Comparative Analysis of the Efficacy of Dental Plaque Removal Between Manual and Powered Toothbrushes in Individuals With Syndactyly.

OBJECTIVE: To compare the efficacy of dental plaque removal between manual and powered toothbrushes in individuals with syndactyly. MATERIAL AND METHODS: Seventeen patients with Apert syndrome aged 11 to 30 years. The efficacy of toothbrushing was evaluated by the O'Leary plaque index at 2 periods: initial (before toothbrushing) and final (immediately after toothbrushing), using manual toothbrush (Colgate Twister) and powered toothbrush (Colgate Actibrush). Means were compared by the ANOVA test at a significance level of 5%. RESULTS: The reduction in the plaque index was different for each type of toothbrush (interaction factor between manual and powered toothbrushes and initial and final periods, P = 0.026). The powered toothbrush provided greater reduction of dental plaque than the manual toothbrush. CONCLUSION: In individuals with syndactyly, both manual and powered toothbrushes allowed significant plaque reduction on tooth surfaces; however, the powered toothbrush exhibited greater efficacy of plaque removal compared with the manual toothbrush.

Tooth abnormalities of number and position in the permanent dentition of patients with complete bilateral cleft lip and palate.

OBJECTIVE: To radiographically evaluate the prevalence of tooth abnormalities of number and position in the permanent dentition of individuals with complete bilateral cleft lip and palate. DESIGN: Cross-sectional retrospective. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. PATIENTS: Two hundred five individuals with complete bilateral cleft lip and palate. INTERVENTIONS: Analysis of patient records and panoramic radiographs. MAIN OUTCOME MEASURES: Evaluation of hypodontia and supernumerary teeth and analysis of the position of the permanent maxillary lateral incisor in relation to the alveolar cleft. RESULTS: Hypodontia was observed in 144 patients (70.2%), and the highest prevalence was observed for the maxillary lateral incisor. When both lateral incisors were present (43%), they were primarily located on the distal side of the cleft (25%). Supernumerary teeth were observed in 11.7% of individuals. CONCLUSION: Patients with cleft lip and palate presented high prevalence of hypodontia and supernumerary teeth. The prevailing characteristics of their location may suggest the presence of a similar genetic component for the occurrence of hypodontia and cleft.

The maxillary lateral incisor in the rehabilitation of cleft lip and palate.

Objective This study analyzed the maintenance of lateral incisors in the dental rehabilitation of individuals with cleft lip and palate. Material and Methods The study was conducted on a tertiary craniofacial center and comprised retrospective analysis of panoramic and periapical radiographs of Caucasoid individuals with non-syndromic complete unilateral cleft lip and palate, analyzing all radiographs available on the records of each individual, from the first to the last up to 12 years of age. Overall, 2,826 records were reviewed to achieve a sample of 1,000 individuals. Among these, 487 individuals presented the permanent lateral incisors on both cleft and non-cleft sides, which were included in this study. Results The results were evaluated in percentages and by descriptive statistics. The association between maintenance of the lateral incisor and timing of alveolar bone graft were analyzed by the t test. Among the 487 individuals, 265 had not completed treatment, 62 presented insufficient information, and 44 concluded the treatment elsewhere. Among the remaining 116 individuals, the lateral incisor was extracted from 88 (75.86%) of them on the cleft side (CS) and from 23 (19.83%) people on the non-cleft side (NCS). The age at accomplishment of alveolar bone graft was significantly associated with maintenance of the lateral incisor on the cleft side (p<0.01). Most extractions were indicated because of the inadequate positioning on the CS and for midline correction on the NCS. Rehabilitation was primarily completed by orthodontic movement (53 individuals on the CS and 13 individuals on the NCS). Conclusion In conclusion, the lateral incisor on the cleft side was not maintained in most individuals. Positive relationship was observed between extraction of the lateral incisor and age at accomplishment of the alveolar bone graft, suggesting the need to anticipate the initial radiographic evaluation to enhance its maintenance and reduce the procedures required for rehabilitation.

Susceptibility of bovine dental enamel with initial erosion lesion to new erosive challenges.

This in vitro study evaluated the impact of initial erosion on the susceptibility of enamel to further erosive challenge. Thirty bovine enamel blocks were selected by surface hardness and randomized into two groups (n = 15): GC- group composed by enamel blocks without erosion lesion and GT- group composed by enamel blocks with initial erosion lesion. The baseline profile of each block was determined using the profilometer. The initial erosion was produced by immersing the blocks into HCl 0.01 M, pH 2.3 for 30 seconds, under stirring. The erosive cycling consisted of blocks immersion in hydrochloric acid (0.01 M, pH 2.3) for 2 minutes, followed by immersion in artificial saliva for 120 minutes. This procedure was repeated 4 times a day for 5 days, and the blocks were kept in artificial saliva overnight. After erosive cycling, final profile measurement was performed. Profilometry measured the enamel loss by the superposition of initial and final profiles. Data were analyzed by t-test (p<0.05). The result showed no statistically significant difference between groups (GS = 14.60±2.86 and GE = .14.69±2.21 µm). The presence of initial erosion on bovine dental enamel does not enhance its susceptibility to new erosive challenges.

Influence of removing excess of resin-based materials applied to eroded enamel on the resistance to erosive challenge.

OBJECTIVES: The aim of this study was to evaluate the effect of removing excess of resin-based materials applied to eroded enamel, subjected to erosive challenge. METHODS: Bovine enamel blocks were immersed in HCl 0.01M, pH 2.3, for 30s under agitation at 50 rpm in room temperature, in order to form a softened erosion lesion. The blocks were then randomly divided into eight groups (n=12) and treated as follows: Cn- and Ce-control without treatment, Hn- and He-fissure resin sealant (Helioseal Clear(®)), An- and Ae-self-etch adhesive (Adhese(®)), In- and Ie-infiltrant (Icon(®)); being n-with excess removal and e-without excess removal of the material. After application of the materials, the blocks were immersed in HCl for 2 min, followed by immersion in artificial saliva for 120 min. This cycle was repeated four times a day for five days. Material thickness and enamel wear were assessed using profilometry. Data were analyzed by two-way ANOVA and Tukey's test (P<0.05). RESULTS: Groups He, Ae, and Ie resulted in the formation of a layer of material over enamel, being similar effective in inhibiting erosion progression (P>0.05). Groups Hn, An, and In (with excess removal) were similar to controls (Cn, Ce) and resulted in near enamel loss after application and after erosive challenge (P>0.05). CONCLUSIONS: Resin-based materials are able to protect enamel against erosion only when they are present over enamel, as a physical barrier. CLINICAL SIGNIFICANCE: The resin-based materials demonstrated potential to prevent the progression of erosion lesions when the material remains on the dental surface.

The maxillary lateral incisor in the rehabilitation of cleft lip and palate

Abstract Objective This study analyzed the maintenance of lateral incisors in the dental rehabilitation of individuals with cleft lip and palate. Material and Methods The study was conducted on a tertiary craniofacial center and comprised retrospective analysis of panoramic and periapical radiographs of Caucasoid individuals with non-syndromic complete unilateral cleft lip and palate, analyzing all radiographs available on the records of each individual, from the first to the last up to 12 years of age. Overall, 2,826 records were reviewed to achieve a sample of 1,000 individuals. Among these, 487 individuals presented the permanent lateral incisors on both cleft and non-cleft sides, which were included in this study. Results The results were evaluated in percentages and by descriptive statistics. The association between maintenance of the lateral incisor and timing of alveolar bone graft were analyzed by the t test. Among the 487 individuals, 265 had not completed treatment, 62 presented insufficient information, and 44 concluded the treatment elsewhere. Among the remaining 116 individuals, the lateral incisor was extracted from 88 (75.86%) of them on the cleft side (CS) and from 23 (19.83%) people on the non-cleft side (NCS). The age at accomplishment of alveolar bone graft was significantly associated with maintenance of the lateral incisor on the cleft side (p<0.01). Most extractions were indicated because of the inadequate positioning on the CS and for midline correction on the NCS. Rehabilitation was primarily completed by orthodontic movement (53 individuals on the CS and 13 individuals on the NCS). Conclusion In conclusion, the lateral incisor on the cleft side was not maintained in most individuals. Positive relationship was observed between extraction of the lateral incisor and age at accomplishment of the alveolar bone graft, suggesting the need to anticipate the initial radiographic evaluation to enhance its maintenance and reduce the procedures required for rehabilitation.