Phenome-Wide Scan Finds Potential Orofacial Risk Markers for Cancer.

Cancer is a disease caused by a process that drives the transformation of normal cells into malignant cells. The late diagnosis of cancer has a negative impact on the health care system due to high treatment cost and decreased chances of favorable prognosis. Here, we aimed to identify orofacial conditions that can serve as potential risk markers for cancers by performing a phenome-wide scan (PheWAS). From a pool of 6,100 individuals, both genetic and epidemiological data of 1,671 individuals were selected: 350 because they were previously diagnosed with cancer and 1,321 to match to those individuals that had cancer, based on age, sex, and ethnicity serving as a comparison group. Results of this study showed that when analyzing the individuals affected by cancer separately, tooth loss/edentulism is associated with SNPs in AXIN2 (rs11867417 p = 0.02 and rs2240308 p = 0.02), and leukoplakia of oral mucosa is associated with both AXIN2 (rs2240308 p = 0.03) and RHEB (rs2374261 p = 0.03). These phenotypes did not show the same trends in patients that were not diagnosed with cancer, allowing for the conclusion that these phenotypes are unique to cases with higher cancer risk.

ABORDAGEM ORTOCIRÚRGICA DE UMA MALOCLUSÃO CLASSE III ASSOCIADA ÀS NOVAS TECNOLOGIAS: RELATO DE CASO / ORTHODONTIC-SURGICAL APPROACH TO A CLASS III MALOCCLUSION ASSOCIATED TO NEW TECHNOLOGIES: CASE REPORT

A maloclusão Classe III é desafiadora para a prática ortodôntica devido a etiologia multifatorial e a imprevisibilidade do crescimento do complexo craniofacial. Inúmeros perfis esqueléticos e dentários associados as maloclusões Classe III podem ser resultantes do prognatismo mandibular, retrusão maxilar ou associação de ambos. Ao final do crescimento, o tratamento destas alterações limita-se à compensação dentária ou ao tratamento ortodôntico-cirúrgico. Este artigo apresenta o caso clínico de uma paciente com maloclusão esquelética e dentária Classe III, conduzida ao tratamento ortocirúrgico convencional em decorrência da impossibilidade de camuflagem ortodôntica, com realização de osteotomias combinadas dos maxilares, visando a perspectiva de melhoria estética e funcional. Os dados foram coletados por meio de revisão do prontuário, modelos de estudo, radiografias, tomografia cone beam e registros fotográficos intra e extrabucais. O tratamento proposto proporcionou resultados funcional e estético almejados, com adequada intercuspidação entre os arcos dentários, aumento de volume na região do terço médio da face e redução da projeção do mento no perfil.

Class III maloclusions are challenging for clinical orthodontics due to its multifactorial etiology and the craniofacial growth's unpredictability. Numerous skeletal and dental profiles associated with Class III maloclusions can result from mandibular prognathism, maxillary retrusion or association of both. After growth is ceased, treatment of these conditions is limited to dental compensation or orthodontic- surgical treatment. This article reports the case of a patient with Class III skeletal and dental malocclusion, treated with orthodontics and bimaxillary orthognathic surgery. This treatment plan was chosen due to the impossibility of orthodontic camouflage and to improve aesthetics and function. Data were collected through a review of medical records, study models, radiographs, cone beam computed tomography, and intra and extraoral photos. The treatment achieved the desired functional and aesthetic results, with adequate intercuspidation between the dental arches, increased volume of the face's middle third region, and reduction of chin's projection.

An Argument Against Extraction as a Treatment Alternative for Restorable Teeth.

Extraction is commonly presented as a treatment alternative for restorable teeth, and patients are biased to choose it for a variety of reasons. However, without subsequent rehabilitation, patients' health, function, and esthetics could be compromised. This article explores problematic outcomes where extraction was offered as a treatment option when teeth were restorable; a case report example demonstrates this issue. The case involved a patient who was diagnosed with moderate to severe periodontitis and had severe attrition and lingual erosion on his maxillary teeth. Despite being given the option of full-mouth rehabilitation, ie, periodontal and restorative treatment, due to financial reasons the patient chose to have all maxillary teeth extracted and receive a maxillary denture. Respecting the patient's autonomy, the dental team performed surgical extraction of the maxillary teeth and an alveoloplasty and delivered an interim denture. The patient did not adapt well to the denture, and several postoperative issues transpired, which required unanticipated surgical procedures. Dissatisfied with the treatment, the patient continued to need dental appointments more than a year after the extractions, and his oral health, function, and esthetics have still not been restored. The dental community must educate patients regarding extraction being an irreversible, last-resource procedure, and mainly indicated only when teeth restoration is not possible. Presenting extraction together with more conservative options for restorable teeth may contribute to patients' misconceptions that it is a treatment alternative as good as any other.

Surface morphologic evaluation of orthodontic bonding systems under conditions of cariogenic challenge.

Orthodontic bonding systems are submitted to demineralization and remineralization dynamics that might compromise their surface smoothness, and favor biofilm aggregation and caries development. The aim of the present study was to evaluate the effects of a cariogenic challenge model (in vitro pH-cycling model) on the surface roughness and topography of 3 bonding materials: Transbond™ XT (XT), Transbond™ Plus Color Change (PLUS) and Fuji Ortho™ LC (FUJI), by means of Atomic Force Microscopy (AFM). Six specimens with standardized dimensions and surface smoothness were fabricated per group, and the materials were manipulated in accordance with the manufacturers' instructions. No polishing was necessary. AFM tests were performed before and after pH-cycling, taking 3 readouts per specimen. The roughness results (Ra) were obtained at nanometric levels (nm) and surface records were acquired in two- and three-dimensional images of height and lock-in phase of the material components. The surfaces of all groups analyzed in the study were morphologically altered, presenting images suggestive of matrix degradation and loss of matrix-load integrity. FUJI presented the greatest increase in surface roughness, followed by XT and PLUS, respectively (p≤0.001). Nevertheless, the roughness values found did not present sufficient degradation to harbor bacteria. The surface roughness of all tested materials was increased by pH-cycling. The use of materials capable of resisting degradation in the oral environment is recommended, in order to conserve their integrity and of the surrounding tissues.

Angle Class III malocclusion treated with mandibular first molar extractions.

A Class III malocclusion associated with dental asymmetry is a complex diagnostic and treatment problem in orthodontics. The goals of maintaining or improving the facial profile and achieving good function are decisive factors when considering whether to plan a surgical or a nonsurgical treatment approach. A fixed appliance in combination with extractions could be considered for nonsurgical management of this type of malocclusion in the permanent dentition. This article presents the results of an orthodontic approach to a Class III subdivision malocclusion in an adult treated with mandibular first molar extractions. The extractions provided the space needed to correct the overjet and overbite and to improve the intercuspation.

Assessment of flexural strength of two self-curing acrylic resins containing pigment

Aim: To assess the flexural strength of orthodontic acrylic resins from two different manufacturers (VIPI, OrtoCril versus Clássico, OrtoClas) by comparing pigmented resins to colorless ones. Methods: Resins of blue, yellow and green colors were studied. A total of 120 specimens were made and then divided into groups of 15 elements each, all having the same dimensions. Next, they were kept in aqueous medium until being subjected to mechanical testing. The flexural strength was tested in a universal test machine (EMIC DL 10000) in which the specimens were subjected to a gradual load until fracture occurred. Results: Pigmented resins had flexural strength values compatible with clinical use, being similar to those from colorless ones, except for OrtoClas green-colored and yellow-colored resins, which showed greater flexural strength. The OrtoClas green-colored resin was the most resistant to fracture (482.2 N), whereas the OrtoCril colorless resin was the least resistant (368.4 N). All OrtoClas resins showed higher strength values compared to OrtoCril resins of same color, except for the OrtoCril’s blue-colored resin, which presented higher flexural strength than that of the other trademark. Conclusions: The use of pigments seems to have no effect on decreasing the flexural strength of self-curing acrylic resins. Therefore, pigmented resins are compatible with clinical use.