Stafne’s bone defect: a systematic review

Background: This systematic review integrated the available data published in the literature on Stafne's bone defect (SBD), considering the clinical, imaging and histopathological results. Material and methods: An electronic search was undertaken in six databases. Eligibility criteria were: articles in English, Spanish, and Portuguese describing case reports or case series of SBD, reported up to September/2021. Risk of bias was assessed using the Joanna Briggs Institute tool. Results: A total of 98 articles were retrieved, involving 465 individuals with SBD and were included for quantitative analysis. Mean age was 52.78 years (range: 11-89 years), with male predilection (n=374/80.85%). Radiographs were the most frequent imagiological exams (n=298/64.09%), followed by computed tomography (n=98/21.08%). SBD was more prevalent in the posterior mandible (n=361/93.77%) as a hypodense radiolucent lesion (n=250/77.40%). Mean size was 1.58 cm (range: 0.3-.8.0 cm). Two-hundred-and-two lesions (97.37%) were unilocular and 126 (91.97%) were classified as well-defined. Clinical symptoms were reported in 73 cases, while 68 cases (93.15%) were asymptomatic. Only 34 cases (12.32%) were submitted to histopathological examination. Mean follow-up time was 26.42 ±25.39 months. Conclusions: SBD is more frequent in male patients in the fifth and sixth decade of life. Classic SBD is radiographically characterized as a single, unilocular and well-defined lesion in the posterior region of the jaw with a radiolucent/hypodense appearance. (AU)

O emprego da rede social Instagram com foco na apresentação de Trabalhos de Conclusão de Curso / El uso de la red social Instagram con foco en la presentación de Trabajos de Fin de Curso / Use of the social network Instagram focused on the presentation of Course Completion Monographs

Relata-se a experiência de utilização da plataforma Instagramna criação e disseminação de conhecimento com foco na apresentação de Trabalhos de Conclusão de Curso (TCC) por acadêmicos de graduação em Odontologia. Foi realizado um relato descritivo da veiculação de conteúdo na rede social Instagram, por meio do perfil @powerpoint.tcc. O conteúdo foi produzido por uma acadêmica de graduação em Odontologia, com o apoio de discentes e docentes envolvidos em apresentações científicas e acadêmicas. Foram realizadas postagens frequentes abordando diversas temáticas relacionadas ao tema apresentação de TCC. Foram elaborados materiais variados em formato de posts, destacando-se o uso do softwarePowerPoint para a criação de apresentações; oratória, postura e linguagem; além de informações sobre apresentação de dados de forma atrativa e interessante. Os formatos das postagens realizadas foram aqueles disponíveis na plataforma Instagram: postsno feed, reels, story, vídeos no IGTV, além de livesda própria conta ou em contas parceiras. A periodicidade das postagens temáticas foide pelo menos uma a cada dois dias. A avaliação de alcance e entrega do conteúdo foi obtida por meio das métricas disponibilizadas no próprio aplicativo da rede social. Observou-se grande interesse sobre a temática abordada, uma vez que as apresentações científicas e acadêmicas são habituais para os acadêmicos de graduação. Conclui-se que a experiência prática de utilização da plataforma Instagrampara criação e transmissão de conhecimentos com foco nos TCCs mostrou-se extremamente promissora e propositiva (AU).

Se relata la experiencia del uso de la plataforma Instagram en la creación y difusión de conocimiento, con foco en la presentación de Trabajos de Fin de Curso (TFC) por parte de estudiantes de pregrado en Odontología. Se realizó un relato descriptivo de la colocación de contenidos en la red social Instagram, a través del perfil @powerpoint.tcc. El contenido fue producido por un estudiante de pregrado en Odontología, con el apoyo de estudiantes y profesores involucrados en presentaciones científicas y académicas. Se realizaron publicaciones frecuentes abordando diversos temas relacionados con el tema presentación de TFC. Se prepararon diversos materiales en forma de post, destacándose el uso del software PowerPoint para la creación de presentaciones; oratoria, postura y lenguaje; así como información sobre cómo presentar los datos de forma atractiva e interesante. Los formatos de las publicaciones realizadas fueron los disponibles en la plataforma de Instagram: publicaciones en el feed, reels, story, videos en IGTV, además de live en la propia cuenta o en cuentas de compañeros. La frecuencia de publicaciones temáticas fue de al menos una cada dos días. La evaluación del alcance y entrega del contenido se obtuvo a través de las métricas disponibles en la propia aplicación de la red social. Hubo gran interés en el tema abordado, ya que las presentaciones científicas y académicas son comunes para los estudiantes de pregrado. Se concluye que la experiencia práctica del uso de la plataforma Instagram para la creación y transmisión de conocimiento con enfoque en el TFC demostró ser sumamente promisoria y propositiva (AU).

The experience of using the Instagram platform for creation and dissemination of knowledge is reported, focusing on the presentation of Course Completion Monographs (TCC) by undergraduate dental students. A descriptive report of the diffusion of content on the social network Instagram was performed, on the profile @powerpoint.tcc. The content was produced by an undergraduate dental student, with the support of students and professors involved in scientific and academic presentations. Frequent posts were made addressing several topics related to the presentation of TCC. Several materials were prepared in the form of posts, highlighting the use of PowerPoint software to create presentations; speech, posture and language; as well as information on presenting data in an attractive and interesting manner. The formats of posts were those available on the Instagram platform: feed posts, reels, story, videos on IGTV, besides lives on the account or partner accounts. The frequency of thematic posts was at least one at every two days. The evaluation of content reach and delivery was achieved by the metrics available in the social network application. There was great interest in the topic addressed, since scientific and academic presentations are common for undergraduate students. It was concluded that the practical experience of using the Instagram platform for creating and transmitting knowledge focused on TCCs proved to be extremely promising and purposeful (AU).

Factors associated with root migration after lower third molar coronectomy - preliminary results / Fatores associados com a migração radicular após coronectomia de terceiros molares inferiores - resultados preliminares

Objective: The aim of this prospective study, with preliminary results, was to evaluate factors related with root migration after lower third molar coronectomy, especially radiographic bone density. Material and Methods:Twenty-two patients were submitted to 31 lower third molar coronectomies. Clinical and radiographic evaluation of all patients were performed preoperatively and at 7, 90 and 365 days postoperatively. Sociodemographic, clinical and radiographic data were collected. The root migration was analyzed by the distance from the tooth apex to the mandibular canal, and radiographic bone density above the remaining roots was obtained, both using the software Image J©.Results: After 1-year follow-up no patients showed paresthesia, symptoms or required reintervention, however all roots showed migration. The mean root migration was 2.66 mm at 90 days, and 3.37 mm at 365 days (p = 0.0007). The rate of migration was higher at the early postoperative period. The simple linear regression test between root migration and radiographic bone density was not significant (R=-0.173 and p=0.453; R=-0.045 and p=0.902; at 90 days and 365 days, respectively) as well as the analysis between root migration and other clinical and radiographic variables. Conclusion: It was possible to conclude, based on these preliminary results, that all roots showed migration during the follow-up period. The radiographic bone density increases and, consequently, the root migration rate diminishes within time, however none of the evaluated factors showed significant association with root migration. (AU)

Objetivo: O objetivo deste estudo prospectivo, com resultados preliminaraes, foi avaliar os fatores relacionados com a migração das raízes após corocetomia de terceiros molares inferiores, especialmente a densidade óssea radiográfica. Material e Métodos: Vinte e dois pacientes foram submetidos à 31 coronectomias de terceiros molares inferiores. Avaliação clínica e radiográfica de todos os pacientes foi executada no momento pré-operatório e aos 7, 90 e 365 dias pós-operatórios. Dados sociodemográficos, clínicos and radiográficos foram coletados. A migração das raízes foi analisada pela distância do ápice radicular ao canal mandibular, e a densidade óssea radiográfica foi mensurada acima dos remanescentes radiculares, usando o software Image J©.Resultados: Após 1 ano de acompanhamento, nenhum paciente apresentou parestesia, sintomatologia ou necessitou reintervenção, porém todas as raízes migraram. A média da migração radicular foi de 2,66mm aos 90 dias e de 3,37mm aos 365 dias (p=0,0007). A taxa de migração foi maior no pós-operatório inicial. O teste de regressão linear simples entre migração das raízes e densidade óssea radiográfica não foi significante (R=-0,173 e p=0,453; R=-0,045 e p=0,902; aos 90 e 365 dias, respectivamanete), assim como a análise entre migration radicular e outras variáveis clínicas e radiográficas. Conclusão: Foi possível concluir, com base nesses resultados prelimiares, que todas as raízes apresetaram migração durante o período de acomapanhamento. A densidade óssea radiográfica aumentou e, consequentemente, a taxa de migration radicular dimininiui com o tempo, porém nenhum dos fatores avaliados mostrou associação significante com a migração das raízes(AU)

Antimicrobial and physical properties of experimental endodontic sealers containing vegetable extracts.

To assess the antimicrobial activity and the physical properties of resin-based experimental endodontic sealers with the incorporation of vegetable extracts obtained from Bixa orellana, Mentha piperita, and Tagetes minuta species. The extracts were obtained and characterized by gas chromatography-mass spectrometry (GC-MS), and minimum inhibitory concentration (MIC) against Streptococcus mutans, Enterococcus faecalis, and Candida albicans. The extracts were individually incorporated into a dual-cure experimental sealer at a mass concentration of 0.5%. A commercial reference RealSeal was used. The sealers were evaluated by measuring the setting time, degree of conversion, dimensional stability, radiopacity, flow, and film thickness of these materials, also and its antimicrobial effect was evaluated using the direct contact test. Data were statistically analyzed by analysis of variance and Tukey's post-hoc test at α = 0.05 significance level. The physical properties were not influenced by the addition of the vegetable extracts (p > 0.05). For S. mutans, only T. minuta and B. orellana groups presented antibacterial activity after 24 h of contact (p < 0.05). All extracts evidenced an antibacterial effect against E. faecalis (p < 0.05). The experimental sealers hold promise as a novel vegetable sealer with great antimicrobial activity and also great physical-mechanical properties. Nonetheless, more studies are needed.

What is the relapse after Le Fort I maxillary advancement in cleft lip and palate patients? A systematic review.

Le Fort I osteotomy is the most common procedure for maxillary advancement in cleft patients, and a significant relapse is expected in the postoperative period. This study purpose is to evaluate the maxillary relapse and associated factors in cleft lip and palate (CLP) patients submitted to standard Le Fort I advancement. This systematic review sought studies in PubMed, SCOPUS, and Cochrane and included papers that evaluated the maxillary relapse with at least 1-year postoperative period. The quality assessment was adapted following PRISMA statement. The initial electronic search found 345 papers, and the final selection included 10 studies. In total, 275 CLP patients were evaluated 198 had unilateral CLP and 41 had bilateral CLP. Isolated maxillary advancement was performed in 166 patients, while 109 had bimaxillary surgery. The mean relapse in horizontal and vertical plane was 1.2 mm (19.7%) and 1.0 mm (29.4%), respectively. In conclusion, a relapse after maxillary advancement in patients with CLP is expected, being higher in vertical plane. Patients with UCLP and those who underwent bimaxillary surgery had a higher relapse rate. Due to the miscellaneous data and methodologies, future prospective clinical trials should apply rigorous selection of CLP patients sample and methods for variable analysis to obtain more accurate results.

Fatores preditivos do sucesso en dodôntico em tratamentos realizados por alunos de graduação§ / Predictive factors of endodontic success in treatments performed by undergraduate / Factores predictivos del éxito endodontico en tratamientos realizados por un estudiante

Resumo Introdução e objetivo: Ainda são escassos os estudos que avaliam com exatidão o sucesso do tratamento e retratamento endodônticos e quais as falhas que realmente impactam no desfecho dos mesmos. Determinar o índice e os fatores preditivos para o sucesso de tratamentos e retratamentos endodônticos, realizados por alunos de graduação com o mesmo nível de aprendizado. Materiais e métodos: Foram verificados os registros de proservação, com pelo menos 12 meses, dos tratamentos endodônticos realizados na Faculdade de Odontologia de Pelotas, analisando o sucesso ou o fracasso endodôntico, de acordo com critérios clínicos e radiográficos. As variáveis preditivas no resultado do sucesso do tratamento foram: dente, número de canais, coroa dentária, sintomas, diagnóstico da polpa e índice periapical radiográfico. As variáveis relacionadas ao tratamento foram: técnica de instrumentação, número de sessões e limite de instrumentação apical. Resultados: 136 tratamentos endodônticos foram realizados com um acompanhamento de, pelo menos, 12 meses. A avaliação mostrou que o sucesso endodôntico foi influenciado pelo número de sessões (P = 0,015), diagnóstico inicial e grupo dentário (P= 0.014). Também foi possível observar que, quanto maior o índice periapical radiográfico inicial, pior o prognóstico endodôntico (P < 0.001). Conclusão: O índice de sucesso do tratamento endodôntico foi de 96.7% para casos de polpa vital, 87.5% para os casos de necrose pulpar e 92.9% em retratamentos. Estes índices foram influenciados pelo dente tratado, diagnóstico inicial, índice periapical radiográfico inicial e pelo número de sessões utilizadas no tratamento.

Abstract Introduction and objective: There are still few studies that accurately address endodontic success and which failures actually impact the endodontic treatment outcome. Determine success rate and predictive factors for successful endodontic treatment and retreatment by undergraduate students of the same learning level. Materials and methods: The preservation records (12 months) of the endodontic treatments performed in the Faculty of Dentistry of Pelotas were verified, indicating the success or failure of the treatment. Predictive variables in the outcome of successful endodontic treatment or retreatment were: tooth, number of channels, dental crown, symptoms, pulp diagnosis, radiographic periapical index. The treatmentrelated variables were: instrumentation technique, number of sessions and apical instrumentation limit. Results: 136 endodontic treatments were performed with a follow-up of at least 12 months. The evaluation showed that endodontic success was influenced by the number of sessions (P = 0.015), initial diagnosis and dental group (P = 0.014). It was also observed that the higher the initial radiographic periapical index, the worse the endodontic prognosis (P < 0.001). Conclusion: The success rate of endodontic treatment was 96.7% for cases of vital pulp, 87.5% for cases of pulp necrosis and 92.9% for retreatments. These indices were influenced by type tooth, initial diagnosis, initial radiographic periapical index and the number of visits used in the treatment.

Resumen Introducción y objetivo: Todavía hay pocos estudios que aborden con precisión el éxito endodóntico y cuáles fracasos realmente impactan el resultado del tratamiento endodóntico. Determinar la tasa de éxito y los factores predictivos para el tratamiento y el retratamiento exitoso de endodoncia por estudiantes universitarios del mismo nivel de aprendizaje. Materiales y métodos: Se verificaron los registros de conservación (12 meses) de los tratamientos de endodoncia realizados en la Facultad de Odontología de Pelotas, lo que indica el éxito o el fracaso del tratamiento. Las variables predictivas en el resultado de un tratamiento o retratamiento endodóntico exitoso fueron: diente, número de canales, corona dental, síntomas, diagnóstico pulpar, índice periapical radiográfico. Las variables relacionadas con el tratamiento fueron: técnica de instrumentación, número de sesiones y límite de instrumentación apical. Resultados: se realizaron 136 tratamientos de endodoncia con un seguimiento de al menos 12 meses. La evaluación mostró que el éxito endodóntico estaba influenciado por el número de sesiones (P = 0.015), el diagnóstico inicial y el grupo dental (P = 0.014). También se observó que cuanto mayor es el índice periapical radiográfico inicial, peor es el pronóstico endodóntico (P <0.001). Conclusión: La tasa de éxito del tratamiento endodóntico fue del 96.7% para casos de pulpa vital, 87.5% para casos de necrosis pulpar y 92.9% para retratamientos. Estos índices fueron influenciados por el tipo de diente, el diagnóstico inicial, el índice periapical radiográfico inicial y el número de visitas utilizadas en el tratamiento.

The accuracy of panoramic radiography as a screening of bone mineral density in women: a systematic review.

OBJECTIVES: A systematic review and meta-analysis of diagnostic test accuracy studies was conducted to assess if the radiomorphometric indexes observed in panoramic radiographies could estimate reduced bone mineral density (BMD) similarly to standard technique the bone densitometry (dual energy X-ray absorptiometry) in females older than 30 years. METHODS: A systematic search in four databases was conducted until January 2019. Two evaluators performed data extraction and evaluation of risk of bias independently, and agreement was achieved by consensus. Data were synthesized on a subgroup meta-analysis with a random effect model and the hierarchical summary receiver-operating characteristic curve was used to calculate pooled estimates of studies. RESULTS: Thirty three studies were included and 12 different radiomorphometric indexes identified, including Mandibular Cortical Index (MCI). The final number of cases pooled for the analysis was 5266 females.The MCI for BMD loss (osteopenia) presented values of sensitivity 0.81 [95% confidence interval (CI), 0.78-0.84] and specificity 0.48 (95% CI, 0.45-0.50), while for osteoporosis sensitivity 0.35 (95% CI, 0.30-0.40) and specificity 0.88 (95% CI, 0.86-0.90). The mandibular cortical width presented values of sensitivity 0.58 (95% CI, 0.40-0.73), specificity 0.73 (95% CI, 0.60-0.83) for osteopenia, while for osteoporosis sensitivity 0.57 (95% CI, 0.36-0.76) and specificity 0.83 (95% CI, 0.68-0.92). Due to the high sensitivity, MCI presented a potential value as a screening tool for initial BMD loss (osteopenia), once tests presenting high sensitivity are described as rarely missing subjects with the disease. To the other hand, MCI to osteoporosis and Mandibular Cortical Width for both conditions are not recommended because presented specificity higher than sensitivity. CONCLUSION: The MCI can be recommended as a feasible tool to screen initial BMD loss (osteopenia) in females above 30 years old using panoramic radiography exams.

Outcomes after mandibular third molar coronectomy / Desfechos após coronectomia de terceiros molares inferiores

ABSTRACT Coronectomy is an alternative technique to mandibular third molar removal to avoid inferior alveolar nerve impairment. It is indicated in cases where the dental roots are in close relationship with the nerve which results in a higher risk of damage and paresthesia. The coronectomy technique is considered a safe method to prevent inferior alveolar nerve injury, however it shows particular postoperative outcomes as migration and exposure of the retained roots, and possibility of additional intervention. The aim of this case series is to describe four different outcomes from coronectomy, in patients treated by the same protocol. The outcomes ranged from asymptomatic to migration, infection and root removal. Although the variety of outcomes, none of the patients showed inferior alveolar nerve impairment. Therefore, the main objective of coronectomy was reached.

RESUMO A coronectomia é uma técnica alternativa à extração de terceiros molares inferiores para a prevenção de lesão ao nervo alveolar inferior. É indicada em casos em que as raízes dentárias estão em íntimo contato com o nervo alveolar, resultando em um maior risco de lesão, e consequentemente parestesia. A técnica de coronectomia é considerada um método seguro para prevenção de lesões ao nervo alveolar inferior, entretanto pode apresentar desfechos pós-operatórios singulares, incluindo a migração e exposição dos remanescentes radiculares, além da possibilidade de intervenções adicionais. O objetivo desta série de casos é descrever quatro desfechos diferentes da técnica de coronectomia, em pacientes tratados por meio de um único protocolo. Os desfechos pós-operatórios apresentados variaram entre casos assintomáticos até migração das raízes, infecção e necessidade de remoção do remanescente radicular. Entretanto, apesar da variedade de desfechos, nenhum dos pacientes apresentou lesão ao nervo alveolar inferior. Desta forma, conclui-se que o objetivo principal da técnica foi alcançado apesar dos diferentes desfechos.

Prevalence evaluation of apical periodontitis and its relationship with endodontic and restorative treatment in a community in Southern Brazil / Avaliação da prevalência de periodontite apical e sua relação com o tratamento endodôntico e restaurador em uma comunidade no sul do Brasil

Objetivo: O objetivo deste estudo foi avaliar a prevalência de periodontite apical (PA) em dentes tratados endodonticamente (DTE) e relacioná-la com fatores demográficos, qualidade dos tratamentos endodônticos e restaurações. Material e método: Foram coletados dados de prontuários odontológicos de pacientes que continham levantamentos radiográficos periapicais completos. Nos DTE, arco, grupo dental e presença de PA foram avaliados. Dados sobre a qualidade da obturação do canal radicular, a presença e a qualidade da restauração e o tipo de material restaurador também foram coletados. Os dados foram avaliados por estatística descritiva e Teste Qui-quadrado. Resultados: Dos 70 pacientes incluídos na amostra final, a maioria era do sexo feminino (54,3%) e a idade variou de 13 a 77 anos (47,14 ± 13,18). Dos 1333 dentes avaliados, 73 (5,4%) tinham tratamento endodôntico, sendo a maioria em dentes superiores (74%) e anteriores (52,1%). Dos dentes sem tratamento endodôntico, 320 (25,4%) apresentavam PA. A taxa de falha foi alta (52,8%) e a qualidade da obturação do canal radicular e da restauração foram consideradas inadequadas na maioria dos casos (58,3% e 47,7%, respectivamente). O grupo dentário apresentou relação estatisticamente significante com a presença de PA em DTE, sendo mais frequente nos dentes anteriores (p = 0,019). Conclusão: Concluiu-se que a prevalência de PA em DTE foi alta e o grupo dentário foi o fator que mais influenciou a prevalência de PA nos DTE. (AU)

Dor pós-operatória em dentes tratados endodonticamente por estudantes de Odontologia, utilizando técnicas manual e reciprocante / Postoperative pain in teeth endodontically treated by dental students, using manual and reciprocating techniques

O objetivo do presente estudo foi determinar a frequênciae/ou intensidadede dor pós-operatória e os fatores associados a esta ocorrência em tratamentos e retratamentos endodônticos realizados pelas técnicas de instrumentação manual e reciprocante, por estudantesde graduação em Odontologia da Universidade Federal de Pelotas. Para tal, utilizou-se informações dos prontuários de pacientes atendidos por estudantesdo último ano de graduação, no período compreendido entrejaneiro de 2017 ejulho de 2019, totalizando 182 tratamentos. A dor foi registrada por meiodaEscala de Avaliação Numérica da Dor (EAND). Considerou-se como variáveis preditivas no desfecho de dor pós-operatória: dente, número de canais, sintomas, coroa dentária, tratamento indicadoe índice periapical radiográfico. Como variáveis relativas aos tratamentos, técnica de instrumentação, número de sessões e limite apical de instrumentação. Havia relato de dor no momento do tratamento em 28% dos prontuários, enquanto 11,5% não reportaram dor prévia. Em 149 casos (81,9%) incluídos neste estudo não foi relatada a ocorrência de dor pós-operatória, enquanto dor leve foi relatada em 17 casos (9,3%), moderada em 6(3,3%)e intensa em 10(5,5%). Em 67,4% dos casos dos dentes foram tratados até a marcação 0 do localizador apical,enquanto em 32,6% o comprimento foi estabelecido a 1mm desta marcação. Não houve associação entre o tipo de tratamento realizado e a ocorrência de dor pós-operatória (p=0,206). Conclui-se que, entreos fatores avaliados, apenas a sintomatologia prévia apresentou associação com a maior frequência de dor pós operatória (AU).

This study determined the frequency and/or intensity of postoperative pain and factors associated with such occurrence in endodontic treatments and retreatments performed by manual and reciprocating techniques, by undergraduate dental students at the Federal University of Pelotas. For that purpose, data were collected from the records of patients treated by last-term undergraduate students, in the period between January 2017 and July 2019, adding up to 182 treatments. Pain was recorded by the Numerical Pain Rating Scale (NPRS). The following predictive variables were considered in the outcome of postoperative pain: tooth, number of canals, symptoms, dental crown, indicated treatment and radiographic periapical index. The variables related to the treatments included the instrumentation techniques, number of sessions and apical limit of instrumentation. There was report of pain during treatment in 28% of records, while 11.5% did not report previous pain. In 149 cases (81.9%) included in this study there were no reports of postoperative pain, while mild pain was reported in 17 cases (9.3%), moderate in 6(3.3%)and intensive in 10(5.5%). In 67.4% of cases, the teeth were treated up to mark "0"of the apex locator, while in 32.6% the length was established at 1mm from this mark.There was no association between the type of treatment performed and the occurrence of postoperative pain (p=0.206). It was concluded that, among the evaluated factors, only the previous symptomatology was associated with higher frequency of postoperative pain (AU).

Imaging and histomorphometric evaluation of mandible and tibia of rats treated with bisphosphonates.

OBJECTIVES: To evaluate the mandible and tibia of rats treated with bisphosphonates (BPs) by imaging and histomorphometric analysis. STUDY DESIGN: Thirty-four rat specimens (Rattus norvegicus, Wistar strain) were distributed into 3 groups: (1) 12 rats treated with zoledronic acid; (2) 12 rats treated with clodronate; and (3) the control group, containing 10 rats that received saline. All bones were exposed to cone beam computed tomography (CBCT). The images were analyzed to determine bone density (BD), using the software OsiriX 7.0. Histological slides were prepared from the specimens and the proportion of bone volume (BV) was quantified using the software Adobe Photoshop CC. RESULTS: There was no statistically significant difference in BD either between the drug groups or between mandible and tibia. BV between BPs and control group did not show a significant difference. However, comparing the two bones, the mandibles in the control group displayed higher BV than did the tibiae in the same group. CONCLUSION: According to our results, we conclude that (1) BD was not altered by bone type or by type of BP administered, and (2) treatment with zoledronic acid or clodronate did not affect BV in the mandible or tibia of test groups.

Variações anatômicas do canal mandibular e forame mentual avaliadas através de tomografia computadorizada de feixes cônicos / Anatomical variations of the mandibular canal and mental foramen measured by cone beam computed tomography

Este estudo investigou as variações anatômicas do canal mandibular (CM) e do forame mentual (FM) em uma população do sul do Brasil utilizando exames de tomografia computadorizada de feixes cônicos (TCFC). Exames de 99 pacientes (198 hemimandíbulas) foram avaliados quanto à presença e localização de canais mandibulares duplos (CMD), presença e extensão de alça anterior do CM, presença de forame mentual acessório (FMA), e a relação entre FMA e CM. Em adição às estatísticas descritivas, o teste de Qui-quadrado e o teste Exato de Fisher compararam a ocorrência de variações anatômicas para cada lado da mandíbula e para o gênero dos pacientes. CMD foram encontrados em 63 hemimandíbulas (32,48%) e a maioria foi classificada como canal vestíbulo-lingual. Alça anterior do CM foi detectada em 14 hemimandíbulas (7%) com comprimento médio de 1,87±0,56 mm. FMA foi encontrado em apenas duas hemimandíbulas (1,1%) e um FMA estava em relação com o CM. O teste de Qui-quadrado não mostrou relação entre variações anatômicas e lado da mandíbula. Entretanto, a presença de CMD foi relacionada de forma estatisticamente significativa com o gênero masculino. CMD foi observado em um percentual significativo da população estudada e ocorreu mais em homens. Entretanto, outras variações anatômicas avaliadas através de TCFC não foram associadas de forma significativa com nenhuma outra variável abordada, sugerindo que essas variações não são prevalentes na população estudada (AU).

This study investigated the anatomical variations of the mandibular canal (MC) and mental foramen (MF) in a southern Brazilian population using cone beam computed tomography (CBCT). Exams of 99 patients (198 hemimandibles) were evaluated for the presence and location of double mandibular canals (DMC), the presence and extent of MC anterior loops, the presence of an accessory mental foramen (AMF), and the relationship between the AMF and the MC. In addition to descriptive statistics, Chi-squared and Fisher's exact tests compared the occurrence of anatomical variations to each side of the mandible and the gender of patients. DMC was found in 63 hemimandibles (32.48%) and most was classified as buccolingual canals. Anterior loops were detected in 14 hemimandibles (7%) and they averaged 1.87±0.56 mm in length. AMFs were found in only 2 hemimandibles (1.1%) and one AMF was related to the MC. Chi-square tests showed no relationship between the anatomical variations and the side of the mandible. However, DMC was significantly more common in men. DMC was observed in a significant percentage of the population and they occurred more frequently in men. However, others anatomical variations evaluated by CBCT were not significantly associated with any characteristic of the study population, suggesting that these are not prevalent variations in southern Brazilians (AU).

Prevalence of Abnormal Morphology of the Temporomandibular Joint in Asymptomatic Subjects: A Retrospective Cohort Study Utilizing Cone Beam Computed Tomography.

PURPOSE: This retrospective cohort study in an asymptomatic nonpatient population evaluated the prevalence of specific morphologic changes usually associated with the presence of degenerative joint diseases (DJD) using cone beam computed tomography (CBCT) and examined the associations between DJD and age, sex, and number of teeth present. MATERIALS AND METHODS: CBCT images (268 TMJs) of 134 asymptomatic patients were studied. Patient data were obtained from clinical records, and calibrated examiners interpreted the CBCT images. The presence or absence of traditional radiographic signs of DJD (erosion, generalized sclerosis, osteophytes, and subchondral cysts) in the condyle and articular eminence of each TMJ were evaluated. The data were submitted to bivariate (chi-square and Fisher exact tests) and multivariate (Poisson regression) analyses (α = .05). RESULTS: The sample was primarily composed of men (52.24%) and individuals aged ≥ 61 years (55.64%); 61.94% were partially edentulous with ≤ 12 teeth in the oral cavity. The most common DJD diagnoses were mandibular condyle osteophytes (30.22%) and erosion (12.69%), followed by articular eminence erosion (8.58%) and mandibular condyle subchondral cysts (7.09%). The bivariate analysis showed a statistically significant association between women and subchondral cysts (P = .007), between edentulous individuals and subchondral cysts (P = .008), and between individuals with ≤ 12 teeth and mandibular condyle erosion (P = .005). In the adjusted Poisson regression analysis, a significant association was found between DJD and gender (P = .015). CONCLUSION: Despite the limitations of this study, the results show a high prevalence of morphologic changes usually associated with the presence of DJD in asymptomatic subjects. Osseous TMJ abnormalities were most present in women, individuals with a lower number of teeth, and older individuals.

Comparison of effects of zoledronic acid and clodronate on the bone structure: imaginological and histomorphometrical study in vivo.

OBJECTIVES: To compare histologically and imaginologically the bone structure of rats' mandibles treated with bisphosphonates (BPs) and rats that did not receive BPs. METHODS: Thirty-four rat specimens (Rattus novergicus, Wistar strain) were divided into three groups: (i) 12 rats treated with zoledronic acid; (ii) 12 rats treated with clodronate; and (iii) the control group, containing 10 rats that received saline solution. All individuals were exposed to cone beam computed tomography (CBCT). The images were processed and analyzed to obtain the Hounsfield scores, using the software OsiriX 7.0. Sixty-eight histological slides were obtained from the specimens and stained with hematoxylin and eosin (HE). Using the software Adobe Photoshop CS6, the histological areas containing non-vital bone were identified and quantified. RESULTS: Non-vital bone presented positive association with the zoledronic acid and clodronate groups. Statistically, no significant difference in bone density was observed among the groups. CONCLUSIONS: Based on the results, the BP therapy alone was sufficient to induce osteonecrosis. In addition, the CBCT was not a sensible method for detection of the early signs of bone modification in individuals under BP therapy.

Tratamiento endodóncico en diente permanente avulsionado y con ápice inmaduro / Endodontic treatment in avulsed permanent teeth with immature apex

La avulsión es un desafío para la integridad dental y puede llevar a necrosis pulpar. En vista de estas características, es imperativo una apexificación para obtener una implantación periodontal más larga y un sellado apical adecuado. El siguiente caso clínico describe una reimplantación de un incisivo central avulsionado y el tratamiento de apexificación a través de curativos a base de hidróxido de calcio. Se concluye que la reimplantación asociada con la obturación radicular con mineral trióxido agregado (MTA) en el incisivo central llevó a una exitosa finalización terapéutica

Dental trauma such as avulsion is a challenge to dental integrity and can result in pulp necrosis. When these characteristics are observed, apexification becomes imperative to obtain an adequate apical seal. The objective of this case report is to demonstrate a replantation of an avulsed central incisor and apexification treatment through calcium-hydroxide-based dressing. It is concluded that the replantation associated with a mineral trioxide aggregate (MTA) root obturation in the central incisor led to a successful endodontic procedure

Exames radiográficos solicitados no atendimento inicial de pacientes em uma Faculdade de Odontologia brasileira / Radiographic examination of patient's initial care in a Brazilian Dental School

Introdução: Para que radiografias ofereçam mais benefícios do que riscos, precisam ser realizadas ou solicitadas de acordo com cada situação clínica. Objetivo: Avaliar os exames radiográficos solicitados no atendimento inicial em uma Faculdade de Odontologia, considerando os sinais/sintomas e o motivo para busca pelo atendimento. Material e Método: Foram avaliados os prontuários de 3.100 pacientes adultos, tratados em um período de três anos, excluindo aqueles em que os pacientes não haviam realizado exames radiográficos na consulta inicial. Numa amostra final de 1.567 prontuários, foram coletados os seguintes dados: idade e gênero, razão da procura pelo tratamento, presença de sinais e/ou sintomas, além da técnica e do número de radiografias realizadas. Os dados foram analisados por estatística descritiva. Resultado: 5.034 radiografias realizadas, com média de 3,24 (±2,97) por paciente. Entre as técnicas, a mais utilizada foi a periapical seguida pela panorâmica. Extração dentária e dor foram as razões mais prevalentes da procura pelo atendimento, enquanto dor, doença periodontal e presença de patologias de tecidos moles foram os sinais/sintomas mais comuns. Verificou-se que 35,41% da amostra não apresentou sinais ou sintomas. Conclusão: Há uma grande variação na requisição de radiografias no exame inicial, mostrando uma falha na aplicação de critérios de seleção de imagens para diagnóstico, o que pode levar à exposição desnecessária do paciente à radiação X. .

Introduction: For X-rays offer more benefits than risks, they need to be performed or ordered according to each clinical situation. Objective: To evaluate the radiographic exams requested in the initial care in a dental school, considering signs/symptoms and the reported reasons for seeking care. Material and Method: We evaluated the medical records of 3100 adult patients treated over a period of three years, and eliminated those who had not performed radiographic examinations in the initial care. In a final sample of 1567 records, was collected: age and gender, reason for seeking care, presence of signs and/or symptoms, beyond technique and the number of radiographs requested. The dates were analysed by descriptive statistics. Result: 5034 radiographs were made, mean of 3.24 (±2.97) per patient. Among the techniques, the most widely used was the periapical, followed by panoramic. Tooth extraction and pain were the most prevalent reasons for seeking care, while pain, periodontal disease and the presence of soft tissue pathologies were the signs/symptoms more common. 35.41% of the sample had no signs or symptoms. Conclusion: There is a wide variation in the request of radiographs for initial care showing a lack of application of criteria in the selection diagnostic imaging, which can lead to unnecessary exposure to radiation X. .

Apexificación del incisivo central con rizogénesis incompleta y pulpa necrótica asociada con lesión periapical / Apexification of the central incisor with incomplete root formation and pulp necrosis associated with apical periodontitis

Dientes inmaduros con pulpa necrótica presentando foramen apical amplio y paredes delgadas y frágiles, se convierten en un desafío para el tratamiento endodóntico. En vista de estas características, es imperativo una apexificación para obtener un sellado apical adecuado. El siguiente caso clínico describe el tratamiento de apexificación a través de curativos a base de hidróxido de calcio, donde se ha logrado éxito en la formación de una barrera apical osteocementaria. Hemos encontrado que la apexificación a través del uso de la terapia recomendada en el incisivo central con formación radicular incompleta y necrosis, llevó una exitosa finalización endodóntica (AU)

Immature teeth with necrotic pulp and apical foramen presenting large thin and fragile walls, become a challenge to treat conventional endodontic. Faced with these characteristics, it becomes apexification to obtain an adequate apical seal. The objective of this study is to demonstrate a clinical case in which the apexification through calcium hydroxide-based dressing, succeeded in forming an apical osteocement barrier. It is concluded that the apexification through the use of therapy advocated in the central incisor with incomplete root formation and necrotic pulp led a successful endodontic procedure (AU)

Radiopacity assessment of composite resins through digital systems and InSight intraoral film / Avaliação da radiopacidade de resinas compostas por meio de sistemas digitais e filme radiográfico InSight

Objective: this study aimed to assess the radiopacity of eight composite resins recommended for class II restorations. Materials and method: hence, 2 mm thick and 4 mm in diameter test specimens were made and compared to enamel, dentin, and aluminum using four digital systems: two semi-direct by storage phosphor image plates (SPIP) - Digora™, and DenOptix™, two charged couple devices (CCD) - Sens-A-Ray™ and Computerized Dental Radiograph (CDR™), and radiographic film Kodak Insight IS-21™. The radiographs were scanned to obtain the indirect digital image, and along with direct and semi-direct digital images the radiographic densities were assessed in specific software. The pixel values from the aluminum step wedge were submitted to a linear regression from where the equivalent in millimeters for enamel, dentin, and resins were determined. Results: density means of resins were equal or superior to the means obtained for enamel in all digital systems and the conventional film. SureFil™ resin presented greater numerical radiopacity in all digital systems and the radiographic film. ALERT™ resin showed the smallest radiopacity among the studied resins in all digital systems and radiographic film. ALERT™ and Definite™ were statistically equivalent to enamel in the Sens-A-Ray™ system and in radiographic film. The remaining resins (Charisma™, FillMagic™, P60™, Prodigy™, SureFil™, and Z250™) presented higher radiopacities in comparison to enamel. Only ALERT™ presented radiopacity similar to enamel in other digital systems (CDR™, DenOptix™, and Digora™). In these digital systems, Charisma™, Definite™, FillMagic™, P60™, Prodigy™, SureFil™, and Z250™ were more radiopaque than enamel. Conclusion: all resins showed equal or higher radiopacities of enamel in all assessment systems. There was a statistical correlation between systems CDR™ and Sens-A-Ray™, and between Digora™ and DenOptix™; Sens-A-Ray™ also showed correlation with radiographic film. The percentage of density means equivalent to aluminum millimeters for enamel and dentin were 119.6% and 101.6%, respectively.

Objetivo: este estudo teve como objetivo avaliar a radiopacidade de oito tipos de resinas compostas indicadas para restaurações de classe II. Materiais e método: para tanto foram confeccionados corpos de prova de 2 mm de espessura e 4 mm de largura, os quais foram comparados com esmalte, dentina e alumínio, utilizando- se quatro sistemas digitais, sendo dois semidiretos por placas de fósforo fotoestimuladas - Digora® e DenOptix ®, dois CCD - Sens-A-Ray® e CDR®, e também o filme radiográfico Kodak Insight IS-21®. As radiografias foram escaneadas, obtendo-se imagem digital indireta, e, juntamente com as imagens digitais diretas e semidiretas, suas densidades radiográficas foram avaliadas em software específico. Os valores de pixel da escala de alumínio foram submetidos a uma regressão linear, de onde se pôde obter o equivalente em milímetros para o esmalte, dentina e resinas. Resultados: para todos os sistemas digitais e para o filme convencional, as médias das densidades das resinas foram iguais ou superiores às médias obtidas pelo esmalte. Para todos os sistemas digitais e para o filme radiográfico, a resina Surefil® apresentou maior radiopacidade numérica. A resina ALERT® apresentou a menor radiopacidade entre as resinas estudadas em todos os sistemas digitais e filme radiográfico. ALERT® e Difinite® foram estatisticamente equivalentes ao esmalte no sistema digital Sens-A-Ray® e no filme radiográfico. As demais resinas (Charisma®, FillMagic®, P60®, Prodigy®, Surefil® e Z250®) tiveram maior radiopacidade em comparação ao esmalte. Somente ALERT® teve radiopacidade similar à do esmalte em outros sistemas digitais (CDR®, Denoptix® e Digora ®). Nesses sistemas digitais, Charisma®, FillMagic®, P60®, Prodigy®, Surefil® e Z250® foram mais radiopacos do que o esmalte. Conclusão: todas as resinas, em todos os sistemas de avaliação, mostraram radiopacidade igual ou superior ao esmalte. Houve correlação estatística entre os sistemas CDR® e Sens-A-Ray® e entre Digora ® e DenOptix®, tendo o Sens-A-Ray® apresentado correlação também com o filme radiográfico. As médias de densidade equivalente em mm de alumínio em porcentagem para esmalte e dentina foram de 119,6% e 101,6%, respectivamente.

Frequência de reabsorção radicular inflamatória decorrente de trauma em dentes anteriores / Inflammatory root resorption frequency due to trauma in anterior teeth

Objetivo: a reabsorção radicular inflamatória é uma das consequências do traumatismo dentário, sendo a detecção e o tratamento precoces determinantes na limitação de seus danos. Assim, o objetivo deste estudo foi investigar, em dentes anteriores permanentes traumatizados, a prevalência de reabsorção radicular inflamatória, relacionando-a com os diferentes tipos de traumatismos nos tecidos de sustentação e dentários. Sujeitos e método: os dados relativos à reabsorção inflamatória foram coletados a partir de 111 dentes, nos prontuários de 74 pacientes de um serviço de tratamento de trauma dental da FO/UFPel, no período de 2005 a 2011. Foram registrados, ainda, o sexo e a idade dos pacientes, os dentes envolvidos no trauma, a presença de rizogênese completa ou não e o tempo inicial para o aparecimento da reabsorção. A avaliação dos dados foi realizada por estatística descritiva e teste qui-quadrado, com correção de Yates, ao nível de significância de 5%. Resultados: a reabsorção radicular inflamatória foi mais frequente em pacientes do sexo masculino, em incisivos superiores, em dentes com rizogênese completa e nas lesões de menor gravidade nos tecidos dentários e de sustentação. Ainda, as lesões nos tecidos de sustentação, quando não combinadas às fraturas dentárias, apresentaram maior frequência de reabsorção. O tempo inicial para o aparecimento da patologia foi dentro dos primeiros trinta dias após o trauma. Conclusão: é importante diagnosticar detalhadamente os traumas nos tecidos dentários, a fim de verificar o comprometimento dos tecidos de sustentação, devendo a proservação desses casos ser sistemática e contínua para interceptar a reabsorção radicular.

Objective: inflammatory root resorption is one of the consequences of dental trauma so its early detection and treatment are crucial in limiting their damage. Thus, this study aimed to investigate the prevalence of inflammatory root resorption in traumatized permanent anterior teeth, relating it to the different types of trauma in support and dental tissues. Subjects and method: data concerning inflammatory resorption were collected from 111 teeth, in medical records of 74 patients of a dental trauma care in UFPel’s Dentistry School, from 2005 to 2011. Gender and age of patients, teeth involved in the trauma, presence or absence of full rooting, and the initial time of root resorption emergence were also registered. Data assessment was performed by descriptive statistics and chi-square test with Yate’s correction, at significance level of 5%. Results: inflammatory root resorption was most frequent in male patients, in upper incisors, in teeth with complete root formation, and in minor injuries of dental and support tissues. Also, the supporting tissues injury presented higher resorption frequency when not combined with dental fractures. The starting time for pathology emergence was within the first thirty days after the trauma. Conclusion: it is important to thoroughly diagnose the trauma in dental tissues to verify the impairment of support tissues, since the proservation of these cases should be systematic and continuous to intercept root resorption.

Sensitometric evaluation of a periapical radiographic film Dentix E?: effect of different processing conditions / Avaliação sensitométrica do filme radiográfico periapical Dentix E: efeito de diferentes condições de processamento

Objective: Knowing the properties of new radiogra-phic films is essentially important, because from this evaluation depends the learning of such films, directly affecting the radiation dose received by the patient in radiographic examination. Thus, the aim of this study was to evaluate the sensitometric properties of a new film ? Dentix E?, and compare it to E-speed? and Insight? films, processed with different liquids and under different conditions. Methods: The films were exposed at predetermined times and manually processed, using the temperature/time method and ready-to-use liquids from Kodak and Prograd, and were automatically processed with Kodak liquids. Later, the density of those X-rays was measured and the characteristic curves were built in order to determine their sensitometric properties, such as contrast, indicative value of sensibility, and latitude. The values of properties were evaluated by the inclination of curves in the graphs and by descriptive statistics. Results: It was possible to observe that Dentix E? film presented similar characteristic curves and sensitometric properties to E-speed? film, regardless of processing. Conclusion: This result indicates that Dentix E? presents contrast, sensibility, and latitude compatible to films classified as E sensibility.