[The efficiency of the application of the modern computed technologies in the clinical practice and the prospects for the further use of the biomechanical 3D-models in forensic medicine]. / Éffektivnost' ispol'zovaniia sovremennykh komp'iuternykh tekhnologii v klinicheskoi praktike i perspektivy primeneniia biomekhanicheskikh 3D-modelei v sudebnoi meditsine.

To-day, the computer-assisted 3D-technologies for the mathematical simulation of the engineering facilities are extensively used for the purpose of technical calculations in all branches of industry and building. The positive experience gained with the application of the 3D-models finds wide application in the joined investigations on the topical problems of the prosthetic and surgical treatment of bones, teeth, joints, cardiac valves, blood vessels, etc. The objective of the present study was the analysis of the positive experience with the involvement of the specialists in the design and practical application of 3D-models for the solution of problems facing the medical prosthetics and the management of various pathological conditions. Another objective was to discuss the possible prospects for the interdisciplinary collaboration in these fields with a view to improving the quality of expert conclusions in the framework of forensic medical and criminalistics examinations. The data readily available from the official domestic and foreign Internet resources were used for the purpose of the study. The analysis of the published data has demonstrated the obvious advantages of the application of the mathematical 3D-models and the biomechanical studies for the solution of the concrete medico-biological problems. The currently available positive experience gained due to the participation of domestic specialists in biomechanics in the solution of the specific clinical problems gives hope that their collaboration between themselves and with the forensic medical experts will open up the promising prospects for the further investigations of the issues of common interest.

[Mathematical planning of sandwich-plasty by osseous-muco-periosteal advancement flap].

The method of mathematical planning of sandwich bone plasty is proposed. Displacement level of the bone flap is calculated in advance with regard to prosthetics size, shape and position as well as occlusal relationships. This makes it possible to accurately simulate the bone "basis" improving the prognosis of dental implantation.

Human dental age estimation combining third molar(s) development and tooth morphological age predictors.

In the subadult age group, third molar development, as well as age-related morphological tooth information can be observed on panoramic radiographs. The aim of present study was to combine, in subadults, panoramic radiographic data based on developmental stages of third molar(s) and morphological measurements from permanent teeth, in order to evaluate its added age-predicting performances. In the age range between 15 and 23 years, 25 gender-specific radiographs were collected within each age category of 1 year. Third molar development was classified and registered according the 10-point staging and scoring technique proposed by Gleiser and Hunt (1955), modified by Köhler (1994). The Kvaal (1995) measuring technique was applied on the indicated teeth from the individuals' left side. Linear regression models with age as response and third molar-scored stages as explanatory variables were developed, and morphological measurements from permanent teeth were added. From the models, determination coefficients (R (2)) and root-mean-square errors (RMSE) were calculated. Maximal-added age information was reported as a 6 % R² increase and a 0.10-year decrease of RMSE. Forensic dental age estimations on panoramic radiographic data in the subadult group (15-23 year) should only be based on third molar development.

Pyrophosphate-mediated magnetic interactions in Cu(II) coordination complexes.

The reaction in water of Cu(NO(3))(2)·2.5H(2)O with 2,2'-bipyridine (bipy), 1,10-phenanthroline (phen), or 1,10-phenanthroline-5-amine (phenam), and sodium pyrophosphate (Na(4)P(2)O(7)), at various pHs, afforded three new copper(II)-pyrophosphate complexes, namely, {[Cu(bipy)(cis-H(2)P(2)O(7))](2)}·3H(2)O (1a), {[Cu(phen)(H(2)O)](4)(HP(2)O(7))(2)}(ClO(4))(2)·4H(2)O (2), and {[Cu(2)(phenam)(2)(P(2)O(7))](2)·25H(2)O}(n) (3). A solvent free crystalline phase of 1a was also isolated with formula {[Cu(bipy)(trans-H(2)P(2)O(7))](2)} (1b), which can be regarded as a pseudo-polymorph of 1a. Single crystal X-ray analyses revealed these compounds to have uncommon molecular architectures, with 3 being an unprecedented pyrophosphate-containing two-dimensional (2D) polymer. Compounds 1a/1b and 2 are discrete di- and tetra-nuclear complexes, respectively. The cationic {[Cu(phen)(H(2)O)](4)(HP(2)O(7))(2)}(2+) unit in 2 presents a unique quasi-flat structure, held together by solely in-plane pyrophosphate bridging modes (short O(eq)-P-O(eq) and long O(eq)-P-O-P-O(eq) pathways), a coordination arrangement also not previously reported. A different tetranuclear copper(II)-pyrophosphate arrangement is found in 3, with two classically bridged dimers (O(eq)-P-O(eq) pathway) joined together by auxiliary equatorial-axial µ-O pyrophosphate bridges. Here, the bidimensionality is reached through bridging phenam ligands, which provide further inter-"tetramer" metal-metal connections [(N,N')(eq)-(N'')(ax) pathway], leading to the formation of an expanded covalent network based on the [Cu(2)(phenam)(2)(P(2)O(7))](2) moiety. Variable-temperature magnetic susceptibility measurements on polycrystalline samples of 2 and 3 revealed net antiferromagnetic coupling between metal centers with J(2a) = -7.9(2) cm(-1), J(2b) = -46.9(3) cm(-1), J(2c) = 0 cm(-1) in 2 (H = -J(2a)[S(Cu(1))·S(Cu(2)) + S(Cu(1a))·S(Cu(2a))] - J(2b)[S(Cu(1))·S(Cu(2a)) + S(Cu(1a))·S(Cu(2))] - J(2c)S(Cu(2))·S(Cu(2a))), and J(3a) = -87.9(2) cm(-1), J(3b) = -5(1) cm(-1) and J(3c) = +5(3) cm(-1) in 3 (H = -J(3a)[S(Cu(1))·S(Cu(2)) + S(Cu(1a))·S(Cu(2a))] - J(3b)[S(Cu(1))·S(Cu(2a)) + S(Cu(1a))·S(Cu(2))] - J(3c)S(Cu(2))·S(Cu(2a))). For 1a, a net ferromagnetic coupling is observed with J(1a) = +0.86(1) cm(-1) (H = -J S(A)·S(B) + S(A)·D· S(B) + ßH (g(A)S(A) + g(B)S(B)). This is the first example of ferromagnetic coupling in pyrophosphate-complexes reported to date. A structure-function correlation study focusing on magnetic exchange across the observed diverse pyrophosphate-bridges is described with density functional theory (DFT) calculations included to support the stated observations.

Experimental testing of the variable rotated elastic parabolic equation.

A series of laboratory experiments was conducted to obtain high-quality data for acoustic propagation in shallow water waveguides with sloping elastic bottoms. Accurate modeling of transmission loss in these waveguides can be performed with the variable rotated parabolic equation method. Results from an earlier experiment with a flat or sloped slab of polyvinyl chloride (PVC) demonstrated the necessity of accounting for elasticity in the bottom and the ability of the model to produce benchmark-quality agreement with experimental data [J. M. Collis et al., J. Acoust. Soc. Am. 122, 1987-1993 (2007)]. This paper presents results of a second experiment, using two PVC slabs joined at an angle to create a waveguide with variable bottom slope. Acoustic transmissions over the 100-300 kHz band were received on synthetic horizontal arrays for two source positions. The PVC slabs were oriented to produce three different simulated waveguides: flat bottom followed by downslope, upslope followed by flat bottom, and upslope followed by downslope. Parabolic equation solutions for treating variable slopes are benchmarked against the data.

[Effectiveness of biological treatments based on ACR70 response in rheumatoid arthritis: indirect comparison and meta-regression using Bayes-model]. / A rheumatoid arthritisben alkalmazott biológiai kezelések hatásossága az ACR70-végpont szerint: indirekt összehasonlítás és metaregresszió Bayes-modell alkalmazásával.

UNLABELLED: The therapy of rheumatoid arthritis has been changed by biological treatments. Their efficacy was evaluated in several randomized controlled trials. These trials were different in patient characteristics and the administration regimen. Placebo was the control and direct comparison of biological treatments is missing. OBJECTIVES: In the present study the efficacy of biological treatments in patients with rheumatoid arthritis was compared based on the randomized controlled trials available in the literature. A meta-analysis was conducted and meta-regression was used to explore the relationship between disease characteristic variables and observed efficacy. RESULTS: The related scientific literature is broad. Thirty two trials involving 18,500 patients were included into the current meta-analysis. The relative odds ratios of biological treatments compared to placebo varied between 3.6 and 20.0, and between 6.4 and 35.5 in case of monotherapy and combination with non-biological therapy, respectively. Disease duration and added non-biological therapy were in positive relationship with relative efficacy. More severe disease resulted smaller relative effect. CONCLUSIONS: The results show that the efficacy of biological treatments is similar. The relative efficacy worsens with more severe disease and improves with disease duration.

A novel statistical model for mandibular helical axis analysis.

The purpose of this study was to establish a new statistical method for the analysis of noisy mandibular helical axis parameters, especially the position vector of the finite helical axis (FHA). The subjects were children with anterior cross-bite who had received orthodontic treatment. Maximum mouth-opening was measured by means of an opto-electronic motion analysis system. These movements were compared with similar movement in the same group after treatment of their anterior cross-bite. Each curve of FHA position vectors was modelled as a spline function with random coefficients. To determine the optimal number of knots, two criteria were used: deviance information criteria (DIC) and mean squared prediction error (MSE). We were interested in estimating a typical curve for a population. Self-modelling regression (SEMOR) was extended to three dimensions to model groups of three-dimensional curves. Each curve was modelled as a spline function using nine knots. Population average curves were created using SEMOR. This study provided detailed information about jaw movement for comparing cross-bite to normal occlusion by calculating the population mean curves of the position vector of the FHA. Our results suggested that the two population mean curves for the position vector of the FHA were significantly different in the closing phase. The combination of a spline function with random coefficients and SEMOR extended to three dimensions can be used not only for FHA analysis but also for the analysis of other jaw movements.

Comparison of Three Different Types of Two-Implant-Supported Magnetic Attachments on the Stress Distribution in Edentulous Mandible.

Two-implant-retained mandibular overdentures with magnetic attachments can provide an effective treatment modality for edentulous patients. In this study, a three-dimensional finite element analysis was used to compare the biomechanical characteristics of three different types of magnetic attachments in two-implant-retained mandibular overdentures. Flat-type, dome-type, and cushion-type of the magnetic attachments were designed to retain the overdenture. Four types of load were applied to the overdenture in each model: 100 N vertical and oblique loads on the right first molar and a 100 N vertical load on the right canine and the lower incisors. The biomechanical behaviors of peri-implant bone, abutment, and mucosa were recorded. In vertical incisors, vertical right canine, and oblique molar loading condition, the flat-type group exhibited the highest levels of maximum equivalent strain/stress in the peri-implant bone. The total deformation of mucosa and the maximum equivalent strain/stress in the oblique molar loading condition are about two times as the vertical molar loading condition. These results suggested that both cushion-type and dome-type of the magnetic attachments are better choices in two-implant-retained mandibular overdentures, and oblique loading is more harmful than vertical loading.

[Cross-sectional imaging in dentomaxillofacial diagnostics: dose comparison of dental MSCT and NewTom 9000 DVT]. / Schnittbildverfahren zur dentomaxillofazialen diagnostik: dosisvergleich von dental-MSCT und NewTom 9000 DVT.

PURPOSE: For nonsuperimposed and three-dimensional imaging of jaws and teeth, multislice computer tomography (MSCT) can be performed, or alternatively digital volume tomography as a cone beam technique can be applied. The radiation dose of both procedures should be evaluated with different methods of dose assessment. MATERIALS AND METHODS: A 4-row MSCT (Volume Zoom Siemens) and a cone beam CT (NewTom QR-DVT 9000) were compared regarding the radiation exposure of the patient during a dental examination. Organ dose and effective dose were estimated by thermoluminescence dosimetry (TLD) using an Alderson-Rando phantom for both devices. In addition the effective dose of MSCT was calculated from the CTDIvol-value at scanner display and by CT-Expo program. RESULTS: The effective dose of MSCT was 0.33 mSv for women (w) and 0.32 mSv for men (m) measured with TLD in the Alderson-Rando phantom, 0.39 / 0.35 mSv (w/m) by CTDI calculation and 0.39 / 0.33 mSv by CT-Expo program. The effective dose of NewTom QR-DVT 9000 from TLD measurement was 0.095 / 0.093 mSv (w/m). CONCLUSION: The radiation exposure of a typical dental examination with a NewTom cone beam DVT is about one third of the MSCT dose. Both techniques, however, moderate patient doses. Dosimetry methods as routinely used for MSCT cannot be applied to cone beam DVT.

Sagittal space relations in the maxilla during molar eruption.

OBJECTIVE: The aim of this study was to measure the space relations in the maxilla during upper molar eruption, and to interpret associations. MATERIAL AND METHODS: 154 skulls ranging from infant to adult were measured on the basis of defined distances. The age of the skulls was determined by tooth development. The data were compared and qualitatively interpreted. RESULTS: We observed that, immediately after eruption of the primary dentition, there was nearly enough space in the upper jaw for the first permanent molar. Yet eruption does not occur until the age of 5 to 6 years, at the beginning of the first transition phase. As opposed to the first permanent molar, the second erupted as soon as there is enough space in the upper jaw. This tends to happen at the end of the second transition phase at ca. 12-13 years of age. We noted that there was almost enough space in the maxilla until the age of 17 to accommodate all the teeth in the upper jaw. According to our measurements, growth at the posterior edge of the maxilla also took place after eruption of the third molar. CONCLUSIONS: This leads us to consider that we can postpone the extraction of the upper third molars until after the 18th year, and to consider the possibility that the upper third molar may erupt correctly while the maxilla is still growing. It is precisely this trend that is significant in clinical practice, since maxillary wisdom teeth are often extracted prematurely due to an apparent lack of space.

Morphometric analysis of facial profile in adults.

AIM: Are centroid size, principal component analysis (PCA) and thin-plate splines (TPS) sufficient for determining facial morphology? Is it possible to identify relationships between cranial morphology, gender and facial profile? MATERIAL AND METHODS: Profile photos of 110 adult patients were measured according to A.M. Schwarz landmarks using Onyx Ceph. Centroid size was calculated from x and y-coordinates. After Procrustes transformation, a principal component analysis for identifying major components of facial morphology was performed and the results visualized using thin-plate splines. At the same time, lateral cephalograms of all patients were analyzed according to Hasund. RESULTS: There were significant differences in centroid size betweeen male and female patients. Only the vertical skeletal structure had an impact on centroid size. Six components (PC1 to PC6) were identified using PCA. They were responsible for 86.5% of the variance. PC1 (33.9%) described scaling along an axis from Porion to chin. PC2 (28.6%) characterized the vertical dimensions of the lower face. Significant differences were only apparent between males and females in PC3 and PC4. In terms of cephalometric parameters, PC2 and PC3 differed in the vertical, and PC1 und PC2 in the sagittal configuration. CONCLUSIONS: The analyses presented here suffice for describing facial morphology qualitatively and quantitatively as demonstrated by this example. Separating size from shape is useful for investigating therapeutically and growth-related morphological changes. It is difficult to draw conclusions about skeletal parameters.

A new method for quantitative analysis of dentinal tubules.

Conventional methods to estimate the number of dentinal tubules cannot be considered reliable and repeatable, because results depends on the operator outlining of the tubules contours. In this study, we propose a totally automated computerized analysis technique to evaluate dentinal tubules and their surface area. The comparison test of these conventional with a semi-automatic methods shows that the automated analysis allowed a reliable identification and numbering of dentinal tubules, by means of high-quality images. No statistically significant difference exists in the number of tubules and the total tubule surface area between the control and test groups.

Structure and vibrations of BenOn (n=3-10) clusters.

The structure and harmonic vibrations of Be(n)O(n) (n=3-10) clusters have been investigated using density functional theory. All structures are found to be cumulenic D(nh) rings (equal bonds, alternating angles), with one intense out of plane mode and three infrared-active degenerate modes, of which the highest one is extremely intense and asymptotically increases to 1597 cm(-1) for n=10. Comparisons with C(2n) clusters and B(n)N(n) clusters, the structure and bonding type for the Be(n)O(n) clusters are consistent with those of the C(2n) (n=3, 5, 7, ...) clusters and the B(n)N(n) clusters.

Evaluation of vertical parameters in cephalometry.

AIM: The aim of this study was to determine the validity of different vertical parameters in cephalometry. MATERIALS AND METHODS: The cephalograms of 94 patients were used in this study. The inclusion criteria were as follows: skeletal Class I, completion of maximum skeletal growth, and no history of orthodontic therapy. The control group consisted of 34 subjects with very good occlusion (overbite 2-4 mm). The patients were classified with the help of dental casts: Group 1 (n = 31) patients with cover-bite (overbite > 5.5 mm) and Group 2 (n = 29) patients with anterior open bite (overbite < -0.5 mm). In addition to the 24 standard cephalometric measurements (Bergen-Analysis), we included individualized norm values (Segner & Hasund), the Overbite Depth Indicator (ODI) described by Kim, the Denture Frame Analysis (DFA) described by Sato, and facial-type evaluations according to Schopf. RESULTS: We observed significant differences among the three study groups in all the vertical parameters tested. We demonstrated statistically-significant classification results for the Segner & Hasund harmony box's individualized norm values (83.8%), and those of the ODI (77.7%) and ML-AB angle (76.6%). CONCLUSIONS: Based on the vertical cephalometric parameters, we succeeded in statistically differentiating among the groups with open bite, cover-bite and the control group. Various measurements must be taken to ensure that the cephalometric vertical relationships are reliably evaluated.

Cephalometric assessment of the axial inclination of upper and lower incisors in relation to the third-order angle.

BACKGROUND AND AIM: Estimating incisor inclination cephalometrically by reference lines NA and NB puts the orthodontist in the difficult position of relating these axial inclination data to the bracket's third-order prescription which refers to a perpendicular to the occlusal plane. Purpose of the present study was to evaluate the relationship between the cephalometrically-assessed incisor inclination (using the lines NA and NB for reference) and the third-order angle (syn.: torque angle, TA) according to Andrews' description, and moreover to investigate the correlation between incisor inclination data and skeletal-sagittal and skeletal-vertical findings. MATERIALS AND METHODS: The lateral cephalograms and corresponding dental casts of 67 subjects between 10 and 25 years of age (regardless of skeletal and dental relationships) were considered in the study. All subjects were Caucasian, and none had undergone orthodontic therapy. Upper (U1) and lower (L1) incisor angulations were cephalometrically assessed in reference to the NA and NB lines and compared to third-order angles obtained from dental cast measurements with an incisor inclination-recording appliance. Incisor inclination data from the two measurements were correlated to craniofacial sagittal (angles SNA, SNB, ANB) and vertical (angles NSL-NL, NSL-ML, ML-NL) findings from the radiographs. RESULTS: The third-order angles in the upper arch measured on the dental casts were a mean of 16.2 degrees (SD = 5.3 degrees) smaller than the axial inclination according to the NA line; the lower incisor third-order data were less than those of the axial inclination according to the NB line by a mean of 27.8 degrees (SD = 4.75 degrees). In this sample, there was a range of 42.7 degrees for the U1TA variable (mean = 5.6 degrees, SD 9.73 degrees) and 47 degrees for U1NA/ degrees variable (mean = 21.71 degrees, SD = 8.67 degrees). The L1TA variable showed a range of 29 degrees (mean = -2.95 degrees, SD = 7.17 degrees), the radiographic L1NB/ degrees range was 23 degrees (mean = 24.91 degrees, SD = 5.8 degrees). We observed a highly significant correlation (r(NA) = 0.84***, r(NB) = 0.76***) between the Andrews' angle and the inclination estimated in reference to the NA and NB lines. No significant correlation between incisor inclination and craniofacial measurements was detected. CONCLUSIONS: Dental cast measurements seem to be more precise and more valid than lateral radiographs. The method we describe enables clinicians to get a good idea precisely and quickly of how much torque potential remains in the brackets and archwires during treatment. The inclination of the incisors can also be calculated using the regression equations provided, making additional lateral cephalograms unnecessary.

Glass ionomer heated or not to identify bone defect created in rat calvaria / Ionômero de vidro aquecido ou não para identificação de defeitos ósseos criados em calvárias de ratos

Introduction: Some experimental models have been used to evaluate the use of biomaterials in bone regeneration. Among them are the critical size defects (CSD) created in rat calvaria. An experimental model has been described in the literature, in which "L" markings are performed on the margins of the bone defects in order to assist in the precise identification of these defects during laboratory processing and analysis of the results. In the proposed model, the "L" markings are filled with amalgam. Objective: The purpose of the present study was to evaluate the amalgam replacement of an experimental bony defect model in rat calvaria by heated or unheated glass ionomer. Material and method: 24 rats were used. A 5 mm CSD was created at each animal calvaria. Two "L" shaped markings were made 2 mm from the margins of the bone defect, filled with amalgam (Group AM), heated glass ionomer cement (Group GIh) or not (Group GI). The animals were euthanized 15 days postoperatively. The areas of the surgical defect and the L-shaped marking were histomorphometrically analyzed and the data were analyzed statistically (p <0.05). Result: There were no significant clinical, histological or methodological differences among the experimental groups. Conclusion: It can be concluded that GI can replace AM in the proposed experimental model and GI heating did not promote additional benefits.

Introdução: Alguns modelos experimentais têm sido usados para avaliar o uso de biomateriais na regeneração óssea. Entre eles estão os defeitos de tamanho crítico (DTC) criados em calvárias de ratos. Um modelo experimental foi descrito na literatura onde marcações em L são realizadas nas margens do defeito ósseo para auxiliar na identificação precisa desses defeitos durante o processamento laboratorial e análise dos resultados. No modelo experimental proposto, as marcações em "L" são preenchidas com amálgama. Objetivo: Avaliar a substituição do amálgama por ionômero de vidro aquecido ou não em um modelo experimental para identificação de defeito ósseo criado em calvária de ratos. Material e método: Foram utilizados 24 ratos. Um DTC de 5 mm de diâmetro foi criado na calvária de cada animal. Duas marcações em "L" foram realizadas a 2 mm das margens do defeito ósseo, preenchidas com amálgama (Grupo AM), ionômero de vidro aquecido (Grupo CIVaq) ou não (Grupo CIV). Os animais foram eutanasiados aos 15 dias pós-operatórios. A área do defeito cirúrgico e das marcações em "L" foram histomorfometricamente avaliadas e os dados estatisticamente analisados (p<0,05). Resultado: Não houve diferença estatisticamente significativa entre os grupos experimentais para as análises metodológicas, clínicas ou histomorfométrica realizadas. Conclusão: Dentro dos limites deste estudo, pode-se concluir que CIV pode substituir o AM no modelo experimental proposto e o aquecimento do CIV não promoveu benefícios adicionais.

Determination of forces on a split palatal screw after rapid maxillary expansion.

OBJECTIVES: Aim of this study was to develop a finite element model of the forces that patients with rapid maxillary expansion bear and to validate it by a mechanical test. METHODS: Computer-aided design models of the metallic screw and polymeric splint were modelled and discretized. Two forces were generated and considered independently: F1 at the temporary molar (2.5 N) and F2 at the permanent molar (2.5 N). The results of the finite element analysis were used to define the strain values which the anterior and posterior arms of the rapid maxillary expansion appliance bore as a linear function of F1-F2 by calculating the strain-force coefficient δ ij . Two strain gauge rosettes were attached to an appliance which was placed in an XY motorized stage to reproduce the same forces used in the finite element analysis. Once the system was validated, the matrix was inverted to determine forces F1 and F2 that a group of 40 patients underwent (median age 8.33 years, standard deviation 1.86 years) for 75 days, using their strain values. The parents of the patients activated a quarter turn (0.20 mm) twice a day until 50% transversal overcorrection was achieved. RESULTS: Finite element analysis showed that the effects of the forces on stress at the location of the arms were notably different. There was a satisfactory correlation between finite element analysis predictions and in vitro values. Dissipation of F1 and F2 in patients was predicted to be 62.5 and 80%, respectively, after 75 days of retention. CONCLUSION: These results back the finite element analysis model for force prediction.

A double-blinded randomized clinical trial of pain perception during orthodontic treatment / Ensaio clínico randomizado duplo cego de percepção da dor durante tratamento ortodôntico

Introduction: Orthodontic movement can cause painful symptoms, especially in the early stages of treatment. Objective: This study aimed to compare the performance of chewing gum and ibuprofen in pain control during the initial period of orthodontic treatment. Material and method: A randomized blind clinical trial, with an allocation ratio of 1:1, was developed with patients aged ≥18 years old. The sample size was established considering a significance level of 5% and test power of 80%, resulting in a minimum of 30 volunteers per group (n=90). Participants were paired regarding sex, age, the severity of malocclusion, defined by the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN), and crowding, determined by Little's irregularity index. The sample was randomly allocated to three groups: Group I (control) placebo; Group II chewing gum; and Group III Ibuprofen. Pain perception was evaluated by the Visual Analog Scale (VAS) in the first 24, 36, and 48 hours after activation of the orthodontic appliance. The data were analyzed by generalized linear models for repeated measures in time. Result: No statistically significant difference (p>0.05) was observed among the groups for the methods of pain therapy evaluated in 24, 36, and 48 hours post-activation. Conclusion: There was no difference among the method used for pain control during the orthodontic treatment.

Introdução: A movimentação ortodôntica pode causar sintomatologia dolorosa, principalmente nas fases iniciais do tratamento. Objetivo: Este estudo teve como objetivo comparar o desempenho da goma de mascar e do ibuprofeno no controle da dor durante o período inicial do tratamento ortodôntico. Material e método: Foi desenvolvido um ensaio clínico randomizado cego, com razão de alocação de 1:1, com pacientes com idade ≥ 18 anos. O tamanho da amostra foi estabelecido considerando um nível de significância de 5% e poder do teste de 80%, resultando em um mínimo de 30 voluntários por grupo (n=90). Os participantes foram pareados quanto ao sexo, idade, gravidade da má oclusão, definida pelo Componente de Saúde Bucal (DHC) do Índice de Necessidade de Tratamento Ortodôntico (IOTN), e apinhamento, determinado pelo índice de irregularidade de Little. A amostra foi distribuída aleatoriamente em três grupos: Grupo I (controle) placebo; Goma de mascar Grupo II; e Grupo III Ibuprofeno. A percepção da dor foi avaliada pela Escala Visual Analógica (EVA) nas primeiras 24, 36 e 48 horas após a ativação do aparelho ortodôntico. Os dados foram analisados por modelos lineares generalizados para medidas repetidas no tempo. Resultado Não foi observada diferença estatisticamente significativa (p>0.05) entre os grupos para os métodos de terapia da dor avaliados em 24, 36 e 48 horas pós-ativação. Conclusão: Não houve diferença entre o método utilizado para controle da dor durante o tratamento ortodôntico.

Association between periodontitis and type 2 diabetes mellitus: study in a population attended by the Brazilian Health System / Associação entre periodontite e diabetes mellitus tipo 2: estudo em uma população atendida pelo Sistema Único de Saúde Brasileiro

Introduction: Periodontitis control helps to prevent and control diabetes mellitus and understanding of this relationship can lead to changes in health policy. Objective: The purpose of this study was to investigate the association between periodontitis, knowledge, and glycemic control. Material and method: This is a cross-sectional analytical epidemiological survey with 216 Type 2 diabetic patients, non-smokers, who had current blood screenings with glycated hemoglobin (HbA1c). Result: Overall, 93.51% of the patients reported brushing their teeth at least twice a day, 62.5% visited the dentist last year, 81.58% have already undergone treatment for periodontal disease, 43.52% reported having periodontitis and 59.72% had controlled diabetes. No significant (p=0.603) association between HbA1c control and the presence of periodontitis was found. Among the patients with periodontitis, no association between HbA1c control and information on the periodontal disease was found (p=0.996), and know/believe in its relationship with diabetes (p=0.659; p=0.973). Conclusion: No relationship between periodontitis and diabetes was found in the sample, as well as in patients with periodontitis, those with knowledge on periodontal disease and knowledge/belief in its relationship with diabetes, which could be justified by the care by a multi-professional health team.

Introdução: O controle da doença periodontal auxilia na prevenção e no controle do diabetes mellitus. A compreensão dessa relação pode desencadear mudanças nas políticas públicas de saúde. Objetivo: O objetivo deste estudo foi investigar a associação entre a doença periodontal, o controle glicêmico e o conhecimento dessa relação. Material e método: Trata-se de um inquérito epidemiológico analítico transversal com 216 pacientes com diabetes mellitus tipo 2, não fumantes, que realizaram exames de sangue atuais com hemoglobina glicada (HbA1c). Resultado: No geral, 93,51% dos pacientes relataram escovar os dentes pelo menos duas vezes ao dia, 62,5% visitaram o dentista no último ano, 81,58% já fizeram tratamento para doença periodontal, 43,52% relataram ter periodontite e 59,72% tinham diabetes controlado. Não foi encontrada associação significativa (p=0,603) entre o controle da HbA1c e a presença de periodontite. Entre os pacientes com periodontite, não foi encontrada associação entre o controle da HbA1c e informações sobre a doença periodontal (p=0,996), e conhecer/acreditar na sua relação com o diabetes (p=0,659; p=0,973). Conclusão: Não foi encontrada relação entre a doença periodontal e diabetes na amostra, o que poderia ser justificado pelo atendimento por uma equipe multiprofissional de saúde no Sistema Único de Saúde Brasileiro.