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1.
Allergol Immunopathol (Madr) ; 51(4): 55-62, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37422780

RESUMO

AIM: To evaluate the effects of rapid maxillary expansion (RME) on nasal patency in mouth breathing (MB) children with maxillary atresia due to or not due to allergic rhinitis (AR) associated with asthma. METHODS: Fifty-three MB children/adolescents (aged 7-14 years) with mixed or permanent dentition and maxillary atresia participated, with or without unilateral or bilateral crossbite. They formed the groups: RAD (AR + asthma; clinical treatment, RME); RAC (AR + asthma; clinical treatment, no RME); and D (mouth breathers; RME only). RAD and RAC patients received topical nasal corticosteroid and/or systemic H1 antihistamine (continuous use) and environmental exposure control. All were evaluated before RME (T1) and 6 months after (T2) with the CARATkids score, acoustic rhinometry, and nasal cavity computed tomography (CT). Patients RAD and D underwent RME (Hyrax® orthopedic appliance). RESULTS: A significant reduction in the CARATkids score occurred in the RAD (-4.06; p < 0.05), similarly when patient and parent/guardian scores were evaluated (-3.28 and -3.16, respectively). Acoustic rhinometry (V5) showed increased nasal volume in all groups, significantly higher in RAD patients than in RAC and D (0.99 × 0.71 × 0.69 cm3, respectively). CT of the nasal cavity documented increased volume in all three groups, with no significant differences between them. CONCLUSION: In MB patients with AR, asthma, and maxillary atresia, RME increased nasal cavity volume and improved respiratory symptoms. However, it should not be used as the only treatment for managing patients with respiratory allergies.


Assuntos
Asma , Rinite Alérgica , Adolescente , Humanos , Criança , Respiração Bucal/terapia , Técnica de Expansão Palatina , Nariz , Rinite Alérgica/terapia
2.
Clin Oral Investig ; 26(9): 5595-5609, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35809115

RESUMO

OBJECTIVE: To identify and describe unusual soft tissue complications of periodontal plastic surgery procedures at the recipient site after periodontal grafts. MATERIALS AND METHODS: Two independent reviewers performed a comprehensive search in MEDLINE, Cochrane, periodontics journals, reference lists, and grey literature for articles dated up to July 2021. Publications related to surgical interventions only around the teeth with an unusual complication at the recipient site were selected. No restrictions were made in the number of cases, follow-up period, or language. The Cochrane Collaboration's tool for assessing risk of bias, the Newcastle-Ottawa Scale (NOS), and two validated case report/series checklists were used to critically appraise the studies. RESULTS: A total of 1434 articles were examined, of which 28 met the inclusion criteria: one RCT, two cohort studies, and twenty-five case reports/series. The periodontal plastic surgery procedures described in these articles were conducted to treat lack of attached gingiva and gingival recessions. The following unusual complications were found: bone exostosis, epithelial inclusion, root resorption, abscess, overgrowth, "liver clot" formation, and oroantral communication. CONCLUSION: Bone exostosis and epithelial inclusions were the most prevalent unusual complications following treatment with subepithelial connective tissue graft, free gingival graft, and acellular dermal matrix allograft. Due to the nature of the reports, the clinical recommendations for diagnosis and treatment cannot be homogenized. Clinical studies reporting complications are required to develop management protocols (PROSPERO CRD42021230875). CLINICAL RELEVANCE: Clinicians need to know the main complications that can occur in mucogingival surgeries as well as their clinical management to provide a successful and predictable treatment.


Assuntos
Exostose , Retração Gengival , Procedimentos de Cirurgia Plástica , Cirurgia Plástica , Tecido Conjuntivo/transplante , Gengiva/transplante , Retração Gengival/etiologia , Retração Gengival/cirurgia , Humanos , Complicações Pós-Operatórias , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/cirurgia , Raiz Dentária/cirurgia
3.
Clin Oral Investig ; 26(2): 1889-1902, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34505916

RESUMO

OBJECTIVES: To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid. MATERIALS AND METHODS: Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2 years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used. RESULTS: No differences in clinical performance were found among groups. Group I had lower retention at 2 years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2 years. MMP-2 decreased after 1 year, and its activity increased back to the initial level after 2 years, mainly for groups I, II, and III. MMP-9 increased after 1 year, and it was reduced to the initial level after 2 years, mainly for group I. CONCLUSIONS: All restorative techniques performed similarly in NCCLs after 2 years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2 years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2 years of clinical functioning and have similar effects on MMPs present in crevicular fluid.


Assuntos
Restauração Dentária Permanente , Líquido do Sulco Gengival , Resinas Compostas , Adaptação Marginal Dentária , Cimentos de Ionômeros de Vidro , Humanos , Metaloproteinases da Matriz , Cimentos de Resina
4.
J Prosthet Dent ; 125(2): 266-272, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32111393

RESUMO

STATEMENT OF PROBLEM: Correct implant placement by means of a pretreatment planning software program is still subject to deviations between the planned and achieved implant positions. Inaccuracy at this level may have drastic consequences, including neurovascular trauma. Further data are therefore needed to evaluate the accuracy of such computer-guided implant planning software programs. PURPOSE: The purpose of this clinical study was to evaluate the accuracy of computer-guided implant surgery associated with prototyped surgical guides. MATERIAL AND METHODS: Cone beam computed tomography (CBCT) scans were made of the participants with a tomographic guide to merge anatomic and prosthetic data. This allowed virtual planning with a prosthetically guided approach respecting the anatomy of the participant. A prototyped surgical guide was then fabricated from the virtual plan, determining the intrasurgical position of the implants. Flapless guided implant surgery was carried out according to the manufacturer's instructions. A second CBCT was made 30 days after the surgery, to enable overlapping of the data from before and after the implant placement. The angular, coronal, central, and apical deviations of the placed implants were measured and compared with those virtually planned. The data were submitted to descriptive statistic and intraclass correlation coefficient (ICC), analysis of variance, and the Student t test (α=.05). RESULTS: A total of 61 implants were analyzed. The mean angular deviation was 2.04 degrees. The mean coronal, central, and apical linear deviations were 0.68 mm, 0.72 mm, and 0.82 mm, respectively. No statistically significant difference was found between the virtual and the real position of the implants inserted. A tendency toward a greater absolute error was observed in the mandible than in the maxilla in terms of angular (P=.047), central (P=.043), and coronal error (P=.031). CONCLUSIONS: Flapless computer-guided implant surgery with virtual planning had some angular and linear deviations; nevertheless, this technique should be acceptably safe and accurate.


Assuntos
Implantes Dentários , Cirurgia Assistida por Computador , Desenho Assistido por Computador , Computadores , Tomografia Computadorizada de Feixe Cônico , Implantação Dentária Endóssea , Humanos , Imageamento Tridimensional , Planejamento de Assistência ao Paciente
5.
Mol Biol Rep ; 47(4): 2845-2859, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32239466

RESUMO

The present work aimed to investigate the antioxidant, anti-inflammatory and wound healing potential of ethyl acetate fraction from Bauhinia ungulata L. (FABU) on in vitro and in vivo models. Wound healing assay using human lung adenocarcinoma A549 cell line was employed to evaluate the ability of FABU in modulating cell migration. In addition, a surgical wound model in C57BL/6 mice was used to study the healing potential of FABU incorporated into gel carbomer 940 (Carbopol®). Evaluation of lipid peroxidation, inflammatory and anti-inflammatory mediator gene expression, rate of wound closure, and histological analysis were done. FABU significantly reduced the gap area in in vitro wound healing assay, 24 h after treatment. In the animal model, FABU at 0.5% topically applied once-daily for 5 days to the surgical wounds significantly reduced the lesion area. Moreover, it significantly decreased the levels of lipid peroxidation in the lesions and decreased the relative gene expression levels of IL-1ß and TNF-α in the injured region. In conclusion, our study suggests that Bauhinia ungulata can effectively promote the wound healing, probably by regulating the inflammatory environment during the early stages of the process.


Assuntos
Bauhinia/metabolismo , Extratos Vegetais/farmacologia , Cicatrização/efeitos dos fármacos , Células A549 , Acetatos/química , Acetatos/farmacologia , Resinas Acrílicas/farmacologia , Animais , Anti-Inflamatórios/metabolismo , Anti-Inflamatórios/farmacologia , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Modelos Animais de Doenças , Fabaceae/metabolismo , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Fitoterapia , Pele/metabolismo , Cicatrização/fisiologia
6.
Lasers Med Sci ; 34(8): 1527-1534, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31111263

RESUMO

The periodontal disease (PD) etiology is mainly associated with some bacterial strains, such as Porphyromonas gingivalis (P. gingivalis). Nonsurgical root scaling (e.g., antibiotics) may achieve a temporary decrease in the P. gingivalis level, yet it cannot eradicate the microorganism. Moreover, antibiotics can lead to bacterial resistance and undesirable side effects. This systematic review was performed to identify animal data defining antimicrobial photodynamic therapy (PACT) role on experimental PD models in the treatment of P. gingivalis. Embase, MEDLINE, and PubMed were examined for studies published from January 1980 to August 2018. MeSH terms and Scopus data were used to find more related keywords. Four studies were selected and reviewed by two independent researches with a structured tool for rating the research quality. The beneficial effect of PACT included reductions in P. gingivalis counts, bleeding on probing, redness, and inflammation on multiple sites (i.e., first molar, dental implants; subgingival; and mandibular premolars). Although our results suggest that PACT displays antimicrobial action on P. gingivalis, thus improving the PD, a nonuniformity in the PACT protocol and the limited number of studies included lead to consider that the bactericidal efficacy of PACT against periodontal pathogens in PD remains unclear.


Assuntos
Anti-Infecciosos/farmacologia , Periodonto/microbiologia , Fotoquimioterapia , Fármacos Fotossensibilizantes/farmacologia , Porphyromonas gingivalis/efeitos dos fármacos , Animais , Anti-Infecciosos/uso terapêutico , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/microbiologia , Humanos , Doenças Periodontais/tratamento farmacológico , Doenças Periodontais/microbiologia , Periodonto/efeitos dos fármacos , Fármacos Fotossensibilizantes/uso terapêutico
7.
Clin Oral Investig ; 23(12): 4383-4397, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30972600

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the biomechanical behavior of the interface formed between bone and implants with machined surfaces (MS) and those modified by Al2O3 sandblasting and acid etching (SBAS). MATERIALS AND METHODS: Before surgery, topographic characterization was performed by SEM-EDX and by mean roughness measurements. Ten Albinus rabbits received randomly 20 Ti-6Al-4V implants on its right and left tibiae, with one implant placed in each tibia. After implant insertion, the implant stability quotient (ISQ) was measured by means of resonance frequency analysis (RFA). After 3 and 6 weeks, the ISQ was again measured, followed by torque removal measurements. Analysis of variance and Tukey tests were used to analyze the data. The surface of the implants removed was evaluated by SEM-EDX. Immunohistochemical analysis of osteopontin (OPN) and osteocalcin (OC) protein was performed in bone tissue. RESULTS: The topographic characterization showed differences between the analyzed surfaces, and the mean roughness values of SBAS group were statistically higher than MS. Overall, higher statistically significant ISQ values were observed in the SBAS group compared to the MS group (p = 0.012). The intra-group comparison of ISQ values in the SBAS group showed statistically significant differences between 0 and 3 weeks (p = 0.032) and 0 and 6 weeks (p = 0.003). The torque removal measurements of group SBAS were statistically higher when compared with the torque removal measurements of group MS in the time intervals of 3 weeks (p = 0.002) and 6 weeks (p < 0.001). SEM-EDX of the implant surfaces removed in SBAS group showed greater bone tissue covering and mean values atomic in percentage of Ca, P, and O statistically superior (p < 0.05) than MS group. Immunohistochemical reactions showed intense OC immunolabeling at 6 weeks postoperative for SBAS group. CONCLUSIONS: The topographical modifications made in group SBAS allowed a better mechanical interlocking between the implant and bone tissue.


Assuntos
Implantes Dentários , Osseointegração , Titânio , Ligas , Animais , Planejamento de Prótese Dentária , Coelhos , Distribuição Aleatória , Propriedades de Superfície , Torque
8.
J Esthet Restor Dent ; 31(5): 403-414, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31095876

RESUMO

OBJECTIVE: Esthetic complications in implant therapy today represent a clinical challenge, when the aim is to overcome the sequelae and obtain a pleasing result. The current scientific literature about this topic is scarce and often based on case reports and the personal opinions of clinicians. CLINICAL CONSIDERATIONS: The aim of this article is to introduce a decision tree for diagnosis and treatment of complications, focusing on the pink esthetic of single-tooth implants and based on three diagnostic pillars (3D implant position, peri-implant hard-tissue anatomy, and peri-implant soft-tissue anatomy). Different shortcomings have been identified for each of the three diagnostic areas. CONCLUSIONS: Following this tree, the article proposes treatment alternatives including soft- and hard-tissue reconstruction, implant submergence, orthodontic extrusion, and implant extraction in order to help clinicians establish a logical therapeutic sequence. CLINICAL SIGNIFICANCE: Guidelines for adequate diagnosis and management of single implant-supported restorations with compromised esthetics is mandatory when attempt to overcome shortcoming in the pink esthetic result.


Assuntos
Implantes Dentários para Um Único Dente , Árvores de Decisões , Estética Dentária , Maxila , Resultado do Tratamento
9.
Gen Dent ; 67(1): 51-54, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30644832

RESUMO

The dimensional accuracy of orthodontic brackets slots is extremely important, since inaccuracy can affect orthodontic mechanics. The aim of this study was to investigate the slot heights of Roth prescription brackets from several commercial manufacturers. A total of 360 maxillary and mandibular incisor brackets from 6 different commercial models (Kirium Line, Ovation, Roth Light, Synthesis, Integra, and Miniature Twin) were selected and divided into 18 experimental groups containing maxillary central incisor, maxillary lateral incisor, or mandibular central incisor brackets (n = 20). Brackets were viewed under a scanning electron microscope to acquire a clear image of all slot edges, and slot heights were measured at 2 locations on each bracket to acquire mean values. Group means and standard deviations were calculated and compared with the manufacturer reference value of 0.5588 mm (0.0220 inch) plus or minus a tolerance level of 0.0100 mm (∼0.0004 inch). With the exception of Synthesis maxillary lateral incisor brackets (P = 0.230), all brackets had slot heights that were significantly smaller than 0.5588 mm (P < 0.05). The measured slot heights were 1.84% to 14.91% smaller than the reference value. Virtually all measured bracket slot heights were smaller than claimed by the manufacturers, with great variability within the same brand and indication, revealing a lack of precision in the fabrication process.


Assuntos
Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Humanos , Incisivo , Teste de Materiais , Fios Ortodônticos
10.
Gen Dent ; 66(6): 56-59, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30444708

RESUMO

This pediatric study aimed to assess the masticatory function of patients with anterior open bite through a method that utilizes colorimetric capsules. The sample consisted of 106 patients aged 7-11 years, of whom 51 presented with anterior open bite (experimental group) and 55 presented with normal overbite (control group). The colorimetric capsules used in this evaluation contained basic fuchsin granules, which were used to produce a solution after they were ground during chewing. Each patient was asked to chew 1 capsule for 20 seconds. The absorbance of the obtained solutions was analyzed with a spectrophotometer. Greater masticatory efficiency is directly related to the greater light absorbance of a solution, since light absorbance increases with solution concentration. A nonparametric Wilcoxon test indicated that the solutions obtained from the control group presented significantly greater light absorbance than did those from the experimental group (P < 0.05). Therefore, children with an anterior open bite exhibited less masticatory efficiency than those with a normal overbite.


Assuntos
Mordida Aberta/diagnóstico , Cápsulas , Estudos de Casos e Controles , Criança , Colorimetria/métodos , Humanos , Mastigação/fisiologia , Mordida Aberta/fisiopatologia
11.
Implant Dent ; 26(6): 875-881, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29095789

RESUMO

PURPOSE: To evaluate if an inorganic graft applied before implant insertion interferes with osseointegration. MATERIALS AND METHODS: The bilateral mandibular incisors of 12 rabbits were extracted. One of the sockets was randomly filled with an inorganic xenogenic bone graft, whereas the remaining socket was allowed to heal naturally and served as a control. After 60 days, titanium implants were inserted into healing areas. The animals were killed 60 days after. Bone depositions were marked with fluorochrome oxytetracycline, alizarin, and calcein and evaluated using confocal laser scanning microscopy. Bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were analyzed. Data were compared statically by paired t tests, one-way ANOVA, and Bonferroni post hoc tests (α = 0.05). RESULTS: No differences between the control and experimental groups in bone deposition for each marker, in either the BIC or BA analysis were observed. The bone deposition marked by alizarin (14-21 days) was the highest, followed by oxytetracycline (0 and 7 days) and calcein (45 and 52 days) in both groups (P < 0.05). CONCLUSION: The bone healing or the course of osseointegration was not impaired by the use of an inorganic xenogenic graft before insertion of a titanium implant.


Assuntos
Implantação Dentária Endóssea/métodos , Implantes Dentários , Minerais/farmacologia , Osseointegração/fisiologia , Cicatrização/fisiologia , Animais , Interface Osso-Implante/fisiologia , Mandíbula/cirurgia , Microscopia Confocal , Coelhos , Coloração e Rotulagem , Titânio , Alvéolo Dental/cirurgia , Transplante Heterólogo
12.
Clin Oral Investig ; 20(9): 2437-2445, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26895757

RESUMO

OBJECTIVE: The aim of this in vitro study was to evaluate the mechanical behavior and bacterial microleakage at the implant/abutment-tapered interface following mechanical cycling. MATERIALS AND METHODS: Two groups of screwless (Morse taper) implants (G1 and G2) and two groups of prosthetic screwed implants (G3 and G4) were tested. One group from each model (G2 and G4) were submitted to mechanical cycling, 500,000 cycles per sample, at a load of 120 N at 2 Hz prior to analysis. Microbiological analysis was performed via immersion of all samples in an Escherichia coli-containing suspension, incubated at 37 °C. After 14 days, the abutments were removed from their respective implants, registering the removal force (G1 and G2) or reverse torque (G3 and G4), and the presence of bacterial leakage was evaluated. Scanning electron microscopy (SEM) was performed to analyze the tapered surfaces of the selected samples. The Student t, binomial, and G tests were used for statistical analysis at a 5 % significance level. RESULTS: The results showed no significant difference between removal force, reverse torque, and contamination values when comparing implants of the same type. However, when the four groups were compared, contamination differed significantly (p = 0.044), with G1 having the least number of contaminated samples (8.3 %). SEM analysis showed superficial defects and damage. CONCLUSIONS: The abutment removal force or torque was not affected by mechanical cycling. Bacterial sealing of the implant/abutment tapered interface was not effective for any condition analyzed. Imprecise machining of implant parts does not allow a sufficient contact area between surfaces to provide effective sealing and prevent bacterial leakage. CLINICAL RELEVANCE: The microscopic gap caused by unsatisfactory implant/abutment adaptation, surface irregularities, and plastic deformation of all parts enabled bacterial contamination of the oral implants.


Assuntos
Dente Suporte/microbiologia , Implantes Dentários/microbiologia , Infiltração Dentária , Projeto do Implante Dentário-Pivô , Análise do Estresse Dentário , Remoção de Dispositivo , Escherichia coli , Técnicas In Vitro , Teste de Materiais , Microscopia Eletrônica de Varredura , Propriedades de Superfície , Torque
13.
J Prosthet Dent ; 115(4): 406-8, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26723097

RESUMO

This clinical report describes the deepening of a patient's anterior mandibular lingual sulcus in combination with frenectomy and the use of an acrylic resin guiding device fixed to an osseointegrated dental implant to maintain the patency of the new sulcular depth.


Assuntos
Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Freio Lingual/cirurgia , Idoso , Implantes Dentários , Humanos , Masculino , Mandíbula/cirurgia , Osseointegração
14.
J Contemp Dent Pract ; 17(1): 63-9, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27084865

RESUMO

AIM: The purpose of this study was to evaluate the dentoskeletal and soft tissue effects resulting from treatment with Klammt's elastic open activator (EOA) functional orthopedic appliance in patients with Class II malocclusion characterized by mandibular deficiency. MATERIALS AND METHODS: Teleradiographs were evaluated in the lateral aspect of the initial (T1) and final (T2) orthopedic phases for 16 patients with Class II, Division 1 malocclusion. The age range was from 9 to 11.2 years, with a mean age of 9.9 years. The cephalometric points were demarcated, and cephalometric measurements were obtained by the same investigator to avoid interobserver variability. RESULTS: The EOA promoted increased lower anterior facial height (LAFH), increased effective mandibular length, clockwise rotation of the mandible, retrusion and verticalization of the upper incisors, proclination and protrusion of the lower incisors, extrusion of the upper molars, mesial movement of the lower molars and anterior projection of the lower lip. CONCLUSION: Skeletal changes characterized by an increase in mandibular length and dentoalveolar changes with an emphasis on the verticalization and retrusion of the upper incisors, proclination of the lower incisors and mesial positioning of the lower molars were key to improving the occlusal relationship and esthetic facial factors. CLINICAL SIGNIFICANCE: The EOA is well indicated in patients with Class II malocclusion due to mandibular deficiency with increased overbite, proclined upper incisors and verticalized lower incisors.


Assuntos
Aparelhos Ativadores , Má Oclusão Classe II de Angle/terapia , Cefalometria , Criança , Feminino , Humanos , Masculino , Má Oclusão , Mandíbula
15.
J Clin Pediatr Dent ; 40(3): 175-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27472562

RESUMO

OBJECTIVE: This study presents 38 cases of primary molars with necrotic pulps treated with antibiotics-based paste. CASE REPORT: The technique consisted of necrotic tissue removal of the pulp chamber, using spoons excavators and low speed drills. Pulp cavity was washed with saline solution and dried with sterile cotton balls. Then an antibiotic paste composed of chloramphenicol, tetracycline, zinc oxide and eugenol - CTZ paste - was inserted at the entrance of root canals. Patients were evaluated clinically and radiographically at different times. The criteria that defined clinical success were the lack of periapical abscess and mobility compatible with chronological age. Radiographic assessments consisted in absence of radiolucency in the region of root bifurcation and pathological bone resorption. CONCLUSION: There were 100% and 93% of clinical and radiographic success, respectively. The results suggest that the CTZ paste is an optional therapy for pulp of primary molars.


Assuntos
Antibacterianos/uso terapêutico , Dente Molar/patologia , Tratamento do Canal Radicular/métodos , Dente Decíduo/patologia , Perda do Osso Alveolar/prevenção & controle , Criança , Pré-Escolar , Cloranfenicol/administração & dosagem , Necrose da Polpa Dentária/terapia , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Dente Molar/diagnóstico por imagem , Abscesso Periapical/prevenção & controle , Pulpectomia/instrumentação , Pulpectomia/métodos , Radiografia Dentária , Irrigantes do Canal Radicular/uso terapêutico , Cloreto de Sódio/uso terapêutico , Tetraciclina/administração & dosagem , Dente Decíduo/diagnóstico por imagem , Resultado do Tratamento , Cimento de Óxido de Zinco e Eugenol/administração & dosagem
16.
J Oral Maxillofac Surg ; 73(7): 1288-95, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25871903

RESUMO

PURPOSE: Bisphosphonates are drugs commonly used to treat osteoporosis, hypercalcemia of malignancy, and bone metastases. In some cases, its administration has been associated with osteonecrosis of the jaws. The management of medication-related osteonecrosis of the jaw (MRONJ) has not been completely elucidated, and its treatment can vary from no or limited surgery to more extensive surgery. The objective of the present study was to evaluate the efficacy of surgical therapy for patients presenting with MRONJ. PATIENTS AND METHODS: A retrospective study was conducted that evaluated all MRONJ cases resulting from bisphosphonate use and treated by surgery from 2006 to 2012. All patients underwent surgery under general anesthesia. RESULTS: A total of 33 patients with 46 MRONJ sites were evaluated. Most of the patients were women, with an age range of 39 to 83 years (mean 65.6 ± 10.6). Complete healing of the MRONJ region was observed in 40 of the 46 sites (87%), with partial improvement (symptom control and reduction of the exposed bone area) observed in 3 sites (6.5%), for a 93.5% clinical benefit rate. Of the remaining regions, 2 showed no significant changes, and 1 presented with a worse aspect compared with the patient's preoperative condition. Such cases were located in the posterior mandible region. The number of applications and type of bisphosphonate did not influence the treatment response. CONCLUSION: The surgical approach to treating MRONJ showed a high rate of clinical control. Therefore, surgery should be considered as a therapy for some cases of this condition.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Administração Intravenosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Conservadores da Densidade Óssea/administração & dosagem , Estudos de Coortes , Difosfonatos/administração & dosagem , Feminino , Seguimentos , Humanos , Imidazóis/administração & dosagem , Masculino , Doenças Mandibulares/cirurgia , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Osteotomia/métodos , Estudos Retrospectivos , Retalhos Cirúrgicos/cirurgia , Deiscência da Ferida Operatória/etiologia , Resultado do Tratamento , Cicatrização/fisiologia , Ácido Zoledrônico
17.
Support Care Cancer ; 22(10): 2645-50, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24752564

RESUMO

BACKGROUND: Most of the oral problems affecting patients in the ICU (intensive care unit) are conditions resulting from their general health status/immunosuppression, medications, and trauma due to tracheal intubation. Furthermore, microorganisms present in the oral cavity and oropharynx may be transported into the lungs resulting in pneumonia. PURPOSE: The objectives of this study were to evaluate the oral problems in patients in the ICU of a cancer center and describe the procedures performed by the dentists in such patients. METHODS: The sample consisted of 116 patients and 329 procedures performed in the period between May 2007 and July 2011 at A.C. Camargo Cancer Center. RESULTS: Oral mucositis was the main problem (20.3 %), especially in immunosuppressed patients (p < 0.001). Other most prevalent problems were candidiasis (16.6 %), bacterial biofilm (14.9 %), and xerostomia (7.18 %). The main procedures performed were clinical evaluation and medication prescription corresponding to 35.10 and 27.81 %, respectively. CONCLUSIONS: In conclusion, most of the patients presented oral problems related to side effects of oncological treatment. The dentist's participation in the ICU is important for the prevention, diagnosis, and treatment of oral problems.


Assuntos
Terapia de Imunossupressão/efeitos adversos , Doenças da Boca , Neoplasias/terapia , Doenças Dentárias , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/epidemiologia , Doenças da Boca/terapia , Neoplasias/epidemiologia , Doenças Dentárias/diagnóstico , Doenças Dentárias/epidemiologia , Doenças Dentárias/terapia
18.
J Craniofac Surg ; 24(4): 1373-5, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23851811

RESUMO

Dentists are often faced with extensively resorbed mandibular ridges with shallow buccal vestibule and high insertion of the mentalis muscle in relation to the crest of the ridge, causing the displacement of the prosthesis. Vestibuloplasty techniques aim at eliminating the muscle insertions, reposition the mucosa, and increase the area chapeável, giving more stability to the prosthesis. Among the techniques to deepen the vestibule are submucosal vestibuloplasties by secondary epithelialization and with mucosal and skin grafts. We will discuss vestibuloplasty by secondary epithelialization with emphasis on the so-called modified Kazanjian technique. This technique provides an appropriate result and does not require hospitalization, additional surgery at the donor, or prolonged periods without the use of prosthesis.


Assuntos
Implantes Dentários , Mandíbula/cirurgia , Vestibuloplastia/métodos , Idoso , Perda do Osso Alveolar/cirurgia , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Prótese Total Inferior , Revestimento de Dentadura , Feminino , Humanos , Doenças Mandibulares/cirurgia , Mucosa Bucal/cirurgia , Satisfação do Paciente , Reepitelização
19.
J Oral Implantol ; 39(4): 425-31, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21463183

RESUMO

The aim of this study was to evaluate the stress distribution in implants of regular platforms and of wide diameter with different sizes of hexagon by the 3-dimensional finite element method. We used simulated 3-dimensional models with the aid of Solidworks 2006 and Rhinoceros 4.0 software for the design of the implant and abutment and the InVesalius software for the design of the bone. Each model represented a block of bone from the mandibular molar region with an implant 10 mm in length and different diameters. Model A was an implant 3.75 mm/regular hexagon, model B was an implant 5.00 mm/regular hexagon, and model C was an implant 5.00 mm/expanded hexagon. A load of 200 N was applied in the axial, lateral, and oblique directions. At implant, applying the load (axial, lateral, and oblique), the 3 models presented stress concentration at the threads in the cervical and middle regions, and the stress was higher for model A. At the abutment, models A and B showed a similar stress distribution, concentrated at the cervical and middle third; model C showed the highest stresses. On the cortical bone, the stress was concentrated at the cervical region for the 3 models and was higher for model A. In the trabecular bone, the stresses were less intense and concentrated around the implant body, and were more intense for model A. Among the models of wide diameter (models B and C), model B (implant 5.00 mm/regular hexagon) was more favorable with regard to distribution of stresses. Model A (implant 3.75 mm/regular hexagon) showed the largest areas and the most intense stress, and model B (implant 5.00 mm/regular hexagon) showed a more favorable stress distribution. The highest stresses were observed in the application of lateral load.


Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Análise do Estresse Dentário , Força Compressiva , Análise do Estresse Dentário/métodos , Módulo de Elasticidade , Análise de Elementos Finitos , Humanos , Modelos Dentários , Resistência à Tração
20.
J Biomed Mater Res B Appl Biomater ; 111(5): 1024-1034, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36517955

RESUMO

To evaluate the osteoconductive potential of inorganic biomaterials of bovine origin submitted to different temperatures in the bone repair of critical defects in rat calvaria. Forty-eight rats were divided into four groups according to the material used to fill the defect: control group (GC), the defect was filled only with blood clot (n = 12); GBO, defect filled with Bio-Oss®, deproteinzed at 300°C (n = 12); GOX, defect filled with Inorganic GenOx®, deproteinzed from 850 to 1200°C (n = 12) and G700, defect filled with Inorganic GenOx 700, deproteinzed at 700°C (n = 12). In each animal's calvaria, a trephine bur with 5 mm internal diameter was used to produce a 6 mm-diameter central defect. Gen Derm® resorbable bovine membrane was superimposed over all defects. Subsequently, animals were euthanized at 30 and 60 days after surgery. The pieces were sent for histological and histometric analysis to evaluate the following variables: bone neoformation, presence of biomaterial, mononuclear and polymorphonuclear leukocytes, presence of other tissues (granulation and medullary) and maturation of collagen fibers. The most representative group for bone neoformation was GC. At 30 days, there was a higher mean of mature bone tissue (75.8). At 60 days, there was no statistical difference between the GC (64.9), GBO (32.9), GOX (45.3), and G700 (26.6) groups. GBO presented the highest amount of biomaterial after 30 days (115.9) and 60 days (118.5). All bovine biomaterials were biocompatible and osteoconductive. GOX promoted the best bone repair of the studied materials.


Assuntos
Materiais Biocompatíveis , Crânio , Ratos , Animais , Bovinos , Ratos Wistar , Temperatura , Materiais Biocompatíveis/farmacologia , Crânio/cirurgia , Crânio/patologia , Regeneração Óssea
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