Craniofacial morphology of patients with unilateral cleft lip and palate at two stages of skeletal maturation

Abstract The aim of this retrospective cross-sectional investigation was to perform a 3D analysis of craniofacial morphology of patients with unilateral cleft lip and palate (UCLP) at two stages of skeletal maturation. Cone-beam computed tomography (CBCT) scans of 52 UCLP patients (34 prepubertal; 18 pubertal) were collected from an outpatient referral center for the treatment of craniofacial deformities. In total 15 multiplanar craniofacial landmarks were identified, 3D virtual surface models were created, and 13 variables were measured to assess the 3D Euclidean distances between landmarks and spatial position of the landmarks in the projected X, Y and Z components. Maxillary and mandibular pitch (clockwise, counterclockwise) rotation relative to the cranial base was also evaluated. The significance level was set at 5%. Maxillary retrusion value relative to the cranial base was higher and statistically significant greater (p = 0.028) in pubertal (SNA, 77.4° ± 6.2; N-ANS Y, 3.3 mm ± 3.1) than in prepubertal patients (SNA 81.0° ± 5.2; N-ANS Y, 5.8 mm ± 2.7). The posterior cranial base length (S-Ba Y) was significantly longer (p = 0.013) in pubertal (20.7 mm ± 3.4) than in prepubertal patients (18.4 mm ± 2.7). The upper facial height (N-ANS Z) was significantly greater (p = 0.01) in pubertal (46.9 mm ± 4.5) than in prepubertal patients (43.4 mm ± 3.0). Prepubertal and pubertal UCLP patients presented distinct patterns of craniofacial morphology, mainly in the sagittal component of the maxilla and in the posterior cranial base length. Pubertal patients had greater maxillary retrusion and posterior cranial base length.

Information and Communications Technology in Dentistry: an informative and educational approach for patients with fixed orthodontic appliances

ABSTRACT Objective: To develop and make available, at no cost to the user, Information and Communications Technology (ICT) tools for Dentistry, providing dental information and advice geared toward patients undergoing orthodontic treatment with fixed appliances. Material and Methods: A Dentistry-based content that contemplated information and advice concerning orthodontic treatment with fixed appliances was elaborated. The materials, which included instructions on oral hygiene and treatment strategies when faced with possible complications, were evaluated and validated by specialists, whose assessments reached a 85% approval. From the validated content, products using four distinct ICT tools were formulated. Results: The following technological products were developed: a program for community radios, three blog posts, four educational and informative videos, and a smartphone application - using texts, as well as images and videos. These ICT tools, geared toward patients wearing fixed orthodontic appliances, were made available by internet at no cost to the user, and the number of accesses is already expressive. Conclusion: These technological-scientific tools, developed and provided freely to the population, can aid patients during their treatment with fixed orthodontic appliances, contributing to the dissemination of reliable information, and clarifying doubts that may arise during orthodontic therapy. These free ICT tools serve to facilitate access to scientific knowledge, thereby favoring social inclusion, bearing in mind that this educational and informative material was offered in a simple and accessible manner to the general population.

RESUMO Objetivos: Desenvolver e disponibilizar, gratuitamente, ferramentas de tecnologia da informação e comunicação (TIC) para a Odontologia, abordando informações e orientações direcionadas a pacientes em tratamento ortodôntico com aparelho fixo. Material e Métodos: Foi elaborado um conteúdo que contemplou informações e orientações concernentes ao tratamento ortodôntico com aparelho fixo. O material, que abrangeu instruções sobre higiene bucal e sobre abordagens diante de possíveis intercorrências, foi avaliado e validado por especialistas. A partir do conteúdo validado, foram elaborados produtos utilizando quatro ferramentas distintas de TIC. Resultados: Foram desenvolvidos os seguintes produtos tecnológicos: um programa para rádios comunitárias, três postagens para blog, quatro vídeos educacionais e informativos, e um aplicativo para smartphones, utilizando não apenas textos, mas também imagens e vídeos. Essas ferramentas de TIC direcionadas a pacientes fazendo uso de aparelho ortodôntico fixo foram disponibilizadas gratuitamente via internet, e já contam com expressivo número de acessos. Conclusões: As ferramentas técnico-científicas, desenvolvidas e fornecidas livremente à população, podem auxiliar pacientes durante o tratamento com aparelho ortodôntico fixo, contribuir para disseminar informações confiáveis e esclarecer dúvidas que surgem durante a terapia ortodôntica. Essas ferramentas gratuitas de TIC facilitam o acesso ao conhecimento científico e, consequentemente, favorecem a inserção social, tendo em vista que esse material educacional e informativo foi ofertado de maneira simples e acessível à população.

Panoramic Radiography and Cone Beam Computed Tomography in the Early Diagnosis of Atheroma in the Extracranial and Intracranial Internal Carotid Artery: A Case Report / Radiografía Panorámica y Tomografía Computarizada de Haz Cónico en el Diagnóstico Precoz de Ateroma en la Arteria Carótida Interna, Extracraneal e Intracraneal: Reporte de Caso

ABSTRACT: Carotid stenosis usually results from the accumulation of atherosclerotic plaque in the carotid artery wall and is an important risk factor for ischemic cerebral vascular accident (CVA). This study describes the importance of diagnostic imaging exams used in dentistry for the early identification of atheroma plaques in the extracranial and intracranial internal carotid artery. A male patient was referred to a radiology clinic to perform panoramic radiography (PR) and a cone beam computed tomography (CBCT) to develop treatment plan options. In the PR and CBCT a radiopaque image, suggestive of atheroma in the extracranial internal carotid artery, was observed on the right side. The diagnosis was confirmed by color DOPPLER ultrasonography. In the CBCT, the presence of calcifications in the intracranial internal carotid artery was also observed. Diagnostic imaging exams used in dentistry allow the identification of asymptomatic individuals, facilitating early intervention and consequent reduction in the risk of ischemic CVA.

RESUMEN: La estenosis carotídea generalmente es consecuencia de la acumulación de placa aterosclerótica en la pared de la arteria carótida y es un factor de riesgo importante para el accidente cerebral vascular (ACV) isquémico. Este estudio describe la importancia de los exámenes de diagnóstico por imágenes utilizados en odontología para la identificación precoz de placas de ateroma en la arteria carótida interna, a nivel extracraneal e intracraneal. Un paciente masculino fue remitido a una clínica de radiología para realizar una radiografía panorámica (RP) y tomografía computarizada de haz cónico (TCHC) para analizar opciones de tratamiento. En el RP y TCHC se observó una imagen radiopaca, sugestiva de ateroma en la arteria carótida, extracraneal, en el lado derecho. El diagnóstico fue confirmado por ultrasonido DOPPLER color carotídeo. En el TCHC, también se observó la presencia de calcificaciones en la arteria carótida interna, intracraneal. Los exámenes de imagenología diagnóstica utilizados en odontología permiten la identificación de individuos asintomáticos, lo que facilita la intervención temprana y la consiguiente reducción en el riesgo de ACV isquémico.

Plaque index and gingival index during rapid maxillary expansion of patients with unilateral cleft lip and palate

ABSTRACT Objective: To assess, during rapid maxillary expansion, the plaque index (PI) and the gingival index (GI) of patients with unilateral cleft lip and palate(UCLP) using Hyrax (HX) or inverted mini-Hyrax (IMHX) rapid maxillary expanders (RME) considering patients' sex and age. Methods: PI (Quigley Index modified by Turesky et al) and GI (Löe and Silness) of 28 UCLP (11 females; 17 males: aged 8 to 15 years) submitted to daily RME activation were assessed before (T0) and 7 (T1), 28 (T2) and 90 (T3) days after activation. Log-linear models and Bonferroni correction were performed to analyze possible differences in PI and GI between RME, sexes or age groups over time. Results: Intra-group comparison revealed significant increases in PI of patients using HX (T0 < T2), IMHX (T0 < T3; T1< T3), males (T0 < T1; T0 < T2; T0 < T3) or aged 12-15 years (T0 < T1; T0 < T2; T0 < T3), and in GI of patients using IMHX (T0 < T3; T1 < T3), females (T1 < T3; T2 < T3) or aged 12-15 years (T0 < T3; T2 < T3). One inter-group difference in GI according to patients' age (8-11 < 12-15; T1) was observed. Conclusions: Since a single difference between groups was encountered, the results of this study indicated that PI and GI during maxillary expansion were similar between HX and IMHX, sexes and the analyzed age groups. Therefore, orthodontists can use these RME in UCLP patients according to the patient's necessity or their preferences.

RESUMO Objetivo: avaliar, durante a expansão rápida da maxila (ERM), o índice de placa dentária (IP) e o índice gengival (IG) de pacientes com fissura labiopalatina unilateral (FLPU), usando o aparelho disjuntor Hyrax (HX) ou o mini-Hyrax invertido (MHXI), considerando-se também o sexo e a idade. Métodos: o IP (Quigley-Hein modificado por Turesky et al.) e o IG (Silness e Löe) de 28 pacientes com FLPU (11 meninas; 8-15 anos de idade) tratados com ativação diária do aparelho de ERM foram avaliados antes (T0) e após 7 (T1), 28 (T2) e 90 (T3) dias da ativação inicial. Modelos de regressão log-linear e correção de Bonferroni foram usados para analisar as possíveis diferenças de IP e IG entre os grupos, de acordo com o tipo de aparelho de ERM, sexo e idade, ao longo do tempo. Resultados: as comparações intragrupos revelaram aumentos significativos do IP em pacientes usando HX (T0< T2) ou MHXI (T0< T3; T1< T3), com idades entre 12 e 15 anos (T0 < T1; T0 < T2; T0 < T3), e do IG de pacientes usando MHXI (T0< T3; T1< T3), que eram meninas (T1 < T3; T2 < T3), com idades entre 12 e 15 anos (T0 < T3; T2 < T3). Uma diferença no IG entre grupos foi observada em relação à idade dos pacientes (8-11 < 12-15; T1). Conclusões: uma única diferença entre grupos foi encontrada, o que sugere que os resultados de IP e IG, durante a expansão maxilar, foram semelhantes entre os grupos HX e MHXI, bem como entre os sexos e idades analisadas. Dessa forma, os ortodontistas podem usar esses aparelhos de ERM no tratamento de pacientes com FLPU de acordo com as necessidades do paciente ou suas preferências.

Selective alveolar corticotomy to intrude overerupted maxillary first molars: analysis of pulp vitality / Corticotomía alveolar selectiva para la intrusión de los primeros molares superiores extruidos: análisis de la vitalidad pulpar

The excessive and prolonged orthodontic treatment might result in loss of pulp vitality. Selective alveolar corticotomy is an alternative to accelerate the orthodontic treatment in adults. This study aimed to evaluate the impact of selective alveolar corticotomy associated with orthodontic intrusion on pulp vitality of overerupted maxillary first molars. Six individuals with extruded maxillary first molars were randomly selected to undergo corticotomy as coadjuvant therapy for intrusion. Pulp vitality was evaluated with thermal (Endo-Ice and Heated gutta-percha) and electric tests before the surgical procedure and after intrusion (90 days). The intrusion of all teeth was obtained (mean 2.26 ± 0.52 mm), and all teeth responded positively to pulp vitality tests before and after intrusion. This suggests that selective alveolar corticotomy did not promote pulp damage, and can be considered an effective and safe auxiliary method to intrusion of overerupted maxillary molars.

El tratamiento de ortodoncia prolongado puede provocar la pérdida de la vitalidad pulpar. La corticotomía alveolar selectiva es una alternativa para acelerar el tratamiento de ortodoncia en adultos. El objetivo del presente estudio fue evaluar el impacto de corticotomía alveolar selectiva asociada a la intrusión dental con ortodoncia en la vitalidad pulpar de los primeros molares superiores extruidos. Seis individuos con primeros molares superiores extruidos fueron seleccionados al azar para someterse a corticotomía como terapia adyuvante para la intrusión dental. La vitalidad pulpar se evaluó en ensayos térmicos (Endo-ice y gutapercha climatizada) y eléctrica antes del procedimiento quirúrgico y después de la intrusión (90 días). Se obtuvo la intrusión de todos los dientes (media 2,26 ± 0,52 mm) y todos los primeros molares respondieron positivamente a las pruebas de vitalidad pulpar, antes y después de la intrusión. Los resultados sugieren que la corticotomía alveolar selectiva no promueve daño pulpar y se puede considerar un método eficaz y seguro para ayudar a la intrusión de molares extruidos.

Oral Lichen Sclerosus: A Rare Case Report and Review of the Literature.

Lichen sclerosus (LS) is a chronic inflammatory mucocutaneous disease that often affects the anogenital area and causes significant discomfort and morbidity. Oral mucosal lesions in LS are extremely rare and might be associated with genital and/or skin manifestations. As a unique manifestation of LS, oral lesions are even more rare, with only 20 cases reported in English-language literature. In reviewing that literature in this paper, we present the case of a 44-year-old white man who sought dental assistance with a complaint of a white spot on his upper lip. Extraoral clinical examination revealed a slight white macule on the left upper lip vermilion next to the labial commissure. Intraoral examination revealed that the macule was approximately 3.5 × 2.0 cm, extended to the upper left labial mucosa, and presented an ivory-white color. Following an incisional biopsy and microscopy, the lesion was shown to be covered by a stratified squamous epithelium showing hyperkeratosis and atrophy. The superficial lamina propria revealed a well-marked band of subepithelial hyalinization and, below it, a band-like mononuclear inflammatory infiltrate. Sections stained by Verhoeff's technique revealed a scantiness of elastic fibers in the superficial lamina propria. The diagnosis of LS was then established. The patient was referred for dermatologic evaluation, which identified no skin or genital lesions, and no treatment was employed. After 6 years, no significant changes in clinical features were observed. Altogether, this rare case makes an important contribution to knowledge on this uncommon condition.

Incisor proclination and gingival recessions: is there a relationship?

Aim: To test the hypothesis that there is no relationship between the amount of vestibular inclination of mandibular incisors and the appearance of gingival recession in this region. Methods: This study included 20 patients selected in accordance with the following inclusion criteria: 1. adult patients without gingival recession in the mandibular incisors before treatment (T0), 2. no previous orthodontic treatment, 3. treated without tooth extraction in the mandibular arch, 4. bonded mandibular splinting from one canine to another after the active stage of orthodontic treatment (T1), 5. no visible wear of the incisal edge of the mandibular incisors, 6. Pre- and post-treatment teleradiography and plaster casts, and plaster casts 3 years post-treatment (T2). Depending on the amount of inclination of the mandibular incisors after treatment, the sample was divided into two groups: Group 1- 10 individuals (IMPA T1-T0 ≤ 5˚) and Group 2- 10 individuals (IMPA T1-T0 > 5˚). The measurement of length of the clinical crown (LCC) of the four mandibular incisors, distance between the incisal edge and vestibular marginal gingiva were made in plaster casts at T0, T1 and T2. Results: In spite of Group 1 presenting a reduction in LCC at T2, there was no statistically significant difference in LCC in the 3 time intervals evaluated in the two groups. Conclusions: The null hypothesis was accepted. The variation in the amount of vestibular inclination of the mandibular incisors during orthodontic treatment and 3 years after conclusion of treatment did not promote the appearance of gingival recessions in this group of patients (Au)

Color stability of ceramic brackets immersed in potentially staining solutions

OBJECTIVE: To assess the color stability of five types of ceramic brackets after immersion in potentially staining solutions.METHODS: Ninety brackets were divided into 5 groups (n = 18) according to brackets commercial brands and the solutions in which they were immersed (coffee, red wine, coke and artificial saliva). The brackets assessed were Transcend (3M/Unitek, Monrovia, CA, USA), Radiance (American Orthodontics, Sheboygan, WI, USA), Mystique (GAC International Inc., Bohemia, NY, USA) and Luxi II (Rocky Mountain Orthodontics, Denver, CO, USA). Chromatic changes were analyzed with the aid of a reflectance spectrophotometer and by visual inspection at five specific time intervals. Assessment periods were as received from the manufacturer (T0), 24 hours (T1), 72 hours (T2), as well as 7 days (T3) and 14 days (T4) of immersion in the aforementioned solutions. Results were submitted to statistical analysis with ANOVA and Bonferroni correction, as well as to a multivariate profile analysis for independent and paired samples with significance level set at 5%.RESULTS: The duration of the immersion period influenced color alteration of all tested brackets, even though these changes could not always be visually observed. Different behaviors were observed for each immersion solution; however, brackets immersed in one solution progressed similarly despite minor variations.CONCLUSIONS: Staining became more intense over time and all brackets underwent color alterations when immersed in the aforementioned solutions.

OBJETIVO: avaliar a estabilidade da cor de cinco tipos de braquetes cerâmicos após imersão em soluções potencialmente corantes.MÉTODOS: noventa braquetes foram divididos em 5 grupos (n = 18) de acordo com a marca comercial dos braquetes e as soluções em que foram imersos (café, vinho tinto, Coca-Cola e saliva artificial). Os baquetes avaliados foram Transcend (3M / Unitek, Monrovia, CA, EUA), Radiance (American Ortodontia, Sheboygan, WI, EUA), Mystique (GAC International Inc., Bohemia, NY, EUA) e Luxi II (Rocky Mountain Orthodontics, Denver, CO, EUA). Alterações cromáticas foram analisadas com o uso de um espectrofotômetro de reflectância e por inspecção visual, em cinco intervalos de tempo específicos. Os momentos de avaliação foram: 24 horas (T1), 72 horas (T2), 7 dias (T3) e 14 dias (T4) de imersão nas soluções. Os resultados foram submetidos à avaliação estatística com análise de variância e correção de Bonferroni, bem como a uma análise do perfil multivariada para amostras independentes e pareadas, com nível de significância de 5%.RESULTADOS: a duração do período de imersão influenciou na alteração de cor de todos os braquetes testados, mesmo admitindo-se que essas alterações nem sempre puderam ser observadas visualmente. Diferentes comportamentos foram observados em cada solução de imersão; no entanto, braquetes imersos em um mesmo tipo de solução progrediram de forma semelhante, apesar das pequenas variações.CONCLUSÕES: a coloração se tornou mais intensa com o tempo, e todos os braquetes sofreram alteração de cor nas soluções imersas.

Oral Congenital Melanocytic Nevus: A Rare Case Report and Review of the Literature.

Melanocytic nevi are congenital or acquired benign proliferations of cells of melanocytic origin. Oral congenital melanocytic nevi are rare, and only a few cases have been reported in the literature. The purpose of this study is to present the clinical, histological and immunohistochemical features of an oral congenital melanocytic nevus in a 16-year-old female with an 11-year follow-up and to review the pertinent literature. The reported case is the fifth well-documented case report of oral congenital melanocytic nevus in the English literature and the first with a long period of follow-up, thereby making it an important contribution to the knowledge regarding this uncommon oral mucosa lesion.

Tissue adhesive in free gingival graft / Adesivo tecidual no enxerto gengival livre

The aim of the present study was to review the literature regarding the utilization of 2-octyl cyanoacrylate's (Dermabond®, Ethicon US, USA) as a tissue adhesive in dentistry; also, to report its use in the stabilization and fixation of a free gingival graft, indicated to increase the width of the keratinized attached mucosa at the lower incisive region. Literature analysis revealed numerous indications for this tissue adhesive in the medical field related to maxillofacial injuries. In dentistry, clinical reports, as well as controlled clinical studies conducted in humans and in animal models, using histological analysis described positive results for the use of different cyanoacrylate-based tissue adhesives. These studies reported that the use of tissue adhesives reduced the surgical procedure time period, eliminated postoperative visits as well as the discomfort of suture removal and, in addition, did not interfere with the clinical repair process. Favorable results, like the ones described in the literature, were obtained in the present case report using Dermabond®.

O objetivo do presente estudo foi revisar a literatura pertinente sobre a utilização do 2-octil cianoacrilato (Dermabond®, Ethicon US, USA) como adesivo tecidual na Odontologia, assim como relatar seu uso na estabilização e fixação de um enxerto gengival livre indicado para aumento da mucosa ceratinizada inserida na região dos incisivos inferiores. A análise da literatura revelou ampla aplicabilidade deste adesivo tecidual na área médica relacionada aos ferimentos maxilofaciais. Na Odontologia existem relatos clínicos e estudos controlados em humanos e em modelos animais, descrevendo resultados positivos, inclusive por meio da análise histológica, sobre a utilização de diferentes adesivos teciduais, à base do cianocrilato. Estes estudos relataram que o uso dos adesivos teciduais, reduz o tempo operatório, elimina visitas pós-operatórias, não apresenta o desconforto da remoção de suturas, além de não interferir no processo de reparo clínico. Resultados favoráveis como os descritos na literatura, foram obtidos no presente relato de caso com a utilização do Dermabond®.

Parâmetros clínicos e moleculares podem ser usados como biomarcadores das doenças peri-implantares e periodontais? / Can clinical and molecular parameters be used as biomarker of peri-implant and periodontally affected sites? - a literature review

O objetivo deste trabalho foi realizar uma revisão da literatura sobre os parâmetros clínicos e moleculares como marcadores de doenças peri-implantares e periodontais. Uma busca eletrônica foi realizada entre os anos de 2000 e 2014, apenas em periódicos de língua inglesa, utilizando-se as palavras-chave “dental implants”, “interleukin-1” e “peri-implantitis” no site Medline/PubMed. Parâmetros clínicos – sangramento (SS), profundidade de sondagem (PS), índice gengival (IG) e índice de placa (IP) –, bem como as diversas citocinas pró-inflamatórias, foram analisados em estudos com seres humanos com mucosite e, ou peri-implantite. Foram recuperados 325 artigos com 45 destes inicialmente selecionados e, após a avaliação dos textos completos, foram incluídos 20 trabalhos. Pôde-se concluir que: 1) As citocinas pró-inflamatórias são utilizadas como marcadores das doenças peri-implantar e periodontal; 2) Os trabalhos apresentam diversos parâmetros clínicos e moleculares como meio de diagnóstico; 3) Estes achados clínicos mostram a doença peri-implantar apenas em seu estágio atual; 4) Os resultados são variados pela natureza transversal dos estudos e das populações; e 5) Novas avaliações deverão ser feitas com o intuito de reforçar estas informações e torná-las úteis à prática clínica diária.

The aim of this paper was to make a literature review on the clinical and molecular parameters as biomarkers of the peri-implant and periodontal diseases. An electronic search was made between the 2000 and 2014 in the English language journals at the Medline/PubMed site. Clinical parameters - bleeding on probing (BoP), pocket depth (PD), gingival index (GI), and the plaque index (PI), as well as proinfl ammatory cytokines were analyzed in human models with mucositis and peri-implantitis. Overall, 325 references were retrieved, 45 initially selected, but only 20 papers included. it can be concluded that: 1) the proinfl ammatory cytokines are used as markers of peri-implant and periodontal diseases; 2) several clinical and molecular parameters were used for diagnostic purposes; 3) The clinical fi ndings show the peri-implant disease on its early stages; 4) The results varied due to its cross-sectional nature and targeted populations; and 5) New evaluations need to be made with the aim to reinforce these information and make them useful at the clinical practice.

In vitro Evaluation of Color Changes of Aesthetic Orthodontic Elastic Ligatures / Evaluación in vitro de los Cambios de Color en Ligaduras Elásticas Ortodónticas Estéticas

The objective of this study was to evaluate the possible changes in color of aesthetic elastic ligatures soaked in different solutions. Five different brands of aesthetic elastic ligatures were evaluated in the present study. Measurement of the discs´ color was performed using a reflectance spectrophotometer (UV-visible spectrophotometer, UV-2450, Shimadzu®, Kyoto, Japan). Subsequently, the discs were immersed in artificial saliva (AS) or three different solutions: red wine (RW) (Miolo Terranova® 2010, Casa Nova, Brazil), coffee (CF) (Café Três Corações®, RioGrande do Norte, Brazil) or Coca-Cola® (CC) (Coca-Cola®, Belo Horizonte, Brazil). It was determined that the tested solutions were able to cause color changes in the aesthetic elastic ligatures. The coffee solution caused the greatest color change in all of the brands of ligatures evaluated, followed by the red wine solution. In conclusion, OSE and GAC brands of aesthetic elastic ligatures displayed the best performance.

El objetivo de este estudio fue evaluar los posibles cambios en el color de ligaduras elásticas estéticas embebidas en diferentes soluciones. Cinco diferentes marcas de ligaduras elásticas estéticas fueron evaluados en el presente estudio. La medición de discos de color se realizó con un espectrofotómetro de reflectancia (espectrofotómetro UV-visible, UV-2450, Shimadzu®, Kyoto, Japón). A continuación, los discos se sumergieron en saliva artificial o tres soluciones diferentes: vino tinto (Miolo Terranova® 2010, Casa Nova, Brasil), café (Café Três Corações®, RioGrande do Norte, Brasil) o Coca-Cola® (Coca-Cola®, Belo Horizonte, Brasil). Se determinó que las soluciones testeadas fueron capaces de causar cambios de color en las ligaduras elásticas estéticas. La solución de café causó el mayor cambio de color en todas las marcas de ligaduras evaluados, seguido por la solución de vino tinto. En conclusión, las marcas de ligaduras elásticas estéticas OSE y GAC muestran el mejor desempeño.

Parâmetros clínicos no tratamento de recessões periodontais / Influence of periodontal parameters in gingival recessions treatment by coronaliy positioned fiap procedure

Embora alguns estudos tenham abordado o tratamento de recessões periodontais, não existe na literatura um consenso sobre a influência dos parâmetros clínicos periodontais no grau de cobertura radicular. O número de estudos é reduzido e há limitações e diferenças metodológicas que não permitem o delineamento de conclusões definitivas. Assim, por meio da análise crítica da literatura, o presente estudo teve como objetivo avaliar o estado atual, no que se refere à influência dos parâmetros clínicos periodontais no recobrimento radicular, por meio da técnica do retalho posicionado coronalmente.

Tratamento orto-cirúrgico de mordida aberta esquelética associada a múltiplas recessões periodontais e abfrações - relato de caso / Surgical-orthodontic treatment of a skeletal open bite associated with multiple periodontal recessions and abfractions - case report

O número de indivíduos adultos que vem procurando por tratamento ortodôntico nas últimas décadas é crescente. O tratamento desses pacientes, muitas vezes, apresenta dificuldades adicionais à má oclusão e, dentre as mais comuns, estão aquelas que envolvem problemas nos tecidos periodontais. Quando tais fatores estão associados à má oclusão severa, como a de etiologia esquelética, a correção ortodôntica torna-se ainda mais complexa. O objetivo do presente artigo é descrever uma abordagem interdisciplinar de uma paciente com mordida aberta esquelética e dentária severas, bem como comprometimento estético também derivado da presença de múltiplas recessões gengivais e abfrações, que resultou em importante ganho em estética facial e dentária, assim como em significativa melhora funcional.

The number of adults seeking for orthodontic treatment has consistently increased in the past decades. Treatment of these patients may be more challenging if the periodontal tissues exhibit limitations. When these factors are associated to severe skeletal malocclusions, the orthodontic treatment becomes even more complex. The purpose of the present study was to report an interdisciplinary approach implemented in the treatment of a patient with a severe skeletal open bite and a compromised aesthetic condition that was also derived from the presence of multiple periodontal recessions and abfractions, which resulted in a significant intra and extra-oral aesthetics improvement as well as in functional enhancement.

Impacto da regeneração por biomateriais no tratamento de recessões periodontais / Impact of regeneration using biomaterials in the treatment

O tratamento das recessões periodontais tem sido motivo de estudos nasúltimas décadas. As técnicas cirúrgicas clássicas apresentam significativorecobrimento radicular e a regeneração tecidual guiada, associada aos biomateriais,tem sido sugerida como promotora de regeneração do periodontode inserção perdido. O objetivo do presente estudo foi, por meio derevisão da literatura, avaliar às técnicas de avanço coronal do retalho e daregeneração tecidual guiada associada à membrana bioabsorvível de colágenoe o fosfato de cálcio bifásico no tratamento das recessões periodontais.Os resultados obtidos nessa revisão sugerem que os procedimentosde avanço coronal do retalho e o protocolo de regeneração periodontalpromovem o recobrimento radicular, sendo que o avanço coronal do retalhoapresentou melhores resultados quanto aos parâmetros clínicos de alturade gengiva ceratinizada e percentual de recobrimento radicular, sem,entretanto, sugerir formação de novo cemento, ligamento periodontal eosso alveolar. Mais estudos longitudinais são necessários para avaliar o impactodas membranas e dos substitutos ósseos no recobrimento radiculare no ganho do periodonto de inserção.

O papel do VEGF nas periodontites / The role of VEGF in periodontitis: a literature review

A doença periodontal é uma doença inflamatória crônica dos tecidos desuporte dos dentes que resulta em perda de inserção clínica e perda ósseaalveolar. A vascularização periodontal é profundamente afetada durante aprogressão da doença periodontal e há evidências de que os tecidos inflamadosaumentam a expressão de várias citocinas e fatores de crescimento.Estas moléculas modulam a angiogênese, um processo essencialno desenvolvimento da inflamação crônica, que é definida como a formaçãode novos capilares que possuem a capacidade de transportar célulaspró-inflamatórias para a lesão e suprir de nutrientes e oxigênio o tecidoinflamado. O fator de crescimento do endotélio vascular (VEGF) atua comomodulador da angiogênese, tendo em vista que promove o aumento dapermeabilidade microvascular, induz a expressão de enzimas proteolíticas,estimula a proliferação de células endoteliais e a migração celular. O VEGFé detectado dentro de células endoteliais, plasmáticas e macrófagos, noepitélio juncional, sulcular e gengival nos tecidos periodontais e no fluidogengival crevicular de pacientes com doença periodontal. O propósito desteestudo foi descrever, por meio de estudos prévios, o papel do VEGF naetiopatogênese da doença periodontal.

Differential expression of salivary glycoproteins in aggressive and chronic periodontitis

OBJECTIVES:The aim of this study was to compare the pattern of secretion and the expression of mucin glycoprotein-2 (MG2) and lactoferrin in individuals with or without periodontitis. MATERIAL AND METHODS: Five individuals with aggressive periodontitis (APG), 5 with generalized chronic periodontitis (CPG) and 5 without periodontitis (CG) were enrolled after informed consent. Non-stimulated and stimulated submandibular and sublingual saliva was collected and samples analyzed by Western blot probed with specific antibodies. RESULTS: Stimulated and non-stimulated salivary flow rates did not differ among groups. Western blot analysis revealed that stimulation led to: an increase in MG2 expression in all groups, and to lactoferrin expression in APG and CPG. In non-stimulated saliva, CG exhibited the highest expression of both glycoproteins. In stimulated saliva, CG exhibited the highest expression of MG2, whereas APG the highest of lactoferrin. CONCLUSIONS: The pattern of secretion of MG2 and lactoferrin in health and disease is complex. Although the present study analyzed samples from a limited number of participants, the reduced expression of MG2 and lactoferrin in APG and CPG under non-stimulated condition, the predominant circumstance of salivary secretion during the day, suggests that these salivary constituents may play a role in the etiopathogenesis of these diseases.

Effect of vegetable oil (Brazil nut oil) and mineral oil (liquid petrolatum) on dental biofilm control.

Dental biofilm control represents a basic procedure to prevent caries and the occurrence of periodontal diseases. Currently, toothbrushes and dentifrices are used almost universally, and the employment of good oral hygiene allows for appropriate biofilm removal by both mechanical and chemical control. The aim of this study was to evaluate the effectiveness of adding vegetable or mineral oil to a commercially available dentifrice in dental biofilm control. A comparison using the Oral Hygiene Index Simplified (OHI-S) was performed in 30 individuals who were randomly divided into three groups. Group 1 (G1) received a commercially available dentifrice; the composition of this dentifrice was modified by addition of mineral oil (Nujol®) for group 2 (G2) or a vegetable oil (Alpha Care®) for group 3 (G3) at 10% of the total volume, respectively. The two-way repeated-measures analysis of variance (two-way ANOVA) was used to test the effect of group (G1, G2 and G3) or time (baseline, 45 days and 90 days) on the OHI-S index scores. Statistical analysis revealed a significant reduction in the OHI-S at day 90 in G2 (p < 0.05) and G3 (p < 0.0001) in comparison to G1. Therefore, the addition of a vegetable or a mineral oil to a commercially available dentifrice improved dental biofilm control, suggesting that these oils may aid in the prevention and/or control of caries and periodontal disease.

Effect of vegetable oil (Brazil nut oil) and mineral oil (liquid petrolatum) on dental biofilm control

Dental biofilm control represents a basic procedure to prevent caries and the occurrence of periodontal diseases. Currently, toothbrushes and dentifrices are used almost universally, and the employment of good oral hygiene allows for appropriate biofilm removal by both mechanical and chemical control. The aim of this study was to evaluate the effectiveness of adding vegetable or mineral oil to a commercially available dentifrice in dental biofilm control. A comparison using the Oral Hygiene Index Simplified (OHI-S) was performed in 30 individuals who were randomly divided into three groups. Group 1 (G1) received a commercially available dentifrice; the composition of this dentifrice was modified by addition of mineral oil (Nujol®) for group 2 (G2) or a vegetable oil (Alpha Care®) for group 3 (G3) at 10 percent of the total volume, respectively. The two-way repeated-measures analysis of variance (two-way ANOVA) was used to test the effect of group (G1, G2 and G3) or time (baseline, 45 days and 90 days) on the OHI-S index scores. Statistical analysis revealed a significant reduction in the OHI-S at day 90 in G2 (p < 0.05) and G3 (p < 0.0001) in comparison to G1. Therefore, the addition of a vegetable or a mineral oil to a commercially available dentifrice improved dental biofilm control, suggesting that these oils may aid in the prevention and/or control of caries and periodontal disease.