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INTRODUCTION: Hereditary gingival fibromatosis (HGF) is a rare disease characterized by gingival enlargement, normal color with benign and firm consistency. This growth may be exacerbated by use of drugs and plaque build-up. The treatment for this clinical condition is surgical excision of the enlarged gingival tissue or the extraction of all teeth. CASE REPORT: A 20-year-old Brazilian female handicapped patient with a chief complaint of exaggerated gingival enlargement who had been prescribed Carbamazepine and Gardenal was referred to our center. According to the clinical presentation and family history, the final diagnosis of gingival enlargement was HGF. Full dental treatment was performed, including basic periodontal treatment, restorations, sealants, and gingivoplasty with internal bevel. Special care was taken to ensure that there was no change in patient's anticonvulsant medication. The patient has been monitored for seven years without signs of recurrence of gingival hyperplasia due to constant professional and home control of plaque.
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Objetivo: Comparar a radiografia interproximal (convencional e digital) e a tomografia computadorizada de feixe cônico quanto ao diagnóstico de lesões oclusais de cárie. Material e método: Os exames de imagem foram realizados em 145 terceiros molares e avaliados por dois especialistas em radiologia que classificaram as imagens quanto à presença de lesões de cárie oclusais. Foram aplicados os testes de Kappa, de McNemar e análise ROC associada aos testes de Mann-Whitney e Qui-quadrado. Resultados: Com o teste Kappa evidenciaram-se graus excelente e moderado de concordância para as avaliações intra e interexaminadores, respectivamente. A partir da aplicação do teste de McNemar identificou-se diferença estatisticamente significativa (p=0.0026) entre a proporção de dentes diagnosticados com lesão de cárie na radiografia convencional e na tomografia computadorizada de feixe cônico. Para a radiografia digital a diferença encontrada não foi significativa (p=0.2858). Todos os exames mostraram sensibilidade menor que a especificidade e, utilizando como parâmetro a tomografia, a radiografia digital apresentou resultados discretamente superiores para avaliação das lesões oclusais. Conclusão: As três modalidades diagnósticas estudadas são válidas para abordagem de lesões oclusais de cárie. A radiografia digital e a tomografia computadorizada de feixe cônico mostraram-se superiores para o diagnóstico dessa patologia.
Objective: Compare interproximal radiography (conventional and digital) and cone beam computed tomography in the assessment of occlusal caries. Material and Methods: The image studies were performed in 145 third molars and evaluated by two radiologists who rated the images for the presence of occlusal caries. Kappa, McNemar and ROC analysis associated with Mann-Whitney and Chi-square were the statistical tests applied. Results: Kappa test revealed excellent and moderate degree of agreement for intra and inter-evaluations, respectively. From the application of the McNemar test a statistically significant difference (p = 0.0026) between the proportion of teeth diagnosed with caries in conventional radiography and tomography was identified. For digital radiography the difference found was not significant (p = 0.2858). All examinations showed lower sensitivity than specificity. Selecting as parameter the tomographic image, digital radiography showed slightly higher results for the assessment of occlusal lesions. Conclusion: All the diagnostic modalities studied approach is valid for occlusal caries. Digital radiography and cone beam computed tomography proved to be better to the diagnosis of this pathology.
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This study evaluated microleakage in vitro using different bonding agents. Forty-two freshly extracted caries-free human teeth were randomly divided into seven groups of six teeth and restored with different adhesive systems: Single Bond, Prime&Bond NT, Excite, Durafill Bond, Etch&Prime 3.0, Prompt L-Pop and Vitremer as the control group. All groups were treated according to manufacturers' instructions. Class V cavities were prepared on buccal and lingual surfaces (3 x 2.5 x 1.5 mm) of each tooth (12 restorations per group), with gingival margins in dentin. The teeth were restored with Charisma resin composite. After finishing and polishing with Denco-Flex disks, the teeth were thermocycled for 200 cycles (5 degrees C-55 degrees C +/- 2 degrees C, 60-second dwell time). Apical foramina and surfaces around restorations were coated with nail varnish, stained in 50% AgNO3 solution for 12 hours and longitudinally sectioned. Microleakage was evaluated with a stereomicroscope. Marginal penetration was scored on a 0-4 scale. Statistical analysis using the Kruskal-Wallis test revealed significant (p < or = 0.05) leakage at dentin margins for all adhesive systems when compared to the control. Except for Durafill Bond, no significant difference was found between the self-etching adhesives and one-bottle adhesives.
