Fluctuating arch symmetry: a comparison of two methods of assessment - applicability and efficiency.

INTRODUCTION: Symmetry is balance, some correspondence in the size, form, and arrangements of parts on opposite sides of a plane, line, or point. The opposite of this concept is asymmetry, or imbalance. OBJECTIVE: This retrospective study compared two methods for assessing arch symmetry with linear measurements based on triangles, to determine their applicability and efficiency. METHODS: Two groups were enrolled: children (n=20) and adults (n=20), and the arch symmetry was assessed from linear measurements. Method 1: the incisor-canine (INC), canine-molar (CM), and incisor-molar (INM) distances (paired t-test and Pearson correlation). Method 2: a mathematical equation between the cusps measurements of the canines and the distobuccal of the first molars leading to result 1 (t-test for one sample and bootstrapping analysis). Dental casts were digitized and analyzed using a software program. The Bland-Altman test compared the methods (α=0.05). RESULTS: The Bland-Altman test revealed concordance between the methods; however, separately the results were different: In method 1, the mandibular arch did not demonstrate correlation (children, INC r=0.33; CM r=0.45; INM r=0.51; adults, CM r=0.46; INM r=0.35), however, the maxilla revealed a strong correlation in children and a strong/moderate correlation in adults. In method 2, both arches were symmetrical (p>0.05). CONCLUSION: Method 1 may be appropriate during orthodontic treatment, and method 2 may be indicated for final treatment. These methods are useful; however, only method 1 identified the side of asymmetry. The methods can contribute to future studies in syndromic and non-syndromic patients, before and after orthognathic surgeries and orthodontic treatment, comparing results.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study.

This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

Correlation between cleft width and dental arch symmetry in cleft lip and palate: a longitudinal study

Abstract This study aimed to evaluate the influence of cleft width on dental arch symmetry of children with unilateral cleft lip and palate. Forty-one children were subjected to impression preoperatively (T1; mean age = 0.31 ± 0.07 years) and postoperatively (T2; mean age = 6 .73 ± 1.02 years). Eighty-two digitized dental casts were analyzed by stereophotogrammetry software. The cleft palate width was measured in the anterior (P-P'), middle (M-M'), and posterior (U-U') regions. Also, the following measurements were obtained: anterior intersegment (I-C') and intrasegment (I-C); total intersegment (I-T') and intrasegment (I-T); cleft-side (C'-T') and non-cleft-side (C-T) canine tuberosity. Paired t test and Pearson correlation coefficient were applied (α = 5%). Cleft width had the following means: 10.16 (± 3.46) mm for P-P', 12.45 (± 3.00) mm for M-M', and 12.57 (± 2.71) mm for U-U'. In the longitudinal analysis, I-C' had a significant reduction, while the other measurements significantly increased (p < 0.001). Asymmetry was verified in the following analyses at T1: I-C' vs. I-C and I-T' vs. I-T (p < 0.001); at T2, only in I-C' vs. I-C (p < 0.001). At T1, P-P' vs. I-C' (r = 0.722 and p < 0.001), P-P' vs. I-T' (r = 0.593 and p < 0.001), M-M' vs. I-C' (r = 0.620 and p < 0.001), and M-M' vs. I-T' (r = 0.327 and p < 0.05) showed a positive and significant correlation. At T2, there was a correlation between M-M' and I-C' (r = 0.377 and p < 0.05). In conclusion, the anterior and middle cleft widths influenced palatal asymmetry in the first months of life, while middle width influenced residual asymmetry.

Evaluation by 3D stereophotogrammetry of facial changes in edentulous patients after rehabilitation.

OBJECTIVE: To assess facial changes after oral rehabilitation with complete dentures (CDs) by 3D technology allows understanding the results of a treatment that changes facial proportions. Precise outcome parameters can improve decision making. This descriptive observational research aimed to assess facial changes in completely edentulous patients after oral rehabilitation with a CD by a 3D stereophotogrammetry system. METHODOLOGY: 30 edentulous patients (7 men and 23 women), aged 50 to 75, were analyzed with stereophotogrammetry at 28 previously determined anthropometric landmarks, at 2 different times: T1, before treatment, and T2, after inserting the CDs. Images were analyzed with a specific software for linear and angular measurements. The paired t-test was used to compare timestamps (α=0.05). RESULTS: Major changes were observed in 7 of the 13 linear measures and 7 of the 9 angular measures. The following linear measurements had an increase: Sn-Gn (lower third of the face), Ls-Li (height of the vermilion lip), and ChL-ChR (mouth width). Sn-Ls (nasal philtrum height) decreased. For angular measurements, Sn-St-Pg (lower facial convexity) angles increased, and the Prn-Sn-Ls (nasolabial angle) and GoR-Pg-GoL (mandible convexity) angles decreased. CONCLUSIONS: Major facial changes in newly rehabilitated edentulous patients with CDs included an increase of the lower third of the face, of the vermilion lip, of mouth width, and of the lower facial convexity, and a decrease of the nasolabial angle and mandible convexity.

3D comparison of dental arch stability in patients with and without cleft lip and palate after orthodontic/rehabilitative treatment.

This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.

Three-Dimensional Soft-Tissue Facial Morphometry in Caucasian Obese Adults

Objective: To evaluate the facial morphology of Caucasian obese adults in relation to normal weight peers, and to study the association between three-dimensional soft-tissue facial measurements and cardiometabolic risk factors. Material and Methods: Nineteen Caucasian obese subjects aged 25 to 73 years underwent anthropometric measurements, blood samples and a stereophotogrammetric facial scan. Soft-tissue facial linear distances, angles, and volumes were obtained and compared to those collected on normal weight subjects by computing z-scores. Spearman correlation was used to assess the associations between facial measurements and metabolic parameters. Logistic regression analysis adjusted for sex and age was used to assess the risk of metabolic syndrome associated to the facial measurements. Results: Overall, when compared to normal weight persons, obese adults had a wider face in the horizontal dimension, with a middle face (maxilla) that was larger both in absolute value and relatively to the lower face (mandible), and a larger right side gonial angle (Wilcoxon test, p < 0.01). Only the mean (left and right) gonial angle was positively associated to serum triglycerides level, while the other facial measurements were associated with none of the cardiometabolic parameters. Moreover, none of the facial measurements was associated with the risk of metabolic syndrome. Conclusion: Despite larger facial dimensions and altered mandible/maxilla volume ratio, three-dimensional soft-tissue facial morphometry in Caucasian obese adults is not related to cardiometabolic risk factors. The actual association between morphological facial characteristics and clinical information on the health conditions of patients is still to be investigated.

3D comparison of dental arch stability in patients with and without cleft lip and palate after orthodontic/rehabilitative treatment

Abstract This study aimed to compare the linear dimensions of the dental arches of adult patients with complete unilateral cleft lip and palate (UCLP) after orthodontic and prosthetic treatment with fixed partial dentures (FPD) to patients without clefts, using 3D technology. This retrospective longitudinal study sample consisted of 35 subjects divided into two groups. Included in this sample were 15 complete UCLP individuals who had received orthodontic treatment before rehabilitation with a fixed partial denture (FG), as well as 20 patients without cleft as control group (CG). All patients were aged between 18 and 30 years. Digital dental casts were obtained in two stages: (T1) end of orthodontic treatment and (T2) one year after prosthetic rehabilitation (FG); and (T1) end of orthodontic treatment and (T2) one year after removal of the orthodontic appliance (CG). Intercanine, interfirst premolar and intermolar distances, and incisor-molar length were obtained. A precalibrated and trained examiner performed the assessments. Intergroup differences between T2 and T1 were compared between the groups using the t test or Mann-Whitney test with a significance level of 5% (p<0.05). The intercanine distance variation (T2-T1) showed statistical difference (p=0.005) increasing in the FG group and decreasing in the CG group. In the interfirst premolar distance variation, FG decreased, while CG increased with statistically significant difference (p=0.008). The intercanine distance of individuals with cleft showed stability, while that of the CG had no stability. The CG showed stability in the interfirst premolar distance, while FG had no stability. These findings showed that the FPD is capable of restricting orthodontic results, leading to a stabilization of the dental arches.

Desenvolvimento de lesões artificiais de cárie em dentina humana e bovina comparada a lesões de cárie natural / Development of caries-like lesions in human and bovine dentin compared to natural caries

Dada a complexidade, aspectos éticos e custos envolvidos na condução de experimentos clínicos relacionados a cárie dental, estudos in vitro têm sido uma alternativa às pesquisas clínicas. O objetivo deste estudo foi avaliar o desenvolvimento de lesões artificiais de cárie em dentina humana e bovina, comparado à lesões de cárie natural em dentina humana (CT). Quinze fragmentos de dentina humana naturalmente cariada, 45 fragmentos de dentina humana (H) e 45 fragmentos de dentina bovina (B) foram planificados e polidos. Os espécimes dos grupos H e B foram então submetidos a três protocolos de ciclos de pH: 8 (H8 e B8), 12 (H12 e B12) e 16 ciclos (H16 e B16). Após o desafio cariogênico, valores de microdureza Knoop (KHN) foram obtidos a 30, 60, 90, 120 e 150 µm da superfície das lesões. A Análise de Variância mostrou efeito significativo da interação ciclo-profundidade. O teste t-Student foi empregado para comparar as médias de KHN do substrato naturalmente cariado (CT) em relação a cada desafio cariogênico desenvolvido nos grupos H e B, em cada profundidade. Os modelos de ciclos de pH que mais se aproximaram em termos de microdureza das lesões de cárie natural foram o grupo B8, para dentina bovina e o grupo H16, para dentina humana. Dentro das condições do presente estudo, pode-se concluir que a utilização tanto de substrato humano quanto bovino pode ser considerada uma alternativa viável para o desenvolvimento de lesões de cárie artificial.

Due to the complexity, ethical aspects and high costs involving clinical experiments on dental caries, in vitro studies have been considered as an alternative option to clinical researches. The purpose of this study was to compare artificial caries-like lesions in human and bovine dentin to natural caries in human dentin (CT). Fifteen specimens of human dentin with natural caries, 45 specimens of human dentin (H), and 45 specimens of bovine dentin (B) were flattened and polished. The specimens from groups H and B were submitted to three different protocols of pH cycles: 8 (H8 and B8), 12 (H12 and B12), and 16 cycles (H16 and B16). Each cycle consisted of immersion of the specimens for 6 hours in a demineralising solution and for 18 hours in a remineralising solution. After the cariogenic challenge, the Knoop microhardness (KHN) was determined at 30, 60, 90, 120 and 150 µm from the lesion surface. The Analysis of Variance showed a significant effect of the interaction cycle-depth. The Student?s t-test was employed to compare the mean values of KHN from the substrate with natural caries to the values of KHN of each cycle of the experimental groups (H or B), at each depth. The pH-cycling models closest to natural caries were group B8, for bovine dentin and group H16, for human dentin. Within the conditions of the present study, it can be concluded that the use of both human and bovine substrates can be considered a viable alternative to the development of artificial caries lesions.

Iniciação profissional em odontologia / Professional iniciation in dentistry

A iniciação profissional representa uma etapa difícil para todo recém-formado na área de Odontologia, porque muitas decisões tomadas nesse momento refletirão na satisfação profissional do novo cirurgiãodentista. Por esse motivo, torna-se fundamental efetuar a escolha mais correta do caminho a seguir, seja na área privada ou pública, sabendo-se as vantagens e dificuldades de cada área.

The start of one's professional practice is a difficult phase for all newly-graduated dental professionals. Since many decisions made at this point may reflect in the professional satisfaction of the new dental surgeon. Due to such, it is fundamental to make the most correct choice with regard to the path to be followed, whether in private or public practice, aware of the advantages and difficulties that each present.

Influência do tipo de armazenamento e do método de desinfecção de dentes extraídos sobre a adesão à estrutura dental / The influence of storage and sterilization methods more used in tests of adhesive resistance with extractec teeth

O presente estudo de revisão de literatura procura destacar a influência do tipo de armazenamento e dos métodos de desinfecção mais utilizados nos testes de resistência adesiva realizados com dentes extraídos. Observou-se entre os autores que várias substâncias são utilizadas com esta finalidade em suas avaliações. Em relação ao tempo de armazenamento e tipo de solução utilizada houve grande variabilidade nos resultados. Para desinfecção, a autoclave foi o método mais seguro empregado para esterilização dos dentes, não causando alteração nos valores de resistência adesiva à dentina.

The present study of literature review tried to determinate the influence of the storage and the sterilization methods more used in the tests of adhesive resistance with extracted teeth. Most of the works used different substances in their evaluations. An autoclave was the safest method employed for sterilization of the teeth. In relationship at the time of stockpiling and type of used solution was found a great variability in the results.

Utilização da resina composta sub-microhíbrida em dentes posteriores / Sub-microhibrid restorative composite for posterior teeth

O presente trabalho relata a realização de um caso clínico no qual foi utilizado uma resina composta sub-microhíbrida com o intuito de devolver a função e a estética, por meio de técnica direta. Após a realização dos exames clínicos e radiográfico, verificou-se a presença de fratura das cúspides linguais do elemento 36, assim como, da restauração presente. Em seguida, foi reallizada a verificação dos contatos oclusais e registro da cor, no qual verificou-se que os dentes apresentavam matiz A3, de acordo com a escala Vita. O sistema adesivo selecionado foi o Excite, associado à resina composta In Ten-S, além de pigmentos Tetric color. Concluiu-se que a utilização da resiina composta de baixo escoamento demostrou bons resultados clínicos, ante às suas propriedades.

Diabete inicial e candidíase bucal / Early diabetes mellitus and oral candidiasis susceptibility

A mucosa bucal atual como interface entre os ambientes interno e externo, protegendo contra a penetração de microrganismos. Suas alterações podem levar a um aumento da patogenicidade ou diminuição da capacidade de defesa. A diabete é um grupo heterogêneo de alterações, caracterizada principalmente por estado hiperglicêmico. Suas complicações são associadas principalmente à sua duração, e pouca informação existe a respeito dos eventos iniciais dessa doença. Foi realizada a avaliação da suscetibilidade à candidíase nos momentos iniciais da diabete. Foram utilizados ratos Wistar, com diabete induzida por aloxana. Animais não injetados foram utilizados como controle. Todos os animais receberam a inoculação de um "pool" de Candida sp, e foram avaliados durante 7 dias após a inoculação. os resultados nos permitiram observar que, mesmo em estágios bastante iniciais da diabete existe um aumento da suscetibilidade à candidíase bucal

Clareamento caseiro de dentes vitais / Home vital bleaching

O presente trabalho descreve um caso clínico que empregou peróxido de carbamida a 16 por cento com desensibilizante pela técnica de clareamento caseiro, com o intuito de melhorar a estética. Após a realização dos exames clínico e radiográfico, verificou-se a ausência de lesões de cáries, e de restaurações deficientes, sendo então registrado a cor na escala Vita. Selecionou-se o agente clareador Nite White Excel 2 Z, sendo aplicado com moldeira individual, durante 10 dias, porum período de8 horas. após este período observou-se a eficácia do branqueamento dos dentes sem ocasionar sensibilidade dentinária, proporcionando a satisfação do paciente