Diagnosis, treatment and maxillofacial rehabilitation in rhinocerebral mucormycosis patient: A case report and review of the literature.

Mucormycosis is an aggressive, rare and opportunistic infectious disease, with a high mortality rate. Etiologic agents are filamentous fungi, and infection among humans normally occurs through spore inhalation. A 61-year-old male individual, presenting left eye amaurosis, dark epistaxis, hyperalgesia and malodor underwent clinical examination, which detected ulcerative lesion and wide bone exposure in the hard palate and alveolar ridge. Direct microbiological examination, microbiological culture and lesion biopsy were performed. Non-septate smooth fungal hyphae forming right angles with each other were observed through the direct microbiological examination. Microbiological culture revealed fast-growing fungal colonies with cottony texture, identified as Rhizopus sp. Histopathological examination exhibited necrosis areas, intense mononuclear inflammatory infiltrate and bulky hyphae, thus concluding the mucormycosis diagnosis. Amphotericin B antifungal therapy and surgical intervention were adopted as treatment. The patient was then rehabilitated with maxillofacial prosthesis, subsequently to the healing of the surgical wound.

Preparation, Antimicrobial Properties, and Cytotoxicity of Acrylic Resins Containing Poly(diallyldimethylammonium chloride).

PURPOSE: To design and analyze the biologic properties (antibacterial and antifungal, as well as cytotoxicity) of a dental biomaterial based on incorporation of the biocide poly(diallyldimethylammonium chloride) (PDADMAC) into the masses of self- and thermopolymerizable acrylic resins. MATERIALS AND METHODS: PDADMAC was diluted into tetrahydrofuran (4 wt%) and incorporated into self- and thermopolymerizable acrylic resins. PDADMAC inclusion was verified by measuring the contact angle with water droplets. Plain resins were used as controls. The antibacterial activity was evaluated against Staphylococcus aureus (ATCC 6538P) and Escherichia coli (ATCC 8739), and the antifungal activity was tested against Candida albicans (ATCC 10231) and Aspergillus niger (ATCC 16404). The cytotoxicity of substances leached from these materials was analyzed in human dental pulp stem cells using MTT reduction assay. RESULTS: Reduction of contact angle confirmed the incorporation of PDADMAC in the resins. Both resins containing PDADMAC were more effective against Gram-positive and Gram-negative bacteria than their controls. The modified resins were also significantly more effective against Candida albicans than controls, but no resin was effective against Aspergillus niger. The cell viability of cultures submitted to substances leached from the PDADMAC resins was similar to that of cells cultured under ideal conditions. CONCLUSION: The incorporation of PDADMAC into the acrylic resins achieved the desired antibacterial effect, with no changes in the biocompatibility properties of the resins. Moreover, the modified resins were effective against Candida albicans, the most common fungus in the oral cavity. Thus, the incorporation of PDADMAC in biomaterials seems to be promising in dentistry.

Orofacial trauma and mouthguard use in Brazilian rugby union players.

BACKGROUND/AIM: Rugby union represents a high-risk sport for orofacial trauma due to its impact collisions and repetitive tackles. The aim of this study was to investigate the prevalence of orofacial trauma according to mouthguard use among a sample of Brazilian rugby union players. METHODS: An online questionnaire was sent to the 16 best rugby union clubs in Brazil. The questionnaire contained questions about the training history of each athlete, prevalence of orofacial trauma, and details about mouthguard use. Only participants who reported using a mouthguard were selected for this analysis. RESULTS: A total of 244 individuals were included. The prevalence of orofacial trauma was 34.4%, and 61.9% of them did not wear a mouthguard at the time of the incident. The only type of mouthguard reported was the pre-fabricated ("boil and bite" and "ready-to-wear") type. A stronger association was observed between the reason for using a mouthguard and the outcome, whereas a lower proportion of trauma was observed among individuals who claimed mandatory mouthguard use at the gym/sport (20.0%). Time since the respondent started playing rugby union and who instructed them to use a mouthguard were not associated with orofacial trauma. CONCLUSION: Prevalence of orofacial trauma was high among this sample of rugby union players from Brazil, even with the use of pre-fabricated mouthguards. This study encourages further investigation on the use of custom-made mouthguards in rugby union and the role of coach/physical educators to reduce the prevalence of orofacial trauma.

Does Oral Hygiene Influence Salivary pH, Lactate, and IL-1β of Basketball Players During Intense Exercise? / La Higiene Oral Influye en el pH Salival, el Lactato y la IL-1β de los Jugadores de Baloncesto Durante el Ejercicio Intenso?

ABSTRACT: This study examined the salivary pH, salivary lactate, and salivary IL-1 β responses from a high-intensity intermittent running test, and the influence of hygiene oral status on these biomarkers in elite adolescent basketball players. Forty-six adolescent players participated. Saliva sampling was taken before and 3 min after a high-intensity exercise (Yo-Yo Intermittent Recovery Test Level 1; Yo-Yo IR1). In order to quantify and classify the oral hygiene level, the athletes were submitted to a dental examination, and an adapted Simplified Oral Hygiene Index was applied. After the dental examination, the whole group was divided into good oral hygiene group (GHG) and poor oral hygiene group (PHG). The results of a two- way analysis of variance showed a significant interaction effect (P = 0.0003), group effect (P < 0.0001), and time effect (pre to post Yo-yo IR1; P < 0.0001) for salivary pH and for salivary lactate (interaction effect, P = 0.008; group effect, P < 0.000 1; time effect, P < 0.0001) with a lower salivary pH and a higher salivary lactate at pre and post-Yo-Yo IR1 for PHG, but no difference was observed for IL-1β. The data demonstrated that the high-intensity exercise led to a significant change in salivary pH and salivary lactate concentration of the basketball players, and that the oral hygiene status influenced these responses, with a greater change for those players showing a poor oral hygiene.

RESUMEN: Este estudio examinó las respuestas de pH salival, lactato salival e IL-1β salival de una prueba de carrera intermitente de alta intensidad, y la influencia del estado de higiene oral en los biomarcadores en jugadores adolescentes de baloncesto de élite. En el análisis participaron 46 jugadores adolescentes. Se tomó una muestra de saliva antes y 3 minutos después de un ejercicio de alta intensidad (Prueba de recuperación intermitente Yo-Yo Nivel 1; Yo-Yo IR1). Para cuantificar y clasificar el nivel de higiene oral, los atletas fueron sometidos a un examen dental y se aplicó un índice adaptado de higiene oral simplificado. Después del examen dental, el grupo se dividió en un grupo de buena higiene oral (GHG) y un grupo de mala higiene oral (PHG). Los resultados de un análisis de varianza mostraron un efecto de interacción significativo (P = 0.0003), efecto de grupo (P<0.0001) y efecto de tiempo (antes y después de Yo-yo IR1; P <0.0001) para el pH salival y para lactato salival (efecto de interacción, P = 0.008; efecto de grupo, P <0.0001; efecto de tiempo, P <0.0001) con pH salival más bajo y lactato salival más alto en IR1 pre y post YoY para PHG, pero no se observó una diferencia para IL-1β. Los datos demostraron que el ejercicio de alta intensidad genera un cambio significativo en el pH salival y el lactato de los jugadores de baloncesto, y que el estado de higiene oral influyó en estas respuestas, con un cambio mayor para aquellos jugadores que mostraron una mala higiene oral.

Determinants for traumatic orofacial injuries in sport: Extrinsic factors in a scoping review.

BACKGROUND/AIM: Sports practices carry a risk for orofacial injuries and, to avoid them, preventive measures are necessary. The aim of this study was to investigate a web of extrinsic determinants for orofacial trauma in sports. MATERIALS AND METHODS: Through a scoping review, eight extrinsic risk factors for sports-related orofacial trauma emerged from the thematic analysis. These were sports modality, sports philosophy, competition rules, level of competition, accessory equipment, environmental conditions, acting regimen, pitch conditions, and human resources. The data collection was conducted on seven databases, using terms based on health science descriptors and keywords related to orofacial trauma and sports. RESULTS: From the 1155 articles found, 157 were selected based on eligibility criteria and classified according to the mentioned factors. After the full reading of the articles, the most cited risk factor was sports modality while acting regimen and environmental factors were the least mentioned. Therefore, a scheme following the web of determinants was constructed with the purpose of establishing a risk profile, which was based on the interactions between the determinants and on the frequency that they were mentioned as contributors to injury. From this, it was observed that each traumatic event is possibly a result of the interrelationships among the eight suggested determinants. CONCLUSION: Sports modality was the most cited extrinsic determinant observed in the literature, while environmental conditions and acting regimen were the least cited. In addition, more than establishing the determinants, it is necessary to comprehend how they relate, once preventive strategies should intercede on these relations, to help reduce sports injuries.

Use of panoramic dental radiography for talent identification and development in youth soccer: a pilot case / Uso de la radiografía panorámica para la identificación de talentos y el desarrollo en el fútbol juvenil: caso piloto

The aim of the study was to determine the possibility of using panoramic X-ray as an auxiliary tool for the identification of talent in young athletes using the physical body growth indicator. Thirty three radiographs were used of athletes aged 13 to 15 years. Analysis was performed using the Eklof and Ringertz method. Dental age (40 %) came the closest to chronological age. Dental age determined in this study proved to be the most effective radiographic method for the determination of bone maturity for use in the identification of talent through imaging exams. This method was also the simplest and can be performed by the dentist of a sports club without exposing athletes to unnecessary radiation.

El objetivo del estudio consistió en determinar la posibilidad de usar radiografía panorámica como herramienta auxiliar para la identificación de talentos en los atletas usando el indicador de crecimiento del cuerpo físico. Fueron utilizadas 33 radiografías de atletas, de entre 13 a 15 años. Se realizó un análisis de la aplicación utilizando el método de Eklof y Ringertz. Se encontró que la edad dentaria (40 %) se aproximó a la edad cronológica. La edad dental utilizada en este estudio demostró ser el método radiográfico más efectivo para la determinación de la madurez ósea para su uso en la identificación del talento a través de exámenes de imágenes. Este método también fue el más simple y puede ser realizado por el dentista de un club deportivo sin exponer a los atletas a radiaciones innecesarias.

Quality of Life and Maxillary Defects: A Cross-Sectional Study / Calidad de Vida y Defectos Maxilares: Un Estudio Transversal

ABSTRACT: There has been little discussion about the quality of life of patients with maxillary defects. This article evaluates the issues related to the condition. We performed a cross-sectional study of patients with maxillary defects from referral centers in Brazil. To avoid subject burden, a questionnaire was developed, based on questions from seven instruments, which dealt with domains and conclusions that were similar to those from other studies. The predictor variable was the patients' score for each question. The outcome measure was the presence of the best-ranked items on the questionnaire as the impact factor. Six experts assessed these items and suggested which questions to include or exclude. Patients scored each item according to its occurrence and importance. Descriptive statistics and the items' rank according to the impact factor were computed to determine whether there is a comprehensive instrument available. Thirteen patients and six professionals were included in this study. The patients' age ranged from 24 to 72 years (mean (standard deviation, SD), 50.41 (14.46) years). We obtained a 60-item instrument from the selected questionnaires and subject interviews. Only 12 (37.5 %) out of the 32 best-rated items were verified by the existing instruments, two (6.25 %) were suggested by professionals and 18 (56.25 %) were conclusions from other studies. To the best of our knowledge, this is the first study to provide many features related to the quality of life in patients with maxillary defects.

RESUMEN: Existe escasa discusión en la literatura sobre la calidad de vida de los pacientes con defectos maxilares. Este artículo evalúa los problemas relacionados con esta condición. Realizamos un estudio transversal de pacientes con defectos maxilares de centros de referencia en Brasil. Se desarrolló un cuestionario basado en preguntas de siete instrumentos, que trataba sobre dominios y conclusiones similares a las de otros estudios. La variable de estimación fue la puntuación de los pacientes para cada pregunta. La medida de resultado fue la presencia de los elementos mejor clasificados en el cuestionario como factor de impacto. Seis expertos evaluaron estos ítems y sugirieron qué preguntas incluir o excluir. Los pacientes puntuaron cada ítem según su ocurrencia e importancia. Se calcularon las estadísticas descriptivas y la clasificación de los ítems según el factor de impacto, para determinar si existe un instrumento completo. Trece pacientes y seis profesionales fueron incluidos en este estudio. La edad de los pacientes osciló entre 24 y 72 años [media (desviación estándar), 50,41 (14,46) años]. Obtuvimos un instrumento de 60 ítems de los cuestionarios y entrevistas de temas seleccionados. Solo 12 (37,5 %) de los 32 ítems mejor calificados se verificaron de acuerdo a los instrumentos existentes, dos (6,25 %) fueron sugeridos por profesionales y 18 (56,25 %) fueron conclusiones de otros estudios. De acuerdo a nuestro conocimiento, este es el primer estudio que proporciona características relacionadas con la calidad de vida en pacientes con defectos maxilares.

Sports supplement induces dental structure corrosion: an in vitro pilot study / El suplemento deportivo induce corrosión en la estructura dental: un estudio piloto in vitro

Dietary supplements are being consumed with an increasingly high frequency among sports practitioners, whether at professional and/or amateur level. The supplements contain some nutritional properties in their composition, so they can dissolute the hydroxyapatite crystals of the enamel and favor the process of dental corrosion. The objective was to measure the corrosive power of protein-based supplementation (Whey Protein), under conditions that resemble the use of the supplement by the athletes, increasing the ecological validity of the study. The teeth of the test group (TG) were placed in contact with the Whey protein solution and then exposed to artificial saliva. And the teeth of the control group (CG) were exposed only to artificial saliva. The analysis occurred in natural healthy molar teeth, so that each tooth of the TG was immersed in 50 mL of supplement for 1.5 minutes and then placed in contact with the artificial saliva for 30 seconds. The same procedure was performed 5 times a day for 30, 60, 90, 120, 150 and 180 days. Each group, in its time (TG0 to TG180), underwent analysis of superficial roughness with the aid of optical profilometer (Talysurf CCI®, 3D model). The control group (CG) did not change its superficial roughness. Half of the teeth of the test group (TG) suffered loss of enamel surface. The values, in micrometers, of surface loss of the TG samples were 1.21; 2.1; 2.0; 1.04; 0.97; 0.8; 0.53; 1.14; 1.9; 2.0; 1.66; 1.80. The dietary supplement (Whey protein®) may be a potential cause of the dental corrosion process, considering the demineralization of hydroxyapatite that occurs along with the surface enamel loss.

Los suplementos dietéticos se consumen con una frecuencia cada vez más alta entre los practicantes de deportes, sea a nivel profesional y / o aficionado. Los suplementos contienen algunas propiedades nutricionales en su composición, por lo que pueden disolver los cristales de hidroxiapatita del esmalte y favorecer el proceso de corrosión dental. El objetivo fue medir el poder corrosivo de la suplementación a base de proteínas (proteína de suero), en condiciones que se asemejan al uso del suplemento por parte de los atletas, aumentando la validez ecológica del estudio. Los dientes del grupo de prueba (TG) se pusieron en contacto con la solución de proteína de suero y luego se expusieron a saliva artificial. Y los dientes del grupo de control (CG) estuvieron expuestos solo a saliva artificial. El análisis se realizó en dientes molares sanos naturales, cada diente del TG se sumergió en 50 ml de suplemento durante 1,5 minutos y luego se puso en contacto con la saliva artificial durante 30 segundos. El mismo procedimiento se realizó 5 veces al día durante 30, 60, 90, 120, 150 y 180 días. Cada grupo, en su momento (TG0 a TG180), se sometió a un análisis de rugosidad superficial con la ayuda de un perfilómetro óptico (Talysurf CCI®, modelo 3D). El grupo de control (CG) no cambió su rugosidad superficial. La mitad de los dientes del grupo de prueba (TG) sufrieron pérdida de la superficie del esmalte. Los valores, en micrómetros, de pérdida de superficie de las muestras de TG fueron 1.21; 2.1; 2,0; 1.04; 0,97; 0.8; 0,53; 1.14; 1.9; 2,0; 1,66; 1.80. El suplemento dietético (Whey protein®) puede ser una causa potencial del proceso de corrosión dental, considerando la desmineralización de la hidroxiapatita que ocurre junto con la pérdida de esmalte superficial.

Proposition of integrated electrical mechanism and facial prosthesis for eyelid motion on prosthetic oculopalpebral rehabilitation: technical note / Proposta de mecanismo elétrico integrado e prótese facial para movimentação da pálpebra na reabilitação protética oculopalpebral: nota técnica

Surgical reconstruction of large facial defects may not be always possible, therefore extraoral maxillofacial prosthesis is a good restorative option. The oculopalpebral prosthesis has a natural appearance however it can be easily noticed because its eyelids do not move. For esthetic purposes, it is desirable that the prosthetic eyelids open and close synchronously with the contralateral eye, which provides a challenge to the prosthetic reconstruction of the oculopalpebral region. To improve the esthetic outcome, an oculopalpebral prosthesis prototype with mechanical and electric features allowing synchronization of the eyelid motion with the sound eye was planned, designed, and built. An oculopalpebral prosthesis was made in thermoactivated acrylic resin. A gap was created to accommodate an electrical system and allow free motion of a thin eyelid made of silicone attached to the appliance. The movable eyelid was made with medical grade silicone (SILASTIC® MDX4-4210) and connected to an electrical and electronic system responsible to command the opening and closing movements. This mechanical and electrical prototype with the system connected to a sensor, successfully captured the eyelid motion of the contralateral sound eye. The proposed mechanical and electrical system attached to an oculopalpebral prosthesis could successfully establish and synchronize the eyelid movements with the sound eye.

A reconstrução cirúrgica de grandes defeitos faciais pode não ser sempre possível, portanto, a prótese bucomaxilofacial extra-oral é uma boa opção restauradora. A prótese oculopalpebral tem uma aparência natural, mas pode ser facilmente notada pois as pálpebras não se movimentam. Para fins estéticos, é desejável que as pálpebras protéticas se abram e se fechem em sincronia com o olho contralateral, o que representa um desafio para a reconstrução protética da região oculopalpebral. Para melhorar o resultado estético, um protótipo de prótese oculopalpebral com características mecânicas e elétricas permitindo a sincronização do movimento da pálpebra com o olho sadio foi planejado, projetado e construído. Uma prótese oculopalpebral foi confeccionada em resina acrílica termoativada. Um nicho foi criada para acomodar umsistema elétrico e permitir o movimento livre de uma pálpebra fina confeccionada em silicone preso ao sistema. A pálpebra móvel foi confeccionada com silicone de grau médico (SILASTIC® MDX4-4210) e conectada a um sistema elétrico e eletrônico responsável por comandar os movimentos de abertura e fechamento. Esteprotótipo mecânico e elétrico com o sistema conectado a um sensor capturou com sucesso o movimento das pálpebras do olho acústico contralateral. O sistema mecânico e elétrico proposto, fixado a uma próteseoculopalpebral, conseguiu estabelecer e sincronizar os movimentos da pálpebra com o olho sadio.

Production of Medical Grade Silicone for Facial Prosthesis with Bactericidal Properties from the Inclusion of Poly (Diallyldimethylammonium Chloride): An in Vitro Study

Objective: To evaluate the inclusion capacity and bactericidal efficiency of diallyl dimethyl ammonium chloride (PDADMAC) diluted in tetrahydrofuran (THF) upon inclusion in the medical grade silicone polymer structure. Material and Methods: It was diluted the PDADMAC in THF at the concentration of 4wt%. It was included in the silicon paste during its vulcanization process. The contact angle measurements were performed to evaluate whether the biocide inclusion into the silicon paste was successful. All samples were sterilized with gamma radiation at 25KGy-dosage prior to the microbiological tests. Microbiological testing strictly followed the Antibacterial products - Test for antibacterial activity and efficacy JIS Z 2801: 201010 and the used of specific bacteria, as Staphylococcus aureus ATCC 6538P and Escherichia coli ATCC 8739. Results: The results showed that PDADMAC, when dissolved in THF at 4wt%, displayed good incorporation in medical silicone and a broad-spectrum antibacterial response. The results of the tests using Escherichia coli ATCC 8739 and Staphylococcus aureus ATCC 6538P showed that the silicone with no biocide addition did not present antibacterial activity. In contrast, the experimental group plus 2 mL of PDADMAC would have an ideal antibacterial response. Conclusion: Medical grade silicone can be used as a material with antibacterial properties, since it has been able to keep PDADMAC compound attached to its structure, thus acquiring antimicrobial property.

Is there enough evidence that mouthguards do not affect athletic performance? A systematic literature review.

BACKGROUND: Although there is evidence that mouthguards prevent orofacial trauma occurrence during sport practice, the influence of this device on athletic performance has not been systematically quantified. OBJECTIVES: We aim to systematically review the literature to determine the effect of mouthguards on athletic performance and if the type of mouthguard influences this overcome. MATERIALS AND METHODS: A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Scopus, Web of Science and the Cochrane Library from their inception to February 2017. The publications were grouped based on their outcome: (i) the use of mouthguards; or (ii) the type of mouthguards. We conducted descriptive analyses and quality assessments of the included studies. RESULTS: The search identified 489 citations. After screening the studies, we identified 15 trials comprising a population of 312 athletes. According to the risk of bias evaluation, nine studies were considered 'high' risk of bias, and six 'low' risk of bias. Overall, custom-made mouthguards did not interfere or improve athletes' performance when compared with the control group (without mouthguard). Custom-made mouthguards showed the smallest range of changes in players' performance compared with other types of mouthguards. CONCLUSIONS: This systematic review provides evidence for sports professionals to advocate the use of custom-made mouthguards to prevent injury, and these devices do not impair performance. The scientific evidence should be interpreted carefully because there is a great variability in outcome measures and lack of important methodological details.

Custom-made facemask as a coadjuvant in the postoperative treatment of sport-related facial trauma: Case report.

Maxillofacial injuries are a regular consequence of sport activities that can force athletes to take a long time off from training and competitions. One way to decrease the time that the athlete needs to get back to his or her training exercises after surgery is to use a custom facemask as a coadjuvant in the postoperative recovery phase. This case report describes the case of a 16-year-old male athlete who suffered facial trauma (orbitozygomatic fractures) during a soccer game. After surgery, a facemask was used during the postoperative phase. He returned to his regular physical activities only 3 weeks after surgery. This simple and very efficient procedure is a good option for athletes who suffer facial injuries.

Genomic identification of microbial species adhering to maxillofacial prostheses and susceptibility to different hygiene protocols.

This study investigated the microbial colonization of maxillofacial prostheses and support tissues using the Checkerboard DNA-DNA hybridization method, and the efficacy of 0.12% chlorhexidine gluconate, 10% Ricinus communis solutions, or brushing, on colony forming unit (CFU) reduction in monospecies biofilms (Candida glabrata, Staphylococcus aureus, Streptococcus mutans, Escherichia coli, Enterococcus faecalis, and Pseudomonas aeruginosa) formed on two silicones (MDX 4-4210 and Bio-Skin). Biofilm was harvested from 43 maxillofacial prosthesis wearers for detection of 38 species of microorganisms. The CFU counts of the six above mentioned species were recorded after using the hygiene protocols. All 38 investigated species were identified in prostheses and tissues, with a higher prevalence in the prostheses. 0.12% chlorhexidine gluconate immersion showed the greatest antimicrobial effectiveness, followed by mechanical brushing protocols. MDX 4-4210 silicone produced lower CFU counts than Bio-Skin.

Uso de biocidas na superfície de materiais para confecção de próteses bucomaxilofaciais / Use of biocides on the surface of materials for making bucomaxillofacial prostheses

As próteses bucomaxilofaciais têm um importante papel na devolução da estética e de algumas funções para os pacientes. Suas boas condições são primordiais, para que possam exercer suas funções adequadamente e manter o local, onde estão inseridas, livre de infecções e inflamações. Portanto, as não formações de colônias e biofilmes bacterianos em materiais eleitos para confecção dessas próteses trarão benefícios aos pacientes reabilitados. Com esse propósito, o presente artigo verificou a eficiência bactericida dos biocidas policloreto de dialildimetilamônio (PDADMAC) e poliacrilamida catiônica (PAC) quando pincelado em resina acrílica termopolimerizável e silicone de grau médico. Os resultados mostraram que o biocida PDADMAC dissolvido em água obteve boa resposta antibacteriana, quando pincelado sobre ambos os materiais. Já o biocida PAC, entretando, mostrou eficiência antibacteriana apenas quando aplicado resina acrílica termopolimerizável... (AU)

The maxillofacial prosthesis have an important role in reestablishing esthetics and some of the patients functions. The prosthesis' condition is imperative to guarantee their appropriate function and keep the receptor site free of infections or inflammatory processes. Therefore, preventing the infection of the chosen material by bacterial colonies and biofilm can be hazardous to the patient's health. To investigate such problem, the present article evaluated the efficiency of two biocides: pol(diallyldimethylammonium chloride (PDADMAC) and polyacrylamide cationic (PAC). The biocides were applied over heat-cured acrylic resin or silicone. The results shows that the PDADMAC biocide dissolved in water had positive outcome when brushed over both materials. The PAC biocide had antibacterial efficiency only when brushed over the heat-cured acrylic resin... (AU)

Abordagem cirúrgica de Luxação Condilar Prolongada / Surgical Approach of Prolonged Condylar Dislocation

A luxação condilar é uma condição dolorosa que causa limitação funcional grave. Como tratamento, a redução manual com ou sem a ajuda farmacológica deve ser realizada o quanto antes. Em algumas situações, o deslocamento mandibular pode não ser notado pelos pacientes acometidos levando assim a omissão do diagnóstico por um longo período. Com isso, o tratamento cirúrgico da Articulação Temporomandibular (ATM) é indicado. O objetivo desse artigo é relatar um caso sobre a luxação condilar prolongada e seu tratamento.

The condylar dislocation is a painful condition that causes severe functional limitation. As treatment, the manual reduction with or without pharmacological aid must be performed as soon as possible. In some situations, the mandibular dislocation can not be noticed by affected patients thus leading to failure in this diagnosis for a long period. Thus, the surgical treatment of temporomandibular joint (TMJ) is indicated. The aim of this paper is to report a case of prolonged condylar dislocation that persisted for more than 8 months and its surgical treatment.

Contribuição da Prótese Bucomaxilofacial na internacionalização da Odontologia / Contribution of Maxillofacial Prosthetics for the dentistry internationalization

Objetivos: Este artigo visa exemplificar uma parceria internacional técnico cientifica por meio da utilização de técnica idealizada e patenteada por pesquisadores brasileiros. Materiais e Métodos: Um grupo de pesquisadores brasileiros idealizou, pesquisou e patenteou uma técnica de obtenção e utilização de íris digitalizada na reabilitação protética ocular. A internacionalização do método foi decorrente do intercâmbio estabelecido entre professores do Brasil e do México.A permanência do pesquisador mexicano, por um período em que especializou e concluiu o curso de mestrado, junto aos colegas brasileiros, pôde oferecer conhecimento e treinamento na aplicação da técnica proposta. Resultados: São apresentados casos clínicos em que a reabilitação protética ocular foi realizada usando a técnica brasileira de íris digitalizada. Conclusão:Pesquisas brasileiras, principalmente na área da saúde, vêm tendo destaque internacional. A preocupação com a melhora da qualidade de vida torna relevantes nossos estudos e técnica sem âmbito mundial.

Objectives: This article aims to illustrate a scientific technical international relation ship through the use of technique created and patented by Brazilian researchers. Materials and Methods: A group of Brazilian researchers devised, researched and patented a technique of obtaining and using scanned iris in ocular prosthetic rehabilitation. The internationalization of the technique was due to technical and scientific partner ship between Brazilian and Mexican researchers. A Mexican researcher remained for a period in which he specialized and completed his master’s course with the Brazilian team that was able to transfer knowledge and offer atraining in the application of the technique. Results: Three cases are shown, two Brazilian an done Mexican. Ocular Prosthetic rehabilitation of these cases was performed using the Brazilian technique of scanned iris. Conclusion: Brazilian research, especially in health, comes with international relevance. The concern with improving life quality makes our technical studies relevant world wide.

A three-dimensional finite element analysis of the sports mouthguard.

BACKGROUND/AIM: The aim of this study was to evaluate the compressive and tensile stresses on dentin and enamel in five different situations: no mouthguard and mouthguards from 1 mm thickness up to 4 mm thickness, using finite element analysis. MATERIALS AND METHODS: A three-dimensional geometry of an upper right central incisor was obtained from a computed tomography and transformed into a mesh separating enamel from dentin. A mouthguard was created covering the buccal surface of the enamel in different thicknesses, and a rubber ball with a velocity of 5 m s(-1) was made as the impact object. RESULTS: The maximum principal stress and the minimal principal stress were evaluated in all situations on dentin and enamel. Both maximum and minimal stress on enamel had the greatest value on the control situation (no mouthguard), and their value decreased as the mouthguard thickness increased. The reduction ranged from 66.62% to 85.5% for compressive stress and from 9.76% to 33.37% for tensile stress on enamel. The results for dentin were similar among the situations with or without mouthguards. CONCLUSION: The mouthguard had beneficial effect considering the stresses on enamel, and between the mouthguard thickness of 3 and 4 mm, there was minimum difference.

Utilização de novas tecnologias empregadas na reabilitação protética bucomaxilofacial: relato de caso / Use of news technologies on the maxillofacial rehabilitation: a case report

A Prótese Bucomaxilofacial é a especialidade odontológica responsável pelo estudo clínico e tratamento das malformações congênitas, distúrbios do desenvolvimento e mutilações patológicas ou traumáticas da região intra e extraoral da face. As perdas do globo ocular podem ser reparadas com o auxilio de próteses oculares, confeccionadas de modo individualizado, com características semelhantes ao olho são. O maior desafio é a obtenção da íris protética que deve ser cópia fiel da íris do olho remanescente para que a dissimulação da perda seja completa. Este trabalho, por meio de apresentação de caso clinico, traz um avanço de técnica para a obtenção de íris protética com sua digitalização.

The maxilofacial prosthetics is the dentistry speciality responsible for the clinical study and treatment of congenital malformations, developmental disorders and pathological or traumatic mutilations of intra and extra oral region of the face. The eye loss can be repaired with the help of ocular prostheses, made in a individualized way, with characteristics similar to the healthy eye. The biggest challenge is getting the prosthetic iris that should be a true copy of the remaining one to the loss concealment process is complete. This paper, through a case report, brings a technical advance to obtain prosthetic iris with your scan.

Evaluation of the mechanical properties of acetic-cure silicone with the addition of magnesium silicate / Avaliação das propriedades mecânicas de silicone de cura acética, com a adição de silicato de magnésio

Current study evaluates the mechanical properties (tensile and tear strength) of an acetic- cure silicone with the addition of 10 or 20% vol. magnesium silicate. Magnesium silicate was added to the silicone at concentrations of 10 (MS-10) and 20% (MS-20) volume, followed by the analysis of tensile strength, maximal elongation during tensile and tear strength. Results were compared to control group of silicone without additives (CG). Mean rates were determined and compared by analysis of variance and Tukey's test (p < 0.05). Control group had the greatest elongation when subjected to tensile strength (650%), whereas the MS-10 group statistically showed a better tensile strength (8.8 MPa) when compared to CG (7.5 MPa) and MS -20 (7.5 MPa) groups. Both magnesium silicate groups exhibited statistically similar tear strength, whereas MS-20 group demonstrated statistically greater tear strength. The addition of 10% magnesium silicate increased tensile strength, but tear strength and elongation were similar to control. The addition of 20% magnesium silicate did not affect tensile but increased tear strength.

O objetivo deste estudo foi avaliar as propriedades mecânicas (resistência à tração e ao rasgamento) de um silicone de cura acética com adição de 10 ou 20% em volume de silicato de magnésio. O silicato de magnésio foi adicionado ao silicone em concentrações de 10 (MS-10) e 20% (MS-20), em volume, avaliado por análise de resistência à tração, deformação máxima em tração e resistência ao rasgamento. Os resultados foram comparados com um grupo de controle sem aditivos de silicone (GC). Os valores médios foram determinados e comparados através de análise de variância e teste de Tukey (p < 0,05). O grupo de controle apresentou o maior alongamento quando submetido à tensão (650%). O grupo MS-10 exibiu estatisticamente melhor resistência à tração (8,8 MPa) em relação ao GC (7,5 MPa) e MS-20 (7,5 MPa) grupos. Ambos os grupos de silicato de magnésio exibiram médias de resistência ao rasgamento estatisticamente semelhantes, enquanto que o grupo de EM-20 demonstrou estatisticamente maior resistência ao rasgamento em comparação com o grupo de controle. A adição de 10% de silicato de magnésio em volume propiciou maiores valores de resistência ao rasgamento e resistência à tração. A adição de 20% de silicato de magnésio não afetou a resistência à tração, mas produziu aumento na resistência ao rasgamento.

Estudo Sistematizado do Copolímero de Etileno e Acetato de viníla ( EVA) na confecção de dispositivos de proteção do complexo orofacial / Systematic study of Ethylene-Vinyl Acetate (EVA) in the manufacturing of protector devices for the orofacial system

As fraturas de ossos da face e elementos dentais, bem como lace ração dos tecidos moles intra e extra orais na prática das mais diversas modalidades esportivas, vêm apresentando um crescente número de casos nos últimos anos. Como a norma ASTM 678-80 determina que o Cirurgião Dentista é o profissional responsável pela confecção de protetores bucais para esporte, faz-se necessário conhecer os materiais disponíveis e indicados para esta finalidade. O EVA é um material termoplástico, facilmente encontrado, de fácil manuseio e com custo acessível. Contudo, suas propriedades mecânicas e capacidade de absorção e dissipação de energia de impacto em diferentes ambientes, como o da cavidade oral, com presença de saliva e em temperatura distinta, devem ser conhecidos. Este trabalho, portanto, traz um estudo sistematizado da aplicação do EVA na confecção de protetores orofaciais, principalmente para uso durante a prática esportiva. Os estudos objetivaram duas vertentes: ensaios experimentais e análise numérica. Nos ensaios experimentais do EVA aplicado à proteção oral, observou-se o ambiente bucal, com sua temperatura característica e presença de saliva. No caso da saliva, foram necessários estudos mais específicos para se conhecer sua influência no comportamento mecânico do EV A. Quanto à análise numérica do EVA, o foco do estudo foi seu efeito na proteção do osso nasal considerando a geometria complexa da face; e do osso zigomático, em geometria simplificada. Pode-se observar que o EVA de proximadamente 3mm de espessura oferece proteção oral satisfatória. Porém, deve ser analisado o tempo de uso para indicar sua troca, já que a saliva altera suas características mecânicas, fazendo-o se comportar como material rígido conforme sua utilização. Quando o EVA é aplicado na proteção facial, uma sobreposição de laminas rígidas e flexíveis é necessária, sendo que a sobreposição indicada para a proteção do osso zigomático é uma lâmina de EVA de 3mm flexível...

Fracture of facial bones and dental elements, and laceration of intra and extra oral soft tissue, are increasing in sports over recent years. Once the ASTM 678-80 standard states that the Dentist is the only professional responsible for the mouth protection design, the knowledge about suitable materiais is essential. EVA is a thermoplastic material, available on the market, easy handling and processing, and low cost. However, it is important to understand the mechanical properties and ability to absorb and dissipate the impact energy, when this material is submitted to different environments, such as oral cavity with saliva and different temperatures. This study, therefore, provides a systematic evaluation of the EVA application in orofacial protectors while focusing on sports. The research comprises two aspects: experimental tests and numerical analyses. During experimental tests, the EVA was analysed in special buccal conditions, concerning temperature and presence of saliva. Regarding the presence of saliva, more specific studies about its influence on the mechanical behavior of EVA were performed. In the numerical analyses of the EVA orofacial protector, the studies focused on its effect in the nasal bone integrity, considering the complex geometry of the face; and in the zygomatic bone protection, in a simplified geometry. It can be observed that the approximately 3mm thick EVA offers satisfactory oral protection. However, life cycle should be analysed, since its performance deteriorates over time, mainly due to the saliva originated changes to the EVA mechanical characteristics, it behaves like rigid material. For facial protection, better performance is obtained with a combination of rigid and soft EVA material. Particularly for the zygomatic bone, 3mm thick plate of soft EVA overlapped by a 1 mm thick plate of rigid EVA is indicated. According to the experimental and numerical results obtained from a systematic study of EVA...