Influence of Chitosan 0.2% in Various Final Cleaning Methods on the Bond Strength of Fiberglass Post to Intrarradicular Dentin.

The purpose of this study was to analyze the influence of Chitosan 0.2% in various final cleaning methods on the bond strength of fiberglass post (FP) to intrarradicular dentin. Ninety bovine incisors were sectioned to obtain root remnants measuring 18 mm in length. The roots were divided: G1: EDTA 17%; G2: EDTA 17% + PUI; G3: EDTA 17% + EA; G4: EDTA 17% + XPF; G5: Chitosan 2%; G6: Chitosan 2% + PUI; G7: Chitosan 2% + EA; G8: Chitosan 2% +XPF. After carrying out the cleaning methods, the posts were installed, and the root was cleaved to generate two disks from each root third. Bond strength values (MPa) obtained from the micro push-out test data were assessed by using Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests for multiple comparisons (α = 5%). Differences were observed in the cervical third between G1 and G8 (p = 0.038), G4 and G8 (p = 0.003), G6 and G8 (p = 0.049), and Control and G8 (p = 0.019). The final cleaning method influenced the adhesion strength of cemented FP to intrarradicular dentin. Chitosan 0.2% + XPF positively influenced adhesion strength, with the highest values in the cervical third.

9-year follow-up of uncommon cleft palate in Aarskog-Scott syndrome.

Aarskog-Scott syndrome (AAS) is characterized by different facial, skeletal and genital anomalies and may have oral manifestations. A 7-year-old boy was referred to the University General Hospital for treatment of speech difficulties and frequent regurgitation. Characteristics such as a triangle-shaped face, hypertelorism, low-set ears, flattened nose, shawl scrotum and partial syndactylia on hands and feet were observed. Based on these clinical features, the child was diagnosed with AAS. Upon intraoral examination, maxillary atresia and an incomplete cleft palate were observed. The mixed dentition was characterized by extensive coronary destruction of primary teeth and caries lesions on permanent teeth. Here, the case of a 9-year follow-up of this child with uncommon AAS associated with cleft palate is reported. The child was referred to a multidisciplinary team for planning and carrying out the treatment. In the follow-up visit after 9 years from the beginning of the treatment, the child showed greater sociability, with significant improvement in spontaneous speech and pronunciation of phonemes. However, the patient continues until now with articulation and spontaneous speech training. The correction of class II malocclusion, better dental alignment and canine extrusion were achieved. At the moment, the patient uses a nighttime extraoral device, and the treatment continues for dental alignment and prevention of tooth decay. The presence of cleft palate could be coincidental with AAS and may aggravate the prognosis, requiring careful patient monitoring by a multiprofessional team. Key words:Aarskog-Scott syndrome, cleft lip, cleft palate, multidisciplinary treatment.

The Relation between Maxillary Sinuses and Cleft Lip and Palate / A Relação Entre os Seios Maxilares e a Fissura Labiopalatina

Cleft lip and palate are anomalies of craniofacial development that require reparative surgery to provide considerable improvement in the individual's quality of life, but which can also have a negative impact on the maxilla development. The aim of this study was to understand the influence of surgical repair of cleft lip and palate on the volume of the maxillary sinus of these individuals. A narrative review was carried out using the scientific databases Pubmed and Scielo, where the articles selected by the abstract were fully read, categorized and critically analyzed. There are reports of high frequency of chronic sinusitis in patients with cleft lip and palate, especially children, that may be related to hypoplasia of the maxilla and lower volume of the maxillary sinus related to the cleft. In addition, these individuals are submitted to several surgical corrections that can also negatively influence the maxilla development due to tissue fibrosis, with suggestions for surgical techniques to reduce this interference. Thus, the patient with cleft lip and palate may present maxillary underdevelopment, which may result in hypoplasia of the maxillary sinus, and reparative surgeries can aggravate this complication. This review suggests some surgical techniques to reduce this interference, although there are few articles with clinical trials found in the literature that can explore these alternatives and correlate the results with current surgical protocols. (AU)

As fissuras labiopalatinas são anomalias de desenvolvimento craniofacial que necessitam de cirurgias reparadoras para proporcionar melhora considerável à qualidade de vida do indivíduo, mas que também podem repercutir negativamente no desenvolvimento da maxila. O objetivo deste estudo foi compreender a influência das cirurgias reparadoras de fissuras labiopalatais no volume do seio maxilar desses indivíduos. Foi realizada uma revisão narrativa pelas bases de dados científicos Pubmed e Scielo, de onde os artigos selecionados pelo abstract foram lidos na íntegra, categorizados e analisados criticamente. Há relatos de alta frequência de sinusite crônica em pacientes com fissuras labiopalatais, principalmente crianças, que podem estar relacionada a hipoplasia de maxila e menor volume do seio maxilar relacionado à fissura. Além disso, esses indivíduos são submetidos a diversas correções cirúrgicas que também podem influenciar negativamente o desenvolvimento da maxila devido a fibrose tecidual, havendo sugestões de técnicas cirúrgicas para diminuir essa interferência. Então, o paciente com fissuras labiopalatais pode apresentar hipodesenvolvimento maxilar podendo ter como consequência a hipoplasia do seio maxilar e as cirurgias reparadoras podem agravar essa complicação. Essa revisão sugere algumas técnicas cirúrgicas para diminuir essa interferência, embora existam poucos artigos com ensaios clínicos encontrados na literatura que possam explorar essas alternativas e correlacionar os resultados com os protocolos cirúrgicos atuais. (AU)

Antimicrobial potential of plant extracts from the Brazilian Cerrado.

Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 µg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 µg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 µg/mL, Senna martiniana (73.28%) in the concentration of 40 µg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 µg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.

The Impact of Leprosy on the Quality of Life of Patients Undergoing Treatment / O Impacto da Hanseníase na Qualidade de Vida dos Pacientes em Fase de Tratamento

The individuals with Hansen's disease experience situations of prejudice that, together with stigma and discrimination, culminate in social isolation and restrictions in social relationships. The aim of this study was to assess the perception of leprosy patients about their quality of life. This is a cross-sectional, quantitative study, whose convenience sample consisted of 94 leprosy patients, undergoing treatment, who attended health units in the city of Cuiabá, MT, Brazil. A structured questionnaire with sociodemographic data and information about the patient's knowledge about leprosy, prejudice, self-esteem and quality of life, was applied between April and August 2018.The results showed in the investigated population a predominance of males (55.3%), individuals with high school education (28.7%) and with an income ranging from 1 to 3 minimum wages (67%).The interviewees pointed out the side effects (44.7%) and the duration period (28.7%) as the greatest difficulty in the treatment. Most of the investigated (72.3%) had great knowledge about the disease, among which 26.6% had already suffered the leprosy reaction.40.4% of individuals were depressed and sad, and 69.1% had problems in employment after the diagnosis of the disease. When the quality of life was investigated, 45.7% of leprosy patients classified the domains evaluated between bad and very bad. Physical pain was associated with 43.7% of the individuals being unable to perform daily tasks. It can be concluded that leprosy causes suffering beyond pain and discomfort, with great social and psychological impact. (AU)

Os pacientes com hanseníase vivenciam situações de preconceito que, com o estigma e a discriminação, culminam para o isolamento social e a restrição dos relacionamentos sociais. O objetivo do presente estudo foi avaliar a percepção do paciente com hanseníase sobre sua qualidade de vida. Trata-se de um estudo transversal, quantitativo, cuja amostra de conveniência foi composta por 94 pacientes hansenianos, em fase de tratamento, que frequentavam as Unidades de Saúde do município de Cuiabá/MT, Brasil. Um questionário estruturado com dados sociodemográficos e informações sobre o conhecimento do paciente sobre a hanseníase, preconceito, autoestima e qualidade de vida, foi aplicado entre abril e agosto de 2018. Os resultados mostraram, na população investigada, um predomínio de indivíduos do sexo masculino (55,3%), com ensino médio completo (28,7%) e com renda entre 1 e 3 salários mínimos (67%). Os entrevistados apontaram como maior dificuldade do tratamento os efeitos colaterais (44,7%) e o período de duração (28,7%). A maioria dos investigados (72,3%) apresentava grande conhecimento sobre a doença, dentre os quais 26,6% já haviam sofrido a reação hansênica. 40,4% dos indivíduos encontravam-se deprimidos e tristes e 69,1%, tiveram problemas no emprego após o diagnóstico da doença. Quando a qualidade de vida foi investigada, 45,7% dos hansenianos classificaram os domínios avaliados entre ruim e muito ruim. A dor física foi associada ao impedimento do desempenho das tarefas diárias por 43,7% dos indivíduos. Pode-se concluir que a hanseníase causa sofrimento aos indivíduos que ultrapassa a dor e o mal-estar estritamente vinculados ao prejuízo físico, com grande impacto social e psicológico. (AU)

Antimicrobial potential of plant extracts from the Brazilian Cerrado

Abstract Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 μg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 μg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 μg/mL, Senna martiniana (73.28%) in the concentration of 40 μg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 μg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.

Resumo Bactérias estão relacionadas a diferentes doenças bucais, como a cárie dentária e a doença periodontal. Assim, o controle e/ou erradicação de microrganismos e seus subprodutos é primordial para o sucesso dos tratamentos. Uma alternativa para diminuir a carga bacteriana é a utilização de extratos vegetais utilizados na medicina popular. A citotoxicidade e ação antimicrobiana de extratos de Cariniana rubra Gardinerex Miers, Senna martiniana H.S. Irwin & Barneby, Anadenanthera colubrina (Vell.) Brenan e Spiranthera odoratissima St. Hil. contra cepas de Streptococcus mutans, Enterococcusfaecalis, Staphylococcus aureus, Escherichia coli, Agartibacter actinomycetencomitans e Candida albicans foram investigados. A citotoxicidade foi avaliada nas concentrações de 1, 10, 40, 80, 100 e 1000 μg/mL por meio do teste MTT. Aqueles com citotoxicidade aceitável tiveram a ação antimicrobiana medida pelo teste XTT. Cariniana rubra Gardinerex Miers apresentou os maiores resultados de citototoxicidade, enquanto Spiranthera odoratissima St. Hil. obteve os melhores resultados, mas todos os extratos apresentaram citotoxicidade aceitável em diferentes concentrações. Os extratos vegetais apresentaram maior atividade contra A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80,52%) a 40 μg/mL, Spiranthera odoratissima St. Hil (78,48%) em 1 μg/mL, Senna martiniana H.S. Irwin & Barneby (73,28%) na concentração de 40 μg/mL e Cariniana rubra Gardinerex Miers (70,50%) em 10 μg/mL. Todos os extratos analisados apresentaram citotoxicidade aceitável em diferentes concentrações e foram promissores na inibição dos microrganismos patogênicos estudados.

Clinical Management of Trauma to Primary Teeth and Delay in Eruption of Permanent Successor Tooth / Conduta Clínica de Trauma em Dente Decíduo e Atraso na Irrupção do Dente Permanente Sucessor

Abstract Dental trauma is considered a complication in oral health, which has attracted the attention of researchers, as its prevalence has increased in recent years. Dental trauma in primary dentition can lead to early tooth loss and impairment of permanent successor teeth, depending on the stage of development of the tooth germ. The aim of the present study was to describe a clinical case of a 4-year-old child who was referred to a pediatric dentist after dental trauma and early loss of deciduous teeth. During the anamnesis, it was observed that the upper deciduous teeth (#51 and #61) were affected by successive traumas, resulting in the early loss of the affected teeth. Nance arch device with a tube-bar system was selected to restore function and aesthetics to the child, while the eruption of the successor permanent teeth was monitored. During the follow-up period, a delay in the eruption of #21 tooth was observed, and ulectomy of the region was indicated to allow the tooth eruption and the proper alignment of the central incisors, which occurred after 5 months of the surgical procedure. Through this report it was possible to conclude that the early diagnosis and the long-term periodic control of traumatic dental lesions in the primary dentition are of fundamental importance to prevent and minimize the damages that can occur to the permanent dentition. (AU)

Resumo O traumatismo dentário é considerado uma complicação à saúde bucal que vem chamando a atenção de pesquisadores, pois sua prevalência tem aumentado nos últimos anos. O trauma dentário na dentição decídua pode ocasionar a perda precoce dos dentes, e comprometimento dos dentes sucessores permanentes, dependendo do estágio de desenvolvimento do germe dentário. O objetivo do presente estudo foi descrever um caso clínico de uma criança de 4 anos de idade que foi encaminhada ao odontopediatra após traumatismo dentário e perda precoce de dente decíduo. Durante a anamnese, foi observado que os dentes decíduos incisivos superiores (#51 e #61) foram afetados por sucessivos traumas, resultando na perda precoce dos dentes afetados. O dispositivo arco de Nance com sistema do tipo tubo-barra foi selecionado para devolver função e estética à criança, enquanto a irrupção dos dentes permanentes sucessores foi acompanhada. Durante consulta de controle, um atraso na erupção do dente #21 foi observado e a ulectomia da região foi indicada para permitir a irrupção do dente e o alinhamento adequado dos incisivos centrais, que ocorreu após 5 meses do procedimento cirúrgico. Por meio do presente relato foi possível concluir que o diagnóstico precoce e o controle periódico a longo prazo das lesões dentárias traumáticas na dentição decídua são de fundamental importância para prevenir e minimizar os prejuízos que podem ocorrer à dentição permanente. (AU)

Relationship between Oral Parafunctions and Signs and Symptoms of Craniomandibular Dysfunction in Children with Cleft Lip and Palate / Relação Entre Parafunções Orais e Sinais e Sintomas de Disfunção Craniomandibular em Crianças com Fissura Labiopalatina

The aim of this study was to evaluate the association of oral parafunctions with the presence of signs and symptoms of craniomandibular disorder in children with cleft lip and palate (CLP). A cross-sectional study was performed in which one hundred and eighty-eight children with CLP and absence of associated syndromes or malformations were investigated. During clinical examination, the presence of wear facets and dental occlusion were observed and palpation was performed in the temporomandibular joint region (TMJ) and orofacial musculature . The children and their guardians were interviewed regarding the presence of oral parafunctional habits (bruxism, the act of biting the lips and/or cheeks, nail biting, sucking of fingers and pacifiers) and signs and symptoms of craniomandibular dysfunction (headache, ear and/or neckache, tiredness or crack in the TMJ during mouth opening and chewing movements). The data were analyzed by means of absolute and relative frequency measurements, and bivariate analysis using Pearson's chi-square test and likelihood ratio test were performed, considering the significance level of 5%. A higher prevalence of cleft lip and palate type (76.0%) and the presence of malocclusion (61.7%) was observed, highlighting the anterior crossbite (58.7%) and midline deviation (48.9%). There was a higher occurrence of teeth grinding (40.4%), onychophagy (28.7%) and biting lips and/or cheeks (28.7%). Onychophagia was associated with headache (p <0.05) and with pain or cracking during mouth opening (p <0.05). It was concluded that parafunctional oral habits may be associated with signs and symptoms of craniomandibular disorder in children with cleft lip and palate.

O objetivo do estudo foi avaliar a associação de parafunções orais com sinais e sintomas da disfunção craniomandibular em crianças com fissuras labiopalatinas (FLP). Um estudo transversal foi realizado, no qual cento e oitenta e oito crianças com FLP e ausência de síndromes ou malformações associadas, foram investigadas. Durante exame clínico, a presença de facetas de desgaste e a oclusão dentária foram observadas e foi realizada a palpação na região da articulação temporomandibular (ATM) e musculatura orofacial. As crianças e seus responsáveis foram entrevistados com relação à presença de hábitos orais parafuncionais (bruxismo, ato de morder os lábios e/ou bochechas, onicofagia, sucção de dedos e de chupeta) e sinais e sintomas de disfunção craniomandibular (cefaléia, ouvido, dor, cansaço ou estalo na ATM durante movimentos de abertura bucal e de mastigação). Os dados foram analisados por meio de medidas de frequência absoluta e relativa e a análise bivariada foi realizada por meio dos testes do Qui-quadrado de Pearson (χ2) e a Razão de verossimilhança, considerando o nível de significância de 5%. Uma maior prevalência das fissuras envolvendo lábio e palato (76,0%) e presença de maloclusão (61,7%) foi observada, com destaque para mordida cruzada anterior (58,7%) e desvio de linha média (48,9%). Houve uma maior ocorrência do ato de ranger os dentes (40,4%), da onicofagia (28,7%) e do hábito de morder lábios e/ou bochechas (28,7%). A onicofagia foi associada à cefaléia (p<0,05) e à dor ou estalo durante abertura bucal (p<0,05). Conclui-se que hábitos orais parafuncionais podem estar associados a presença de sinais e sintomas da disfunção craniomandibular em crianças com FLP.

Periodontal Findings in Children and Adolescents with Cleft Lip and/or Palate: A Case-Control Study.

Purpose: The purpose of this study was to evaluate periodontal disease and oral biofilm in children and adolescents with cleft lip and/or palate (CLP). Methods: A total of 118 individuals aged six to 18 years, with CLP (n equals 60) and without CLP (n equals 58), were evaluated according to plaque index (PI), gingival bleeding index (BI), clinical attachment level (CAL), and probing pocket depth (PPD). Gingivitis and periodontitis were also diagnosed. Samples of subgingival oral biofilm were collected, and genomic DNA was extracted for oral microbial analysis. Aggregatibacter actinomycetemcomitans, Tannerela forsythia, Porphyromonas gingivalis, and Streptococcus oralis were identified and quantified by qPCR using Taqman primers and probes. Results: PI, BI, CAL, and PPD were statistically higher in the CLP group. Gingivitis was observed in 52 percent and 29 percent (P<0.001) and mild periodontitis was observed in 48 percent and 22 percent (P<0.001) of the CLP and control groups, respectively. When the permanent dentition group was evaluated, a greater occurrence of mild periodontitis was observed in the CLP group (P<0.001). The level of A. actinomycetemcomitans (P<0.001), P. gingivalis (P<0.001), and T. forsythia (P<0.001) was statistically higher in the subgingival biofilm of the CLP group. Conclusions: The presence of cleft lip and/or palate negatively affects oral hygiene and levels of periodontopathogens in oral biofilm. In addition, clinical and microbiological results highlight the importance of early assessment of young people with cleft lip and/or palate and the permanent dentition to prevent periodontal disease.

Physicomechanical Properties of Tertiary Monoblock in Endodontics: A Systematic Review and Meta-analysis.

Introduction: A systematic review and meta-analysis were conducted to evaluate the physicomechanical properties of tertiary monoblock obturation with different obturation techniques. Methods and Materials: PubMed (MEDLINE), Web of Science, Scopus, the Cochrane Library, LILACS, IBECS, and BBO were searched time. PICO question was: "In extracted human teeth (Population), does tertiary monoblock obturation (Intervention) have superior physicomechanical properties (Outcome) compared to conventional obturation systems (Comparison)?". Statistical analyses for push-out bond strength were performed with RevMan software by comparing the mean differences of each study, with a 95% confidence interval. Inverse variance was used as statistical method, random-effects models as analysis model, and heterogeneity between studies was assessed by Cochran's Q test and I2 statistic (P <0.05). Results: Of 2162 studies retrieved, 31 were included in this review for "Study Characteristics". Ten studies were included in the meta-analysis. Analysis demonstrated that conventional obturation had significantly higher push-out bond strength than tertiary monoblock obturation (P <0 .01), with a mean difference of -1.00 (95% CI, -1.41 to -0.58; I2=100%). Subgroups using single-cone and cold lateral condensation techniques showed significantly lower push-out bond strength for tertiary monoblock obturation (P <0.01), respectively with a mean difference of -0.09 (95% CI, -1.13 to -0.67; I2=97%) and of -1.97 (95% CI, -3.19 to -0.75; I2=100%). The warm vertical compaction subgroup showed no statistically significant difference between tertiary monoblock and conventional systems (P =0.13), with a mean difference of 0.49 (95% CI, -0.14 to 1.12; I2=10%). Conclusion: Tertiary monoblock systems have a push-out bond strength similar to conventional systems when used with warm vertical compaction.

Effects of Brown and Green Propolis on Bond Strength of Fiberglass Posts to Root Canal Dentin.

Introduction: The purpose of this study was to evaluate the effect of brown and green propolis on bond strength of the fiberglass posts to root canal dentin, and to compare it with conventional endodontic irrigants. Methods and Materials: Sixty bovine teeth were selected, decoronated and randomly distributed into six groups (n=10), according to the irrigation solution: 0.9% saline solution (Control); 2% chlorhexidine (CHX); 5% malic acid (MA); 0.5% ethanolic extract of brown propolis (BP); 0.25% ethanolic extract of green propolis (GP); 2.5% sodium hypochlorite (NaOCl). After root canal treatment, fiber posts were cemented into prepared root canals with a self-adhesive resin cement. The roots were cross-sectioned to obtain two discs from each third and submitted to the micro push-out test. Failure patterns were evaluated under optical microscopy. The influence of irrigants agents was analyzed using one-way ANOVA followed by Games-Howell's test (α=0.05). Failure modes were analyzed using Fischer's exact test (α=0.05). Results: There were statistically significant differences among the groups (P<0.05). The control, NaOCl and BP groups showed the highest bond strength with no statistically significant difference between them (P>0.05). Adhesive failure type was the predominant in all groups. Conclusion: Based on this in vitro study, the use of 0.5% brown propolis did not influence the bond strength of fiberglass posts to root canal dentin, while the use of 0.25% green propolis did affect it negatively.

Effect of post space preparation drills on the incidence of root dentin defects.

OBJECTIVES: This study investigated the incidence of root dentin defects after the use of different post space preparation (PSP) drills. MATERIALS AND METHODS: Seventy-two bovine incisors were selected and obtained 14-mm-long root sections. Twelve roots served as controls with no intervention (G1). The 60 root canals remaining were instrumented using the crown-down technique with the ProTaper Next system and obturated using the lateral condensation technique. Specimens were randomly distributed into 5 groups (n = 12) according to the operative steps performed: G2, root canal instrumentation and filling (I+F); G3, I+F and PSP with Gates-Glidden drills; G4, I+F and PSP with Largo-Peeso reamers; G5, I+F and PSP with Exacto drill; and G6, I+F and PSP with WhitePost drill. Roots were sectioned at 3, 6, 9, and 12 mm from the apex, and digital images were captured. The presence of root dentin defects was recorded. Data were analyzed by the χ2 test, with p < 0.05 considered to indicate statistical significance. RESULTS: Root dentin defects were observed in 39.6% of the root sections. No defects were observed in G1. G5 had significantly more cracks and craze lines than G1, G2, and G3 (p < 0.05), and more fractures than G1, G2, G3, and G4 (p < 0.05). When all root sections were analyzed together, significantly more defects were observed at the 12-mm level than at the 3-mm level (p < 0.05). CONCLUSIONS: PSP drills caused defects in the root dentin. Gates-Glidden drills caused fewer root defects than Largo-Peeso reamers and Exacto drills.

Influence of Parental Exposure to Risk Factors in the Occurrence of Oral Clefts.

STATEMENT OF THE PROBLEM: Non-syndromic cleft lip and palate are the most frequent craniofacial abnormalities in humans. The genetic, environmental and behavioral factors involved in this malformation must be clarified in different parts of the globe in the view of implementing preventive measures. PURPOSE: To analyze the influence of parental exposure to risk factors on the occurrence of oral clefts. MATERIALS AND METHOD: A case-control study was conducted with 150 mothers of oral cleft children paired by the children's gender to 300 mothers of children without congenital anomalies from Mato Grosso, Brazil, for the study of the variables: gender and race/color of the children; parental educational level; age; number of pregnancies; prenatal care; obesity; stress; diabetes; hypertension; use of medications, alcohol and illicit drugs; smoking and exposure to ionizing radiation during the first trimester of pregnancy. The results were analyzed in relation to the chances possibility of each variable for the occurrence of oral cleft through the bivariate and multivariate analysis by applying the model of logistic regression. RESULTS: Passive smoking, obesity, exposure to ionizing radiation and use of antibiotics were associated with the presence of clefts. The use of folic acid and analgesics were identified as preventive factors. The father's low educational level was found as a risk factor, while the black race/color was a preventive factor; nevertheless these variables were not associated in the multivariate analysis. CONCLUSION: The results reinforce the need to follow up the pregnant women, especially in the first trimester of pregnancy, in order to control the identified risk factors. Considering the factors associated with occurrence of oral clefts and those associated with its prevention, it is possible to apply specific health promotion measures during pregnancy, which can result in the reduction of oral clefts' occurrence.

Head and Neck Cancer Patients' Quality of Life: Analysis of Three Instruments.

STATEMENT OF THE PROBLEM: Head and neck cancer treatment has provided better cure and survival rates but the patient's quality of life is still an issue. PURPOSE: To verify the correlation between the three most used instruments for evaluating the quality of life of head and neck cancer patients. MATERIALS AND METHOD: This cross-sectional study evaluated patients treated for head and neck cancer at the Mato Grosso Cancer Hospital, Cuiabá, MT, Brazil. The variables age, gender, cohabitation status, education, religion, smoking, ethnicity, tumor location and histological type and treatment modality were collected. The patients quality of life was assessed by the Functional Assessment of Cancer Therapy Quality of Life Measurement System (FACT-H&N), University of Washington Quality of Life Questionnaire (UW-QOL), and EORTC QLQ-C30/EORTC QLQ-H&N35 of the European Organization for Research and Treatment of Cancer. RESULTS: The study population consisted of 33 individuals with a mean age of 63.42±11.25 years; 69.70% were males; 54.55% had no partner; 45.45% had only elementary education; 87.9% followed a religion; 84.38% were smokers and 87.50% alcoholics. Squamous cell carcinoma responded for 78.79% of the cases and palate/oropharynx and mouth floor (21.21% each) were the most affected sites. All patients underwent radiotherapy, 90.91% chemotherapy and 63.64% surgery. On the analysis of quality of life, shoulder (UW-QOL), social performance (EORTC QLQ-C30/QLQ-H&N35) and overall well-being (FACT-H&N) had the highest scores while saliva (UW-QOL), nausea and vomiting (EORTC QLQ-C30/QLQ-H&N35) and emotional well-being (FACT-H&N) had the lowest scores. A positive correlation was found between the questionnaires for the patient's overall quality of life and the domains Pain, Appearan-ce, Activity, Deglutition, Chewing, Speech, Taste, Saliva, Mood and Anxiety. CONCLUSION: Given the correlation between the questionnaires, the selection of the instrument for future research involving head and neck cancer patients' quality of life should consider the specific aspects to be evaluated.

Aesthetic-Functional Fixed Appliance as Treatment of Premature Loss of primary Anterior Teeth / Mantenedor de Espaço Fixo Estético-Funcional como Tratamento para Perda Precoce de Dentes Decíduos Anteriores

The early loss of anterior primary teeth is frequent in the pediatric dentistry clinic and it is associated with extensive caries or dental trauma. The purpose of this study was to report two cases of aesthetic-functional rehabilitation due to early loss of anterior primary teeth, with the aid of fixed space maintainers of the tube-bar type. In the first case, a 4-year-old female child referred for dental treatment is reported. During clinical examination, several restorations in the posterior teeth and absent upper anterior teeth were observed. The treatment plan consisted of installing a tube-bar type upper fixed space maintainer, considering the ease of installation and adaptation for young children. The second case reports a 5-year-old male patient with the main complaint of dental caries. Clinical examination revealed extensive coronary destruction in the upper central incisors, as well as in the posterior teeth that presented carious lesions in several teeth. For the case planning, it was determined the need for the posterior teeth restorations and the exodontia of the anterior dental remnants. After oral rehabilitation, an aesthetic-functional space maintainer of the tube-bar type was made and installed. In both cases, prosthetic rehabilitation was fundamental to maintain the space until the eruption of the permanent successors, avoiding future damages, as well as to restore the children's self-esteem and introversion behavior. (AU)

perda precoce dos dentes decíduos anteriores é frequente na clínica odontopediátrica e está associada a processos de cáries extensas ou traumas dentários. O objetivo do presente estudo foi relatar dois casos clínicos de reabilitação estético-funcional após perda precoce de dentes decíduos anteriores, com auxílio de mantenedores de espaço fixo do tipo tubo-barra. O primeiro caso refere-se a uma criança do sexo feminino, quatro anos de idade, encaminhada para atendimento odontológico. Durante exame clínico, observou-se restaurações nos dentes posteriores e ausência dos dentes anteriores superiores. O plano de tratamento consistiu na instalação de um mantenedor de espaço fixo superior do tipo tubo-barra, levando em consideração a facilidade de instalação e adaptação para crianças com pouca idade. O segundo caso reporta um paciente de sexo masculino, cinco anos de idade, tendo como queixa principal a presença de cáries dentárias. Ao exame clínico, foi notado extensas destruições coronárias nos incisivos centrais superiores, assim como nos dentes posteriores. Para o planejamento do caso, determinou-se a necessidade de restaurações dos dentes posteriores e as exodontia dos remanescentes dentários anteriores. Após adequação do meio bucal foi confeccionado e instalado um mantenedor de espaço estético-funcional do tipo tubo-barra. Em ambos os casos, a reabilitação protética foi fundamental para a manutenção do espaço até a irrupção dos sucessores permanentes, evitando prejuízos futuros, devolvendo a autoestima e a mudança do comportamento de introversão das crianças.(AU)

Correlation of periodontal and microbiological evaluations, with serum levels of estradiol and progesterone, during different trimesters of gestation.

Our purpouse was to identify quantitatively and qualitatively the subgingival flora in different gestational trimesters, compared to non-pregnant women; evaluating the correlations between epidemiological characteristics, clinical diagnosis, microbiological findings and levels of estradiol and progesterone. 52 pregnant women divided into 3 groups, according to the gestational trimester and 15 non-pregnant patients, without hormonal contraceptives, were evaluated. Plaque index (PI), gingival index (GI), probing depth (PD) and clinical attachment level (CAL) were evaluated. Subgingival biofilm samples were processed by the qPCR technique and the serum levels of estradiol and progesterone quantified by chemiluminescence. Clinical diagnosis during gestation was correlated with the total bacterial count. A higher prevalence of Tannerella forsythia (Tf) was identified in first trimester of pregnancy and this periodontopathogen was correlated with the diagnosis of gingivitis among pregnant women. Porphyromonas gingivalis (Pg) showed a positive correlation with progesterone levels in the first trimester. High prevalence of periodontopathogens was noticed in this population. Clinical diagnosis in gestation was positively correlated with the total amount of bacteria, without influence of the hormonal levels or the epidemiological factors evaluated. The presence of Tf favored occurrence of gingivitis during pregnancy and the progesterone levels in the first trimester enhanced the growth of Pg.

Maternal Confidence for Breastfeeding and Infant Feeding Practices in a Brazilian Population / Confiança Materna para Práticas de Aleitamento e Alimentação Infantil em uma População Brasileira

Exclusive breastfeeding has not been effectively enforced in Brazil. Among the factors that can lead to early weaning is low maternal confidence for breastfeeding. The purpose of this study was to evaluate the maternal confidence for breastfeeding, the role of associated factors that could affect the practice, and the infant feeding practices. Four hundred and seventy brazilian women were interviewed about their confidence for breastfeeding by the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), comparing it in three different periods: immediately before giving birth, and 3 and 6 months of postnatal. The influence of sociodemographic characteristics and prenatal assistance on the mother's confidence for breastfeeding was evaluated. Also, the infant feeding practices up to 6 months after birth were investigated. 77% of women felt highly confident about breastfeeding, even before the beginning of practice whereas after 3 and 6 months of delivery, 85% believed to be highly capable. The more practice time, the greater the BSES-SF scores. After 3 months of postnatal, mothers with over 31 years showed the highest values of the BSES-SF, feeling more confident for breastfeeding. The sociodemographic characteristics and prenatal care did not affect the mother's confidence to breastfeed. 52% of mothers were exclusively breastfeeding after 3 months of giving birth. After 6 months, 84.8% of mothers were performing the complementary breastfeeding. The results showed the need for planning and implementing interventions that could help the relationship between maternal confidence and practice of breastfeeding from prenatal care until the first six months after delivery. (AU).

Amamentação exclusiva não foi efetivamente aplicada no Brasil. Os fatores que levam ao desmame precoce está a baixa confiança materna para a amamentação. O objetivo deste estudo foi avaliar a confiança materna para a amamentação, fatores associados que podem afetar a prática de alimentação infantil. Quatrocentas e setenta mulheres foram entrevistadas sobre sua confiança no aleitamento materno pela Escala de Auto eficácia em Amamentar (BSES-SF), comparando em três períodos diferentes: imediatamente antes do parto, 3 e 6 meses de pós-natal. A influência das características sociodemográficas e assistência pré-natal na confiança da mãe para a amamentação foi avaliada. Além disso, as práticas de alimentação até 6 meses após o nascimento foram investigadas. 77% das mulheres sentiam-se altamente confiantes em relação à amamentação, mesmo antes do início da prática, após 3 e 6 meses de parto, 85% acreditavam ser altamente capazes. Quanto mais tempo de prática, maior a pontuação da BSES-SF. Após 3 meses do pós-parto, as mães com mais de 31 anos apresentaram os maiores valores da BSES-SF, sentindo-se mais confiantes para a amamentação. As características sociodemográficas e o pré-natal não afetaram a confiança da mãe em amamentar. 52% das mães estavam amamentando exclusivamente após 3 meses do parto. Após 6 meses, 84,8% das mães realizavam a amamentação complementar. Os resultados mostraram a necessidade de planejar e implementar intervenções que possam ajudar a relação entre a confiança materna e a prática do aleitamento materno desde o pré-natal até os primeiros seis meses após o parto. (AU).

Maxillofacial Fractures in a University Hospital in Central Brazil / Fraturas Oralmaxilofaciais em um Hospital Universitário do Brasil Central

The objective of this study was to evaluate epidemiological aspects of maxillofacial fractures in 346 hospitalized patients treated at the Department of Oral and Maxillofacial Surgery of the University General Hospital, Mato Grosso, Brazil. The following information was collected from the patients' medical records: gender, age, etiologic factor, type of injury, patient origin, seasonal distribution and hospital stay period. The statistical treatment analyzed data from frequency distribution and chi-squared test. The level of significance was set at 5% for all analyses. The highest incidence of maxillofacial fractures was found among males (n=290; 83.8%), with 21-30 years-old (n=120; 34.5%) and from inner cities of Mato Grosso (n=169; 48.9%). The main etiologic factor were vehicle traffic accidents (n=169; 48.9%), violence (n=65; 18.8%) and falls (n=25; 7.2%). The seasonal distribution showed that most of the cases occurred in the fall (n=89; 25.8%), winter and spring (n=77; 22.2% each). The lower third of the face was the most commonly involved region (n=276; 54.3%). The most frequently observed fracture involved the zygomatic complex (n=146; 28.7%), followed by the mandible body (n=99; 19.4%). The epidemiological aspects of maxillofacial fractures in this study were similar to those observed in other studies, regarding the prevalence of the male, age group and traffic accidents as the main etiological factor. (AU).

Avaliou-se os aspectos epidemiológicos das fraturas oralmaxilofaciais em prontuários de pacientes atendidos em um Hospital Universitário do Brasil central. A amostra do estudo foi proveniente da revisão de prontuários de 346 pacientes atendidos no Serviço de Cirurgia e Traumatologia Oralmaxilofacial do Hospital Geral Universitário na cidade de Cuiabá, Mato Grosso, Brasil. Os seguintes dados foram coletados dos registros hospitalares de cada paciente: sexo, idade, fator etiológico, região anatômica afetada, procedência, distribuição sazonal e período de internação. O tratamento estatístico analisou os dados frente à distribuição de frequência e qui-quadrado. O nível de significância foi de p<0,05. Observouse elevada frequência de fraturas oralmaxilofaciais em indivíduos do sexo masculino (n=290; 83,8%), com idade variando entre 21-30 anos (n=120; 34,5%) e provenientes de cidades do interior do estado do Mato Grosso (n=169; 48,8%). Os principais fatores etiológicos foram os acidentes de trânsito motorizados (n=169; 48,9%), violência (n=65; 18,8%) e quedas (n=25; 7,2%). A distribuição sazonal evidenciou elevado número de lesões no outono (n=89; 25,8%), inverno e primavera (n=77; 22,2%, cada um). O terço inferior da face foi a região mais comumente envolvida (n=276; 54,3%). A injúria mais comum foi a fratura do complexo zigomático (n=146; 28,7%), seguida da fratura do corpo da mandíbula (n=99; 19,4%). Os dados obtidos se assemelham aos encontrados na literatura, no que diz respeito à prevalência do sexo masculino, da faixa etária e dos acidentes de trânsito como principal agente etiológico. (AU).

Evaluation of the effects of whitening mouth rinses combined with conventional tooth bleaching treatments.

OBJECTIVES: The aim of the present study was to evaluate the effect of whitening mouth rinses alone and in combination with conventional whitening treatments on color, microhardness, and surface roughness changes in enamel specimens. MATERIALS AND METHODS: A total of 108 enamel specimens were collected from human third molars and divided into 9 groups (n = 12): 38% hydrogen peroxide (HP), 10% carbamide peroxide (CP), 38% HP + Listerine Whitening (LW), 10% CP + LW, 38% HP + Colgate Plax Whitening (CPW), 10% CP + CPW, LW, CPW, and the control group (CG). The initial color of the specimens was measured, followed by microhardness and roughness tests. Next, the samples were bleached, and their color, microhardness, and roughness were assessed. Data were analyzed through 2-way analysis of variance (ANOVA; microhardness and roughness) and 1-way ANOVA (color change), followed by the Tukey post hoc test. The Dunnett test was used to compare the roughness and microhardness data of the CG to those of the treated groups. RESULTS: Statistically significant color change was observed in all groups compared to the CG. All groups, except the LW group, showed statistically significant decreases in microhardness. Roughness showed a statistically significant increase after the treatments, except for the 38% HP group. CONCLUSIONS: Whitening mouth rinses led to a whitening effect when they were used after conventional treatments; however, this process caused major changes on the surface of the enamel specimens.

Can different stages of leprosy treatment influence the profile of oral health? Oral status in leprosy

BACKGROUND: The aim of study was to evaluate the oral health status, salivary flow and halitosis among individuals diagnosed with leprosy as compared with healthy subjects. MATERIAL AND METHODS: A sample of 160 individuals was allocated into four groups, as follows: (G1) individuals with complete leprosy treatment; (G2) individuals diagnosed with leprosy and under multi-drug therapy; (G3) individuals diagnosed with leprosy not yet under treatment; and (G4) healthy individuals. Then individuals were submitted to periodontal clinical examination (visible plaque index, bleeding index, depth of probing and clinical attachment level); DMFT index (decayed-missing-filled teeth index); evaluation of salivary flow and halitosis using a halimeter equipment (Interscan Corp, Chatsworth, CA, USA). RESULTS: The data were analyzed using Kruskal-Wallis and chi-square tests. The mean DMFT was found to be higher than 6.6, which is considered very high, with no significant difference between groups (P>0.05). As for salivary flow, 76.2% of the subjects presented normal flow rates, while 10% and 13.7% showed low and very low salivary flow rates, respectively, with hyposalivation being mostly observed in Groups 1 and 2. The highest prevalence of noticeable odor was found in healthy individuals (G4), and the most prevalent periodontal diagnosis was gingivitis (63.1%) in Group 3 (individuals with leprosy not yet under multi-drug therapy) followed by periodontitis (25%) in Group 1 (individuals who had completed leprosy treatment). CONCLUSIONS: It was observed that individuals with a history of leprosy present poor oral health similar to that of systemically healthy individuals