Recontorno gengival e reposicionamento labial cirúrgico para tratamento do sorriso gengival: resultados após um ano / Gummy smile treatment with gingival recontouring and surgical lip repositioning: 1-year follow-up results

O presente artigo teve como objetivo esclarecer as diferentes alternativas utilizadas para o reposicionamento labial e melhora da estética do sorriso, propondo uma nova classificação para o diagnóstico e tratamento do sorriso gengival. A técnica cirúrgica descrita no relato de caso associa o recontorno gengival e o reposicionamento labial com tratamento estético restaurador. A cirurgia realizada proporcionou a correção da erupção passiva alterada dos dentes anterossuperiores, combinada com o alongamento do feixe lateral do músculo levantador do lábio superior e da asa do nariz, e a contenção do mesmo com sutura mononylon, diminuindo o sorriso gengival. Notou-se, após a cirurgia, que a linha alta do sorriso foi corrigida sem comprometer a harmonia labial. A paciente manifestou alto grau de satisfação com o tratamento. O diagnóstico e a técnica cirúrgica proposta neste estudo podem ser uma opção terapêutica para o reposicionamento labial e harmonia do sorriso.

The present article aims to address the different alternatives used for lip repositioning and improved smile aesthetics, proposing a new classification for the diagnosis and treatment of the gummy smile. The surgical technique described this a case report associates gingival recontouring and lip repositioning with restorative aesthetic treatment. The surgery provided the correction of altered passive eruption of the anterior superior teeth combined with lengthening of the lateral bundle levator muscle of the upper lip and the ala of the nose, containing them with mononylon sutures, decreasing the gummy smile. It was noted that after surgery, the high smile line was corrected without compromising the labial harmony. The patient expressed high satisfaction with the treatment. The diagnosis and surgical technique proposed in the present study may be a therapeutic option for lip repositioning and smile harmony.

Evaluation of the flexural strength and elastic modulus of resins used for temporary restorations reinforced with particulate glass fibre.

OBJECTIVE: The flexural strength and the elastic modulus of acrylic resins, Dencor, Duralay and Trim Plus II, were evaluated with and without the addition of silanised glass fibre. MATERIALS AND METHODS: To evaluate the flexural strength and elastic modulus, 60 test specimens were fabricated with the addition of 10% ground silanised glass fibres for the experimental group, and 60 without the incorporation of fibres, for the control group, with 20 test specimens being made of each commercial brand of resin (Dencor, Duralay and Trim Plus II) for the control group and experimental group. After the test specimens had been completed, the flexural strength and elastic modulus tests were performed in a universal testing device, using the three-point bending test. For the specimens without fibres the One-Way Analysis of Variance and the complementary Tukey test were used, and for those with fibres it was not normal, so that the non-parametric Mann-Whitney test was applied. RESULTS: For the flexural strength test, there was no statistical difference (p > 0.05) between each commercial brand of resin without fibres [Duralay 84.32(±8.54), Trim plus 85.39(±6.74), Dencor 96.70(±6.52)] and with fibres (Duralay 87.18, Trim plus 88.33, Dencor 98.10). However, for the elastic modulus, there was statistical difference (p > 0.01) between each commercial brand of resin without fibres [Duralay 2380.64 (±168.60), Trim plus 2740.37(±311.74), Dencor 2595.42(±261.22)] and with fibres (Duralay 3750.42, Trim plus 3188.80, Dencor 3400.75). CONCLUSION: The result showed that the incorporation of fibre did not interfere in the flexural strength values, but it increased the values for the elastic modulus.

Evaluation of the efficacy of chemical disinfectants for disinfection of heat-polymerised acrylic resin.

OBJECTIVE: This study evaluated the efficacy of disinfectants on the internal aspect of heat-polymerised acrylic resin contaminated with microbial strains. BACKGROUND: Dentures absorb oral fluids and become contaminated by different microorganisms. METHODS: Two hundred and fifty rectangular specimens were made of heat-polymerised acrylic resin, and then divided into five groups corresponding to the microbial strains (Staphylococcus aureus, Pseudomonas aeruginosa, Candida albicans, S. mutans and Enterococcus faecalis). After contamination, the specimens were immersed in 1 and 2% sodium hypochlorite and 2% glutaraldehyde for periods of 5, 10 and 15 min. The specimens were placed into tubes containing different broths and incubated at 35°C and then visually analysed. Turbidity in the medium indicated microbial growth. The Fisher's exact test was used in the analysis of the results. RESULTS: The strain E. faecalis was the most resistant to the disinfectant solutions, and among them, glutaraldehyde was more effective than 2 and 1% hypochlorite for disinfection for 5 min; in the 10-min period there were no differences between the disinfectants. In 15 min of immersion, 1% hypochlorite and glutaraldehyde were more effective than 2% hypochlorite. CONCLUSIONS: Disinfection for 10 min with 1% hypochlorite and glutaraldehyde is effective in disinfecting the internal aspect of heat-polymerised acrylic resin.

Antimicrobial efficacy of chemical disinfectants on contaminated full metal crowns.

Prosthetic restorations that have been tried in the patient's mouth are potential sources of infection. In order to avoid cross-infection, protocols for infection control should be established in dental office and laboratory. This study evaluated the antimicrobial efficacy of disinfectants on full metal crowns contaminated with microorganisms. Full crowns cast in a Ni-Cr alloy were assigned to one control group (n=6) and 5 experimental groups (n=18). The crowns were placed in flat-bottom glass balloons and were autoclaved. A microbial suspension of each type of strain - S. aureus, P. aeruginosa, S. mutans, E. faecalis and C. albicans- was aseptically added to each experimental group, the crowns being allowed for contamination during 30 min. The contaminated specimens were placed into recipients with the chemical disinfectants (1% and 2% sodium hypochlorite and 2% glutaraldehyde) for 5, 10 and 15 min. Thereafter, the crowns were placed into tubes containing different broths and incubated at 35ºC. The control specimens were contaminated, immersed in distilled water for 20 min and cultured in Thioglycollate broth at 35ºC. Microbial growth assay was performed by qualitative visual examination after 48 h, 7 and 12 days. Microbial growth was noticed only in the control group. In the experimental groups, turbidity of the broths was not observed, regardless of the strains and immersion intervals, thus indicating absence of microbial growth. In conclusion, all chemical disinfectants were effective in preventing microbial growth onto full metal crowns.

Antimicrobial efficacy of chemical disinfectants on contaminated full metal crowns

Prosthetic restorations that have been tried in the patient's mouth are potential sources of infection. In order to avoid cross-infection, protocols for infection control should be established in dental office and laboratory. This study evaluated the antimicrobial efficacy of disinfectants on full metal crowns contaminated with microorganisms. Full crowns cast in a Ni-Cr alloy were assigned to one control group (n=6) and 5 experimental groups (n=18). The crowns were placed in flat-bottom glass balloons and were autoclaved. A microbial suspension of each type of strain - S. aureus, P. aeruginosa, S. mutans, E. faecalis and C. albicans- was aseptically added to each experimental group, the crowns being allowed for contamination during 30 min. The contaminated specimens were placed into recipients with the chemical disinfectants (1 percent and 2 percent sodium hypochlorite and 2 percent glutaraldehyde) for 5, 10 and 15 min. Thereafter, the crowns were placed into tubes containing different broths and incubated at 35ºC. The control specimens were contaminated, immersed in distilled water for 20 min and cultured in Thioglycollate broth at 35ºC. Microbial growth assay was performed by qualitative visual examination after 48 h, 7 and 12 days. Microbial growth was noticed only in the control group. In the experimental groups, turbidity of the broths was not observed, regardless of the strains and immersion intervals, thus indicating absence of microbial growth. In conclusion, all chemical disinfectants were effective in preventing microbial growth onto full metal crowns.

Restaurações protéticas provadas na cavidade bucal dos pacientes são fontes potenciais de infecção. Para evitar infecção cruzada, protocolos de controle de infecção devem ser estabelecidos no consultório e laboratório odontológicos. Este estudo avaliou a eficácia antimicrobiana de desinfetantes químicos em coroas metálicas contaminadas com microorganismos. Coroas totais fundidas com liga de Ni-Cr foram divididas em grupo controle (n=6) e 5 grupos experimentais (n=18). As coroas foram colocadas em balões de vidro e esterilizadas em autoclave. A suspensão microbiana de cada tipo de cepa (S. aureus, P. aeruginosa, S. mutans, E. faecalis e C. albicans) foi assepticamente adicionada a cada grupo experimental, e as coroas foram deixadas contaminar por 30 min. Os corpos-de-prova contaminados foram colocados em recipientes com os desinfetantes químicos (hipoclorito de sódio 1 por cento e 2 por cento e glutaraldeído) por 5, 10 e 15 min. A seguir, as coroas foram colocadas em tubos contendo diferentes meios de cultura e incubadas a 35ºC. Os corpos-de-prova do grupo controle foram contaminados, imersos em água destilada por 20 min e a seguir colocados em tubos de ensaio com meio de cultura Thioglycollate e incubados a 35ºC. A análise do crescimento microbiano foi realizada pelo exame visual qualitativo após 48 h, 7 e 12 dias. Houve crescimento microbiano apenas no grupo controle. No grupo experimental não foi observada turvação dos meios de cultura, independentemente das cepas e períodos de imersão. Conclui-se que todos desinfetantes químicos foram eficazes para prevenir o crescimento microbiano.