Prosthetic rehabilitation after hemimaxillectomy: a case report.

Maxillofacial defects created by the surgical resection of a tumor negatively impact the mastication, phonation, swallowing, and psychological function of patients. A 68-year-old woman received a diagnosis of oral squamous cell carcinoma involving the hard palate. The hemimaxillectomy procedure for tumor resection created a defect on the left side of the palate. This case report describes the patient's cancer treatment from presurgical planning to final rehabilitation with a conventional obturator and subsequent follow-up care for 1 year. The rehabilitation strategy was satisfactory for the patient, reestablishing lost function and esthetics.

Miconazole Nitrate-loaded Microparticles For Buccal Use: Immediate Drug Release and Antifungal Effect.

BACKGROUND: Miconazole nitrate has been widely employed in treatment of oral mycoses, however your immediate bio-availability and location in the affected area is critical. OBJECTIVE: The aim of this study was to prepare and evaluate Eudragit® L100 and Gantrez MS-955 microparticles containing miconazole nitrate for oral delivery. METHODS: Microparticles were prepared by spray-drying method to achieve high encapsulation efficiency and increase the drug solubility. The microparticles were formed containing 10% and 20% of drug on polymer Eudragit® L100 (E10 and E20), Gantrez MS-955 (G10 and G20) or their combination (EG10 and EG20). The influence of formulation factors (polymer:drug ratio, type of polymer) on yield percent, encapsulation efficiency, particle size, Fourier-transformed infrared spectroscopy (FTIR), X-ray diffraction, differential scanning calorimetry, in vitro drug release and antifungal activity were investigated. RESULTS: Acceptable yield, micrometer-sized and drug-loading efficiencies higher than 89% were obtained. No change in FTIR assignments was recorded after the microencapsulation procedure. X-ray and differential scanning calorimetry studies revealed amorphous/non-crystalline formulations. Miconazole nitrate-microparticles provided a remarkable increase of dissolution rate of the drug. Miconazole nitrate and G10, G20 and EG20 microparticles fitted to biexponential kinetic model, and E10, E20 and EG10 microparticles, monoexponential kinetic model. The antifungal activity test demonstrated that miconazole nitrate-microparticles possessed the same anti-Candida albicans activity as the pure drug. CONCLUSION: These results indicate that miconazole nitrate-microparticles are feasible carriers for increased release of miconazole at oral environment.

New denture adhesive containing miconazole nitrate polymeric microparticles: Antifungal, adhesive force and toxicity properties.

OBJECTIVE: The purpose of this study was to develop a new oral drug delivery system by incorporating polymeric miconazole nitrate (MN) microparticles on an experimental antifungal denture adhesive (DA). METHODS: Spray drying Eudragit L-100 (E) and Gantrez MS-955 (G) MN-microparticles were incorporated in DA. DAE1, DAG1, DAEG1, DAE2, DAG2, DAEG2 groups were obtained from the combination of polymers used in MN-microparticles (E, G and EG) and concentration of MN into DA (1, for 1% and 2, for 2%). DA with 2% pure MN (DAM) and DA without microparticles or drug (DACT) were both control groups. All groups were evaluated to determine microbiological assay, adhesive force and toxicity. Minimum inhibitory concentration (MIC) against Candida albicans was performed by broth micro-dilution and agar dilution methods in extract of DAs and conventional gel form (Daktarin®). Adhesive load testing was made between acrylic resin samples on a universal testing machine after immersion in water. The toxicity of several dilutions of DAs was performed with Artemia salina bioassay after 24 and 48h. Data of adhesive force were evaluated with two-way ANOVA and Bonferroni tests (α=0.05). RESULTS: The concentration required to kill 50% (LC50) was determined using the Provit analysis. DA with polymeric microparticles and pure drug presented MIC between 1.25-5µg/mL similar to MIC values of DAM. DAEG2, DAEG1, DAG20 showed the most actives against C. albicans. The best adhesive properties were exhibited by DAEG2, consisting of high initial adhesive force which was maintained for up to 6h. The extracts of all DA presented low or not toxicity at 24 and 48h. SIGNIFICANCE: DA containing 2% of MN loaded in microparticles made by Gantrez MS-955 alone or combined with Eudragit L-100 produce effective antifungal activity, good adhesive force, and no toxicity effect being a promising therapeutics for removable denture wearers affected by denture stomatitis.

In-office bleaching effects on the pulp flow and tooth sensitivity - case series.

Laser Doppler flowmetry (LDF) is a noninvasive method capable of evaluating variations in pulp blood flow (PBF) and pulp vitality. This method has thus far not been used to assess changes in blood flow after in-office bleaching. The aim of this case series report was to measure changes in PBF by LDF in the upper central incisor of three patients submitted to in-office bleaching. The buccal surfaces of the upper arch were bleached with a single session of 35% hydrogen peroxide gel with three 15-min applications. The color was recorded using a value-oriented Vita shade guide before in-office bleaching and one week after the procedure. The tooth sensitivity (TS) in a verbal scale was reported, and PBF was assessed by LDF before, immediately, and one week after the bleaching session. The lower arch was submitted to dental bleaching but not used for data assessment. A whitening degree of 3 to 4 shade guide units was detected. All participants experienced moderate to considerable TS after the procedure. The PBF readings reduced 20% to 40% immediately after bleaching. One week post-bleaching, TS and PBF were shown to be equal to baseline values. A reversible decrease of PBF was detected immediately after bleaching, which recovered to the baseline values or showed a slight increase sooner than one week post-bleaching. The LDF method allows detection of pulp blood changes in teeth submitted to in-office bleaching, but further studies are still required.

In-office bleaching effects on the pulp flow and tooth sensitivity – case series

Laser Doppler flowmetry (LDF) is a noninvasive method capable of evaluating variations in pulp blood flow (PBF) and pulp vitality. This method has thus far not been used to assess changes in blood flow after in-office bleaching. The aim of this case series report was to measure changes in PBF by LDF in the upper central incisor of three patients submitted to in-office bleaching. The buccal surfaces of the upper arch were bleached with a single session of 35% hydrogen peroxide gel with three 15-min applications. The color was recorded using a value-oriented Vita shade guide before in-office bleaching and one week after the procedure. The tooth sensitivity (TS) in a verbal scale was reported, and PBF was assessed by LDF before, immediately, and one week after the bleaching session. The lower arch was submitted to dental bleaching but not used for data assessment. A whitening degree of 3 to 4 shade guide units was detected. All participants experienced moderate to considerable TS after the procedure. The PBF readings reduced 20% to 40% immediately after bleaching. One week post-bleaching, TS and PBF were shown to be equal to baseline values. A reversible decrease of PBF was detected immediately after bleaching, which recovered to the baseline values or showed a slight increase sooner than one week post-bleaching. The LDF method allows detection of pulp blood changes in teeth submitted to in-office bleaching, but further studies are still required.

Montagem de modelos de próteses removíveis em articulador semiajustável / Mounting casts from removable prostheses in semi adjustable articulator

Introdução: O relacionamento dos modelos de diagnóstico ou de trabalho em articulador semiajustável é um dos procedimentos mais importantes no tratamento reabilitador com próteses removíveis parciais ou totais. Objetivo:  Este trabalho descreve as diversas etapas da montagem em articulador semiajustável em situações de dois pacientes com arcos parcial ou totalmente edêntulos. Material e método: Foram discutidos os materiais e as técnicas que são indicados para registro das relações intermaxilares, inclusive em situações diferentes dos casos apresentados. Conclusão: A montagem de modelos de pacientes parcialmente edêntulos em articulador é de grande importância e apresenta uma ampla variação de indicação de acordo com diferentes situações.

Introduction: Articulating preliminary or working casts in semiadjustable articulators is one of the most important procedures in the prosthetic rehabilitation of partially and fully edentulous patients. Objective: This work described the several steps involving mounting casts in semiadjustable articulator in cases of two patients presenting partial and fully edentulous arcs. Material and method: It was discussed the recommended material and techniques for recording the maxilomandibular positions, including a range of situations different from the presented cases. Conclusion: The fitting of models of the edentulous patients in articulator is of great importance and presents a wide range of indication according to different situations.