Effect of Disinfection Protocols on Bacterial Reduction in Mandibular Molars.

OBJECTIVE: Evaluate the bacterial reduction effect of disinfection protocols used in lower molars infected by Enterococcus faecalis. METHODS: Eighty extracted lower molars were prepared and inoculated with E. faecalis for 2 months. The teeth were then distributed into 2 control groups (n = 4) and 4 experimental groups (n = 18) in function of the disinfection protocol utilized: G1. WaveOne Gold (WOG), passive ultrasonic irrigation (PUI) and Ultracal; G2. WOG, PUI and calcium hydroxide (CH); G3. WOG, XP-Endo Finisher (XPF) and Ultracal; G4. WOG, XPF and CH. Bacteriological samples were collected previously (S1), after preparation (S2), final agitation (S3) and intracanal dressing (S4). Microbial growth was assessed according to culture turbidity and UV spectrophotometry. Statistical analyses used the Friedman test for paired samples and Kruskal-Wallis test for non-paired data (p<0.05). RESULTS: No protocol eliminated E. faecalis effectively. The S2, S3 and S4 samples were statistically different from the S1 samples in G1, G2, G3 and G4 (p<0.05). Statistical differences were observed in bacterial reduction between G1 and G2 and G1 and G3 after the intracanal medicament (S4) (p<0.05). CONCLUSION: The WOG + PUI + CH disinfection protocol showed higher percentages of bacterial reduction.

Age Estimation in Brazilian Adults Using the Pulp/Tooth Ratio of the Maxillary Canine and Mandibular Second Premolar.

(1) Background/Objectives: Accurate determination of chronological age is crucial in legal dental identification. This study aimed to compare the effectiveness of different formulas in estimating the age of a Brazilian subpopulation by analyzing the pulp/tooth ratio of the maxillary canine and mandibular second premolar in panoramic and periapical radiographs. (2) Methods: The sample consisted of panoramic and periapical radiographs of 247 individuals. The file of each radiograph was opened in the Adobe Photoshop CS4® program to outline and obtain values in pixels for calculating the pulp/tooth ratio. Statistical analysis was conducted using the SPSS program, with a significance level set at 5%. (3) Results: The interclass correlation coefficient demonstrated excellent intra-observer agreement (0.990-0.999). The determination coefficients (R2) suggested that only 30-35% of the actual age results could be explained by the pulp/tooth ratio. The smallest differences were observed with Cameriere's formula for the mandibular second premolar on panoramic radiographs (+4.1 years). The greatest differences were found with the formulas for the mandibular second premolar in panoramic radiographs of the Korean (+12.5 years) and Portuguese (-12.1 years) populations. (4) Conclusions: The equations employed showed little agreement between the actual age and the estimated age.

Method to determine the root canal spatial geometry using an algorithm of the e-Vol DX CBCT software.

This study evaluated a method to determine the spatial geometry of root canal preparation (RCP) using navigation dynamics and a specific algorithm from a new CBCT software (e-Vol DX). CBCT scans of 168 root canals of mandibular molars were acquired before and after RCP, using nickel-titanium (NiTi) instruments (ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold). The spatial geometry of the root canals and the operative risk of disproportional wear of dentinal walls after RCP were evaluated using a new CBCT software. A 3-point scoring system was used after the measuring of cementum/dentin thickness before and after RCP in all root thirds. The root thirds were distributed into three parts of similar sizes, and the scores were categorized at three levels: 1. mild risk (1/3), 2. moderate risk (2/3), 3. severe risk (3/3). These levels were proposed according to the risk of creating disproportionate shapes, thin walls, or perforations. The data were analyzed statistically by Fischer's exact test (α = 5%). There were no significant differences in operative risk among the NiTi engine-driven systems, for the distal or mesial walls of all the root canal thirds (p>0.05). The spatial geometry method to assess operative risk allows clinical planning for a predictable enlargement of the root canal in all root thirds. Based on using a map-reading strategy on root canals in CBCT scans, NiTi engine-driven instruments did not present an increased operative risk during RCPs.

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.

Influence of different agitation techniques on bacterial reduction in curved root canals.

The aim of this study was to evaluate the influence of agitation techniques on bacterial reduction in curved root canals. Eighty human mandibular molars were prepared, inoculated with Enterococcus faecalis and incubated at 37°C for 60 days. Then, specimens were randomly separated into two test groups (n = 36) and two control groups (n = 04) according to agitation technique: Passive ultrasonic irrigation (PUI, Irrisonic) and XP-endo Finisher (XPF). Microbial samples were collected before and after instrumentation and after final agitation using sterile paper points. Bacterial growth was analysed by turbidity of culture medium and UV spectrophotometry. The Wilcoxon rank test was used for the paired analysis, while the Mann-Whitney U-test was used for the non-paired analysis. The samples collected after final agitation were significantly different between test groups (p < 0.05). Bacterial reduction was greater in the PUI than in the XPF (p < 0.05) group. The irrigant agitation provided significant bacterial reduction. The use of the PUI showed better results.

Method to determine the root canal spatial geometry using an algorithm of the e-Vol DX CBCT software

Abstract This study evaluated a method to determine the spatial geometry of root canal preparation (RCP) using navigation dynamics and a specific algorithm from a new CBCT software (e-Vol DX). CBCT scans of 168 root canals of mandibular molars were acquired before and after RCP, using nickel-titanium (NiTi) instruments (ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold). The spatial geometry of the root canals and the operative risk of disproportional wear of dentinal walls after RCP were evaluated using a new CBCT software. A 3-point scoring system was used after the measuring of cementum/dentin thickness before and after RCP in all root thirds. The root thirds were distributed into three parts of similar sizes, and the scores were categorized at three levels: 1. mild risk (1/3), 2. moderate risk (2/3), 3. severe risk (3/3). These levels were proposed according to the risk of creating disproportionate shapes, thin walls, or perforations. The data were analyzed statistically by Fischer's exact test (α = 5%). There were no significant differences in operative risk among the NiTi engine-driven systems, for the distal or mesial walls of all the root canal thirds (p>0.05). The spatial geometry method to assess operative risk allows clinical planning for a predictable enlargement of the root canal in all root thirds. Based on using a map-reading strategy on root canals in CBCT scans, NiTi engine-driven instruments did not present an increased operative risk during RCPs.

Resumo Este estudo avaliou um método para determinar a geometria espacial do preparo do canal radicular (PCR) usando uma dinâmica de navegação e um algoritmo específico do software e-Vol DX. Imagens de tomografia computadorizada de feixe cônico (TCFC) de 168 molares inferiores foram adquiridas antes e depois do PCR, usando instrumentos de níquel-titânio (NiTi) (ProTaper Next, BioRace, Reciproc Blue e WaveOne Gold). A geometria espacial dos canais radiculares e o risco operatório de desgaste desproporcional das paredes dentinárias após o preparo foram avaliados usando o software de TCFC e-Vol DX. Um sistema de Score de 3 pontos foi usado após a mensuração da espessura cemento/dentina antes e depois do PCR, em toda extensão dos canais radiculares. Os terços radiculares foram distribuídos em três partes de tamanhos semelhantes, e os Scores foram categorizados em três níveis: 1. risco leve (1/3), 2. risco moderado (2/3), 3. risco severo (3/3). Esses níveis foram propostos de acordo com o risco de criar formas desproporcionais, paredes finas ou perfurações radiculares. Os dados foram analisados estatisticamente pelo teste exato de Fischer ((=5%). Não houve diferenças significativas no risco operatório entre os sistemas de NiTi acionados a motor, para as paredes distal ou mesial em todos os terços do canal radicular (p>0,05). O método de geometria espacial para avaliar o risco operatório permite o planejamento clínico para um alargamento previsível do canal radicular em todos os terços radiculares. Com base no uso de uma estratégia de navegação dinâmica de canais radiculares de molares inferiores analisados em imagens de TCFC, os instrumentos de NiTi acionados estudados não apresentaram um aumento do risco operatório durante o preparo dos canais radiculares.

Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts.

BACKGROUND: The appearance of high-density root obturating materials, such as gutta-percha and intracanal posts, on cone-beam computed tomography (CBCT) scans is substantially different from that seen in the specimen. This study evaluated the effectiveness of different CBCT software in the reduction of blooming artifacts when examining teeth with intracanal posts. METHOD: The sample included 42 human single-rooted teeth with two types of posts: G1 - low-fusion alloy posts; G2 - gold alloy posts. CBCT scans were obtained using two scanners, PreXion 3D Elite® and Carestream 9000C 3D®. First, the posts were measured using a digital micrometer (standard reference, control). Post diameters were determined using the Blooming Artifact Reduction (BAR) tool of the e-Vol DX software and of the PreXion3D Image Analysis System. Statistical data were evaluated using the van Der Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5 %. RESULTS: There were no significant differences (p > 0.05) between the diameters of intracanal posts on the CT scans when the e-Vol DX was used, or when these results were compared with those obtained using a micrometer. There were significant differences in post diameters determined using the PreXion3D Image Analysis System when compared with the e-Vol DX and the micrometer values (p < 0.05). CONCLUSIONS: The use of the e-Vol DX BAR filter eliminated blooming artifacts. There were no dimensional changes in the CBCT images of the low-fusion and gold alloy intracanal posts using the e-Vol DX BAR filter.

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.

Cytotoxicity of Chelating Agents Used In Endodontics and Their Influence on MMPs of Cell Membranes.

This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Cytotoxicity of chelating agents used in endodontics and their influence on mmps of cell membranes

Abstract This study evaluated the cytotoxic effect and the ability to inhibit matrix metalloproteinases (MMP-2 and MMP-9) of 0.2% chitosan (CH) and 1% acetic acid (AA) compared with 17% ethylenediaminetetraacetic acid (EDTA). Cell viability assay was performed according to ISO 10993-5 with mouse fibroblasts (L929). The culture was exposed to 0.2% CH, 1% AA, and 17% EDTA. The chelating agents were evaluated immediately after contact with the cells and after 6 h, 12 h, and 24 h of incubation. Cell viability was analyzed using the 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Inhibition of the gelatinolytic activity of MMP-2 and MMP-9 was evaluated by gelatin zymography. Different concentrations of CH were evaluated: 50 mM, 5 mM, 0.5 mM, and 0.05 mM. EDTA (0.5 mM) was used as a positive control. The results demonstrated that CH and AA had an initial cytotoxic effect, which decreased after 6 h, 12 h, and 24 h, being statistically similar to EDTA (P > 0.05). Additionally, CH at concentrations of 50 mM, 5 mM, and 0.5 mM had an inhibitory effect on MMP-2 and MMP-9, similar to that of the control with EDTA. The chelating agents had no cytotoxic effects after 24 h. MMP-2 and MMP-9 were inhibited by the experimental solutions.

Resumo Este estudo avaliou o efeito citotóxico e a capacidade de inibição das metaloproteinases da matriz extracelular (MMP-2 e MMP-9) pela quitosana 0,2%(CH) e o ácido acético 1% (AA) em comparação com o ácido etilenodiaminotetracético 17% (EDTA). O ensaio de viabilidade celular foi realizado de acordo com a ISO 10993-5 com fibroblastos de camundongo (L929). A cultura foi exposta a CH 0,2%, AA 1% e EDTA 17%. Os agentes quelantes foram avaliados imediatamente após o contato com as células e após 6 h, 12 h e 24 h de incubação. A viabilidade celular foi analisada utilizando o ensaio de brometo de 3- (4,5-dimetitiazol-2-il) -2,5-difeniltetrazólio (MTT). A inibição da atividade gelatinolítica de MMP-2 e MMP-9 foi avaliada por zimografia de gelatina. Diferentes concentrações de CH foram avaliadas: 50 mM, 5 mM, 0,5 mM e 0,05 mM. EDTA (0,5 mM) foi usado como controlo positivo. Os resultados demonstraram que CH e AA apresentaram um efeito citotóxico inicial, que diminuiu após 6 h, 12 h e 24 h, sendo estatisticamente similar ao EDTA (P> 0,05). Adicionalmente, CH a concentrações de 50 mM, 5 mM e 0,5 mM tiveram um efeito inibidor sobre MMP-2 e MMP-9, semelhante ao controlo com EDTA. Os agentes quelantes apresentaram efeitos não citotóxicos após 24 h. MMP-2 e MMP-9 foram inibidas pelas soluções experimentais.

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.

Avaliação por TCFC do Transporte do Canal Radicular após o Uso de Diferentes Sistemas Rotatórios de NiTi / CBCT Assessment of the Root Canal Transportation After the Use of Different NiTi Rotary Systems

Objetivo: o objetivo do estudo foi avaliar a ocorrência de transporte do canal radicular após o preparo com instrumentos de níquel-titânio (NiTi) de rotação contínua, por meio do exame de tomografia computadorizada de feixe cônico (TCFC). Material e método: Canais mesiovestibulares e mesiolinguais de vinte molares inferiores humanos foram distribuídos aleatoriamente em dois grupos experimentais (n=10), de acordo com o sistema rotatório de NiTi: Grupo 1 ­ BioRace; e Grupo 2 - ProTaper Next. Imagens de TCFC foram obtidas antes do preparo do canal radicular (TCFC 1) e após o uso dos instrumentos BR2 (#25/.04) e X2 (#25/.06) (TCFC 2) e BR5 (#40/.04) e X4 (#40/.06) (TCFC 3). Dois examinadores avaliaram todas as imagens determinando a ocorrência ou não de transporte do canal radicular. Foram estabelecidos 3 níveis para a mensuração nas imagens: 1-2 mm aquém do vértice radicular (terço apical); 3-4 mm aquém do vértice radicular (terço médio); 4- 2 mm abaixo da furca (terço cervical). Os dados foram analisados utilizando o teste de Kruskal-Wallis com pós-teste de Dunn para comparações múltiplas. O nível de significância foi de 5%. Resultados: Os canais radiculares preparados com o sistema BioRace não apresentaram transporte (P<0,05). Foi observado transporte apenas no terço apical do canal mesiovestibular após o uso do instrumento ProTaper Next X4 (#40/.06) (P<0,05). Conclusão: O sistema BioRace permitiu a ampliação dos canais mesiovestibular e mesiolingual de molares inferiores até o diâmetro cirúrgico 40 sem resultar em transporte do canal.

Aim: This study evaluated root canal transportation after root canal instrumentation with two nickel-titanium (NiTi) rotary systems, by using cone beam computed tomography (CBCT) imaging. Material and Methods: Mesiobuccal and mesiolingual root canals of twenty human mandibular molars were randomly divided into two experimental groups (n = 10), according to the NiTi rotary system: Group 1 ­ BioRace; and Group 2 ­ ProTaper Next. CBCT scans were obtained before the root canal instrumentation (CBCT 1) and after the use of BR2 (#25/.04) and X2 (#25/.06) instruments (CBCT 2) and after the use of BR5 (#40/.04) and X4 (#40/.06) instruments (CBCT 3). Two examiners evaluated the occurrence or not of transportation. Measurements were made at 3 different points: 1-2 mm from the apex (apical third); 3-4 mm from the apex (middle third); 4- 2 mm below furcation (cervical third). The Kruskal-Wallis and Dunn tests were used for statistical analysis. The level of significance was set at 5%. Results: Root canals instrumented with BioRace instruments showed no transportation (P<0.05). Transportation was observed only in the apical third of the mesiobuccal root canal after the use of ProTaper Next X4 instrument (#40/.06) (P<0.05). Conclusions: The BioRace system allowed the widening of mesiobuccal and mesiolingual root canals of mandibular molars up to apical diameter 40 without resulting in root canal transportation.

Conhecimento e Conduta em Relação as Injúrias Dentárias Traumáticas de Professores do Ensino Fundamental de João Pessoa-PB, Brasil / Knowledge and Attitudes Towards Dental Trauma of School Teachers in João Pessoa-PB, Brazil

Objetivo: Avaliar o conhecimento de professores do ensino fundamental sobre as condutas nos casos de injúrias dentárias traumáticas (IDTs) em escolares. Material e método: O estudo foi realizado em uma amostra de 172 professores do ensino fundamental em João Pessoa-PB, e que responderam a um questionário com perguntas sobre os conhecimentos a cerca das condutas relacionadas ao tratamento emergencial de IDTs. Resultados: Os participantes do estudo eram em sua grande maioria do gênero feminino (79,6%) e tinham entre 20 e 40 anos (49,4%). Sobre os procedimentos a tomar após um acidente com trauma da face, 78% disseram que examinariam a boca das crianças. Com relação a possibilidade de salvar um dente fraturado, 78,5% dos entrevistados responderam positivamente. Em casos de dentes avulsionados, verificou-se que 7,6% dos professores não se preocupariam com o dente, apenas com a criança, e somente 33,7% procurariam o dente. O tempo ideal para procurar o cirurgião-dentista foi relatado por 52,8% como sendo no máximo 30 minutos. Quanto ao meio de armazenamento, 8,1% transportariam o dente imerso em leite e 29,7% em soro fisiológico. Conclusões: O nível de conhecimento dos professores foi insuficiente frente ao atendimento de urgência de traumatismos dentários, necessitando-se de capacitação com o intuito de minimizar as perdas dentárias.

Objective: To evaluate the knowledge of school teachers regarding the proper conduct in cases of dental trauma (DT) in school students. Material and methods: This study was conducted using a sample made up of 172 teachers from schools in João Pessoa-PB. These teachers answered a questionnaire concerning their knowledge about the emergency treatment of DTs. Results: Participants were mostly female (79.6%) and were between 20 and 40 years old (49.4%). Regarding the proper procedures to be taken in case of facial trauma, 78% said they would examine children's mouths. Regarding the possibility of saving a fractured tooth, 78.5% of respondents answered positively. In cases of avulsed teeth, it was found that 7.6% of teachers would not care about the tooth, only the child, and only 33.7% would look for the tooth. The ideal time to go to the dentist was reported by 52.8% as a maximum of 30 minutes. Regarding the storage medium, 8.1% would transport the tooth immersed in milk and 29.7% in saline. Conclusions: The teachers' knowledge concerning the most appropriate measure to be taken faced with TDs was inadequate. Further training of these professionals could minimize tooth loss.

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 Selective Physicochemical and Biological Properties of Different Root Canal Sealers.

Introduction: This in vitro study aimed to evaluate the chemical composition, water solubility, radiopacity, pH, electrical conductivity and cytotoxicity of four different root canal sealers. Methods and Materials: Four materials were tested including an epoxy resin-based sealer (AH-Plus), a calcium silicate-based sealer (MTA Fillapex), a calcium hydroxide-based sealer (Sealapex) and a zinc-oxide-eugenol-based sealer (Endofill). The materials were submitted to energy-dispersive x-ray microanalysis for elemental chemical composition. Solubility and radiopacity were evaluated according to ANSI/ADA. The pH and electrical conductivity were measured at different periods of time. L929 immortalized mouse fibroblast line were used for cytotoxicity evaluation. Statistical analyses were carried out using the ANOVA and Tukey's test. Results: The main elements were found to be silicon and calcium in MTA Fillapex, calcium and bismuth in Sealapex, zirconium and tungsten in AH-Plus and zinc and bismuth in Endofill. Sealapex had the highest value for solubility (P<0.05), AH-Plus showed the highest radiopacity value (P<0.05) while MTA Fillapex had the highest pH and electrical conductivity values (P<0.05). AH-Plus showed the highest rate of cell viability (P<0.05). Conclusion: Based on the results of this in vitro study, it was possible to conclude that Endofill and Sealpex did not meet the requirements for water solubility. The tested sealers were alkaline and showed radiopacity in accordance with ANSI/ADA standards. AH-Plus showed to be less cytotoxic than other tested root canal sealers.

Prevalência de granulomas, abscessos e cistos periapicais em inflamações de origem endodôntica / Prevalence of granulomas, abscesses and periapical cysts in inflammations of endodontic origin

Introdução: a necrose do tecido pulpar seguida da colonização e infecção do canal radicular representa eventos determinantes na instalação, desenvolvimento e perpetuação da periodontite apical. Objetivo: avaliar a prevalência dos diferentes tipos de lesões inflamatórias periapicais de origem endodôntica. Métodos: a amostra do estudo foi proveniente da revisão de laudos histopatológicos de 805 espécimes cirúrgicos encaminhados ao Serviço de Patologia Bucal do Laboratório Público do estado de Mato Grosso, Brasil, entre os anos de 2008 e 2014. Os seguintes dados foram coletados dos laudos de cada paciente: gênero, faixa etária, grupo dentário, localização anatômica e diagnóstico histopatológico (granuloma periapical, abscesso periapical e cisto radicular). A análise estatística dos dados incluiu distribuição de frequência e teste de associação. A significância estatística para a associação entre as variáveis foi determinada pelo teste qui-quadrado. O nível de significância estabelecido foi de p < 0,05. Resultados: observou-se maior frequência de lesões periapicais em indivíduos do gênero masculino (n = 405; 50,31%) e com idade entre 21 e 30 anos (n = 212; 26,34%). Os dentes mais comumente envolvidos foram os molares inferiores (n = 293; 36,40%), seguidos pelos molares superiores (n = 213; 26,46%). O granuloma periapical (n = 458; 56,89%) foi a lesão inflamatória periapical mais prevalente. Foram observadas associações significativas entre tipo de lesão periapical e localização anatômica (p < 0,05). Conclusões: verificou- se maior ocorrência de lesões periapicais em indivíduos do gênero masculino; a faixa etária mais acometida foi entre 21 e 30 anos; o granuloma periapical foi a lesão mais comumente diagnosticada, sendo os dentes localizados na região posterior da mandíbula os mais afetados. (AU)

Root perforations: a review of diagnosis, prognosis and materials.

Root perforation results in the communication between root canal walls and periodontal space (external tooth surface). It is commonly caused by an operative procedural accident or pathological alteration (such as extensive dental caries, and external or internal inflammatory root resorption). Different factors may predispose to this communication, such as the presence of pulp stones, calcification, resorptions, tooth malposition (unusual inclination in the arch, tipping or rotation), an extra-coronal restoration or intracanal posts. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis (including such issues as clinically healthy pulp, inflamed or infected pulp, primary or secondary infection, and presence or absence of intracanal post). Clinical and imaging exams are necessary to identify root perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of this clinical condition. Clinical factors influencing the prognosis and healing of root perforations include its treatment timeline, extent and location. A small root perforation, sealed immediately and apical to the crest bone and epithelial attachment, presents with a better prognosis. The three most widely recommended materials to seal root perforations have been calcium hydroxide, mineral trioxide aggregate and calcium silicate cements. This review aimed to discuss contemporary therapeutic alternatives to treat root canal perforations. Accordingly, the essential aspects for repairing this deleterious tissue injury will be addressed, including its diagnosis, prognosis, and a discussion about the materials actually suggested to seal root canal perforation.

Perfil das mães com filhos diagnosticados com fissura labiopalatal / Profile of mothers with children diagnosed with cleft lip and palate

Objetivo: Avaliar o perfil das mães com filhos diagnosticados com fissura lábiopalatal e verificar as orientações recebidas acerca desta patologia e sobre o aleitamento materno. Material e método: Foram entrevistadas 50 mães de crianças com fissuras labiopalatinas, de ambos os sexos e sem outras anomalias congênitas associadas. As mães foram entrevistadas utilizando um questionário modificado, aplicado logo após a triagem no Ambulatório de Anomalias Craniofaciais do Hospital Geral Universitário de Cuiabá, Mato Grosso - Brasil. Os dados foram analisados utilizando os testes estatísticos ANOVA (análise de variância) e Tukey para nível de significância de 5% (p < 0,05). Resultados: A maioria das mães pertencia à faixa etária de 20-30 anos, 64% delas não possuíam o ensino médio completo. De todas as mães que realizaram consultas de pré-natal, 74% receberam o diagnóstico da fissura ainda na gestação, sendo que essas realizaram número maior de consultas de pré-natal em relação àquelas que receberam o diagnóstico no pós-natal. Sobre o aleitamento materno 62% delas receberam orientações no pré-natal, sendo este índice elevado a 70% na maternidade, após o diagnóstico da fissura. Os sentimentos de preocupação e aceitação foram os mais relatados pelas mães. O uso de mamadeira como forma de aleitamento foi observado em 54% dos casos após a alta da maternidade. Conclusão: Foi verificado que as mães eram jovens, com baixo nível escolar e um número expressivo delas recebeu a informação do diagnóstico da fissura durante a gestação e informações sobre o aleitamento materno. Medo e preocupação foram sentimentos comumente relatados.

Objective: To evaluate the profile of mothers with children with cleft lip and palate and to verify the guidelines received about this pathology and about breastfeeding. Material and method: Fifty mothers of children with cleft lip and palate of both sexes and without other associated congenital anomalies. Mothers were interviewed using a modified questionnaire, which was applied soon after screening at the Craniofacial Anomalies Outpatient Clinic of the General University Hospital of Cuiabá, Mato Grosso - Brazil. The data were analyzed using the ANOVA and Tukey tests for significance level of 5% (p <0.05). Results: The results showed a higher prevalence of mothers with mean age of 20-30 yearsold, and 64% of them did not have completed high school. Of all the mothers who underwent prenatal consultations, 74% of the fissure were diagnosed during pregnancy, and they performed a larger number of prenatal consultations in comparison to those who received the diagnosis in the postnatal period. Regarding breastfeeding, 62% of them received prenatal guidance, which was 70% in the maternity ward, after diagnosis of the fissure. The feelings of concern and acceptance were the most reported by the mothers. The use of bottle feeding as a form of breastfeeding was observed in 54% of cases after discharge from maternity. Conclusion: It was verified that the mothers were young, with low school level and a significant number of them received the information of the diagnosis of fissure during pregnancy and about breastfeeding. Fear and worry were commonly reported feelings.