RESUMEN
Van der Woude syndrome (VWS) is a rare syndrome of genetic etiology, commonly occasioned by mutations in the IRF6 gene and that causes disorders in craniofacial development. VWS is characterized by the presence of paramedian fistulas in the lower lip and cleft lip and / or cleft palate. Although some dental phenotypes have been reported in this syndrome, multiple and rare hypodontias were not described. Through this case report, we present a case of Van der Woude Syndrome (VWS) with rare and multiple hypodontia in which clinical data and radiographic exams were evaluated. The patient presented hypodontia of eight permanent teeth (lateral incisors, second premolars and second molars). So, when the dentist recognizes multiple and/or rare hypodontias, for an accurate diagnosis, detailed examination of the lower lip is indicated, as well as a survey of the family history and referral for genetic counseling, since the syndrome presents high penetrance. The patient is expected to be rehabilitated to have a good quality of life. Rehabilitation in these cases requires alveolar bone graft, orthodontics and prosthesis to replace missing teeth.
Asunto(s)
Anodoncia , Labio Leporino , Fisura del Paladar , Humanos , Labio Leporino/genética , Fisura del Paladar/genética , Anodoncia/diagnóstico por imagen , Anodoncia/genética , Calidad de Vida , Factores Reguladores del Interferón/genéticaRESUMEN
OBJECTIVE: Frontonasal dysplasia is a rare developmental defect of the midface, and little is known about the dental involvement in individuals with this condition. This study investigated tooth abnormalities and occlusal disorders in individuals with frontonasal dysplasia. DESIGN: Cross-sectional. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, Brazil. INTERVENTIONS: Clinical oral examination, analysis of patient records, and panoramic radiographs. PARTICIPANTS: A total of 20 individuals with frontonasal dysplasia aged 7 to 17 years. MAIN OUTCOME MEASURES: Prevalence of the several tooth abnormalities and occlusal disorders analyzed. RESULTS: A total of 19 individuals presented at least one tooth abnormality, with highly variable findings. In radiographs, 20% of individuals (all presenting oral clefts) presented agenesis of lateral incisors and second premolars. No supernumerary teeth were observed; 65% of individuals exhibited occlusal alterations, especially anterior open bite in the two individuals with median cleft lip. CONCLUSIONS: Variable clinical and radiographic alterations were observed, probably due to the large variety of phenotypic characteristics. No specific dental alteration could be related with frontonasal dysplasia.
Asunto(s)
Anomalías Craneofaciales/epidemiología , Cara/anomalías , Maloclusión/epidemiología , Anomalías Dentarias/epidemiología , Adolescente , Brasil/epidemiología , Niño , Anomalías Craneofaciales/diagnóstico por imagen , Estudios Transversales , Cara/diagnóstico por imagen , Femenino , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Prevalencia , Radiografía Panorámica , Anomalías Dentarias/diagnóstico por imagenRESUMEN
AIM: Current literature on chronic periodontitis genetics encompasses numerous single nucleotide polymorphisms-focused case-control studies with inconsistent and controversial results, which typically disregards the exposure concept embraced by case-control definition. Herein, we propose a case-control design reappraisal by clear phenotype selection, where chronic gingivitis represents a genetically resistant phenotype/genotype opposing the susceptible cohort. MATERIAL AND METHODS: The hypothesis was tested in healthy, chronic periodontitis and gingivitis groups through Real-time PCR-based allelic discrimination of classic variants IL1B-3954, IL6-174, TNFA-308, IL10-592 and TLR4-299. RESULTS: Observed allele/genotype frequencies characterize the healthy group with an intermediate genetic profile between periodontitis and gingivitis cohorts. When comparing genotype/allele frequencies in periodontitis versus healthy and periodontitis versus gingivitis scenarios, the number of positive associations (2-4) and the degree of association (p and odds ratio values) were significantly increased by the new approach proposed (periodontitis versus gingivitis), suggesting the association of IL1B-3954, TNFA-308, IL10-592 and TLR4-299 with periodontitis risk. Power study was also significantly improved by the new study design proposed when compared to the traditional approach. CONCLUSIONS: The data presented herein support the use of new case-control study design based on the case-control definition and clear resistance/susceptibility phenotypes selection, which can significantly impact the study power and odds of identification of genetic factors involved in PD.
Asunto(s)
Periodontitis Crónica/genética , Gingivitis/genética , Modelos Genéticos , Estudios de Casos y Controles , Enfermedad Crónica , Femenino , Frecuencia de los Genes , Genes Dominantes , Genes Recesivos , Predisposición Genética a la Enfermedad , Humanos , Interleucina-10/genética , Interleucina-1beta/genética , Interleucina-6/genética , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Polimorfismo de Nucleótido Simple , Valores de Referencia , Proyectos de Investigación , Receptor Toll-Like 4/genética , Factor de Necrosis Tumoral alfa/genéticaRESUMEN
This study aimed to analyze the 100 most-cited papers in the field of oral medicine and pathology over time, identifying the areas of more intense research. Papers in journals of oral medicine and pathology were identified using the Web of Science database. The specified research period was between 1900 and 2019. Descriptive statistics was used to analyze the data. Pearson's correlation analysis was used to explore the relationships among Web of Science citations, Dimensions citations, and Altmetric Attention Score. The number of citations of an article in the top 100 most-cited papers published in 1953 or later ranged from 541 to 3623. The papers were published in 47 different journals. The New England Journal of Medicine, American Cancer Society, and Nature Genetics published the most papers. Authors from 18 different countries published papers on head and neck cancer, craniofacial congenital anomalies, and osteonecrosis. Most of the papers were laboratory and descriptive studies. A correlation analysis showed a strong correlation only between Web of Science and Dimensions citations. In sum, although non-specific journals for pathology and oral medicine published the majority of the 100 most-cited papers, this biometric citation study show that head and neck cancer was the issue with the most citations. Together, these results make an important scientific contribution by providing a historical perspective on the research carried out.
Asunto(s)
Bibliometría , Medicina OralRESUMEN
OBJECTIVES: To investigate the association of MSX1 rs12532 polymorphism with the risk of nonsyndromic unilateral complete cleft lip and palate (NSCLP) and tooth agenesis. MATERIALS AND METHODS: The study is comprised of 384 individuals divided into 4 groups: group 1, patients with unilateral complete NSCLP and premolar agenesis (nâ¯=â¯57); group 2, patients with unilateral NSCLP without tooth agenesis (nâ¯=â¯117); group 3, patients with premolar agenesis without oral cleft (nâ¯=â¯53) and group 4 (nâ¯=â¯157), a control group with individuals without tooth agenesis and oral cleft. Genotyping of rs12532 was carried out with Taqman chemistry, and associations were investigated using logistic regression analyses. RESULTS: Overall rs12532 allele and genotype distributions revealed no significant differences between the groups of NSCLP or tooth agenesis. CONCLUSION: Although our results are consistent with a lack of association of MSX1 rs12532 and the risk of unilateral NSCLP and tooth agenesis, further studies with additional SNPs and a more diverse ethnic cohort are warranted.
Asunto(s)
Labio Leporino/genética , Fisura del Paladar/genética , Factor de Transcripción MSX1/genética , Adolescente , Adulto , Alelos , Anodoncia , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Polimorfismo de Nucleótido Simple , Adulto JovenRESUMEN
Aim: This study aimed to investigate the occurrence of enamelin gene (ENAM) single nucleotide polymorphisms (SNP) and ENAM polymorphism association with dental anomalies (DA) in individuals with unilateral or bilateral cleft lip and palate (CLP). Methods: Saliva samples were collected from 147 individuals aged between 6 and 15 years-old, both genders, and divided into 4 groups: Group 1 (G1) - CLP and DA; Group 2 (G2) - CLP without DA; Group 3 (G3) - without CLP with DA; Group 4 (G4) - without CLP and DA. The genomic DNA was extracted from saliva samples and the following ENAM SNPs markers were genotyped: rs3796703, rs3796704, rs3796705, rs7671281, rs2609428, and rs35951442. Fisher exact and Pearson's Chi-square tests statistically analyzed the results (α=5%). Results: Individuals without CLP with DA (Group 3 - 19.2%) showed statistically higher prevalence of SNP rs2609428 heterozygotes (p=0.006) than individuals with CLP and DA (Group 1 - 0%). Individuals without CLP (10%) exhibited statistically higher prevalence of mutated heterozygotes/homozygous (p=0.028) than in individuals with CLP (1.3%). Conclusion: SNP rs2609428 marker of ENAM gene may be associated with dental anomalies in individuals without cleft lip and palate
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Anomalías Dentarias , Proteínas de la Matriz Extracelular , Labio Leporino , Fisura del Paladar , Polimorfismo de Nucleótido SimpleRESUMEN
OBJECTIVE AND MATERIAL AND METHODS: This study aimed to compare the quantity and quality of human DNA extracted from saliva that was fresh or frozen for three, six and twelve months using five different DNA extraction protocols: protocol 1 - Oragene™ commercial kit, protocol 2 - QIAamp DNA mini kit, protocol 3 - DNA extraction using ammonium acetate, protocol 4 - Instagene™ Matrix and protocol 5 - Instagene™ Matrix diluted 1:1 using proteinase K and 1% SDS. Briefly, DNA was analyzed using spectrophotometry, electrophoresis and PCR. RESULTS: Results indicated that time spent in storage typically decreased the DNA quantity with the exception of protocol 1. The purity of DNA was generally not affected by storage times for the commercial based protocols, while the purity of the DNA samples extracted by the noncommercial protocols typically decreased when the saliva was stored longer. Only protocol 1 consistently extracted unfragmented DNA samples. In general, DNA samples extracted through protocols 1, 2, 3 and 4, regardless of storage time, were amplified by human specific primers whereas protocol 5 produced almost no samples that were able to be amplified by human specific primers. Depending on the protocol used, it was possible to extract DNA in high quantities and of good quality using whole saliva, and furthermore, for the purposes of DNA extraction, saliva can be reliably stored for relatively long time periods. CONCLUSIONS: In summary, a complicated picture emerges when taking into account the extracted DNA's quantity, purity and quality; depending on a given researchers needs, one protocol's particular strengths and costs might be the deciding factor for its employment.
Asunto(s)
ADN/aislamiento & purificación , Saliva/química , Electroforesis , Femenino , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Control de Calidad , Juego de Reactivos para Diagnóstico , Valores de Referencia , Reproducibilidad de los Resultados , Manejo de Especímenes/métodos , Espectrofotometría , Estadísticas no Paramétricas , Factores de TiempoRESUMEN
OBJECTIVE: To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. MATERIAL AND METHODS: The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). RESULTS: PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. CONCLUSION: Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.
Asunto(s)
Diente Canino/anomalías , Dentición Mixta , Anomalías Dentarias/complicaciones , Erupción Ectópica de Dientes/etiología , Brasil/epidemiología , Niño , Diente Canino/diagnóstico por imagen , Diagnóstico Precoz , Femenino , Humanos , Estudios Longitudinales , Masculino , Maxilar/anomalías , Prevalencia , Radiografía Panorámica , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Distribución por Sexo , Anomalías Dentarias/diagnóstico por imagen , Anomalías Dentarias/epidemiología , Erupción Ectópica de Dientes/diagnóstico por imagen , Erupción Ectópica de Dientes/epidemiología , Diente Impactado/etiologíaRESUMEN
Resumen Introducción: El oscurecimiento de un diente anterior interfiere negativamente en el aspecto de la sonrisa, y varias son las causas que pueden ser responsables por este oscurecimiento. Objetivo: Describir las técnicas de blanqueamiento mixto e inmediato a través del reporte de dos casos clínicos. Caso 1: Individuo de sexo masculino, con Síndrome de Treacher Collins, se quejó sobre alteración cromática del diente 33, verificada mediante examen clínico, radiográficamente presencia de tratamiento endodóntico satisfactorio. Por lo que fue planeado el blanqueamiento interno mediante técnica mixta. Caso 2: Individuo de sexo masculino, con Síndrome de Apert reportó cambio cromático en el diente 22, observado en el examen clínico, radiográficamente presentando tratamiento endodóntico insatisfactorio. Se realizó retratamiento endodóntico y a los 6 meses se realizó blanqueamiento interno mediante técnica inmediata. Conclusión: El blanqueamiento dental ejecutado con las técnicas mixtas e inmediatas, devuelve la armonía de la sonrisa, recuperando el color ideal y elevando la autoestima a los pacientes.
Resumo Introdução: O escurecimento de um dente anterior interfere negativamente na aparência do sorriso, e várias são as causas que podem ser responsáveis por esse escurecimento. Objetivo: Descrever as técnicas clareadoras mista e imediata através do relato de dois casos clínicos. Caso 1: Indivíduo do gênero masculino com Síndrome de Treacher Collins, queixou-se de alteração cromática no dente 33, constatado no exame clínico, radiograficamente apresentando tratamento endodôntico satisfatório. O clareamento interno foi planejado e realizado pela técnica mista. Caso 2: Indivíduo do gênero masculino, com Síndrome de Apert, relatou alteração cromática no dente 22, constatado ao exame clínico, apresentando tratamento endodôntico insatisfatório. Foi realizada a reintervenção endodôntica e após 6 meses, foi realizado clareamento interno pela técnica imediata. Conclusão: O uso das técnicas clareadoras mista e imediata, resulta na devolução da harmonia do sorriso, recuperando a coloração ideal e devolvendo a autoestima aos pacientes.
Abstract Introduction: The darkening of a single anterior tooth negatively affects the smile's appearance, and several factors may cause this darkening. Objective: To describe the mixed and immediate bleaching techniques by reporting two clinical cases. Case 1: A male individual with Treacher Collins Syndrome. He complained of chromatic alteration in tooth 33, which was verified on clinical examination. X-ray imaging showed satisfactory endodontic treatment. Internal bleaching was performed with the mixed technique. Case 2: A male individual with Apert Syndrome reported chromatic alteration in tooth 22, observed on clinical examination. X-ray imaging showed unsatisfactory endodontic treatment. Endodontic retreatment was performed. Six months later, internal whitening was performed immediately. Conclusion: The use of mixed and immediate whitening techniques restores the smile's harmony, the tooth's ideal color, and patients' self-esteem.
Asunto(s)
Humanos , Masculino , Adulto , Adulto Joven , Blanqueamiento de Dientes/métodos , Diente no Vital , Diente Canino , Blanqueadores DentalesRESUMEN
Abstract This study aimed to analyze the 100 most-cited papers in the field of oral medicine and pathology over time, identifying the areas of more intense research. Papers in journals of oral medicine and pathology were identified using the Web of Science database. The specified research period was between 1900 and 2019. Descriptive statistics was used to analyze the data. Pearson's correlation analysis was used to explore the relationships among Web of Science citations, Dimensions citations, and Altmetric Attention Score. The number of citations of an article in the top 100 most-cited papers published in 1953 or later ranged from 541 to 3623. The papers were published in 47 different journals. The New England Journal of Medicine, American Cancer Society, and Nature Genetics published the most papers. Authors from 18 different countries published papers on head and neck cancer, craniofacial congenital anomalies, and osteonecrosis. Most of the papers were laboratory and descriptive studies. A correlation analysis showed a strong correlation only between Web of Science and Dimensions citations. In sum, although non-specific journals for pathology and oral medicine published the majority of the 100 most-cited papers, this biometric citation study show that head and neck cancer was the issue with the most citations. Together, these results make an important scientific contribution by providing a historical perspective on the research carried out.
Asunto(s)
Bibliometría , Medicina OralRESUMEN
Introduction: chromatic alterations in devitalized teeth are not rare, being a common cause of aesthetic dissatisfaction on the part of the patient. In endodontically treated teeth that present chromatic alterations, the endodontist should select the whitening agent and the most prudent technique for the resolution of each case. Objective: to emphasize, through the report of two clinical cases, that internal bleaching techniques, whether immediate or mixed, can achieve success when indicated and performed correctly. Case reports: Case 1 - Female subject with incomplete labiopalatine fissure reported a complaint of chromatic alteration in the crown of the tooth 22, found on clinical examination presenting unsatisfactory endodontic treatment. Endodontic reintervention was successfully performed through 2 years of proservation and internal bleaching was performed through the immediate bleaching technique. Case 2 - Male subject with complete unilateral left cleft lip and palate and a history of endodontic treatment in the dental element 21 which presented yellowish staining, internal bleaching was performed by the mixed technique. In both cases, results were successful. Final considerations: bleaching in devitalized teeth using the immediate and mixed whitening techniques recovered the ideal coloration of the dental elements.Introdução: alterações cromáticas em dentes desvitalizados não são raras, sendo motivo comum de insatisfação estética por parte do paciente. Diante do dente tratado endodonticamente que apresenta alteração cromática, o endodontista deve eleger o agente clareador e a técnica mais prudente para resolução de cada caso. Objetivo: enfatizar, através do relato de dois casos clínicos, que as técnicas de clareamento interno, independente se imediata ou mista, podem alcançar o sucesso quando indicadas e realizadas corretamente. Re lato de casos: Caso 1 - indivíduo do gênero feminino com fissura labiopalatina incompleta relatou queixa de alteração cromática na coroa do dente 22, constatado ao exame clínico apresentando tratamento endodôntico insatisfatório. A reintervenção endodôntica foi realizada com sucesso comprovada por meio de proservação durante 2 anos e o clareamento interno foi realizado através da técnica clareadora imediata. Caso 2 - Indivíduo do gênero masculino com fissura labiopalatina completa unilateral esquerda e histórico de tratamento endodôntico no elemento dentário 21 que apresentava coloração amarelada realizou-se o clareamento interno pela técnica mista. Em ambos os casos, o sucesso foi alcançado. Considerações finais: o clareamento em dentes desvitalizados valendo-se da utilização das técnicas clareadoras imediata e mista recuperou a coloração ideal dos elementos dentários.
Asunto(s)
Humanos , Blanqueadores Dentales , EndodonciaRESUMEN
Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.
Asunto(s)
Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Prótesis Dental/métodos , Rehabilitación Bucal/métodos , Adulto , Brasil , Estética , Hospitales Universitarios , Humanos , Resultado del TratamientoRESUMEN
The Laboratory of Physiology provides support for the diagnosis of functional disorders associated with cleft lip and palate and also conducts studies to assess, objectively, the institutional outcomes, as recommended by the World Health Organization. The Laboratory is conceptually divided into three units, namely the Unit for Upper Airway Studies, Unit for Stomatognathic System Studies and the Unit for Sleep Studies, which aims at analyzing the impact of different surgical and dental procedures on the upper airways, stomatognathic system and the quality of sleep of individuals with cleft lip and palate. This paper describes the main goals of the Laboratory in the assessment of procedures which constitute the basis of the rehabilitation of cleft lip and palate, i.e., Plastic Surgery, Orthodontics and Maxillofacial Surgery and Speech Pathology.
Asunto(s)
Labio Leporino/rehabilitación , Fisura del Paladar/rehabilitación , Laboratorios de Hospital , Evaluación de Resultado en la Atención de Salud/organización & administración , Brasil , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Hospitales Universitarios , Humanos , Resultado del TratamientoRESUMEN
Abstract Saliva when compared to blood collection has the following advantages: it requires no specialized personnel for collection, allows for remote collection by the patient, is painless, well accepted by participants, has decreased risks of disease transmission, does not clot, can be frozen before DNA extraction and possibly has a longer storage time. Objective and Material and Methods This study aimed to compare the quantity and quality of human DNA extracted from saliva that was fresh or frozen for three, six and twelve months using five different DNA extraction protocols: protocol 1 – Oragene™ commercial kit, protocol 2 – QIAamp DNA mini kit, protocol 3 – DNA extraction using ammonium acetate, protocol 4 – Instagene™ Matrix and protocol 5 – Instagene™ Matrix diluted 1:1 using proteinase K and 1% SDS. Briefly, DNA was analyzed using spectrophotometry, electrophoresis and PCR. Results Results indicated that time spent in storage typically decreased the DNA quantity with the exception of protocol 1. The purity of DNA was generally not affected by storage times for the commercial based protocols, while the purity of the DNA samples extracted by the noncommercial protocols typically decreased when the saliva was stored longer. Only protocol 1 consistently extracted unfragmented DNA samples. In general, DNA samples extracted through protocols 1, 2, 3 and 4, regardless of storage time, were amplified by human specific primers whereas protocol 5 produced almost no samples that were able to be amplified by human specific primers. Depending on the protocol used, it was possible to extract DNA in high quantities and of good quality using whole saliva, and furthermore, for the purposes of DNA extraction, saliva can be reliably stored for relatively long time periods. Conclusions In summary, a complicated picture emerges when taking into account the extracted DNA’s quantity, purity and quality; depending on a given researchers needs, one protocol’s particular strengths and costs might be the deciding factor for its employment.
Asunto(s)
Humanos , Masculino , Femenino , Saliva/química , ADN/aislamiento & purificación , Control de Calidad , Juego de Reactivos para Diagnóstico , Valores de Referencia , Manejo de Especímenes/métodos , Espectrofotometría , Factores de Tiempo , Reacción en Cadena de la Polimerasa , Reproducibilidad de los Resultados , Estadísticas no Paramétricas , ElectroforesisRESUMEN
This paper presents the treatment protocol of maxillofacial surgery in the rehabilitation process of cleft lip and palate patients adopted at HRAC-USP. Maxillofacial surgeons are responsible for the accomplishment of two main procedures, alveolar bone graft surgery and orthognathic surgery. The primary objective of alveolar bone graft is to provide bone tissue for the cleft site and then allow orthodontic movements for the establishment of an an adequate occlusion. When performed before the eruption of the maxillary permanent canine, it presents high rates of success. Orthognathic surgery aims at correcting maxillomandibular discrepancies, especially anteroposterior maxillary deficiencies, commonly observed in cleft lip and palate patients, for the achievement of a functional occlusion combined with a balanced face.
Asunto(s)
Alveoloplastia/métodos , Labio Leporino/cirugía , Fisura del Paladar/rehabilitación , Fisura del Paladar/cirugía , Brasil , Labio Leporino/patología , Labio Leporino/rehabilitación , Fisura del Paladar/patología , Hospitales Universitarios , Humanos , Ilion/trasplante , Alveolo Dental/cirugía , Resultado del TratamientoRESUMEN
Para o sucesso do tratamento endodôntico é essencial a perfeita limpeza, conformação e desinfecção do canal radicular, obtendo-se uma forma cônica, respeitando a sua forma original, promovendo assim, condições necessárias para que o sistema de canais radiculares possa ser hermeticamente obturado. O preparo biomecânico sofreu grandes transformações nos últimos anos, sendo a instrumentação manual gradualmente substituída pelos sistemas mecanizados. Uma das principais inovações em Endodontia foi a introdução da liga de níquel-titânio (NiTi) para fabricação de instrumentos endodônticos, permitindo que os mesmos trabalhassem dentro dos canais radiculares. Apesar das apreciáveis propriedades mecânicas da liga de NiTi convencional, a separação dos instrumentos continua sendo uma preocupação. Entre os novos sistemas mecanizados de NiTi que visam amenizar esta problemática, vale destacar os que apresentam uma liga melhorada por processos térmicos. Dentre deles o sistema HyFlex® CM™ (ColténeEndo/Whaledent, Inc, Cuyahoga Falls, OH, EUA) torna-se uma excelente alternativa por sua alta resistência à fadiga cíclica e possibilidades de serem pré-curvados. Por tanto, o objetivo deste trabalho é apresentar o sistema HyFlex® CM™ através de um caso clínico (AU).
For the success of endodontic treatment, perfect cleaning, shaping and disinfection of the root canal are essential as well as getting a conical shape, similar to its original shape, enabling the conditions for hermetic sealing of the root canal system. The step that has undergone major changes in recent years was the biomechanical preparation with gradual mechanized systems to "substitute" the manual preparation. One of the main innovations in Endodontics was the introduction of nickel-titanium (NiTi) for manufacturing endodontic instruments. Despite the good mechanical properties of conventional NiTi alloy, fracture of the instruments remains a concern. Among the new mechanized systems of NiTi, treated by thermal processes which improved NiTi alloy, the HyFlex® CM™ system (ColténeEndo / Whaledent, Inc, Cuyahoga Falls, OH, USA) becomes an excellent alternative to endodontic therapy. Therefore, the objective of this study was to present a clinical case using mechanized instrumentation with HyFlex® CM™ system (AU).
Asunto(s)
Humanos , Femenino , Adulto , Endodoncia , Preparación del Conducto Radicular/estadística & datos numéricos , Tratamiento del Conducto Radicular , Fenómenos Biomecánicos , Brasil , Radiografía Dental/instrumentaciónRESUMEN
Uno de los objetivos de la endodoncia es la eliminación de los microorganismos de la endodoncia es la eliminación de los microorganismos y la prevención de la reinfección en el sistema de conductosradiculares. Una de las fases de la terapia endodóntica que permite laobtención de dichos objetivos es la obturación de los conductos radiculares;esto significa rellenarlos con un material inerte de la manera más hermética posible y un cemento que permita estimular el proceso de reparación apical y periapical. Los microorganismos pueden permanecer en el sistema de conductos radiculares inclusive después de los procesos de instrumentación e irrigación porque pueden presentar una anatomía compleja. En endodoncia, una de las propiedades deseadas en los cementos endodónticos es la acción antimicrobiana, para eliminar las bacterias resistentes. Los cementos a base de hidróxido de calcio son utilizados debido a su acción antimicrobiana y degradación deendotoxinas, entre otras propiedades. Estas premisas nos llevan a larealización de este trabajo, teniendo como objetivo evaluar la actividadantimicrobiana y la biocompatibilidad que presentan los cementos endodónticos a base de hidróxido de calcio a través de una revisión deliteratura. Después de la revisión podemos concluir que los cementosa base de hidróxido de calcio poseen biocompatibilidad y actividad antimicrobiana contra diversos tipos de microorganismos; sin embargo, pueden tener sus propiedades biológicas alteradas dependiendo de la etodología utilizada y del tiempo de aplicación.
One of the aims of endodontics is to eliminate microorganisms and prevent reinfection in the root-canal system. To achieve this, one of the procedures performed in endodontic therapy is the sealing of the root canals. This implies fi lling the root canal with as hermetic an inert material as possible and a sealer that encourages the process of apical and periapical repair. Microorganisms can remain in the root-canal system even after biomechanical preparation and irrigation, as they may have a complex anatomy. In endodontics, one of the desired properties of an endodontic sealer is antimicrobial activity to eliminate resistant bacteria. Calcium hydroxide-based sealers are used due to their antimicrobial activity and role in endotoxin degradation, among other properties. These were the premises that gave rise to this study, which aimed to evaluate the antimicrobial activity and biocompatibil-ity exhibited by a calcium hydroxide-based endodontic sealer based on a review of the literature. As a result of this review, we were able to conclude that while calcium hydroxide-based sealers do display biocompatibility and antimicrobial activity, their biological properties can vary depending on the method used and the time of application.
Asunto(s)
Materiales Biocompatibles , Hidróxido de Calcio/química , Materiales de Obturación del Conducto Radicular/química , Bacterias Aerobias , Bacterias Anaerobias , Recuento de Colonia Microbiana , Medios de Cultivo , Placa Dental/prevención & controlRESUMEN
ABSTRACT The early recognition of risk factors for the occurrence of palatally displaced canines (PDC) can increase the possibility of impaction prevention. Objective To estimate the risk of PDC occurrence in children with dental anomalies identified early during mixed dentition. Material and Methods The sample comprised 730 longitudinal orthodontic records from children (448 females and 282 males) with an initial mean age of 8.3 years (SD=1.36). The dental anomaly group (DA) included 263 records of patients with at least one dental anomaly identified in the initial or middle mixed dentition. The non-dental anomaly group (NDA) was composed of 467 records of patients with no dental anomalies. The occurrence of PDC in both groups was diagnosed using panoramic and periapical radiographs taken in the late mixed dentition or early permanent dentition. The prevalence of PDC in patients with and without early diagnosed dental anomalies was compared using the chi-square test (p<0.01), relative risk assessments (RR), and positive and negative predictive values (PPV and NPV). Results PDC frequency was 16.35% and 6.2% in DA and NDA groups, respectively. A statistically significant difference was observed between groups (p<0.01), with greater risk of PDC development in the DA group (RR=2.63). The PPV and NPV was 16% and 93%, respectively. Small maxillary lateral incisors, deciduous molar infraocclusion, and mandibular second premolar distoangulation were associated with PDC. Conclusion Children with dental anomalies diagnosed during early mixed dentition have an approximately two and a half fold increased risk of developing PDC during late mixed dentition compared with children without dental anomalies.
Asunto(s)
Humanos , Masculino , Femenino , Niño , Anomalías Dentarias/complicaciones , Erupción Ectópica de Dientes/etiología , Diente Canino/anomalías , Dentición Mixta , Anomalías Dentarias/epidemiología , Anomalías Dentarias/diagnóstico por imagen , Erupción Ectópica de Dientes/epidemiología , Erupción Ectópica de Dientes/diagnóstico por imagen , Diente Impactado/etiología , Brasil/epidemiología , Radiografía Panorámica , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Estudios Longitudinales , Distribución por Sexo , Medición de Riesgo , Diente Canino/diagnóstico por imagen , Diagnóstico Precoz , Maxilar/anomalíasRESUMEN
OBJECTIVE: To evaluate the presence of enamel alterations in deciduous maxillary central incisors of infants with unilateral cleft lip and alveolar ridge, with or without cleft palate, and to compare the occurrence and location of these alterations between the central incisor adjacent to the cleft and the contralateral incisor. DESIGN: Intraoral clinical examination was performed after tooth cleaning and drying by a single examiner with the aid of a dental mirror, dental probe, and artificial light, with the child positioned on a dental chair. The defects were recorded in a standardized manner according to the criteria of the Modified Developmental Defects of Enamel Index. SETTING: Hospital for Rehabilitation of Craniofacial Anomalies (HRAC) at Bauru, São Paulo, Brazil. PATIENTS: One hundred one infants were evaluated. All were white, of both genders, aged 12 to 36 months and had at least two thirds of the crowns of maxillary incisors erupted. RESULTS: Demarcated opacity was the most common defect at both cleft and noncleft sides, followed by diffuse opacity. The occurrence of hypoplasia at the cleft side was 11.8%. Most defects affected less than one third of the crown. CONCLUSION: The occurrence of enamel defects in deciduous maxillary central incisors of patients with unilateral cleft lip was 42.6%, mainly affecting the cleft side as to both number and severity.
Asunto(s)
Labio Leporino/patología , Esmalte Dental/patología , Incisivo/patología , Preescolar , Fisura del Paladar/patología , Hipoplasia del Esmalte Dental/patología , Femenino , Humanos , Lactante , Masculino , Maxilar , Diente PrimarioRESUMEN
Treatment of patients with cleft lip and palate is completed with fixed prostheses, removable, total, implants and aims to restore aesthetics, phonetics and function and should be guided by the basic principles of oral rehabilitation, such as physiology, stability, aesthetics, hygiene and the expectations of the patient. In order to obtain longevity of a prosthetic rehabilitation, the periodontal and dental tissue as well as the biomechanics of the prosthesis are to be respected. The purpose of this article is to describe the types of prosthetics treatment, which are performed at HRAC/USP for the rehabilitation of cleft area in adult patients.