Effect of low-power diode laser on infected root canals

Abstract This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.

Resumo Este estudo avaliou o efeito da terapia fotodinâmica (PDT) em canais radiculares infectados com E. faecalis. Vinte e um dentes humanos extraídos foram selecionados, e 18 foram infectados por E. faecalis por 60 dias. As estratégias antimicrobianas testadas foram: G1. Preparo do canal radicular (PCR) com instrumentos rotatórios de NiTi, NaOCl 2,5% e irrigação final com EDTA 17%, seguido de PDT com fotossensibilizador azul de metileno e laser diodo de baixa potência; G2. PCR usando limas de aço inoxidável e os mesmos protocolos de irrigação e PDT do G1; G3. Protocolo de PCR similar que G1 sem PDT; G4. Somente irrigação com NaOCl 2,5%; G5. Protocolo similar ao G1, sem PCR; G6. Controle negativo; G7. Controle positivo. Amostras para exames microbiológicos foram coletadas inicialmente (S1), após PCR (S2) e após PDT (S3). Na sequência, as raízes foram seccionadas e preparadas para análise em microscopia eletrônica de varredura (MEV). O crescimento bacteriano foi analisado de acordo com a turbidez do meio de cultura seguida pela densidade óptica espectrofotométrica (nm). O efeito da PDT na estrutura dentinária foi avaliado em aumentos de 1.600X e 5.000X, e descrito qualitativamente. O teste de Wilcoxon foi utilizado para as comparações dos mesmos espécimes e o teste de Mann-Whitney para as comparações entre os grupos ((=5%). Bactérias foram encontradas em todos os grupos experimentais, e em todas as coletas microbiológicas (S1, S2 e S3). A densidade óptica dos meios de cultura foi menor em S2 do que em S1 de G1, 2, 3 e 4 (p>0,05). Após a PDT (S3) em G1 e 2, houve redução adicional na densidade óptica do meio de cultura de 90,0% e 92,0%, respectivamente (p>0,05). No Grupo 5, a análise dos meios de cultura em S2 revelou um aumento de 3,2% na densidade óptica em comparação com S1(p>0,05). Nas imagens de MEV do G1, 2 e 5 foram evidenciadas dentina com áreas de fusão e recristalização. O PDT utilizado após preparo do canal radicular com sistema rotatório ou manual, associado ao NaOCl 2,5%, não foi capaz de eliminar completamente o E. faecalis em biofilme maduro presente no canal radicular.

Effect of low-power diode laser on infected root canals.

This study evaluated the effect of photodynamic therapy (PDT) on infected root canals. Twenty-one human teeth were selected, and 18 were infected by E. faecalis for 60 days. The antimicrobial strategies tested were: G1. Root canal preparation (RCP) using Niquel-Titanium (NiTi) rotary instruments, 2.5% NaOCl, and final irrigation with 17% EDTA, followed by PDT with methylene blue photosensitizer and laser diode low power; G2. RCP using stainless steel files and the same irrigation and PDT protocols as G1; G3. Same RCP protocol as G1 without PDT; G4. Only irrigation with 2.5% NaOCl; G5. Same PDT protocol as G1 without RCP; G6. Negative control; G7. Positive control. Samples for microbiological tests were collected initially (S1), after RCP (S2), and after PDT (S3). Subsequently, the roots were sectioned and prepared for Scanning Electron Microscopy (SEM) analysis. Bacterial growth was analyzed according to the turbidity of the culture medium, followed by spectrophotometric optical density (nm). The effect of PDT on the dentinal structure was evaluated at magnifications 1,600X and 5,000X and described qualitatively. The Wilcoxon test was used for the comparisons from the same specimens, and the Mann-Whitney test was used to compare groups ((=5%). Bacteria were found in all experimental groups' microbiological samples (S1, S2 and S3). The optical density of culture media was lower in S2 than in S1 of G1, 2, 3, and 4 (p> 0.05). After PDT (S3) in G1 and 2, there was an additional reduction in optical density of the culture medium, respectively (p>0.05). In Group 5, the analysis of culture media at S2 revealed an increase in optical density compared to S1(p>0.05). In SEM images of G1, 2, and 5, dentin with melting and recrystallization areas were evidenced. After preparation of the root canal with the rotary system or manually associated with 2.5% NaOCl, PDT was not able to completely eliminate E. faecalis present in the root canal.

[Periodontal status of temporarily institutionalized homeless adults and associated factors]. / Condição periodontal de adultos em situação de rua temporariamente institucionalizados e fatores associados.

The scope of this cross-sectional study was to describe the periodontal status and its association with sociodemographic, oral-health related behaviors and use of drugs among temporarily institutionalized homeless adults. The data were collected through oral clinical examination and a questionnaire with 102 adults attending the only public institution for this group in Goiânia, Goiás, Brazil. The periodontal condition was measured by the presence of bleeding on probing, dental calculus and pockets, according to the Community Periodontal Index (CPI). Chi-square test and Poisson regressions with robust variance were performed. The prevalence of CPI>1 was 83.3%. Approximately 68% of the sample had bleeding, 82.4% had calculus and 9.8% had periodontal pockets. In the bivariate analyses, those who reported having used illicit drugs had a higher prevalence of calculus; males and unmarried adults had a higher prevalence of pockets. In the adjusted analysis, individuals who used dental floss had a lower prevalence of bleeding (PR=0.58; 95%CI=0.35-0.96). The remaining covariates were not associated with the outcomes. It was concluded that the prevalence of periodontal alteration was high, the most frequent condition was calculus and the only independent association was between bleeding and the use of dental floss.

O objetivo deste estudo transversal foi descrever a condição periodontal e sua associação com fatores sociodemográficos, comportamentos em saúde bucal e uso de drogas entre indivíduos em situação de rua temporariamente institucionalizados. Os dados foram coletados por meio de exame clínico e questionário com 102 adultos atendidos na única instituição pública para este grupo em Goiânia, Goiás. A condição periodontal foi avaliada pela presença de sangramento à sondagem, cálculo dentário e bolsas, de acordo com o Índice Periodontal Comunitário (CPI). Foram realizados o teste Qui-quadrado e regressões de Poisson com variância robusta. A prevalência de CPI>1 foi de 83,3%. Cerca de 68,0% da amostra apresentou sangramento, 82,4% cálculo e 9,8% bolsa periodontal. Nas análises bivariadas, os que tinham usado drogas ilícitas alguma vez tinham maior prevalência de cálculo; os homens e os indivíduos sem união estável tinham maior prevalência de bolsa. Na análise ajustada, indivíduos que usavam fio dental tiveram menor prevalência de sangramento (RP=0,58; IC95%=0,35-0,96). As demais covariáveis não foram associadas aos desfechos. Concluiu-se que a prevalência de alteração periodontal foi alta, houve predomínio de cálculo e a única associação independente foi entre sangramento e uso de fio dental.

Condição periodontal de adultos em situação de rua temporariamente institucionalizados e fatores associados / Periodontal status of temporarily institutionalized homeless adults and associated factors

Resumo O objetivo deste estudo transversal foi descrever a condição periodontal e sua associação com fatores sociodemográficos, comportamentos em saúde bucal e uso de drogas entre indivíduos em situação de rua temporariamente institucionalizados. Os dados foram coletados por meio de exame clínico e questionário com 102 adultos atendidos na única instituição pública para este grupo em Goiânia, Goiás. A condição periodontal foi avaliada pela presença de sangramento à sondagem, cálculo dentário e bolsas, de acordo com o Índice Periodontal Comunitário (CPI). Foram realizados o teste Qui-quadrado e regressões de Poisson com variância robusta. A prevalência de CPI>1 foi de 83,3%. Cerca de 68,0% da amostra apresentou sangramento, 82,4% cálculo e 9,8% bolsa periodontal. Nas análises bivariadas, os que tinham usado drogas ilícitas alguma vez tinham maior prevalência de cálculo; os homens e os indivíduos sem união estável tinham maior prevalência de bolsa. Na análise ajustada, indivíduos que usavam fio dental tiveram menor prevalência de sangramento (RP=0,58; IC95%=0,35-0,96). As demais covariáveis não foram associadas aos desfechos. Concluiu-se que a prevalência de alteração periodontal foi alta, houve predomínio de cálculo e a única associação independente foi entre sangramento e uso de fio dental.

Abstract The scope of this cross-sectional study was to describe the periodontal status and its association with sociodemographic, oral-health related behaviors and use of drugs among temporarily institutionalized homeless adults. The data were collected through oral clinical examination and a questionnaire with 102 adults attending the only public institution for this group in Goiânia, Goiás, Brazil. The periodontal condition was measured by the presence of bleeding on probing, dental calculus and pockets, according to the Community Periodontal Index (CPI). Chi-square test and Poisson regressions with robust variance were performed. The prevalence of CPI>1 was 83.3%. Approximately 68% of the sample had bleeding, 82.4% had calculus and 9.8% had periodontal pockets. In the bivariate analyses, those who reported having used illicit drugs had a higher prevalence of calculus; males and unmarried adults had a higher prevalence of pockets. In the adjusted analysis, individuals who used dental floss had a lower prevalence of bleeding (PR=0.58; 95%CI=0.35-0.96). The remaining covariates were not associated with the outcomes. It was concluded that the prevalence of periodontal alteration was high, the most frequent condition was calculus and the only independent association was between bleeding and the use of dental floss.

Untreated dental trauma among homeless people in Midwest Brazil.

Homeless people are usually more exposed to traumatic events that may cause dental injuries than those with more stable housing. Previous studies on the oral health condition of this population group have shown high levels of dental caries, periodontal diseases, and tooth loss, but evidence on dental trauma is scarce. Furthermore, there is no report from Latin American countries. The aim of this study was to describe the prevalence of untreated traumatic dental injuries (TDI) among adult homeless people in a Brazilian capital city. A sample of 102 adults attending a public homeless shelter was clinically examined using the criteria of the 2010 Brazilian National Oral Health Survey. TDI was found in 10.8% of the participants, and the most common types of injury were enamel-dentin fractures and avulsion. The overall prevalence was relatively low, but the proportion of anterior tooth loss due to trauma and other reasons shows the need for more appropriate health care for this vulnerable population group.

Harmonização do sorriso por meio de cirurgia periodontal e restaurações diretas em resina composta: relato de caso / Smile harmonization by means of periodontal surgery and direct restoration in composite resin: case report

Procedimentos estéticos odontológicos estão cada vez mais integrados com outras áreas, trabalhando em prol da otimização de resultados psicossociais e funcionais, e aumentando as possibilidades inclusas no plano de tratamento. A estética apresenta grande relevância na odontologia moderna, a demanda por sorrisos brancos e harmoniosos aumenta proporcionalmente às novas técnicas existentes. O presente trabalho objetiva relatar um caso de reabilitação estética a partir do planejamento digital do sorriso que dará informações benéficas para avaliar as diversas possibilidades frente ao segmento restaurador e periodontal cirúrgico. Paciente R. C. C., 22 anos, sexo masculino, compareceu a clínica integrada com queixa estética nos dentes anteriores. A partir do exame clínico inicial, foram solicitados exames de rotina concomitantemente à moldagem para modelo de estudo. Após o estudo de caso, esclarecimento do planejamento ao paciente e frente as expectativas estéticas, foi solicitado o exame de Planejamento Digital do Sorriso (Digital Smile Design ­ DSD). Foi realizada a cirurgia de gengivoplastia e osteoplastia dos pré- -molares nos dentes 12, 14, 15, 24 e 25, fundamentada nos parâmetros fornecidos pelo exame digital e restaurações diretas em resina composta após o período de cicatrização adequado. Cada vez mais, é exigido do cirurgião-dentista, uma visão ampla que permita explorar as diversas perspectivas vigentes atendendo aos interesses e necessidades do paciente. Conclui-se, independentemente da área da atuação, a realização e otimização de resultados caminha lado a lado com a multidisciplinariedade que, a cada dia que se passa, ganha importância na formação acadêmica profissional.

Aesthetic dental procedures are increasingly integrated with other areas, working towards the optimization of psychosocial and functional outcomes, and increasing the possibilities included in the treatment plan. Aesthetics has great relevance in modern dentistry, the demand for harmonious white smiles increases in proportion to new techniques. The present abstract aims to report a case of aesthetic rehabilitation from the digital smile planning that will give beneficial information to evaluate the various possibilities before the restorative segment and surgical periodontal. Patient R. C. C., 22 years old, male, attended the integrated clinic with aesthetic complaint in the anterior teeth. From the initial clinical examination, routine exams were requested concomitantly with the modeling of the study model. After the case study, clarification of patient planning and aesthetic expectations, the Digital Smile Design (DSD) exam was requested. Gingival surgery was performed on teeth allied to osteoplasty of the premolars 12, 14, 15, 24 and 25, based on the parameters provided by the digital examination and direct restorations in composite resin after the appropriate healing period. Increasingly, the dental surgeon is required to have a broad vision that allows exploring the diverse perspectives that are in place, taking into account the interests and needs of the patient. We can conclude that, regardless of the area of performance, the realization and optimization of results goes hand in hand with the multidisciplinarity that, every day that passes, gains importance in the professional academic formation.

Impact of oral condition on the quality of life of homeless people.

OBJECTIVE: To describe the prevalence of oral health impact on quality of life and its association with the dental condition and sociodemographic factors of homeless people. METHODS: The sample was composed of 116 adults, temporarily attended by a public institution in the municipality of Goiânia, state of Goiás. Interviews were carried out including the Oral Impact on Daily Performance instrument and sociodemographic aspects. Clinical examinations were done by a trained examiner considering criteria of the World Health Organization. We evaluated dental caries (DMFT index) and use or need to use some type of prosthesis. For the statistical analysis of data, we used Pearson's Chi-square and Fisher's exact tests and Poisson regression with robust variance. RESULTS: Of the total respondents, 81.9% had at least one daily performance affected by dental problems in the six months prior the survey. The most prevalent dental conditions were: need for lower arch (76.7%) and upper arch prosthesis (69.0%); untreated caries (75.9%); and high DMFT (57.8%). In bivariate analysis, only the need for upper prosthesis variable was associated with the impact (high Oral Impact on Daily Performance). In the regression model, adjusted for time in the institution, age, and sex, this association remained significant (p = 0.015). Individuals without need for upper prosthesis had prevalence of high impact on daily performance 55% lower than those in need of this type of prosthesis (p = 0.018). CONCLUSIONS: The prevalence of oral health impact on quality of life of homeless people was high and higher than that verified in the overall Brazilian population. The impact was associated with the need for upper prosthesis, regardless of sociodemographic characteristics of the individuals.

Impact of oral condition on the quality of life of homeless people / Impacto da condição dentária na qualidade de vida de indivíduos em situação de rua

ABSTRACT OBJECTIVE: To describe the prevalence of oral health impact on quality of life and its association with the dental condition and sociodemographic factors of homeless people. METHODS: The sample was composed of 116 adults, temporarily attended by a public institution in the municipality of Goiânia, state of Goiás. Interviews were carried out including the Oral Impact on Daily Performance instrument and sociodemographic aspects. Clinical examinations were done by a trained examiner considering criteria of the World Health Organization. We evaluated dental caries (DMFT index) and use or need to use some type of prosthesis. For the statistical analysis of data, we used Pearson's Chi-square and Fisher's exact tests and Poisson regression with robust variance. RESULTS: Of the total respondents, 81.9% had at least one daily performance affected by dental problems in the six months prior the survey. The most prevalent dental conditions were: need for lower arch (76.7%) and upper arch prosthesis (69.0%); untreated caries (75.9%); and high DMFT (57.8%). In bivariate analysis, only the need for upper prosthesis variable was associated with the impact (high Oral Impact on Daily Performance). In the regression model, adjusted for time in the institution, age, and sex, this association remained significant (p = 0.015). Individuals without need for upper prosthesis had prevalence of high impact on daily performance 55% lower than those in need of this type of prosthesis (p = 0.018). CONCLUSIONS: The prevalence of oral health impact on quality of life of homeless people was high and higher than that verified in the overall Brazilian population. The impact was associated with the need for upper prosthesis, regardless of sociodemographic characteristics of the individuals.

RESUMO OBJETIVO: Descrever a prevalência do impacto da saúde bucal na qualidade de vida e sua associação com a condição dentária e fatores sociodemográficos de indivíduos em situação de rua. MÉTODOS: A amostra foi composta por 116 indivíduos adultos, atendidos temporariamente por uma instituição pública no município de Goiânia, GO. Foram realizadas entrevistas incluindo o instrumento Impacto Bucal no Desempenho Diário e aspectos sociodemográficos. Exames clínicos foram feitos por uma examinadora calibrada, utilizando critérios da Organização Mundial de Saúde. Foram avaliados cárie dentária (índice CPOD) e uso ou necessidade de uso de algum tipo de prótese. Na análise estatística dos dados, usamos os testes qui-quadrado de Pearson e exato de Fisher e a regressão de Poisson com variância robusta. RESULTADOS: Do total de participantes, 81,9% tiveram pelo menos um desempenho diário afetado por problemas odontológicos nos seis meses anteriores à pesquisa. As condições dentárias mais prevalentes foram: necessidade de prótese na arcada inferior (76,7%) e na superior (69,0%); cárie não tratada (75,9%); e CPOD alto (57,8%). Na análise bivariada, apenas a variável necessidade de prótese superior foi associada ao impacto (Impacto Bucal no Desempenho Diário alto). No modelo de regressão, ajustando-se por tempo na instituição, idade e sexo, essa associação se manteve significativa (p = 0,015). Os indivíduos sem necessidade de prótese superior tiveram prevalência de alto impacto no desempenho diário 55% menor do que aqueles com necessidade desse tipo de prótese (p = 0,018). CONCLUSÕES: A prevalência de impacto da saúde bucal na qualidade de vida dos indivíduos em situação de rua foi alta e superior à verificada na população brasileira em geral. O impacto foi associado à necessidade de prótese superior, independente das características sociodemográficas dos indivíduos.

Cranioplasty using Polymethylmethacrylate (PMMA) self-curing by the conventional casting process: clinical case report / Cranioplastia com uso do Polimetilmetacrilato (PMMA) autopolimerizável pelo processo de moldagem convencional: relato de caso clínico

ABSTRACT Cranioencephalic trauma which results in extensive edema and / or bruising usually requires surgical treatment through a greater withdrawal of the bone portion. Thus, the absence of bone tissue implies the lack of protection of the brain tissue or even compromises the esthetics especially when located in the frontal or frontoparietal region. The purpose of this case report is to describe a treatment option for head trauma, through the prefabricated part by obtaining the skull model. These bone faults can be reconstructed either by the direct method using polymethylmethacrylate directly on the defects or by means of pre-made pieces such as prototyping or from the skull model. Although other techniques have many good points, some show certain drawbacks, from storage conditions below abdominal fat, preheating due to the release of heat during the high polymerization reaction or the high cost when they are prototyped. The technique described in this work reports its simple performance, eliminating the risk of local heating, allows prior sterilization in autoclave, it is biocompatible, allows perfect anatomical recovery, easy placement, low cost, also highlighs the advantage of the bucomaxillofacial surgeon's performance due to the familiarization with the relevant head and neck procedures. Clinical and tomographic examination after 24 months of treatment showed stability of the polymethylmethacrylate plate, adhesions to the bone margins, and absence of tissue alterations.

RESUMO Os traumatismos cranioencefálicos que resultam em extensos edemas e ou hematomas normalmente, requerem tratamentos cirúrgicos por meio de uma retirada maior de porção óssea. Deste modo, a ausência do tecido ósseo implica na falta de proteção do tecido cerebral ou até mesmo comprometer a estética especialmente, quando localizadas na região frontal ou frontoparietal. O objetivo deste relato de caso é descrever uma opção de tratamento para os traumatismos cranioencefálicos, por meio da peça pré-fabricada mediante a obtenção do modelo do crânio. Estas falhas ósseas podem ser reconstruídas tanto pelo método direto utilizando o polimetilmetacrilato diretamente sobre as falhas ou por meio das peças pré-confeccionadas como a prototipagem ou a partir do modelo do crânio. Embora outras técnicas apresentem muitos pontos positivos, algumas mostram determinados inconvenientes, desde condição de armazenamento abaixo da gordura abdominal, aquecimento prévio devido a liberação de calor durante a reação de alto polimerização ou o alto custo quando são prototipadas. A técnica neste trabalho descrita relata sua facilidade de execução, elimina o risco do aquecimento local, permite a prévia esterilização em autoclave, é biocompatível, permite a perfeita recuperação anatômica, fácil colocação, baixo custo, ressaltando ainda a vantagem da atuação do cirurgião bucomaxilofacial devido sua familiarização com os procedimentos pertinentes a cabeça e pescoço. Em exame clínico e tomográfico após 24 meses do tratamento, observa-se estabilidade da placa de polimetilmetacrilato, aderências às margens ósseas, e ausência de alterações tissulares.

Length-weight relationship in ten fish species from the Nhamundá River, the Amazon Basin, Brazil / Relação peso-comprimento de dez espécies de peixes do Rio Nhamundá, Bacia Amazônica, Brasil

Studies on the length-weight relationship (LWR) of fishes are an important tool to describe several biological aspects of the species. Consequently, these studies are relevant due the necessity of comprehension about fish life cycle. Thus, this study aimed to establish the length-weight relationship of the ten most common fish in the Lower Nhamundá River, left tributary of the Amazon River. The capture of fish was conducted in January 2008 using gill nets. A total of 807 individuals, ten species and three Orders (Characiformes, Siluriformes and Clupeiformes) were analyzed. The parameter b varied from 2.680 to 3.698. The LWR were shown for the first time for two species: Anostomoides laticeps and Ageneiosus polystictus. Finally, this research emphasizes the importance of LWR studies in the Amazon and the use of primary data for fisheries management plans.

Estudos acerca da relação peso-comprimento em peixes são importantes ferramentas para descrever diversos aspetos biológicos das espécies. Consequentemente, estes estudos são importantes em decorrência da necessidade de compreensão do ciclo de vida dos peixes. Sendo assim, este estudo visou estabelecer a relação peso-comprimento de dez espécies mais comuns de peixes na região do baixo Rio Nhamundá, afluente da margem esquerda do Rio Amazonas. A captura dos peixes foi realizada em janeiro de 2008, utilizando redes de emalhar. Foram analisados 807 indivíduos, pertencentes a dez espécies e três Ordens (Characiformes, Siruliformes e Clupeiformes). O coeficiente alométrico "b" variou de 2,680 à 3,698. A relação peso-comprimento é apresentada pela primeira vez para duas espécies: Anostomoides laticeps e Ageneiosus polystictus. Por fim, esse estudo enfatiza a importância de estudos de relação peso-comprimento de peixes na Amazônia e o uso de dados primários para fins conservacionistas.

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching.

OBJECTIVE:: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. MATERIAL AND METHODS:: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. RESULTS:: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. CONCLUSION:: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Inflammatory response of human dental pulp to at-home and in-office tooth bleaching

ABSTRACT Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp. Objective: This study evaluated the inflammatory responses of human dental pulp after the use of two bleaching techniques. Material and Methods: Pulp samples were collected from human third molars extracted for orthodontic reasons and divided into three groups: control - no tooth bleaching (CG) (n=7); at-home bleaching with 15% carbamide peroxide (AH) (n = 10), and in-office bleaching with 38% hydrogen peroxide (IO) (n=12). Pulps were removed and stained with hematoxylin-eosin for microscopic analysis of inflammation intensity, collagen degradation, and pulp tissue organization. Immunohistochemistry was used to detect mast cells (tryptase+), blood vessels (CD31+), and macrophages (CD68+). Chi-square, Kruskal-Wallis, and Mann Whitney tests were used for statistical analysis. The level of significance was set at p<.05. Results: The inflammation intensity and the number of macrophages were significantly greater in IO than in AH and CG (p<0.05). The results of CD31+ (blood vessels per mm2) were similar in CG (61.39±20.03), AH (52.29±27.62), and IO (57.43±8.69) groups (p>0.05). No mast cells were found in the pulp samples analyzed. Conclusion: In-office bleaching with 38% hydrogen peroxide resulted in more intense inflammation, higher macrophages migration, and greater pulp damage then at-home bleaching with 15% carbamide peroxide, however, these bleaching techniques did not induce migration of mast cells and increased the number of blood vessels.

Radiographic evaluation of orthodontic treatment by means of four different cephalometric superimposition methods.

INTRODUCTION: Despite discussion on the merit of various cephalometric superimposition methods, there remains a need to assess which one can be used in daily practice with reasonably accuracy and less working time. OBJECTIVE: The aim of this study was to investigate four methods of cephalometric superimposition by means of assessing the longitudinal changes in craniofacial morphology caused by growth and response of adolescents with Class I malocclusion to orthodontic treatment involving first premolar extraction. METHODS: Pretreatment (T1) and post-treatment (T2) standardized lateral cephalometric radiographs of 31 adolescents (20 females and 11 males), with Angle Class I malocclusion and indication of premolar extraction, participated in this study. Radiographs were digitized, traced and had structures identified by means of a cephalometric software. Four superimposition methods were used: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point. Positional changes were quantified by horizontal and vertical linear changes in the following cephalometric landmarks: anterior/posterior nasal spine (ANS and PNS), gnathion (Gn), Gonion (Go), Pogonion (Pog), A-point and B-point. Differences between T1 and T2 in horizontal and vertical positional changes for all superimposition methods were assessed by one-way analysis of variance (ANOVA) and Bonferroni correction (p < 0.05). RESULTS: There were no statistically significant differences among the cephalometric superimposition methods or when patients' sex was considered. CONCLUSION: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point methods were reliable and presented similar precision when the overall facial changes due to active growth and/or orthodontic treatment were examined.

Radiographic evaluation of orthodontic treatment by means of four different cephalometric superimposition methods

INTRODUCTION: Despite discussion on the merit of various cephalometric superimposition methods, there remains a need to assess which one can be used in daily practice with reasonably accuracy and less working time. OBJECTIVE: The aim of this study was to investigate four methods of cephalometric superimposition by means of assessing the longitudinal changes in craniofacial morphology caused by growth and response of adolescents with Class I malocclusion to orthodontic treatment involving first premolar extraction. METHODS: Pretreatment (T1) and post-treatment (T2) standardized lateral cephalometric radiographs of 31 adolescents (20 females and 11 males), with Angle Class I malocclusion and indication of premolar extraction, participated in this study. Radiographs were digitized, traced and had structures identified by means of a cephalometric software. Four superimposition methods were used: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point. Positional changes were quantified by horizontal and vertical linear changes in the following cephalometric landmarks: anterior/posterior nasal spine (ANS and PNS), gnathion (Gn), Gonion (Go), Pogonion (Pog), A-point and B-point. Differences between T1 and T2 in horizontal and vertical positional changes for all superimposition methods were assessed by one-way analysis of variance (ANOVA) and Bonferroni correction (p < 0.05). RESULTS: There were no statistically significant differences among the cephalometric superimposition methods or when patients' sex was considered. CONCLUSION: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point methods were reliable and presented similar precision when the overall facial changes due to active growth and/or orthodontic treatment were examined. .

INTRODUÇÃO: apesar dos debates sobre os méritos dos vários métodos de sobreposição cefalométrica, ainda há necessidade de se avaliar quais deles poderiam ser utilizados na prática diária, com razoável precisão e menor tempo de trabalho. OBJETIVO: o objetivo desta pesquisa foi investigar quatro métodos de sobreposição cefalométrica, avaliando as mudanças longitudinais na morfologia craniofacial causadas pelo crescimento e resposta ao tratamento, em adolescentes com má oclusão de Classe I tratados ortodonticamente com extração de primeiros pré-molares. MÉTODOS: foram usadas telerradiografias laterais pré-tratamento (T1) e pós-tratamento (T2) de 31 adolescentes (20 do sexo feminino e 11 do sexo masculino), com Classe I de Angle e indicação de extração de pré-molares. As radiografias foram digitalizadas, traçadas e as estruturas, identificadas com um software cefalométrico (Radiocef, Radio Memory, Belo Horizonte, Brasil). Quatro métodos de sobreposição foram utilizados para avaliar mudanças de posição devidas ao crescimento e/ou tratamento: método Estrutural de Björk; método Steiner/Tweed linha SN; Ricketts linha N-Ba no ponto N; e Ricketts linha N-Ba no ponto CC. As mudanças posicionais avaliadas pelos métodos de sobreposição foram quantificadas por mudanças lineares horizontais e verticais nos seguintes pontos cefalométricos: espinha nasal anterior (ENA), espinha nasal posterior (ENP), gnátio (Gn), Gônio (Go), Pogônio (Pog), Ponto A e Ponto B. Mudanças de posição horizontal e vertical entre T1 e T2 para todos os métodos de sobreposição foram avaliadas por análise de variância (ANOVA) e teste de Bonferroni (p < 0,05). RESULTADOS: não houve diferença estatística significativa entre os métodos de sobreposição cefalométrica em toda a amostra ou quando o sexo dos pacientes foi considerado. CONCLUSÃO: de acordo com a metodologia aplicada nesse estudo, os métodos de sobreposição cefalométrica Estrutural de Björk, de Steiner/Tweed linha SN, ...

Human identification through the analysis of smile photographs.

The comparison between antemortem and portmortem data comprehends the basis of the dental identification process. High-tech devices allow for optimal manipulation of postmortem data. However, in especial situations, the victims do not have records of dental treatments, making necessary the search for antemortem data from personal belongings. Smile photographs are one of the most common sources of dental information detected from personal belongings. In this context, the present study reports a forensic case in which a charred body was positively identified through the application of 3 techniques for the analysis of smile photographs.

Uma estratégia clínica para reabilitar a maxila atrófica com enxertos ósseos da calvária, implantes dentários temporários e definitivos: acompanhamento clínico de cinco anos / A clinical strategy to rehabilitate the atrophic maxilla with calvarial bone grafts, temporary and defi nitive implants: a 5-year follow-up report

O objetivo deste caso clínico foi relatar o tratamento de uma discrepância maxilomandibular de 5 mm através de enxertos da calota craniana para futura colocação de implantes dentários. Uma paciente de 65 anos de idade queixava-se da dificuldade de mastigar e do suporte labial inadequado com sua prótese total superior. Após a anamnese, exames intra e extraoral e por imagem, oito blocos ósseos foram removidos da calota craniana e fixados na região vestibular do rebordo alveolar. Depois, seis implantes (3,5-4,5 mm x 8-11 mm) foram colocados na maxila, porém, com a prótese provisória ficando suportada apenas por dois implantes provisórios (2,5 x 18 mm) para aguardar o tempo de consolidação do enxerto e dos implantes definitivos. Após cinco anos de acompanhamento, esta estratégia clínica se mostrou efetiva na estabilidade da correção do suporte labial e da discrepância maxilomandibular...

The aim of this clinical case was to report the treatment of a 5 mm maxillomandibular discrepancy using calvarial bone grafts for further dental implant placement. A 65-years-old patient had claims of poor mastication and inadequate lip support with her complete denture. After clinical and tomographic exams, 8 bone blocks were harvested from the calvarium region and secured at the buccal aspect of the alveolar maxillary ridge. After, six implants (3.5-4.5 mm x 8-11 mm) were installed; however, the provisional prosthesis was supported only by two provisional implants (2.5 x 18 mm) allowing for proper graft consolidation and implant osseointegration. After fi ve years of follow-up, this clinical strategy proved to be efficient to stabilize the lip support and the maxillomandibular discrepancy...

Effect of root canal sealer and artificial accelerated aging on fibreglass post bond strength to intraradicular dentin.

OBJECTIVES: To evaluate the effect of root canal sealers (RCS) and specimen aging on the bond strength of fibre posts to bovine intraradicular dentin. MATERIAL AND METHODS: 80 teeth were used according the groups - Sealapextm, Sealer 26®, AH Plus® and specimens aging - test with no aging and with aging. The canals prepared were filled using one of each RCS. The posts were cemented. Roots were cross-sectioned to obtain two slices of each third. Samples were submitted to push-out test. Failure mode was evaluated under a confocal microscope. The data were analysed by ANOVA, Tukey's, and Dunnet tests (α = 0.05). RESULTS: No significant difference was detected among RCS. Aged control presented higher bond strength than immediate control. The aging did not result significant difference. Adhesive cement-dentin failure was prevalent in all groups. CONCLUSIONS: RCS interfered negatively with bonding of fibreglass posts cemented with self-adhesive resin cement to intraradicular dentin. Key words:Fibreglass post, bond strength, root dentin, endodontic sealer, aging.

Hard and soft tissue manipulation to optimize the peri-implant aesthetics - case report

Introduction: The demand for aesthetic results in oral rehabilitation by dental implants in the anterior area constitutes a major challenge for dentists. Objective: The purpose of this paper was to report the management of hard and soft tissues to optimize the aesthetics of a single implant at anterior area. Case report: The patient underwent autogenous block bone graft surgery, Morse taper implant installation, peri-implant soft tissue manipulation through the “roll on" technique, provisional tooth and prosthetic finishing with metal free implant-supported crown. Conclusion: After three years of follow-up, this paper strongly suggests that the combination of bone with gingival techniques proved to be essential for obtaining predictability and adequate esthetic results.

Uma revisão para colagem direta de braquetes ortodônticos / A review of direct bonding of orthodontics brackets

A aparente simplicidade do procedimento de colagem de braquetes pode levar a erros. Essa etapa pode, indubitavelmente, ser mal realizada, até por ortodontistas experientes que não realizam os procedimentos com cuidado e a técnica adequada. O propósito dessa revisão de literatura foi aperfeiçoar os resultados e, portanto, melhorar o tratamento ao paciente. Em um levantamento bibliográfico, procurou-se descrever as melhores soluções obtidas em experimentos prévios, nos vários passos clínicos que envolvem a colagem de braquetes em superfície de esmalte, metálica, porcelana entre outras.

Effect of light sources and curing mode techniques on sorption, solubility and biaxial flexural strength of a composite resin.

UNLABELLED: Adequate polymerization plays an important role on the longevity of the composite resin restorations. OBJECTIVES: The aim of this study was to evaluate the effect of light-curing units, curing mode techniques and storage media on sorption, solubility and biaxial flexural strength (BFS) of a composite resin. MATERIAL AND METHODS: Two hundred and forty specimens were made of one composite resin (Esthet-X) in a stainless steel mold (2 mm x 8 mm Ø), and divided into 24 groups (n=10) established according to the 4 study factors: light-curing units: quartz tungsten halogen (QTH) lamp and light-emitting diodes (LED); energy densities: 16 J/cm² and 20 J/cm²; curing modes: conventional (CM) and pulse-delay (PD); and permeants: deionized water and 75% ethanol for 28 days. Sorption and solubility tests were performed according to ISO 4049:2000 specifications. All specimens were then tested for BFS according to ASTM F394-78 specification. Data were analyzed by three-way ANOVA followed by Tukey, Kruskal-Wallis and Mann-Whitney tests (α=0.05). RESULTS: In general, no significant differences were found regarding sorption, solubility or BFS means for the light-curing units and curing modes (p>0.05). Only LED unit using 16 J/cm² and PD using 10 s produced higher sorption and solubility values than QTH. Otherwise, using CM (16 J/cm²), LED produced lower values of BFS than QTH (p<0.05). 75% ethanol permeant produced higher values of sorption and solubility and lower values of BFS than water (p<0.05). CONCLUSION: Ethanol storage media produced more damage on composite resin than water. In general the LED and QTH curing units using 16 and 20 J/cm² by CM and PD curing modes produced no influence on the sorption, solubility or BFS of the tested resin.