does not yet have a definition of the limits inherent with their use. This study attempts to investigate whether extra-short 4-mm implants are capable of receiving a maxillary single crown. MATERIALS AND METHODS: This study evaluates, through the finite element method, the stress distribution generated at implant lengths of 4 mm and 10 mm caused by different crown heights (10, 12.5, and 15 mm) in the posterior maxilla region when submitted to axial (200 N) and oblique (100 N) loads. RESULTS: The 4-mm implant showed a similar level of performance as that of the 10-mm implant when submitted to the axial load. However, the oblique load proved to be highly detrimental to both implants, inducing stresses of up to three times higher than those achieved in conjunction with the axial load, especially in the surrounding bone and the abutment. CONCLUSION: The use of 4-mm short implants to support single crowns in the posterior maxilla region may be feasible in habitual conditions; however, the risk associated with significant oblique loads should be mitigated by adopting a mutually protected occlusion approach and using acrylic occlusal devices if necessary.

Evaluation of Different Heights of Prosthetic Crowns Supported by an Ultra-Short Implant Using Three-Dimensional Finite Element Analysis.

PURPOSE: To apply finite element analysis (FEA) to investigate the stress distribution in a 4-mm-high ultrashort implant when supporting crowns of different heights in order to test the possibility of using this implant unitarily in the posterior edentulous mandible. MATERIALS AND METHODS: Three models of atrophic mandibles were created (M1, M2, and M3). Each model contained a 4-mm-length implant of a titanium-zirconium alloy, screw-type with internal connection, supporting nonsplinted screwed-in crowns of 10, 12.5, and 15 mm in height. Axial and oblique loads were simulated in the three model crowns. RESULTS: In an oblique load, the stress tended to be concentrated in the lingual region. In the qualitative results of the axial load, peaks of tension occurred in the lower angle between the inner groove and the inner conical portion of the implant. Regarding the differences in crown height, the 15-mm height produced a higher stress peak due to the lever effect of the crown under an oblique load. CONCLUSION: Within the limits of this study, the results suggest the possibility of using single crowns of proposed heights with unitary ultrashort implants installed in the posterior edentulous mandible, so long as there is no oblique load on the crown.

The impact of orofacial pain on the quality of life of patients with temporomandibular disorder.

AIMS: To evaluate the relationships between gender, diagnosis, and severity of temporomandibular disorders (TMD) with self-reports of the impact of TMD on the quality of life. METHODS: Eighty-three individuals seeking TMD treatment at the Dental School of Pontifical Catholic University Minas from May to August 2005 were evaluated by a single examiner who was trained and calibrated for diagnosis according to criteria of Axis I of the Research Diagnostic Criteria for TMD (RDC/TMD). The severity of TMD was established by the Temporomandibular Index and the impact on quality of life by the Oral Health Impact Profile (OHIP 14). Complete data were available for 78 of the 83 initial patients and evaluated by the Mann-Whitney test and Spearman correlation analysis. RESULTS: Except for one patient, all individuals showed some impact related to physical pain. Of the seven aspects evaluated on the OHIP 14, women presented a greater impact than men only for functional limitations (Mann-Whitney, P < .05). Patients presenting with diagnoses of muscular disorders (group I) or osteoarthritis (group III) reported a greater impact than those without (P < .05). The Spearman test demonstrated a significant correlation between impact on quality of life and severity of TMD (P < .05). CONCLUSION: Orofacial pain had a great impact on the quality of life of individuals with TMD, without group difference between genders. The presence of muscular disorders (group I) and osteoarthritis (group III) was related to greater impact on quality of life, which was not observed for diagnoses of disc displacement (group II). A correlation between severity of TMD and impact on quality of life was clearly observed.

Urinary levels of catecholamines among individuals with and without sleep bruxism.

INTRODUCTION: Sleep bruxism (SB) is characterized by repetitive and coordinated mandible movements and non-functional teeth contacts during sleep time. Although the etiology of SB is controversial, the literature converges on its multifactorial origin. Occlusal factors, smoking, alcoholism, drug usage, stress, and anxiety have been described as SB trigger factors. Recent studies on this topic discussed the role of neurotransmitters on the development of SB. OBJECTIVE: Thus, the purpose of this study was to detect and quantify the urinary levels of catecholamines, specifically of adrenaline, noradrenaline and dopamine, in subjects with SB and in control individuals. MATERIALS AND METHODS: Urine from individuals with SB (n = 20) and without SB (n = 20) was subjected to liquid chromatography. The catecholamine data were compared by Mann-Whitney's test (p

Association Between In-Office And At-Home Tooth Bleaching: A Single Blind Randomized Clinical Trial.

This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.

Long-term Stability of a Camouflage Retreatment of an Asymmetric Class III/Posterior Open Bite Using Sliding Jigs.

This article reports the camouflage retreatment of an adult patient presenting an asymmetric Class III malocclusion and posterior open bite. Sliding jigs (SJs) associated with intermaxillary elastics were used. The long-term stability of the excellent results suggests that the use of SJs to correct asymmetric posterior occlusions may be effective.

Anatomic and radiograph study of the persistence of Foramen of Huschke.

AIM: The aim of this study is to assess and locate the Foramen of Huschke. STUDY DESIGN: Anatomical. MATERIAL AND METHOD: Using contrast material like gutta-percha and barium sulfate, through extraoral radiographs, such as panoramic, submental vertex and corrected sagittal linear Temporal Mandibular Joint tomograms in four skulls where we clinically checked the existence of foramen of Huschke. RESULTS: The results proved that the foramen of Huschke can be observed in skulls submitted to contrast using radiographic techniques.

Biomechanical development and evaluation of a new framework for all-on-four rehabilitation / Desenvolvimento e avaliação biomecânica de uma nova infraestrutura para reabilitações "all-on-four"

Abstract Introduction For complete rehabilitation of fully edentulous mandibles, the option for immediate loading determines the use of temporary prostheses that splint the installed implants. Although temporary prostheses with reinforcement provide rehabilitations with biomechanical benefits, the non-adoption of this recommendation coexists in different studies on immediate restorations. Objective This study evaluates a type of prosthesis to restore jaws by the all-on-four concept. Material and method: The mechanical behavior of prostheses with the modified framework was evaluated in vitro, under a cantilever mechanical unilateral bending test. Two representative groups were included in the all-on-four concept, with a G1 test group (n = 10) containing modified frameworks and a G2 control group (n = 10) that included full acrylic prostheses. The samples were submitted to thermal cycling with 500 cycles (5° ± 2 °C for 30 s, and 55° ± 2° for 30 s) and to the mechanical bending test on the cantilever. Result The Mann-Whitney test revealed a significant difference between G1 and G2 (p <0.001). In the descriptive evaluation, G1 averaged 830.50 N until the initial resin fracture, while the control group presented a mean of 403.58N. The maximum resistance until complete fracture was recorded in G1, with a mean of 903.03N, while in G2, a mean of 435.20N was recorded. The linear vertical component of the flexion was 0.68 mm and 0.39 mm until the initial fracture of the bar, respectively for G1 and G2. Conclusion The modified framework for the all-on-four protocol determined better mechanical performance when compared to the same full acrylic prosthesis model.

Resumo Introdução Para reabilitação de mandíbulas totalmente edêntulas, a opção por carga imediata determina a utilização de próteses provisórias que esplintem os implantes instalados. Apesar de provisórias com reforço proverem as reabilitações com benefícios biomecânicos, a não adoção desta indicação coexiste em diferentes estudos sobre restaurações imediatas. Objetivo Este estudo avaliou um tipo de prótese para reabilitar mandíbulas pelo conceito "all-on-four". Material e método: Foi avaliado, in-vitro, o comportamento mecânico de próteses com a infraestrutura modificada, sob ensaio mecânico de flexão unilateral em cantilever. Foram avaliados dois grupos representativos para o conceito "all-on-four", sendo um grupo teste G1 (n = 10) contendo próteses com infraestrutura modificada e outro controle G2 (n = 10) que incluiu próteses totalmente acrílicas. As amostras foram submetidas à ciclagem térmica com 500 ciclos (5° ± 2 °C por 30 segundos e 55° ± 2 °C pelo mesmo tempo) e submetidas ao ensaio mecânico à flexão sobre o cantilever. Resultado O teste de Mann-Whitney revelou diferença significativa entre G1 e G2 (p<0,001). Na avaliação descritiva, G1 mostrou média de 830,50 N até a fratura inicial em resina e o grupo controle apresentou média de 403,58N. A resistência máxima até a fratura completa foi de 903,03 N para G1 e para G2 de 435,20 N. O componente vertical linear de flexão foi 0,68 mm e 0,39 mm até a fratura inicial da barra, respectivamente para G1 e G2. Conclusão A infraestrutura modificada para o protocolo "all-on-four" proporcionou melhor desempenho mecânico quando comparado ao mesmo modelo de prótese totalmente acrílico.

Avaliação da resistência de união de uma cerâmica de óxido de zircônia submetida a tratamentos de superfície por abrasão / Evaluation of the bond strength of a ceramics of zirconia oxide subjected to surface treatments by abrasion

Resumo Introdução A cimentação adesiva, com cerâmicas puras, é um passo relevante no estabelecimento da longevidade de trabalhos protéticos, sendo estes os melhores materiais utilizados para a reposição de dentes perdidos, de forma a reabilitar o sorriso. O sistema cerâmico de zircônia não se beneficia do tratamento com ácidos e necessita de diferentes métodos para tratar sua superfície, visando à efetividade na união adesiva. Objetivo Avaliar os resultados de diferentes técnicas de jateamento e aplicação de agente de união desenvolvidas para metais e cerâmica de zircônia (Ceramill ZI®), por meio de ensaio de tração, em dois diferentes tratamentos de superfície. Material e método Foram preparadas 20 amostras de Ceramill Zi® (n = 20), em forma de cilindro, e unidas entre si por meio do cimento resinoso (Multilink®), formando 10 espécimes (n = 10). Formaram-se sete grupos experimentais com os mesmos 10 espécimes e estes receberam dois tratamentos de superfície diferentes: abrasão e aplicação de agentes silânicos de união. Resultado A análise estatística mostrou diferenças significativas na resistência à fratura dos espécimes silicatizados com Rocatec®. Os valores de resistência de união à tração, mensurados em MPa, dos grupos 1 a 7, foram, respectivamente: 2,27; 4,48; 8,06; 8,32; 9,15; 10,56 e 10,70. As médias entre os grupos se apresentam estatisticamente significantes, exceto entre os grupos 3 e 4 e entre 6 e 7. Conclusão Os resultados mostraram que o tratamento da superfície cerâmica baseado no método de silicatização promoveu melhor união nos ensaios com Ceramill ZI® e cimentados com Multilink®.

Abstract Introduction Adhesive cementation, with pure ceramics, is a relevant step in establishing the longevity of prosthetic works. Being these, the best materials used for the replacement of lost teeth, in order to rehabilitate the smile. The ceramic zirconia system does not benefit from the treatment and planning needs for its surface, effectively in adhesive therapy. Objective Evaluate the results of different blasting techniques and application of bonding agent for metals and ceramics (Ceramill ZI®) by means of a tensile test in two different surface treatments. Material and method Twenty samples of Ceramill Zi® (n = 20), cylindrical and joined with resin cooling (Multilink®), were prepared, forming 10 specimens (n ​​= 10). The first 10 ingredients were formed by 7 experimental groups and they received 2 surface problems: abrasion and application of silane bonding agents. Result The research resulted in fracture resistance of Rocatec® silica specimens. The values ​​of tensile strength, measured in MPa, of groups 1 to 7, were: 2.27; 4.48; 8.06; 8.32; 9.15; 10.56 and 10.70. We observe how to enter the groups are statistically significant, except between groups 3 and 4 and between 6 and 7. Conclusion The results of the ceramic surface treatment were based on no silicate method, promoting the union of results with Ceramill ZI® and cemented with Multilink®.

Association between in-office and at-home tooth bleaching: a single blind randomized clinical trial

Abstract This controlled randomized clinical trial evaluated the effect of associating at-home and in-office bleaching procedures on tooth sensitivity (TS) and bleaching effectiveness. Forty patients subjected to on session of in-office bleaching with 38% peroxide hydrogen. Subsequently, the patients were randomly allocated to receive a second session of in-office bleaching or to use a tray containing 10% carbamide peroxide delivered during 7 consecutive days. The worst TS score reported during or after each bleaching procedure was recorded using a verbal rating scale and TS risk (score different from 0) was calculated. Color changes were measured 7 days after each in-office session (for patients receiving in-office procedures only) or after the end of at-home bleaching (for the combined protocol), and 6 months after the last procedure for both bleaching protocols. Color was assessed by a spectrophotometer and by color match with the Vita Classical and Bleach guide scales. Statistical analyses were carried out to assess possible differences between the protocols regarding the outcomes and to analyze the effect of time of assessment on color changes. The bleaching protocol did not affect the risk for and the maximum level of TS reported, irrespective of the time of assessment. In the color evaluation, the bleaching protocol also did not affect the ultimate tooth color. In conclusion, after one in-office bleaching session, there was no difference in bleaching effectiveness and TS between performing a second in-office session and associating it with 1-week at-home bleaching.

Resumo Este ensaio clínico controlado e randomizado avaliou o efeito da associação de procedimentos de clareamento caseiro e de consultório na sensibilidade dental (SD) e efetividade clareadora. Quarenta pacientes receberam uma sessão de clareamento de consultório com peróxido de hidrogênio a 38%. Em seguida, os pacientes foram aleatoriamente alocados para receberem uma segunda sessão de clareamento de consultório ou para usar uma moldeira com peróxido de carbamida a 10% por 7 dias consecutivos. O pior score de SD relatada durante ou após cada procedimento clareador foi mensurado usando uma escala verbal, e o risco a SD (escore diferente de 0) foi calculado. Mudança de cor foi mensurada 7 dias após cada sessão de clareamento de consultório (para paciente submetidos a apenas procedimentos de consultório) ou após o fim do clareamento de caseiro (para o protocolo combinado) e 6 meses após o último procedimento clareador para os dois protocolos de clareamento. A cor foi mensurada através de um espectrofotômetro e pelo uso das escalas Vita Clássica e Bleach guide. As análises estatísticas foram realizadas para verificar possíveis diferenças em relação aos desfechos e para analisar o efeito do momento da mensuração nas mudanças de cor. O protocolo clareador não afetou o risco e o nível máximo de SD relatado, independentemente do tempo de avaliação. Na avaliação de cor, o protocolo clareador também não afetou a cor final dos dentes. Como conclusão, após uma sessão de clareamento de consultório, não há diferença na efetividade clareadora e na SD em realizar uma segunda sessão de consultório ou associá-la com uma semana de clareamento caseiro.

Influence of Class II Elastics on Centric Relation and Centric Occlusion Discrepancy after Orthodontic Treatment / Influencia de los Elásticos de Clase II sobre la Discrepancia de Relación Céntrica para la Oclusión Céntrica Después del Tratamiento Ortodóncico

ABSTRACT: The objective of this study was to verify the influence of the use of Class II intermaxillary elastics on centric relation (CR) to centric occlusion (CO) occlusal discrepancy. A total of 30 patients had been at the contention stage for at least three months were divided in two groups: G1 - 15 had been submitted to intramaxillary orthodontic mechanics only, and G2 - 15 had used Class II intermaxillary elastics. Distances of horizontal and vertical overlap and the distance or coincidence of the mandibular dental midline in relation to the maxillary midline were measured in CR and CO positions. Intergroup comparisons were performed using the Mann-Whitney test. No statistically significant differences (P>0.05) were found between G1 and G2. Both in the horizontal and vertical directions, these discrepancies were smaller than or equal to 1mm in 96.66 % of the patients. In the transverse plane, there was no discrepancy in 63.33 % of the patients, and in 33.33 % these discrepancies were equal to 0.5 mm. The use of Class II elastic didn't be capable of increasing the occlusal discrepancies between CR and CO.

RESUMEN: El objetivo de este estudio fue verificar la influencia del uso de los elásticos intermaxilares Clase II en la discrepancia oclusal entre la relación céntrica (RC) y la oclusión céntrica (OC). Un total de 30 pacientes que permanecieron en la fase de contención durante al menos tres meses se dividieron en dos grupos: G1 - 15 fueron sometidos solamente a la mecánica ortodóncica intramaxilar, y G2 - 15 habían utilizado elásticos de clase II intermaxilar. Se midieron las distancias de traslapo horizontal y vertical y la distancia o coincidencia de la línea mediana dentaria mandibular con respecto a la línea mediana maxilar en las posiciones RC y OC. Las comparaciones entre grupos se realizaron mediante la prueba de Mann-Whitney. No se encontraron diferencias estadísticamente significativas (P> 0.05) entre G1 y G2. Tanto en las direcciones horizontal como vertical, estas discrepancias fueron menores o iguales a 1 mm en el 96,66 % de los pacientes. En el plano transversal, no hubo discrepancia en el 63,33 % de los pacientes, y en un 33,33 % estas discrepancias fueron iguales a 0,5 mm. El uso de la clase II elástica no logró aumentar las discrepancias entre RC y OC.

Uso da radiografia transcraniana para detectar alterações morfológicas no côndilo mandibular / Use of transcranial radiograph to detect morphological changes in mandibular condyles

RESUMO Objetivo: o objetivo deste estudo foi avaliar a acurácia das radiografias transcranianas (TRANS) convencionais na identificação das alterações morfológicas nos côndilos mandibulares. Métodos: a amostra consistiu em 36 côndilos mandibulares, obtidos a partir de 18 crânios secos humanos, aleatoriamente selecionados, sem identificação de idade, gênero ou etnia. Três especialistas em radiologia oral examinaram as TRANS para identificar possíveis alterações nos côndilos. Um quarto examinador realizou o exame macroscópico, que foi considerado o padrão ouro do estudo. As imagens das TRANS e os exames macroscópico foram classificados como (1) côndilos com alteração ou (0) côndilos sem alteração. A análise estatística foi realizada através do teste X 2 e da curva ROC (receiver operator characteristic). O teste Kappa intra e interexaminadores foi realizado para os examinadores 1 a 3. Resultados: o teste X2 mostrou uma associação estatisticamente significativa entre as alterações no côndilo vistas nas imagens TRANS e a presença de alterações macroscópicas (p ( 0,05). A área sob a curva ROC foi de 0,83, com 96% de sensibilidade e 70% de especificidade. O valor Kappa para a concordância intraobservador foi de 0,78, enquanto que a concordância interexaminador foi de 0,71. Conclusão: o uso de radiografias transcranianas apresentou-se como método eficaz para a detecção de alterações morfológicas no côndilo mandibular.

ABSTRACT Purpose: to evaluate the accuracy of conventional transcranial radiographs (TRANS) to identify morphological changes in mandibular condyles. Methods: the sample consisted of 36 mandibular condyles, obtained from 18, randomly selected, dried human skulls, without the identification of age, gender, or ethnicity. Three experts in dental radiology examined the TRANS to identify possible changes in the condyles. The fourth examiner performed the macroscopic examination, which was considered the gold standard of the study. The condyles in both TRANS images and macroscopic examinations were classified as mandibular condyles with change (1) or no change (0). Statistical analyses were performed using the X 2 and the receiver operating characteristic (ROC) curve. Kappa intra- and interobserver tests were performed for examiners 1 to 3. Results: the X2 test showed a statistically significant association between changes in the condyle in the TRANS images and the presence of macroscopic changes in the condyle (p ( 0.05). The area under the curve was 0.83, with 96% sensitivity and 70% specificity. The weighted kappa value for intraobserver agreement was 0.78, while the interobserver agreement was 0.71. Conclusion: the use of TRANS proved to be an effective method to detect morphological changes in the mandibular condyle.

Stress analysis of a fixed implant-supported denture by the finite element method (FEM) when varying the number of teeth used as abutments.

OBJECTIVES: In some clinical situations, dentists come across partially edentulous patients, and it might be necessary to connect teeth to implants. The aim of this study was to evaluate a metal-ceramic fixed tooth/implant-supported denture with a straight segment, located in the posterior region of the maxilla, when varying the number of teeth used as abutments. MATERIAL AND METHODS: A three-element fixed denture composed of one tooth and one implant (Model 1), and a four-element fixed denture composed of two teeth and one implant (Model 2) were modeled. A 100 N load was applied, distributed uniformly on the entire set, simulating functional mastication, for further analysis of the SEQV (Von Mises) principal stresses, which were compared with the flow limit of the materials. RESULTS: In a quantitative analysis, it may be observed that in the denture with one tooth, the maximum SEQV stress was 47.84 MPa, whereas for the denture with two teeth the maximum SEQV stress was 35.82 MPa, both located in the region between the pontic and the tooth. CONCLUSION: Lower stresses were observed in the denture with an additional tooth. Based on the flow limit of the materials, porcelain showed values below the limit of functional mastication.

Improvement of mouth opening for a patient with fibrodysplasia ossificans progressiva: a case report.

The aim of this article is to describe the care of a patient with fibrodysplasia ossificans progressiva (FOP) and to provide dentists with a guide for how to safely care for patients with FOP. Treatment improved the patient's limited mouth opening. FOP is a rare autosomal dominant disorder characterized by congenital malformation of the fingers and toes by heterotopic ossification progressiva of the connective tissue. This ossification causes a limitation in osteoradicular mobility, mainly affecting the spine, shoulders, hips, and peripheral joints. The disease can manifest from pregnancy until adulthood, with no greater prevalence associated with race or gender. Although rare, the disease can be easily identified by its clinical features, and diagnosis can be confirmed by a radiographic examination. There is no known effective treatment for this disease. All therapeutic treatment must be conservative to avoid any condition that may cause heterotopic ossification. Guidelines to prevent new ossifications are important for patients with FOP. Dental professionals should be cautious in planning treatment, avoiding anesthesia, especially in the mandible, to prevent ankylosis of the temporo-mandibular joints. The prevention of dental caries is essential to avoid the need for more invasive treatment.

Avaliação dos níveis de pressão sonora emitidos pelo aparelho de ressonância magnética / Study about the consequences of different sound pressure levels emitted by magnetic resonance imaging equipment

RESUMO Objetivo: mensurar o nível de pressão sonora emitido pelo aparelho de ressonância magnética em funcionamento e verificar as sensações auditivas descritas pelos indivíduos submetidos a este exame após a realização do mesmo. Métodos: foi realizada a mensuração do ruído produzido, durante a aquisição das imagens, por meio de um medidor de nível de pressão sonora (decibelímetro) e a aplicação de um questionário com a finalidade de verificar as sensações auditivas apresentadas por estes indivíduos após a realização do exame. Tal procedimento foi aplicado a 60 indivíduos submetidos ao exame de ressonância magnética do crânio. Resultados: o nível de pressão sonora média apresentada durante a realização do exame foi inferior ao nível de intensidade considerado como risco para lesões auditivas. No entanto, sensações como zumbido, ansiedade, plenitude auricular e alívio após o término do exame foram citados pelos indivíduos após a execução do mesmo. Conclusão: é pertinente o uso de protetores auriculares como medida preventiva para o controle do nível de ruído que atinge a cóclea do indivíduo, minimizando desta forma os efeitos físicos e psicossociais decorrentes da exposição ao ruído.

ABSTRACT Purpose: to measure the sound pressure level emitted by the magnetic resonance imaging in operation and check the auditory sensations described by individuals submitted to this examination after it has been carried out. Methods: the measurement of the deep noise was conducted during image formation in this examination, by means of sound pressure level meter (decibel meter) and the application of a questionnaire for the purpose of checking the hearing sensations presented by those individuals after the exam has been carried out. This procedure was applied to sixty individuals submitted to a magnetic resonance imaging of the skull. Results: it was found that the average of sound pressure level presented while the examination was carried out was lower than the level of intensity considered being a risk for auditory damages. However sensations like tinnitus, anxiety, auricular plenitude and relief after the end of the examination were mentioned by the individuals after it had been carried out. Conclusion: the use of hearing protectors is relevant as a preventive measure for controlling the level of noise that affects the individual's cochlea, thus minimizing the physical and psycho-social effects resulting from noise exposure.