ABSTRACT
OBJECTIVES: This prospective randomized multicenter clinical trial (PRMCT) investigated postoperative pain after single-visit root canal treatments in teeth affected by pulp necrosis (PN), and asymptomatic apical periodontitis (AAP) (with apical radiolucent areas) or normal periradicular tissues (without apical radiolucent areas) comparing different instruments' kinematics and apical instrumentation limits. METHODS: Before chemomechanical preparation, 240 patients/teeth were randomly distributed into four groups (n = 60) according to the instruments' kinematics (rotary or reciprocating) and apical instrumentation limits (with or without intentional foraminal enlargement [IFE]). After that, specimens were submitted to the same irrigation and obturation techniques, and the patients were referred to undergo the definitive restorations. No medication was prescribed, but the patients were instructed to take either paracetamol (750 mg every 6 h for three days) or ibuprofen (600 mg every 6 h for three days) in pain cases. Postoperative pain incidence and levels were assessed at 24-, 48-, and 72 h following treatment completion according to a verbal rating scale (VRS) following a score. The Kolmogorov-Smirnov test was applied to assess the normality of the data. Mann-Whitney U, Chi-square, Friedman's ANOVA, and Friedman's multiple 2 to 2 comparison tests were employed to identify potential significant statistical differences among the variables in the study groups (P < .05). RESULTS: Significant statistical differences were only observed among the groups considering tooth, periradicular status, and the occurrence of overfilling (sealer extrusion) (P < 0.00). Patients with teeth instrumented through rotary kinematics and without IFE experienced lower rates of postoperative pain; however, this difference was relevant only at 24 h (P < 0.05). CONCLUSIONS: Postoperative pain was lower after using a rotary file system (Profile 04) inserted up to the apical constriction (AC). However, this finding was just statistically meaningful at 24 h. TRIAL REGISTRATION: This PRMCT was approved by the Human Research Ethics Committee of the Paranaense University - UNIPAR, Francisco Beltrão, PR, Brazil (CAAE. 46,774,621.6.0000.0109) on 02/09/2021. It was registered at The Brazilian Registry of Clinical Trials - ReBEC (RBR-3r967t) on 01/06/2023, was performed according to the Principles of the Helsinki Declaration and is reported following the Consolidated Standards of Reporting Trials Statement.
Subject(s)
Dental Pulp Cavity , Root Canal Preparation , Humans , Dental Pulp Cavity/surgery , Prospective Studies , Biomechanical Phenomena , Pain, Postoperative/etiology , Pain, Postoperative/epidemiologyABSTRACT
Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.
Subject(s)
Occlusal Splints , Sleep Bruxism , Adult , Female , Male , Humans , Splints , Quality of Life , Reactive Oxygen SpeciesABSTRACT
This in vitro study evaluated the bacterial reduction provided by the EndoActivator (EA), Easy Clean (EC), passive ultrasonic irrigation (PUI), and XP-Endo Finisher. Eight-four mesial roots of mandibular first molars were instrumented, inoculated with Enterococcus faecalis, and divided into four groups (n. 20). Bacterial reduction in the main canals and dentinal tubules were respectively determined by MTT assays and Live/Dead BackLight technique through confocal laser scanning microscopy (CLSM) at 50, 100, and 150 µm in-depth (n. 10 per group). Statistical analyses were conducted following a significance level of 95% (P < 0.05). A significant statistical difference was just identified between XPF and EC in the main canals. In the dentinal tubules from the main root canals, at 100 and 150 µm in-depths, significant statistical differences were only observed between XPF and EC (P = 0.027) for the former and between XPF and EC (P = 0.011) and XPF and PUI (P = 0.021) for the latter. In the dentinal tubules from the isthmus, at 100 µm in-depth, statistically relevant differences did occur between XPF and EC (P = 0.038) and EC and EA (P = 0.029). At 150 µm in-depth, these differences were only significant by comparing XPF and PUI (P = 0.025) and XPF and EC (P = 0.036). Although no irrigation method could thoroughly disinfect the RCS, bacterial reduction indexes were generally better after using XPF.
Subject(s)
Disinfection , Root Canal Preparation , Root Canal Preparation/methods , Disinfection/methods , Dental Pulp Cavity , Root Canal Irrigants , Root Canal Therapy/methods , Bacteria , Sodium HypochloriteABSTRACT
Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.
ABSTRACT
Abstract This study aimed to compare the survival of replanted teeth that followed the 2012 or the 2020 International Association of Dental Traumatology (IADT) guidelines. Sixty-two permanent replanted teeth were retrospectively assessed (IADT 2012, n = 45; IADT 2020, n = 17). Five years after replantation (from January 2017 to December 2021), clinical and radiographic examinations were performed. A significance level of 95% was considered to evaluate the outcomes. Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour. Twelve teeth remained in their sockets without resorption: 8 (66.7%) were replanted within one hour, 2 (16.7%) followed the 2012 IADT, and 2 (16.7%) the 2020 IADT guidelines for late replantation. There was a significant difference (p <0.05) in the extra-alveolar time (< one hour), but without difference between the guidelines in late replantation (p > 0.05). Replanted teeth following both, 2012 or 2020 IADT guidelines, have similar clinical outcomes. The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket.
Resumo Este estudo teve como objetivo comparar a sobrevida, por cinco anos, de dentes reimplantados que seguiram as diretrizes de 2012 ou 2020 da International Association of Dental Traumatology (IADT). Sessenta e dois dentes permanentes reimplantados foram avaliados retrospectivamente (IADT 2012, n = 45; IADT 2020, n = 17). Cinco anos após o reimplante, foram realizados exames clínicos e radiográficos. Foi considerado um nível de significância de 95% para avaliar os desfechos. Trinta e um dentes (50,0%) permaneceram em seus alvéolos e 31 (50,0%) foram perdidos por reabsorção radicular externa. Dos 25 (40,3%) dentes reimplantados em uma hora, 16 (64,0%) permaneceram em seus alvéolos e 9 (36,0%) foram perdidos. Vinte e dois (71,0%) de todos os 31 dentes perdidos tiveram um tempo extra-alveolar superior a uma hora. Doze dentes permaneceram em seus alvéolos sem reabsorção: 8 (66,7%) foram reimplantados em uma hora, 2 (16,7%) seguiram a IADT de 2012 e 2 (16,7%) as diretrizes da IADT de 2020 para reimplante tardio. Houve diferença significativa (p<0,05) no tempo extra-alveolar (< uma hora), mas sem diferença entre as diretrizes no reimplante tardio (p > 0,05). Dentes reimplantados seguindo as diretrizes de 2012 ou 2020 da IADT, tiveram taxas de sucesso semelhantes. O tempo extra-alveolar inferior a uma hora demonstrou ser importante para manter o dente permanente em seu alvéolo.
ABSTRACT
Abstract This study aimed to evaluate the effects of chronic use of fluoxetine on the amount of orthodontic tooth movement and tissue changes in rats. A total of 192 Wistar rats were divided into 4 groups: S, 0.9% saline solution; F, 20 mg/kg of fluoxetine; SM, 0.9% saline solution with orthodontic movement; and FM, 20 mg/kg of fluoxetine with orthodontic movement. After 30 days of daily saline or fluoxetine administration, an orthodontic device (25cN) was used to mesially displace the first molar in animals of the groups SM and FM. The animals were euthanized 2, 7, 14, and 28 days after placement of the orthodontic appliances and animals of groups S and F were euthanized at the same time. The assessment of tooth movement was made in gypsum castings, the collagen neoformation was assessed by polarization microscopy, the number of osteoclasts and root resorption were evaluated using tartrate-resistant acid phosphatase, and presence of hyalinized areas was assessed by hematoxylin-eosin staining. Fluoxetine did not affect the amount of tooth displacement, percentage of collagen, number of osteoclasts, and presence of hyalinized areas (P>0.05). There was a higher frequency of root resorption areas in the FM group than in the SM group only on the second day (P<0.05). The findings of this study show that chronic use of 20 mg/kg fluoxetine does not affect the amount of tooth movement, collagen neoformation, number of osteoclasts, or hyalinized areas and does not affect root resorption until the last day of orthodontic movement.
ABSTRACT
Abstract To investigate the genetic association in a sample of replanted teeth, it is necessary to observe the extreme phenotypes, such as, teeth that underwent functional healing and those extracted due to severe external root resorption. Thus, this study aimed to investigate the association of age of the patients, root development, storage media, and polymorphisms in the interleukin 4 (IL4) and interleukin 6 (IL6) genes with teeth that presented extreme outcomes, as functional healing or extraction, in a group whose replantation techniques did not follow the International Association of Dental Traumatology (IADT) 2012 guidelines. Forty-three avulsed and replanted teeth that did not follow IADT 2012 guidelines and underwent functional healing or were extracted were included. Periapical radiographs employed for this study were taken soon after tooth replantation and after 1 year. For genotypic IL4 and IL6 genes analysis, DNA of oral mucosa cells was extracted. Real-time- PCR performed for genotyping polymorphisms in IL4 and IL6 genes. Clinical and genetic variables were analyzed by the Chi-square test and the "Z" test. P values < .05 were considered significant. The results showed that functional healing and extraction were associated with storage media and with the rs2243268 of IL- 4 gene polymorphisms. As conclusion, the C rs2243268 allele of IL4 gene may have a positive relationship with functional healing teeth that were replanted not following the 2012 IADT guidelines. Keeping the tooth dry is associated to a fast loss of avulsed and replanted teeth after 1-year follow-up.
Resumo Para investigar a influência genética em uma amostra de dentes reimplantados, é necessário observar os fenótipos extremos, como os dentes que sofreram cura funcional e os extraídos devido à reabsorção radicular externa severa. Assim, este estudo teve como objetivo investigar a associação da idade dos pacientes, desenvolvimento radicular dos dentes, assim como o meio de transporte até o reimplante e polimorfismos nos genes da interleucina 4 (IL4) e da interleucina 6 (IL6) com dentes que apresentaram cura funcional ou extração, em um grupo cujas técnicas de reimplante não seguiu a International Association of Dental Traumatology (IADT) 2012. Foram incluídos 43 dentes avulsionados e reimplantados que não seguiram as diretrizes do IADT, e tiveram cura funcional ou foram extraídos. As radiografias periapicais utilizadas para este estudo foram feitas logo após o reimplante dentário e após 1 ano. Para a análise genotípica dos genes IL4 e IL6, foi extraído DNA de células da mucosa oral. PCR em tempo real realizou a análise dos polimorfismos dos genes. As variáveis clínicas e genéticas foram analisadas pelos testes Qui-quadrado e "Z". Valores de p <0,05 foram considerados significativos. Os resultados mostraram que a cura ou perda dos dentes está associada ao meio de armazenamento e polimorfismos no gene rs2243268 da IL-4. Como conclusão, o alelo C rs2243268 do gene IL4 pode ter uma relação positiva com a cura functional do dente reimplantado. Manter o dente seco está associado a uma perda rápida de dentes avulsionados e reimplantados que não seguiram o IADT 2012.
ABSTRACT
ABSTRACT Objective: To study the influence of black space between the maxillary central incisors on the aesthetic visual perception of the face, via eye-tracking and visual analogue scale (VAS). Methods: Black space between the central incisors was created, for both sexes, as follows: control, 1-mm black space, 2-mm black space and 3-mm black space. Ninety raters participated in this study, divided into three groups: 30 laypeople, 30 nonorthodontists, and 30 orthodontists. After the visual calibration of each observer, eight photographs were presented in the Ogama® software concomitant with the use of the hardware The Eye Tribe®. Ogama generated information depending on the eye-tracking of each rater, regarding the time until the first fixation, time of fixation, heatmap, scanpath, and total time of fixation, to evaluate the areas deemed to be of interest according to the raters. Later on, the VAS was used, where each rater evaluated the images in an album on a scale of zero to 10 points. Results: The eyes and mouth were the areas more often noticed by the raters according to the heatmaps, while no significant difference was observed in time until the first fixation between the three groups of raters (p> 0.05). However, regarding the time of fixation on the mouth, a significant difference was observed (p< 0.05) when comparing the three groups. Conclusion: Black space has a negative effect on the aesthetic perception of the face. The amount of attention on the mouth is correspondent to the size of the black space.
RESUMO Objetivo: Avaliar a percepção visual e estética do espaço negro entre os incisivos centrais superiores, via rastreamento do olhar e escala visual analógica (EVA). Métodos: Manipulou-se o espaço negro entre os incisivos centrais superiores, para ambos os sexos, da seguinte forma: imagem controle, espaço negro de 1 mm, espaço negro de 2 mm e espaço negro de 3 mm. Participaram desse estudo noventa avaliadores, divididos em três grupos: 30 leigos, 30 cirurgiões-dentistas e 30 ortodontistas. Após a calibração visual de cada observador, foram projetadas oito fotografias no software OGAMA® em conjunto com o hardware The Eye Tribe®. O OGAMA gerou informações do rastreamento do olhar de cada avaliador com relação ao tempo até a primeira fixação, mapa de calor, trajetória do olhar e tempo total de fixação para avaliar as áreas consideradas de interesse, de acordo com os avaliadores. Posteriormente, utilizou-se a EVA para avaliar as imagens a partir de um álbum, em uma escala de 0 a 10 pontos. Resultados: Os olhos e a boca foram as áreas com maior fixação pelos avaliadores, de acordo com os mapas de calor. Os resultados estatísticos não apresentaram diferença estatisticamente significativa entre os três grupos de avaliadores (p> 0,05), quanto ao tempo até a primeira fixação. Porém, em relação ao tempo de fixação na boca, observou-se diferença estatisticamente significativa (p< 0,05) na comparação dos três grupos. Conclusão: O espaço negro apresentou um efeito negativo na percepção estética da face. O aumento de fixação na boca correspondeu ao aumento do tamanho do espaço negro.
Subject(s)
Humans , Male , Female , Black or African American , Esthetics, Dental , Eye-Tracking Technology , Incisor , Smiling , Visual Analog Scale , Incisor/anatomy & histology , Incisor/diagnostic imagingABSTRACT
[ABSTRACT]. Objective. To describe the estimated prevalence of noncommunicable diseases and their common risk factors among the adult population of Curitiba, Paraná, Brazil, based on results of the EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN) study. Methods. This was a cross-sectional, population-based survey of 1 103 residents of Curitiba, grouped by age (18 – 39 years of age, 40 – 59, and ≥ 60 years), conducted in August 2013 – August 2014. Household interviews, anthropometry, blood pressure measurements, and fasting capillary glycemia were performed during two visits to each participant. The analyses included frequency distribution and prevalence estimates of main outcomes. Prevalence estimates, weighted by age and sex, were presented as absolute numbers and percentages. Results. Prevalence estimates for self-reported depression were 21.2%; hypertension, 31.2%; diabetes, 9.1%; self-reported dyslipidemia, 21.7%; obesity, 21.2%; current smoking, 16.1%; binge drinking, 23.4%; and insufficient physical activity, 35.1%. Prevalences of diabetes and hypertension were higher among individuals with less schooling and the elderly. Binge drinking and leisure-time physical activity were more prevalent in young adults. Men presented higher prevalences of overweight, current smoking, and harmful use of alcohol. Obesity and moderate- to-severe risk of depression were more frequent among women and those with lower income. Conclusions. The prevalence of NCDs and common risk factors among the adult population of Curitiba are high and reveal a gradient of vulnerabilities by age, sex, education level, and income. To address health inequities and meet the needs of different population groups, the health system should monitor NCDs and risk factors and implement equitable public health policies.
[RESUMEN]. Objetivo. Describir la prevalencia estimada de las enfermedades no transmisibles (ENT) y sus factores de riesgo comunes en los habitantes adultos de Curitiba (Paraná, Brasil), con base en los resultados del estudio sobre las características epidemiológicas de Curitiba en el que se evaluaron las ENT (conocido como EPICUREAN por su acrónimo en inglés). Métodos. Encuesta transversal, basada en la población, de 1 103 habitantes de Curitiba, agrupados por edades (de 18 a 39 años, de 40 a 59 años y de 60 años en adelante), efectuada entre agosto del 2013 y agosto del 2014. Se realizaron entrevistas domiciliarias, antropometría y mediciones de presión arterial y glucemia capilar en ayunas en dos visitas a cada participante. Los análisis incluyeron distribución de frecuencias y cálculos de prevalencia de los principales resultados. Los cálculos de prevalencia, ponderados por edad y sexo, se presentaron como números absolutos y porcentajes. Resultados. Las cifras de prevalencia de la depresión autonotificada fueron de 21,2%; hipertensión, 31,2%; diabetes, 9,1%; dislipidemia autonotificada, 21,7%; obesidad, 21,2%; consumo actual de tabaco, 16,1%; consumo compulsivo de bebidas alcohólicas, 23,4%; y actividad física insuficiente, 35,1%. La prevalencia de la diabetes y la hipertensión fue mayor en las personas con menor escolaridad y las de edad avanzada. El consumo compulsivo de bebidas alcohólicas y la actividad física en el tiempo libre fueron más prevalentes en los adultos jóvenes. Los hombres presentaron prevalencias más altas de consumo de tabaco, sobrepeso y consumo nocivo de alcohol. La obesidad y el riesgo de moderado a grave de depresión fueron más frecuentes en las mujeres y las personas de menores ingresos. Conclusiones. La prevalencia de las ENT y los factores de riesgo comunes entre los habitantes adultos de Curitiba es alta y muestra un gradiente de vulnerabilidad por edad, sexo, nivel educativo e ingresos. Para abordar las inequidades en materia de salud y satisfacer las necesidades de diferentes grupos de población, el sistema de salud debe vigilar las ENT y sus factores de riesgo, y ejecutar políticas de salud pública equitativas.
[RESUMO]. Objetivo. Descrever a prevalência estimada de doenças não transmissíveis e principais fatores de risco associados na população adulta da cidade de Curitiba (PR), Brasil, de acordo com os resultados do estudo EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN). Métodos. Foi realizado estudo transversal de base populacional com 1.103 residentes da cidade de Curitiba, por faixas etárias (18–39, 40–59 e ≥60 anos), em agosto de 2013 a agosto 2014. Foram conduzidas entrevistas domiciliares com medidas antropométricas e de pressão arterial e teste da glicemia capilar de jejum em duas visitas a cada participante. Foi analisada a distribuição da frequência e estimada a prevalencia dos principais desfechos. As estimativas de prevalência, ponderadas por idade e sexo, foram apresentadas como números absolutos e porcentagens. Resultados. Foram obtidas as seguintes estimativas de prevalência: 21,2% para depressão autorreferida, 31,2% para hipertensão, 9,1% para diabetes, 21,7% para dislipidemia autorreferida, 21,2% para obesidade, 16,1% para tabagismo atual, 23,4% para uso excessivo de álcool e 35,1% para nível insuficiente de atividade física. A prevalencia de diabetes e hipertensão foi maior nos indivíduos com menor escolaridade e idosos. O uso excessivo de álcool e atividade física no lazer foram mais prevalentes em jovens adultos. Os indivíduos do sexo masculino apresentaram prevalência mais elevada de sobrepeso, tabagismo atual e uso prejudicial de álcool. Obesidade e risco moderado a grave de depressão foram mais frequentes no sexo feminino e em indivíduos de baixa renda. Conclusões. Existe alta prevalência de doenças não transmissíveis e dos principais fatores de risco na população adulta de Curitiba, demonstrando um gradiente de vulnerabilidade por idade, sexo, nível de escolaridade e renda. Para abordar as iniquidades em saúde e suprir as necessidades dos diferentes grupos populacionais, o sistema de saúde deve monitorar as doenças não transmissíveis e os fatores de risco e implementar políticas de saúde pública equitativas.
Subject(s)
Chronic Disease , Epidemiology , Depression , Diabetes Mellitus , Hypertension , Risk Factors , Brazil , Chronic Disease , Risk Factors , Epidemiology , Chronic Disease , Depression , Hypertension , Risk FactorsABSTRACT
ABSTRACT Objective To describe the estimated prevalence of noncommunicable diseases and their common risk factors among the adult population of Curitiba, Paraná, Brazil, based on results of the EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN) study. Methods This was a cross-sectional, population-based survey of 1 103 residents of Curitiba, grouped by age (18 - 39 years of age, 40 - 59, and ≥ 60 years), conducted in August 2013 - August 2014. Household interviews, anthropometry, blood pressure measurements, and fasting capillary glycemia were performed during two visits to each participant. The analyses included frequency distribution and prevalence estimates of main outcomes. Prevalence estimates, weighted by age and sex, were presented as absolute numbers and percentages. Results Prevalence estimates for self-reported depression were 21.2%; hypertension, 31.2%; diabetes, 9.1%; self-reported dyslipidemia, 21.7%; obesity, 21.2%; current smoking, 16.1%; binge drinking, 23.4%; and insufficient physical activity, 35.1%. Prevalences of diabetes and hypertension were higher among individuals with less schooling and the elderly. Binge drinking and leisure-time physical activity were more prevalent in young adults. Men presented higher prevalences of overweight, current smoking, and harmful use of alcohol. Obesity and moderate- to-severe risk of depression were more frequent among women and those with lower income. Conclusions The prevalence of NCDs and common risk factors among the adult population of Curitiba are high and reveal a gradient of vulnerabilities by age, sex, education level, and income. To address health inequities and meet the needs of different population groups, the health system should monitor NCDs and risk factors and implement equitable public health policies.
RESUMEN Objetivo Describir la prevalencia estimada de las enfermedades no transmisibles (ENT) y sus factores de riesgo comunes en los habitantes adultos de Curitiba (Paraná, Brasil), con base en los resultados del estudio sobre las características epidemiológicas de Curitiba en el que se evaluaron las ENT (conocido como EPICUREAN por su acrónimo en inglés). Métodos Encuesta transversal, basada en la población, de 1 103 habitantes de Curitiba, agrupados por edades (de 18 a 39 años, de 40 a 59 años y de 60 años en adelante), efectuada entre agosto del 2013 y agosto del 2014. Se realizaron entrevistas domiciliarias, antropometría y mediciones de presión arterial y glucemia capilar en ayunas en dos visitas a cada participante. Los análisis incluyeron distribución de frecuencias y cálculos de prevalencia de los principales resultados. Los cálculos de prevalencia, ponderados por edad y sexo, se presentaron como números absolutos y porcentajes. Resultados Las cifras de prevalencia de la depresión autonotificada fueron de 21,2%; hipertensión, 31,2%; diabetes, 9,1%; dislipidemia autonotificada, 21,7%; obesidad, 21,2%; consumo actual de tabaco, 16,1%; consumo compulsivo de bebidas alcohólicas, 23,4%; y actividad física insuficiente, 35,1%. La prevalencia de la diabetes y la hipertensión fue mayor en las personas con menor escolaridad y las de edad avanzada. El consumo compulsivo de bebidas alcohólicas y la actividad física en el tiempo libre fueron más prevalentes en los adultos jóvenes. Los hombres presentaron prevalencias más altas de consumo de tabaco, sobrepeso y consumo nocivo de alcohol. La obesidad y el riesgo de moderado a grave de depresión fueron más frecuentes en las mujeres y las personas de menores ingresos. Conclusiones La prevalencia de las ENT y los factores de riesgo comunes entre los habitantes adultos de Curitiba es alta y muestra un gradiente de vulnerabilidad por edad, sexo, nivel educativo e ingresos. Para abordar las inequidades en materia de salud y satisfacer las necesidades de diferentes grupos de población, el sistema de salud debe vigilar las ENT y sus factores de riesgo, y ejecutar políticas de salud pública equitativas.
RESUMO Objetivo Descrever a prevalência estimada de doenças não transmissíveis e principais fatores de risco associados na população adulta da cidade de Curitiba (PR), Brasil, de acordo com os resultados do estudo EPIdemiology of CURitiba: EvaluAtion of Noncommunicable diseases (EPICUREAN). Métodos Foi realizado estudo transversal de base populacional com 1.103 residentes da cidade de Curitiba, por faixas etárias (18-39, 40-59 e ≥60 anos), em agosto de 2013 a agosto 2014. Foram conduzidas entrevistas domiciliares com medidas antropométricas e de pressão arterial e teste da glicemia capilar de jejum em duas visitas a cada participante. Foi analisada a distribuição da frequência e estimada a prevalência dos principais desfechos. As estimativas de prevalência, ponderadas por idade e sexo, foram apresentadas como números absolutos e porcentagens. Resultados Foram obtidas as seguintes estimativas de prevalência: 21,2% para depressão autorreferida, 31,2% para hipertensão, 9,1% para diabetes, 21,7% para dislipidemia autorreferida, 21,2% para obesidade, 16,1% para tabagismo atual, 23,4% para uso excessivo de álcool e 35,1% para nível insuficiente de atividade física. A prevalência de diabetes e hipertensão foi maior nos indivíduos com menor escolaridade e idosos. O uso excessivo de álcool e atividade física no lazer foram mais prevalentes em jovens adultos. Os indivíduos do sexo masculino apresentaram prevalência mais elevada de sobrepeso, tabagismo atual e uso prejudicial de álcool. Obesidade e risco moderado a grave de depressão foram mais frequentes no sexo feminino e em indivíduos de baixa renda. Conclusões Existe alta prevalência de doenças não transmissíveis e dos principais fatores de risco na população adulta de Curitiba, demonstrando um gradiente de vulnerabilidade por idade, sexo, nível de escolaridade e renda. Para abordar as iniquidades em saúde e suprir as necessidades dos diferentes grupos populacionais, o sistema de saúde deve monitorar as doenças não transmissíveis e os fatores de risco e implementar políticas de saúde pública equitativas.
Subject(s)
Humans , Chronic Disease/epidemiology , Risk Factors , Depression , Diabetes Mellitus , Hypertension , BrazilABSTRACT
Tradicionais modelos biomédicos de assistência à saúde, voltados para condições agudas e episódicas, não têm respondido adequadamente às Condições Crônicas que requerem cuidado diferenciado, longitudinal e proativo. Esta pesquisa avaliativa sobre atenção a Condições Crônicas buscou identificar, em abordagem quantitativa, a percepção de usuários e equipes de saúde sobre inovações, com a implantação de um novo modelo de atenção. Os resultados demonstram associação entre a implantação do modelo e as mudanças ocorridas, tais como o cuidado compartilhado e o autocuidado. A forma como é dispensado o cuidado mostra relação direta com o nível de satisfação das equipes de saúde e pessoas usuárias.
Traditional biomedical models of health care, geared predominantly for acute and episodic conditions, have not been responding adequately to Chronic Conditions, which require a different, longitudinal and proactive care. This evaluative research about care for Chronic Conditions sought to identify, in a quantitative approach, the perception of users and health teams about care innovations, with a new care model for Chronic Conditions. The results demonstrate a close association between the implementation of the model and outcome changes, such as shared care and self-care. The way care is dispensed is directly related to the level of satisfaction of health teams and local users of health services.
ABSTRACT
Na descolagem de bráquetes ortodônticos pode ocorrer a perda de esmalte na interface adesivo-esmalte. O objetivo deste estudo foi avaliar os possíveis danos à superfície do esmalte com recolagens de bráquetes metálicos e cerâmicos novos por meio da resistência adesiva ao cisalhamento (RAC), da análise do índice de adesivo remanescente (IAR), da avaliação da rugosidade de superfície (RA) e pela análise de microscopia eletrônica (MEV). Foram usados 120 pré-molares, divididos aleatoriamente em 4 grupos de 30 dentes: CS (Controle Saliva); CA (Condicionamento Ácido); M (Metálico) e C (Cerâmico). Foram colados 120 bráquetes metálicos e 120 cerâmicos, para os grupos M e C, em quatro tempos. Os ensaios mecânicos foram realizados em máquina SHIMADZU, na velocidade 0,5 mm/min. Na avaliação da RAC, o ANOVA a dois critérios demonstrou não haver diferenças (p= 0,052) entre os grupos. Na avaliação do IAR, o teste U de Mann-Whitney demonstrou diferença entre os grupos (p< 0,001), onde o grupo cerâmico exibiu escores mais altos que o metálico. Para a rugosidade, o ANOVA a um critério demonstrou que o grupo M apresentou maior RA (p< 0,001). O teste de Tukey demonstrou que os grupos M e C, após o polimento com discos Sof-Lex, exibiram valores de rugosidade inferiores aos demais grupos. Conclui-se que na remoção de bráquetes metálicos ou cerâmicos e da resina remanescente existe maior risco de danos ao esmalte nas recolagens sucessivas. O polimento com discos Sof-Lex promoveu superfície com maior lisura do esmalte.
Debonding of orthodontic brackets may cause enamel surface loss primarily at the adhesive-enamel interface. The purpose of the present study was to evaluate by means of shear bond strength (SBS), adhesive remnant index (ARI), assessment of surface roughness and electron microscope analysis, the possible damages at enamel surface with repeated rebonding of new metallic and ceramic brackets. One hundred and twenty human premolars were randomly divided into 4 groups of 30 premolars each: CS (Saliva Control); CA (Acid Etching); M (Metal); C (Ceramic). For CA group, 4 repeated acid conditionings were performed. One hundred and twenty metallic and ceramic brackets, for groups M and C, were bonded and rebonded respectively at 4 stages. Mechanical trials were obtained with a SHIMADZU testing machine at 0.5 mm/min cross-speed. The SBS results were statistically tested with ANOVA, and no statistically significant differences (p=0.052) were observed. The ARI was evaluated by Mann-Whitney test, which demonstrated that there was a statistically significant difference between metallic and ceramic brackets (p<0.001). The ceramic group exhibited higher statistically significant scores for ARI than the metallic group. The roughness assessment was made with one-way ANOVA, that showed statistically significant differences between groups (p<0.001). Tukey´s test has demonstrated that the M and C groups that were polished with SofLex discs had statistically significant lower roughness values as compared to other groups. Polishing with Sof-lex discs, lead to increased smoothness of enamel surfaces.
Subject(s)
Humans , Adolescent , Dental Enamel , Orthodontic BracketsABSTRACT
A síndrome de Down (SD) é a alteração cromossômica mais comum no ser humano e caracteriza-se pelo aparecimento de um cromossomo extra, localizado no par 21. Objetivo: Nesta pesquisa estudou-se a velocidade de fluxo, o pH e a capacidade de tamponamento salivar em pacientes portadores da síndrome de Down. Materiais e Métodos: Foram selecionados 60 indivíduos não aparentados, pareados em idade e sexo, residentes em Curitiba, Paraná, sendo 30 indivíduos diagnosticados com SD (grupo experimental) e 30 indivíduos normorreativos (grupo controle). Para as avaliações bioquímicas salivares coletaram-se as amostras pelo método Spitting preconizado por Navazesh (1992) e posteriormente realizaram-se as análises. O fluxo salivar foi calculado através da fórmula de Banderas-Tarabay (1997). O pH salivar foi mensurado com o auxílio de um medidor digital e a capacidade tampão com o kit Caritest® SL. Resultados: O valor médio do fluxo salivar foi estatisticamente menor para os indivíduos portadores da SD e os valores médios de pH e capacidade tampão salivar não diferiram entre os grupos. Conclusão: Indivíduos com SD apresentaram alterações uantitativas e não qualitativas do fluido salivar...
Down syndrome (DS) is the most common chromosomal abnormality in humans and is characterizedby the appearance of an extra chromosome, located at par 21. Objective: In this research we studiedthe flow rate, pH and buffering capacity of saliva in patients with Down syndrome. Materials and methods:60 unrelated individuals were selected matched by age and sex, living in Curitiba, Paraná, with 30 patientsdiagnosed with DS (experimental group) and 30 normoreactive individuals (control group). For biochemicalassessment, salivary samples were collected by Spitting method, recommended by Navazesh (1992) and thenthe analyses were carried out. Salivary flow was calculated using the formula of Banderas-Tarabay (1997).Salivary pH was measured with the aid of a digital meter and buffering capacity with the Caritest® SL kit.Results: The mean salivary flow was statistically lower for patients with SD and the average values of pH andsalivary buffer capacity did not differ between groups. Conclusion: Individuals with SD showed no quantitativeand qualitative changes in salivary fluid...
Subject(s)
Humans , Male , Female , Child , Adolescent , Saliva/physiology , Saliva/chemistry , Salivation/physiology , Down Syndrome/physiopathology , Case-Control Studies , Hydrogen-Ion Concentration , Reference Values , Statistics, Nonparametric , Time FactorsABSTRACT
The aim of this paper was to evaluate a possible correlation between obturation limits and leakage. Thirty-six extracted human mandibular incisors were used, characterized by straight and single canals, non-anatomical complexities, absence of previous endodontic treatment, complete root formation and patent foramen. For standardization of the specimens for the leakage analysis, foraminal instrumentation was performed up to a Flexofile #25 (Dentsply-Maillefer, Ballaigues, Switzerland). All specimens were instrumented and filled following the same protocol, and the obturation limits were measured using Axiovision 4.5 Software (Carl Zeiss Vision, Hallbergmoos, Germany). The specimens were then separated into three groups (n = 12) according to the following variables: Group I - obturation limits ranging from 0 mm to 0.76 mm of the main apical foramen. Group II - obturation limits ranging from 0.77 mm to 0.98 mm of the main apical foramen. Group III - obturation limits ranging from 0.99 mm to 1.68 mm of the main apical foramen. Apical leakage was quantified by fluid filtration. The analyses were confronted using Pearson's test (p > 0.05). Groups I, II and III showed Pearson correlation values (r2) of -0.152, -0.186 and 0.058, respectively. No correlation was found between the obturation limits and apical leakage.
Subject(s)
Humans , Dental Leakage/diagnosis , Root Canal Obturation/methods , Epoxy Resins/chemistry , Gutta-Percha/chemistry , Materials Testing , Root Canal Filling Materials/chemistry , Root Canal Obturation/instrumentation , Root Canal Preparation/instrumentation , Root Canal Preparation/methods , Time Factors , Tooth ApexABSTRACT
Aim: To investigate the association between palatally impacted maxillary canines (PIC) andidiopathic osteosclerosis. Methods: A sample of 54 subjects (28 females and 26 males, mean ageof 12.98±1.59 years) with PIC was selected from the records of 1,650 orthodontic patients treatedat the Discipline of Orthodontics clinics at the Dental School of the Pontifical Catholic University ofParaná (PUCPR), in Curitiba, PR, Brazil. A control group of 54 subjects with normally eruptedcanines was also selected from the same files (mean age of 12.93±1.58 years). Panoramic,lateral skull, postero-anterior skull, periapical and occlusal radiographs, as well as stone casts ofthe patients were examined. The Kolmogorov-Smirnov test revealed a normal distribution ofgender and age in the groups. The results were analyzed with the Chi-square test (α=0.05).Results: There were no statistically significant differences (p>0.05) between the groups. Fourpatients from each group had idiopathic osteosclerosis (7.41%), a rate that falls in the prevalencerange reported in the literature. Conclusions: No correlation was observed between palatallyimpacted maxillary canines and idiopathic osteosclerosis.
Subject(s)
Diagnosis , Osteosclerosis , Tooth , Tooth, UneruptedABSTRACT
Records form the evolutional history show primitive attempts of human individualization by hand printingon cave walls. Later, still under the need of differentiating among other animals, the ancestral used developedprocesses for personal identification. Nowadays, the human individualization continues based on unique morphological characteristics. This study aims to analyze the correlation between the fingerprints and the palatal rugae. A sample of 93 patients, out of 100, aged between 18 and 35 years, was selected. Fingerprintswere collected by impression on paper, and palatal rugae were registered through intra-oral photography.The Vucetichs method was applied for the fingerprints analysis and the Carreas method was utilized for theanalysis on palatal rugae. Frequency of distribution was applied to describe the incidence of fingerprints andpalatal rugae patterns. The Chi-square test was used for correlation analysis between the two variables. Theexternal clip was the most common pattern among fingerprints on the right hand (48,39%), on the oppositeside the internal clip had major incidence (50,54%). The pattern type IV was observed as the most commonamong the palatal rugae (42,55%). The Chi-square test demonstrated significant result only when correlatedright and left hands. No statistical correlation was found involving palatal rugae. It is possible to concludethat genetic intervention is the main factor to explain relevant results on correlations between opposite hands.Considering the absence of previous studies in the literature, this research aims to provide initial support forfurther investigations.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Dermatoglyphics , Biometric Identification/methods , Anatomy , Chi-Square DistributionABSTRACT
OBJECTIVE: The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. MATERIAL AND METHODS: A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years). Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom), chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. RESULTS: Results obtained with Chi-square tests showed that 71 patients (48.9%) presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p <0.05). Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05). CONCLUSION: Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Hospitalization , Xerostomia/diagnosis , Cheek , Chi-Square Distribution , Medical History Taking , Predictive Value of Tests , Saliva , Xerostomia/physiopathologyABSTRACT
Avaliar a efetividade do laser de baixa intensidade (LLLT) no controle da dor pós-operatória em cirurgia de terceiros molares inferiores inclusos, comparando-o com o lado oposto, que não foi exposto ao LLLT, no mesmo indivíduo.Metodologia: participaram do estudo 16 indivíduos, que apresentaram os dentes 38 e 48 inclusos, em posição similar, e que realizaram a remoção dos dentes no mesmo tempo cirúrgico. O laser foi aplicado imediatamente após a remoção do 48 (lado direito - LD), intra-alvéolo, de forma pontual e sobre a região da sutura, em varredura. O mesmo procedimento foi realizado no 38 (lado esquerdo - LE), com o aparelho desligado garantindo o desconhecimento do paciente sobre qual lado recebeu o laser. Todos foram medicados e orientados quanto aos cuidados pós-operatórios e receberam as escalas visuais análogas (VAS) que variavam de 0-10 cm, anotando a ausência ou presença da dor durante 5 dias do lado direito e esquerdo. Os dados foram tabulados e submetidos ao teste de Wilcoxon (p<0,05) comparando-se as médias da VAS de 1 a 5 dias. Resultados: no 3° dia LD e LE, houve diferença estatística significante (p= 0,0284) e do LD a dor foi menor. No 1° e 5° dia houve redução da dor em ambos os lados (LD:p=0,007; LE:p=0,001).Conclusão: dentro dos limites do presente estudo o laser de baixa intensidade mostrou efetividade no controle da dor pós-operatória...
The purpose of the present study was to analyze the effectiveness of LLLT in pain control after impacted third molar removal, comparing it with the opposite side, note exposed to LLLT in the same patient.Methodology: 16 patients who presented both impacted lower third molar in similar position and accepted to remove them in the same operative time were select to this study. LLLT was used immediately after lower right third molar (R3M), intra-socket and after wound closure. The same procedure was done in the opposite side (L3M) but this time the LLLT was not turned on, warrating thus the patient didn´t no which side had received the irradiation. All patients received visual analogue scale (VAS), where they were instructed to write down the presence or absence of pain in the first five postoperative days. Statistical analysis comprised Wilcoxon test (p<0.05), comparing the VAS average data in the first to the fifth postoperative day.Results: the third postoperative day resulted in a statistically significant (p=0.0284) reduction of pain. In the first and fifth day there was pain reduction in both sides (R3m: p=0.0071; L3M: p=0.0010).Conclusion: within the limits of this study LLLT was effective in postoperative pain control...
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Molar/surgery , Pain, Postoperative/radiotherapy , Low-Level Light Therapy/methods , Tooth Extraction/methods , Statistics, Nonparametric , Time Factors , Treatment Outcome , Visual Analog ScaleABSTRACT
Objetivo: Avaliar a prevalência de pacientes de Ortodontia com caninos superiores permanentes inclusos (CSPI), e sua localização e associação com a agenesia dos incisivos laterais superiores permanentes (ILSP). Materiais e métodos: A amostra foi constituída a partir dos prontuários de 825 pacientes, sendo o Grupo Experimental (GE) composto de 27 pacientes, 14 do sexo feminino (idades entre 10,5 anos e 15,4 anos) e 13 do sexo masculino (idades entre 11 anos e 17,6 anos), com CSPI e o Grupo Controle (GC) por 27 pacientes sem CSPI, pareados com GE de mesma idade e sexo. Analisaram-se a anamnese, o exame clínico, os modelos, as fotografias, radiografias panorâmica, periapicais e oclusais, telerradiografias cefalométrica lateral e póstero-anterior, em ambiente escurecido com negastocópio e lupa testeira (aumento 4x). Resultados: Observaram-se 27 pacientes (3,27%), totalizando 31 caninos inclusos, 51,85% ocorreram no sexo feminino e 48,15% no masculino; o Teste de Diferença de duas proporções verificou maior número de agenesias de ILSP(7) no GE do que no GC (1) (p = 0,0255) e que a ocorrência de agenesias concentrou-se nos pacientes comCSPI na região palatina (p = 0,0227). Conclusão: A prevalência de caninos superiores permanentes inclusosé de 3,27%, mais frequente por palatino e há dependência entre a prevalência aumentada de agenesia deincisivos laterais superiores permanentes e a inclusão palatina de caninos superiores.
Objective: The purpose of this study was to evaluate the prevalence of included permanent maxillary canines (IPMC) in orthodontic patients, their location and association of agenesis of the permanent upper lateral incisors (PULI). Materials and methods: A sample from the medical records of 825 patients was analyzed. The experimental group (E.G.) was composed of 27 patients with IPMC, including 14 females (aged from 10.5 to 15.4 years) and 13 males (aged from 11.0 to 17.6 years). The control group (CG) was made up of 27 patients without IPMC, paired with E.G. of the same age and sex. We analyzed clinical histories and clinical examinations, models, photographs; also panoramic, periapical, occlusal and lateral radiographs, and lateral and antero-posterior cephalometric teleradiographs were examined in a darkened room with an illuminated viewbox and headband magnifier (4X magnification). Results: There were 27 patients (3.27%) with IPMC, totaling 31 included maxillary canines, 51,85% in females and 48.15% in males. The difference in proportions test found a higher number of cases of PULI agenesis (7) in the E.G. than in the CG (1) (p = 0.0255) and that the occurrence of agenesis was concentrated in patients with palatal IPMC (p = 0.0277). Conclusions: The prevalence of included permanent maxillary canines is 3.27%, more frequent in the palatine area. There is dependence between the increased prevalence of agenesis of permanent upper lateral incisors and palatal impaction of maxillary canines.
Subject(s)
Humans , Male , Female , Child , Adolescent , Anodontia/complications , Cuspid/physiopathology , Tooth, Unerupted/complications , Tooth, Unerupted/epidemiology , Age Distribution , Anodontia , Brazil/epidemiology , Tooth, Unerupted , Radiography, Dental , Sex DistributionABSTRACT
INTRODUÇÃO E OBJETIVO: Por meio de radiografias panorâmica e periapical teve-se o propósito de quantificar e comparar o nível da perda óssea alveolar de cinco pacientes que apresentavam periodontite. MATERIAL E MÉTODOS: Foram realizadas as medidas da junção esmalte-cemento (JEC) até a crista óssea alveolar (COA) nas superfícies mesial e distal dos incisivos superiores e inferiores, primeiros pré-molares inferiores e primeiros molares inferiores. Submeteram-se os dados à análise estatística Anova e ao teste de Tukey, com nível de significância de 5 por cento. RESULTADOS: Quando comparados os valores da média da perda óssea alveolar entre a radiografia panorâmica e a periapical, verificou-se que a panorâmica se apresentava 0,93 mm maior que a média dos valores da radiografia periapical, uma diferença estatisticamente significante (p < 0,01). A distorção ocorreu no grupo dos dentes molares. Os incisivos inferiores e superiores tiveram as menores distorções. Não houve diferença estatística expressiva entre as medidas efetuadas nas superfícies mesial e distal. CONCLUSÃO: O exame periapical pode ser considerado o melhor método radiográfico para avaliar o nível da perda óssea alveolar e, por conseguinte, ajudar no diagnóstico da doença periodontal. Contudo a radiografia panorâmica ainda é um método válido para analisar o nível de perda óssea causada pela doença periodontal, desde que o cirurgião-dentista esteja familiarizado com as limitações e características dessa técnica. Caso ele tenha dúvida, deve complementar o exame com radiografias periapicais.
INTRODUCTION AND OBJECTIVE: To quantify and compare the level of alveolar bone loss on panoramic and periapical radiographs of five (5) patients presenting periodontitis. MATERIAL AND METHODS: On the panoramic and periapical radiographs of five patients, the measurements from the cement-enamel junction (CEJ) to the alveolar bone crest (ABC), at the mesial and distal surfaces of the upper and lower incisors, lower first premolars and first molars, were performed. Data were submitted to statistic analysis by Anova and Tukey test, with level of significance set at 5 percent. RESULTS: When the mean values of the alveolar bone loss were compared between panoramic and periapical radiograph, it was verified that the panoramic radiograph measurements were 0.93 mm higher than periapical radiograph values. This difference was statistically significant (p < 0.01). The highest distortion occurred in the group of molar teeth. The upper and lower incisors presented lower distortions. It was not found significant statistically differences between the measurements at the mesial and distal surfaces. CONCLUSION: Periapical radiograph can be considered the best radiographic method to evaluate the alveolar bone loss level and, consequently, to help the diagnosis of the periodontal disease. However, the panoramic radiograph is still a valid method for evaluating the level of bone loss caused by the periodontal disease, although the dentist should be aware of the limitation and characteristics of this radiographic technique. When in doubt, radiographic examination should be completed by periapical radiographic.