The weak evidence of lip print analysis for sexual dimorphism in forensic dentistry: a systematic literature review and meta-analysis.

This study aimed to assess the prevalence of lip print patterns among males and females, and to test the diagnostic accuracy of lip pattern analysis for sexual dimorphism in forensic dentistry. A systematic literature review was performed following the PRISMA guidelines. The search was performed in six primary databases and three databases to cover part of the grey literature. Observational and diagnostic accuracy studies that investigated lip print patterns through cheiloscopy for sexual dimorphism were selected. Risk of bias was assessed with the Joanna Briggs Institute (JBI) tool. Proportion meta-analysis using random effects was fitted to pool the accuracy of cheiloscopy. The odds of correctly identifying males and females was assessed through a random effects meta-analysis. GRADE approach was used to assess certainty of evidence. The search found 3,977 records, published between 1982 and 2019. Seventy-two studies fulfilled the eligibility criteria and were included in the qualitative analysis (n = 22,965 participants), and twenty-two studies were sampled for meta-analysis. Fifty studies had low risk of bias. Suzuki and Tsuchihashi's technique was the most prevalent among studies. The accuracy of sexual dimorphism through cheiloscopy ranged between 52.7 and 93.5%, while the pooled accuracy was 76.8% (95% CI = 65.8; 87.7). There was no difference between the accuracy to identify males or females (OR = 0.71; 95% CI = 0.26; 1.99). The large spectrum of studies on sexual dimorphism via cheiloscopy depicted accuracy percentage rates that rise uncertainty and concern. The unclear performance of the technique could lead to wrong forensic practice.

External control of fluoridation in the public water supplies of Brazilian cities as a strategy against caries: a systematic review and meta-analysis.

BACKGROUND: Among the methods currently available to provide fluoride in population levels, fluoridated water is the most successful for presenting high efficacy, safety and good cost-benefit. However, recent studies on external control have shown great variability of fluoride concentrations in the water from treatment stations in Brazilian cities, which must present concentration between 0.6 and 0.8 mg/L to be considered acceptable in most cities. Thus, this study aimed to perform a systematic review of the literature to assess the adequacy of fluoride concentration in the water in Brazilian cities using external control. METHODS: The protocol was registered in PROSPERO. Six databases were used as primary search sources and three databases were used to partially capture the "gray literature". Only observational studies that assessed the fluoride concentration of artificially fluoridated water from the public supply network were included. The JBI Critical Appraisal Tools for Systematic Reviews was used to assess the risk of bias of the studies. A proportion meta-analyses using random-effect models were performed. The heterogeneity between studies was determined by I2 statistic. Meta-regressions were conducted to identify relevant moderators to be used in stratified meta-analyses. Publication bias was investigated by Egger's tests. RESULTS: The search provided 2038 results, from which 14 met the eligibility criteria and were included in the data extraction of the review. Overall, the water samples were collected from 449 different sources in three Brazilian regions. Thirteen studies presented a low risk of bias. The mean concentration of fluoride ranged from 0.17 to 0.89 ppmF. The meta-analyis demonstrated that more than half of the water samples analyzed had fluoride concentration levels outside the acceptable range (56.6%; 95% CI 45.5; 67.3), with high heterogeneity. CONCLUSION: More than half of the public water supply analyzed in the studies selected had fluoride concentration levels outside the acceptable range, which may affect the risk of developing oral diseases in the Brazilian population, having an important impact on public health.

Alternative Method for Full Oral Rehabilitation in Patients with Pycnodysostosis Syndrome: A Case Report.

Pycnodysostosis (PYCD) is a rare autosomal recessive skeletal dysplasia arising from a change in the production of the cathepsin K enzyme and it is also known as Maroteaux-Lamy Syndrome. The main changes in the buccal and maxillofacial region are modifications of the facial bones (leading to the loss of the mandibular angle due to micrognathia), deep palate, premature and/or delayed tooth eruption, hypopneumatization of the maxillary sinuses, chin hypoplasia, hypercementosis, enamel hypoplasia, hyperdontia, incomplete dentin calcification, root hypoplasia, pulp chamber obliteration, and increased free functional space. This paper aims to report a case of a patient with PYCD, in which are highlighted the oral manifestations of this syndrome and present an option of oral rehabilitative treatment through a removable overdenture made on natural tooth of the patient. The technique of dental coating through overdenture is a simple, viable and conservative alternative for oral rehabilitation of patients with large maxillomandibular discrepancies, as in cases of pycnodysostosis, especially in the presence of increased free space - characteristic of patients with this syndrome. The result was quite satisfactory both aesthetically and functionally and provided a better life quality for the patient.

Aesthetic facial perception and need for treatment in simulated laterognathism in male faces of different ethnicities.

PURPOSE: This study aimed to compare the aesthetic perception and treatment need in individuals of different ethnicities with various degrees of laterognathism assessed by orthodontists, oral and maxillofacial surgeons, and laypersons. METHODS: Three male descendants of different ethnicities were assessed, in which the mandibular deviation was manipulated digitally in different angulations (from 0 to 8°). The assessment was performed by three groups (orthodontists, maxillofacial surgeons, and laypersons (n = 20)), and it consisted of scoring the degree of pleasantness of the images presented in a numerical scale and indicating or not a corrective treatment for the respective image. RESULTS: The higher the degree of deviation, the lower the scores assigned to the image (p < 0.05). Laypersons assigned the highest scores, with a significant difference between laypersons and oral and maxillofacial surgeons (p < 0.05). In terms of treatment need according to the group of evaluators, there were no statistically significant differences among them (p > 0.05). Moreover, the increase in degree of deviation increased the perception of treatment need (p < 0.05). The African faces received the highest scores, with significant differences from the Caucasian faces (p < 0.05). The overall tendency was higher treatment indication for the Caucasian faces, with statistically significant differences from the African faces (p < 0.05). CONCLUSION: The greater the mandibular deviation, the lower the aesthetic pleasantness. Laypersons are less critical regarding the assessment of mandibular deviation. There was no difference for treatment indication by the different groups of evaluators. In addition, ethnicity may influence the perception and treatment indication.

Comparative analysis of stress distribution in different prosthetic solutions for Kennedy class I bilateral posterior edentulous arches / Análise comparativa da distribuição de tensão em diferentes soluções protéticas para desdentado posterior bilateral "classe I de Kennedy"

One of greatest challenges of dentists is the rehabilitation of free-end Kennedy class I and class II patients due to the improper occurrence of stress around the supporting structures of conventional removable dentures during mastication. This work aimed to compare the stress distribution in different prosthetic solutions. For this analysis, four photoelastic models (PM) were produced simulating a Kennedy class I arch with the remaining teeth 34 through 44. In all models, teeth 33, 34, 43, and 44 received metal crowns. In addition to the crowns, the A model (PMA) received a conventional removable partial denture (RPD), the B model (PMB) received a RPD associated with a semi-rigid attachment, the C model (PMC) received a RPD associated with a rigid attachment, and the D model (PMD) received a RPD associated with implant and rigid attachment. Evenly distributed loads were applied on the last artificial tooth of the prostheses. Based on the results of the distributed load, the conventional prosthesis presented the best results for all regions (averages ranging from 25.70 to 17.80), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment, and lastly, the prosthesis associated with the semi-rigid attachment. The same result can be observed in the localized load, where the conventional prosthesis presented superior results in all regions (averages ranging from 47.35 to 8.30), followed by the prosthesis associated with the implant, the prosthesis associated with the rigid attachment and, with the prosthesis associated with the semi-rigid attachment. Based on the data obtained, it may be concluded that the conventional RPD presented a balanced stress distribution in the three regions analyzed, and when associated with the semi-rigid attachment, it presented a more favorable behavior than that associated with the rigid attachment.

Um dos maiores desafios para os cirurgiões-dentistas consiste na reabilitação de pacientes com extremidade livre classe I e classe II de Kennedy, devido à ocorrência inadequada de tensão em torno das estruturas de suporte das próteses removíveis convencionais durante o processo da mastigação. O objetivo deste trabalho foi analisar comparativamente a distribuição de tensão em diferentes soluções protéticas. Para essa análise, foram confeccionados quatro Modelos Fotoelásticos (MF) simulando um arco classe I de Kennedy, e tendo como dentes remanescentes do dente 34 ao 44. Em todos os modelos, os dentes 33, 34, 43 e 44 receberam coroas metálicas. Além das coroas, o modelo A (MFA) recebeu uma Prótese Parcial Removível (PPR) convencional, o modelo B (MFB) recebeu uma PPR associada a encaixe semirrígido, o modelo C (MFC) recebeu uma PPR associada a encaixe rígido e o modelo D (MFD) recebeu uma PPR associada a implante e encaixe rígido. Foram aplicadas cargas uniformemente distribuídas e localizadas no último dente artificial das próteses. Baseado nos resultados da carga distribuída, a prótese convencional apresentou os melhores resultados para todas as regiões (médias variando entre 25,70 e 17,80), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. O mesmo resultado pode ser observado na carga localizada, onde a prótese convencional apresentou resultados superiores em todas as regiões (médias variando entre 47,35 e 8,30), seguida da prótese associada ao implante, a prótese associada ao encaixe rígido e, finalmente, com a prótese associada ao encaixe semirrígido. Baseado nos dados obtidos pôde-se concluir que a PPR convencional apresentou uma distribuição equilibrada de tensões nas três regiões analisadas e, quando associado à fixação semi-rígida, apresentou um comportamento mais favorável do que aquele associado à fixação rígida.

Reabilitação oral de paciente com redução de dimensão vertical de oclusão utilizando prótese parcial removível overlay: relato de caso / Oral rehabilitation of patient with reduced vertical dimension of occlusion using overlay removable partial denture: case report

A reabilitação oclusal de pacientes parcialmente desdentados com redução da dimensão vertical de oclusão (DVO) representa um grande desafio para o cirurgião-dentista. Normalmente envolve procedimentos complexos, demorados e de elevado custo. A prótese parcial removível (PPR) do tipo overlay representa uma alternativa reabilitadora que pode ser utilizada para esta finalidade. Por meio do relato de um caso clínico, este trabalho teve por objetivo descrever a técnica de utilização da PPR overlay, bem como discutir a viabilidade clínica e efetividade desta modalidade de tratamento. No caso em questão, diagnosticada a redução da DVO, inicialmente a reabilitação oral foi feita de forma provisória, utilizando PPR overlay provisória no arco superior e PPR provisória convencional no arco inferior. O restabelecimento das posições mandibulares possibilitou a reconstrução dos dentes anteriores desgastados com resina composta e a confecção de PPR overlay com recobrimento metálico como tratamento "definitivo". As PPRs de recobrimento (overlays) representam uma excelente e eficiente alternativa no restabelecimento das relações maxilomandibulares. São procedimentos menos onerosos que os procedimentos fixos convencionais, normalmente utilizados na reabilitação de pacientes com diminuição da DVO, mais conservadores e bem indicados para pacientes que tiveram desgastes em função de hábitos parafuncionais.

The occlusal rehabilitation of partially edentulous patients with reduced vertical dimension of occlusion (VDO) represents a great challenge for the dentist. Normally, involving complex, time-consuming and expensive procedures. The removable partial denture (RPD) overlay type represents a rehabilitative alternative that can be used for this purpose. Through the report of a case, this study aimed to describe the use of the RPD overlay technique as well as discuss the clinical feasibility and effectiveness of this treatment modality. In this case, diagnosed the VDO reduction, initially, the oral rehabilitation was made provisionally, using provisory overlay RPD on the upper arch and conventional provisory RPD in the lower arch. The restoration of mandibular positions made possible the reconstruction of the worn anterior teeth with composite resin and the production of the overlay RPD with metallic covering as the "definitive" treatment. The covering RPDs (overlays) are an excellent and efficient alternative on the restoration of the maxillomandibular relations. They are less costly procedures than conventional fixed procedures, normally used in the rehabilitation of patients with decreased VDO, more conservative and well suited for patients who had wear due parafunctions habits.

Photoelastic study of the support structures of distal-extension removable partial dentures.

PURPOSE: The double system of support, in which the distal-extension removable partial denture adapts, causes inadequate stress around abutment teeth, increasing the possibility of unequal bone resorption. Several ways to reduce or more adequately distribute the stress between abutment teeth and residual ridges have been reported; however, there are no definitive answers to the problem. The purpose of this study was to analyze, by means of photoelasticity, the most favorable stress distribution using three retainers: T bar, rest, proximal plate, I bar (RPI), and circumferential with mesialized rest. MATERIALS AND METHODS: Three photoelastic models were made simulating a Kennedy Class II inferior arch. Fifteen dentures with long saddles, five of each design, were adjusted to the photoelastic patterns and submitted first to uniformly distributed load, and then to a load localized on the last artificial tooth. The saddles were then shortened and the tests repeated. The quantitative and qualitative analyses of stress intensity were done manually and by photography, respectively. For intragroup analyses the Wilcoxon test for paired samples was used, while for intergroup analyses Friedman and Wilcoxon tests were used to better identify the differences (p < 0.05). RESULTS: The RPI retainer, followed by the T bar, demonstrated the best distribution of load between teeth and residual ridge. The circumferential retainer caused greater concentration of stress between dental apexes. Stress distribution was influenced by the type of retainer, the length of the saddle, and the manner of load application. CONCLUSIONS: The long saddles and the uniformly distributed loads demonstrated better distribution of stress on support structures.

Interalar distance to estimate the combined width of the six maxillary anterior teeth in oral rehabilitation treatment.

STATEMENT OF THE PROBLEM: The face's architecture of dentate subjects has been studied to find a reliable guide for the selection of artificial anterior teeth. However, there is no consensus of data regarding a reference to estimate the width of artificial teeth. PURPOSE: The purpose of this study was to analyze whether there is a consistent relationship between the interalar distance (IAD) and the combined mesiodistal width of the six maxillary anterior teeth. METHODS: Standardized digital photographs of 81 dentate Brazilian subjects were included in the sample. They were 37 men and 44 women (age 17 to 33). Through image processing software, the IAD and the distance between the tips of the maxillary canines were measured when viewed from the frontal aspect. Accurate casts were made to quantify the distance between the distal surfaces of the maxillary canines on a curve, by use of a flexible millimeter ruler. Nonparametric statistics were performed to analyze the results (p < 0.05). RESULTS: The IAD when compared with the width of the six maxillary anterior teeth, on a straight line and on a curve, presented a ratio of 0.914 and of 1.305, respectively. The Wilcoxon test showed no significant difference between the calculated width values and the mesiodistal width measured on a curve and on a straight line (p = 0.986). CONCLUSION: The IAD, when increased by 31% of its value, can suggest the circumferential distance of the six maxillary anterior teeth. CLINICAL SIGNIFICANCE: The width of the nose, when measured in digital photographs, can be utilized as a reliable guide for the selection of the maxillary anterior teeth width. It can improve the esthetic result of the oral rehabilitation treatment for the edentulous patient by offering a natural dentofacial relation.

Abordagem interdisciplinar na reabilitação estética e funcional de um incisivo central maxilar / Esthetic and functional rehabilitation of a maxillary central incisor: an interdisciplinary approach

Este trabalho descreve a combinação de procedimentos utilizados na reabilitação estética e funcional de um incisivo central maxilar (11), fraturado por traumatismo acidental. A combinação entre uma intervenção periodontal para restabelecimento da distância biológica e IAR (Interface Alvéolo Restauração), com pequena movimentação ortodôntica, utilizando borracha interdental para recuperação do espaço mésio-distal perdido, possibilitou a confecção de uma coroa total de cerâmica livre de metal na proporção dentária adequada e com contorno gengival compatível com a região do elemento 11. O resultado estético e funcional foi bastante satisfatório

O uso de dentes naturais em prótese total removível - relato de caso / El uso de dientes naturales en prótesis total removible - reporte de caso / The use of natural teeth

O uso de dentes naturais na confecção de uma prótese total removível é descrito neste trabalho. Os resultados estético e funcional obtidos foram bastante satisfatórios, o que encoraja o emprego da técnica em pacientes que perderam seus dentes por doença periodontal ou por acidentes. Durante o período de controle de um ano, nenhuma fratura, deslocamento ou cárie foram detectado nos dentes naturais

Considerações estéticas na construção de uma prótese parcial removível / Esthetic considerations in the construction of a removable partial denture

Através de uma revisão de literatura, buscou-se, com este trabalho, abordar os recursos técnicos capazes de suprir as limitações estéticas de uma prótese removível, descrevendo passos, apresentando vantagens e desvantagens, indicações e contra-indicações de cada técnica proposta pelos vários autores. Esses recursos propõem a modificação de grampos convencionais tornando-os menos perceptíveis, a utilização do conceito de eixo rotacional de inserção, o uso de dentes naturais como substitutos dos dentes artificiais, a utilização do sistema dental D, a caracterização da base protética e o uso de encaixes ou attachments

Overlays: próteses provisórias orientadoras de reabilitação oral / Overlays: provisional prosthesis guiding oral rehabilitation

Neste trabalho, os autores descrevem a técnica de confecção das overlays, abordando a importância desses aparelhos na reabilitação de pacientes com redução na dimensão vertical de oclusão

O uso de dentes naturais em prótese parcial removível / The use of natural teeth in removable partial denture

A técnica de confecçäo de uma prótese parcial removível, usando os dentes naturais do próprio paciente é descrita neste trabalho. O resultado estético e funcional alcançado foi bastante satisfatório, o que encoraja o emprego da técnica em pacientes que perdem os dentes por doença periodontal ou por acidentes. Durante o período de controle (dois anos) nenhuma fratura, deslocamento ou cáries foram detectados nos dentes naturais

Removível com grampos estéticos: nova soluçäo estética para próteses parciais removíveis (Próteses "Metal-Free" -Tipo Dental D©) / Partial dentures with sthetical clamps: a new solution fos sthetics in partial denture

Relato de um caso clínico no qual paciente de 65 anos, possuindo prótese total na arcada superior e prótese parcial removível na arcada inferior (Classe I), necessitando confecçäo de nova prótese parcial removível

Análise espectroscópica do conteúdo de monômero residual liberado pelas resinas acrílicas termopolimerizáveis / Spectroscopic analysis of the content of residual monomer released by the heat polymerized acrylic resins

As técnicas espectroscópicas ultravioleta (UV) e infravermelho (IR) foram utilizadas neste trabalho com o objetivo de analisar o conteúdo de monômero residual em duas resinas acrílicas termopolomerizáveis de uso odontológico, com relaçäo a variaçäo nos ciclos de polimerizaçäo e nos tempos de dosagem do monômero. Os resultados obtidos mostraram que as quantidade de monômero residual liberadas pelas resinas estudadas foram baixas e dependentes do tempo e temperatura de polimerizaçäo. A liberaçäo do monômero também foi maior nas primeiras horas, diminuindo a medida que decorria o tempo de imersão em água

As próteses parciais removíveis e as iatrogenias evitáveis / The removable particial dentures and avoidable iatrogenics

As Próteses Parciais Removíveis nem sempre säo realizadas corretamente no que diz respeito à localizaçäo correta de seus componentes, sendo que, nestes casos este tipo de aparelho pode contribuir para o início de patologias bucais, entre os quais se destacam as doenças periodontais. No presente trabalho procuramos enfocar a localizaçäo do limite terminal do conector principal com relaçäo à raiz do dente suporte, em casos de extremidade livre