Quality of life of patients following orthognathic surgery.

The aim of this study was to evaluate how patients with dentofacial deficiency who have undergone orthognathic surgery perceive their quality of life (QoL) with respect to functional, esthetic, and psychosocial issues. In an observational, cross-sectional, descriptive, and quantitative study, 10 patients who had undergone orthognathic surgery answered questionnaires used internationally for assessing QoL: the Short Form Health Survey (SF-36), Oral Health Impact Profile 14 (OHIP-14), and Orthognathic Quality of Life Questionnaire (OQLQ). In addition, the patients completed the Self-Perception Questionnaire of Esteem, Appearance, and Interpersonal Relationships (ASR-26), which explored the differences between their current self-esteem, appearance satisfaction, and interpersonal relationships and their memories of their presurgical feelings about those topics. The data were submitted to descriptive and multivariable statistical analyses. There was a statistically significant difference between the preoperative and postoperative periods regarding self-esteem, appearance satisfaction, and professional relationships (P < 0.05). The data collected with the SF-36, OHIP-14, and OQLQ questionnaires showed high internal consistency (Cronbach α coefficient). The index (mean) scores for the SF-36 (81.5), OHIP-14 (0.6), and OQLQ (5.0) were close to the conditions of high QoL. Principal component analysis revealed 3 distinct groups of patients, and 70% of patients composed a group with high QoL scores, showing no complaints of physical pain, functional limitation, psychological discomfort, social disability, or excessive concern about their oral condition. In this small sample of patients, orthognathic surgery resulted in improved health-related QoL with variations among patients regarding physical pain, psychological discomfort, oral function, facial esthetics, physical function, social function, and self-awareness of facial deformity. The results of this study indicate the importance of applying a questionnaire in individuals who have undergone orthognathic surgery to investigate their personal motivations for treatment and which physical, social, and psychological problems are limiting their QoL.

Oral leukoplakia-epidemiological survey and histochemical analysis of 107 cases in Brazil.

OBJECTIVE: To perform an epidemiological survey comparing the cell proliferative activity of 107 cases of oral leukoplakia with their clinical and histopathological characteristics. MATERIALS AND METHODS: A cross-sectional, observational, and histological-histochemical study. The cases came from the Histopathological Diagnostic Service of UPF/RS and the School of Dentistry of Araçatuba FOA/UNESP/SP (1986-2016). The histopathological sections were stained using the silver staining (AgNOR) technique and the nuclei of 100 epithelial cells selected randomly were recorded to count the number of nucleolar organizer regions (NORs). The mean NORs per lesion were correlated to clinical and histological characteristics using ANOVA, at 5% significance. RESULTS: Most of the cases included men (62.62%), white (64.49%), and with an average age of 53.94 years. The most probable etiological factors were smoking (44.7%) and alcohol consumption (9.85%). The evolution time of most lesions was fast (33.65%), manifesting mainly in the form of plaques (70.37%) and without symptoms (58.88%). They were located mainly in the cheek mucosa (26.62%) and presented white color (66.35%), well-defined edges (59.81%), firm consistency (47.5%), and keratinized surface (49.53%). Etiological factor (p = 0.003), evolution time (p = 0.006), symptoms (p = 0.029), location (p = 0.020), consistency (p = 0.047), histopathological characteristics (p = 0.004), and superficial keratinization (p = 0.001) were statistically significant regarding the mean NORs of the leukoplakias studied. CLINICAL RELEVANCE: Oral leukoplakias caused by alcohol consumption and/or tobacco use, considering an evolution time of fewer than 12 months, asymptomatic, located in the lower lip or tongue, and with a firm consistency and increased superficial keratinization should be treated more aggressively by the clinician to avoid cancerization.

Impacto da cirurgia ortognática na qualidade de vida em pacientes com diferentes deformidades orofaciais: revisão de literatura / Impact of orthognathic surgery on quality of life in patients with different orofacial deformities: literature review

Objetivos: analisar, por meio de revisão de literatura, o impacto da cirurgia ortognática na qualidade de vida de pacientes com diferentes deformidades orofaciais e identificar a concepção e a percepção dos pacientes em relação às correções de deformidades faciais de um quadro prévio ao procedimento até o momento da avaliação. Metodologia: foi realizado um levantamento da literatura nas bases de dados PubMed e Medline, utilizando os seguintes termos de busca: "ortognática", "distúrbios temporomandibulares", "qualidade de vida" e "psicossocial". Os artigos foram escolhidos nas línguas portuguesa e inglesa, dentre aqueles publicados entre os anos de 1990 a 2019. Considerações finais: a correção das deformidades esqueléticas faciais e das irregularidades dentárias associadas pela cirurgia ortognática apresenta um impacto positivo na qualidade de vida dos pacientes pela melhora harmônica dos ossos esqueléticos faciais, resultando em uma estética facial favorável e em um aprimoramento das funções do sistema estomatognático.(AU)

Objectives: to analyze, through literature review, the impact of orthognathic surgery on the quality of life of patients with different orofacial deformities and to identify the patients' conception and perception about corrections of facial deformities prior to the procedure until the moment of evaluation. Methods: a literature review was performed using the PubMed and Medline databases using the following search terms: "orthognathic", "temporomandibular disorders", "quality of life" and "psychosocial". The articles were chosen in Portuguese and English between 1990 and 2019. Final considerations: correction of facial skeletal deformities and associated dental irregularities, by orthognathic surgery, have a positive impact on patients' quality of life through the harmonious improvement of skeletal facial bones, resulting in a favorable facial esthetics and an improvement of the functions of the stomatognathic system.(AU)

Avaliação periodontal pelo índice cpitn de indivíduos com transtorno do espectro autista ­ revisão integrativa de literatura / Periodontal evaluation of the cpitn index in individuals with autistic spectrum disorders - Integrating Literature Review

Introdução: O Transtorno do Espectro Autista (TEA) é um distúrbio comportamental complexo, na odontologia, os indivíduos com TEA apresentam consequências em sua saúde bucal pela inadequada higiene oral e difícil manejo interferindo na condição periodontal. Objetivo: Verificar a doença periodontal em indivíduos com TEA utilizando-se como instrumento o Índice Periodontal Comunitário de Necessidades de Tratamento (CPITN). Método: Trata-se de uma revisão integrativa da literatura embasada em artigos de periódicos da base de dados PubMed e Portal Regional da Biblioteca Virtual em Saúde (BVS), empregando como critérios de seleção artigos com desenho amostral do tipo caso-controle que utilizaram para avaliação periodontal de indivíduos com TEA, o índice CPITN entre os anos de 1989 a 2019, todos em língua inglesa. Resultados: A busca resultou em 10 artigos que correspondiam aos filtros selecionados. Um total de 4 artigos que foram lidos na íntegra e cuja análise foi o tema central, nos estudos avaliados, os participantes com TEA apresentaram resultados mais severos nas taxas do índice CPITN. Conclusão: Com o índice CPITN tornou-se possível diagnosticar doença periodontal e necessidade de tratamento em indivíduos com TEA, de forma simplificada e eficaz (AU)

Introduction: Autistic Spectrum Disorder (ASD) is a complex behavioral disorder. In dentistry, individuals with ASD have consequences on their oral health due to inadequate oral hygiene and difficult handling interfering with the periodontal condition. Objective: To verify the periodontal disease in individuals with ASD using the Community Periodontal Treatment Needs Index (CPITN) as instrument. Method: This is an integrative review of the literature based on articles from the PubMed and Regional Portal of the Virtual Health Library (VHL) database, using as selection criteria articles with sample design of the case-control type that were used for evaluation periodontal disease of individuals with ASD, the CPITN index between the years 1989 and 2019. Results The search resulted in 10 articles corresponding to the selected filters. A total of 4 articles that were read in full and whose analysis was the central theme, in the evaluated studies, the participants with ASD presented more severe results in the CPITN index rates. Conclusion: With the CPITN index it became possible to diagnose periodontal disease and the need for treatment in individuals with ASD, in a simplified and effective way. (AU)

The impact of oral rehabilitation with implants in nutrition and quality of life: A questionnaire-based survey on self-perception.

BACKGROUND: The association between tooth loss and masticatory problems may influence on food choices and consequently impact nutrition and quality of life. This study aimed to evaluate impact of oral rehabilitation with implants in nutrition and quality of life. MATERIAL AND METHODS: A prospective study was performed. The Questionnaire for Healthy Habits (QHH) and the Oral Health Impact Profile-14 (OHIP-14) tools were used to assess nutrition and oral health status, respectively. Oral implants were placed and the adjacent the bone was radiographically assessed. The mean outcomes of the QHH between pre- and post-rehabilitation periods were assessed with the Wilcoxon Signed Rank test. The OHIP-14 was assessed using Fisher's exact test. RESULTS: The implant surfaces showed a significant bone loss after six and 24 months of rehabilitation (p<0.001). There was no significant change in the masticatory pattern of patients (p>0.05). Nevertheless, the patients perceived a significant reduction in discomfort (p<0.02) when eating, after 24 months of the rehabilitation. CONCLUSIONS: These findings confirm the hypothesis that oral rehabilitation with implants may not trigger direct improvement in nutrition. However, it plays an especial role improving quality of life. Key words:Dentistry, nutrition, oral implants, quality of life.

Morse taper performance: A finite element analysis study.

OBJECTIVES: To evaluate and compare the magnitude and distribution of stresses generated on implants, abutments and first molar metal-ceramic crowns using finite element analysis. METHODS: Preliminary three-dimensional models were created using the computer-aided design software SolidWorks. Stress and strain values were observed for two distinct virtual models: model 1 - Morse taper and solid abutment; model 2 - Morse taper and abutment with screw. A load (250 N) was applied to a single point of the occlusal surface at 15° to the implant long axis. Von Mises stresses were recorded for both groups at four main points: 1) abutment-retaining screws; 2) abutment neck; 3) cervical bone area; 4) implant neck. RESULTS AND CONCLUSION: Model 1 showed a higher stress value (1477.5 MPa) at the abutment-retaining screw area than the stresses found in model 2 (1091.1 MPa for the same area). The cervical bone strain values did not exceed 105 µm for either model.

Alterações estomatológicas mais frequentes e seu processo diagnóstico ­ revisão de literatura / Most frequent stomatological changes and their diagnostic process ­ literature review

Introdução: os estudos epidemiológicos exercem um importante papel na Saúde Pública, indicando a prevalência e a incidência das lesões do complexo bucomaxilofacial, e revelando fatores associados, como perfil socioeconômico, fatores genéticos e ambientais, e permitindo o direcionamento de ações de promoção e de prevenção de saúde. Objetivo: o objetivo do presente trabalho é realizar uma revisão de literatura acerca dos aspectos mais importantes para o estabelecimento do diagnóstico das alterações estomatológicas. Revisão de literatura: um dos principais obstáculos dos profissionais da saúde diante de um caso de lesão bucal é o estabelecimento de um diagnóstico preciso, devido à grande quantidade de diagnósticos diferenciais que tais condições podem apresentar. É viável, através do auxílio dos estudos de prevalência, reduzir o número de diagnósticos diferenciais, identificando a frequência das lesões para cada região, ao considerar também variáveis, como faixa etária, etnia e gênero. Considerações finais: conhecer a prevalência das lesões e saber identificar as variáveis associadas a cada uma é de suma importância para o estudante de odontologia e mesmo para o profissional, uma vez que este conhecimento contribuirá para o melhor manuseio e proservação de seu paciente.

Introduction: epidemiological studies performs an important role in Public Health, indicating the prevalence and incidence of injuries of the bucomaxillofacial complex, and revealing associated factors such as socioeconomic profile, genetic and environmental factors, and allowing the promotion of prevention and Cheers. Objective: the aim of the present study is to carry out a literature review about the most important aspects for establishing the diagnosis of stomatologic alterations. Literature review: one of the main obstacles faced by health professionals in the case of oral lesions is the establishment of an accurate diagnosis, due to the large number of differential diagnoses that such conditions may be present. It is feasible, through the aid of prevalence studies, to reduce the number of differential diagnoses, identifying the frequency of lesions for each region, as well as variables such as age, ethnicity and gender. Final considerations: knowing the prevalence of lesions and knowing how to identify the variables associated with each one is of paramount importance for the student of dentistry and even for the professional, since this knowledge will contribute to the better handling and proservation of his patient.

Sobredentadura retida por sistema barra-clipe: revisão de literatura / Overdenture retained by bar-clip system: literature review

Introdução: as overdentures são próteses totais removíveis, mucoimplanto-suportadas, estabilizadas por elementos instalados sobre raízes residuais e/ou sobre implantes. Uma variedade de sistemas de encaixe tem sido utilizada para suportar as sobredentaduras, dentre os quais os sistemas barra-clipe, bolas, magnetos e coroas telescópicas. Objetivo: avaliar, por meio de uma revisão de literatura, as sobredentaduras retidas por sistema barra-clipe, expondo um correto planejamento, bem como descrevendo protocolos de confecção de tais aparelhos. Métodos: foi realizada uma revisão de literatura nas bases de dados do Centro Latino-americano e do Caribe de Informações em Ciências da Saúde (LILACS), Medline, Bibliografia Brasileira de Odontologia (BBO), na biblioteca virtual (SCIELO), e no acervo de livros da Universidade de Passo Fundo/RS (UPF). Revisão de literatura: o sistema barra-clipe consiste de uma barra plástica para fundição (ou já em metal) e de um clipe de retenção. Em algumas situações, o sistema de encaixes por barra-clipe é mais indicado do que os demais sistemas, apresentando, todavia, limitações em determinados cenários clínicos. O sistema barra-clipe permite considerável retenção e estabilidade, resultando num restabelecimento da função mastigatória, maior segurança e grande satisfação do paciente. Considerações finais: a maior parte dos estudos mostrou uma melhora da qualidade de vida relacionada à saúde bucal dos pacientes após tratamento com overdenture em comparação com a prótese total removível convencional.

Introduction: overdentures are removable, muco-implantsupported, complete dentures, stabilized by elements installed on residual roots or implants. A variety of docking systems have been used to support overdentures, including bar-clip systems, balls, magnets and telescoping crowns. Objective: to evaluate, through a literature review, the overdentures retained by bar-clip system, exposing a correct planning, as well as describing protocols of making such devices. Methods: a literature review was carried out in the databases of the Latin American and Caribbean Center on Health Sciences Information (LILACS), Medline, Brazilian Dentistry Bibliography (BBO), the virtual library (SCIELO) and the collection of books from the University of Passo Fundo/RS (UPF). Literature Review: the bar-clip system consists of a plastic bar for casting or already metal and a retention clip. In some situations, the clip-on system is more suitable than other systems, although it has limitations in certain clinical scenarios. The bar-clip system allows considerable retention and stability, resulting in a restoration of the masticatory function, greater safety and great patient satisfaction. Final considerations: most of the studies showed an improvement in the quality of life related to the oral health of the patients after treatment with overdenture compared to the conventional total removable prosthesis.

Boca Seca em Idosos: Proposta de um Novo Substituto Salivar à Base de Própolis / Dry mouth in elderly people: proposal of a new salivary substitute based on propolis

Introdução: O idoso tem tendência à secura da cavidade oral, a qual está ligada à atrofia da mucosa oral e das glândulas salivares. Objetivo: O presente estudo objetiva, por meio de uma revisão de literatura, estudar a xerostomia e os substitutos artificiais atualmente utilizados para a saliva. Revisão de literatura: Os benefícios na área da saúde das propriedades farmacológicas com produtos apícolas estão sendo estudados devido à sua eficiência, para o crescente desenvolvimento de nutracêuticos e alimentos funcionais. Própolis e seus extratos têm inúmeras aplicações no tratamento de várias doenças devido ao seu efeito antisséptico, anti-inflamatório, antioxidante, antibacteriano, antifúngico, antiúlcera, anticancerígeno, e propriedades imunomoduladoras. No campo odontológico tem atraído a atenção, reduzindo a inflamação resultante de procedimentos cirúrgicos e como agente antimicrobiano no controle da placa bacteriana. Considerações finais: Os sintomas da boca seca (xerostomia e hipossialia) incluem: distúrbios do paladar, mau hálito, intolerância a prótese dentária, com um risco aumentado para infecções, incluindo candidíase e lesões nas mucosas, doença periodontal, desmineralização dos dentes, susceptibilidade a cárie dentária e perda dentária, principalmente nos idosos. Por isso a importância em estudar um novo substituto salivar (APIS saliva) a base de própolis, para amenizar e substituir a falta de saliva na cavidade oral.

Introduction: The elderly tends to dry the oral cavity, and it is linked to the atrophy of the oral mucosa and salivary glands. Objective: This study aims, through a literature review, to study xerostomia and the artificial substitutes currently used for saliva. Literature review: The health benefits of pharmacological properties with bee products are being studied because of their efficiencies, for the growing development of nutraceuticals and functional foods. Propolis and its extracts have numerous applications in the treatment of various diseases due to their antiseptic, antiinflammatory, antioxidant, antibacterial, antifungal, anti-ulcer, anticancer, and immunomodulatory properties. In the dental field has attracted attention, reducing inflammation resulting from surgical procedures and as an antimicrobial agent in plaque control. Final considerations: Dry mouth symptoms (xerostomia and hyposialia) include taste disturbances, bad breath, intolerance to dental prostheses, increased risk of infection, including candidiasis and mucosal lesions, periodontal disease, tooth demineralization, tooth decay susceptibility and dental loss, especially in the elderly. Therefore, the importance in studying a new salivary substitute (APIS saliva) based on propolis, to soften and replace the lack of saliva in the oral cavity.

Morse taper performance: A finite element analysis study

OBJECTIVES: To evaluate and compare the magnitude and distribution of stresses generated on implants, abutments and first molar metal-ceramic crowns using finite element analysis. METHODS: Preliminary three-dimensional models were created using the computer-aided design software SolidWorks. Stress and strain values were observed for two distinct virtual models: model 1 - Morse taper and solid abutment; model 2 - Morse taper and abutment with screw. A load (250 N) was applied to a single point of the occlusal surface at 15° to the implant long axis. Von Mises stresses were recorded for both groups at four main points: 1) abutment-retaining screws; 2) abutment neck; 3) cervical bone area; 4) implant neck. RESULTS AND CONCLUSION: Model 1 showed a higher stress value (1477.5 MPa) at the abutment-retaining screw area than the stresses found in model 2 (1091.1 MPa for the same area). The cervical bone strain values did not exceed 105 µm for either model.

Relationship between dentition, anthropometric measurements, and metabolic syndrome in the elderly / Relação entre dentição, medidas antropométricas e síndrome metabólica em idosos

Abstract Introduction Tooth loss is a health disorder of the elderly population that may lead to masticatory deficiency and nutritional risks, inducing the biochemical changes of metabolic syndrome (MS). Objective To verify the relationship among number of teeth, anthropometric measurements, and MS in a group of elderly people. Material and method The study was developed in Porto Alegre, RS, Brazil, and it was divided into three phases. The first phase collected information from the database of all project participants and the second one collected sociodemographic, anthropometric, and biochemical data. The third phase was divided into two other phases: first, oral health interviews were applied to the elderly (281 patients evaluated by telephone and 23 visited at home) and second, 45 patients were randomly selected and invited to validate the data obtained by telephone with oral clinical examinations performed by a trained dental surgeon. The sample consisted of 304 individuals. The data collected were tabulated and analyzed using statistical tests. Result Elderly women with severe tooth loss present a significantly higher risk of developing MS. Thus, the maintenance of natural teeth in the elderly is a protective factor for the syndrome. Conclusion The findings support the hypothesis that the oral health of individuals, expressed by the number of teeth, may compromise and increase the risk of MS in the elderly.

Resumo Introdução A perda dentária é um distúrbio de saúde dos idosos que pode levar à deficiência mastigatória e riscos nutricionais, induzindo alterações bioquímicas da síndrome metabólica (SM). Objetivo Verificar a relação entre número de dentes, medidas antropométricas e SM em um grupo de idosos. Material e método O estudo foi desenvolvido na cidade de Porto Alegre, RS, Brasil, e foi dividido em três fases. A primeira fase coletou informações do banco de dados de todos os participantes do projeto e a segunda coletou dados sociodemográficos, antropométricos e bioquímicos. A terceira fase foi dividida em duas outras fases: primeiro foram aplicadas entrevistas de saúde bucal aos idosos (281 pacientes avaliados por ligações telefônicas e 23 atendidos em domicílio) e, segundo, 45 pacientes foram selecionados aleatoriamente e convidados a validar os dados obtidos por telefone com exames clínicos orais. A amostra foi composta por 304 indivíduos. Os dados coletados foram tabulados e analisados ​​por meio de testes estatísticos. Resultado Mulheres idosas com perda dentária severa apresentam um risco significativamente maior de desenvolver SM. Assim, a manutenção dos dentes naturais nos idosos é um fator protetor para a síndrome. Conclusão Os achados reforçam a hipótese de que a saúde bucal dos indivíduos, expressa pelo número de dentes, pode comprometer e aumentar o risco de SM em idosos.

Implant-retained overdenture and o-ring attachments ­ case report / Overdenture retida por implantes e encaixes do tipo o'ring ­ relato de caso

The increase in life expectancy occurred along an increase in the demand of edentulous patients for a type of rehabilitation that provides higher masticatory efficiency. Thus, implant overdentures using the ball/o-ring and bar-clip attachment systems represent a muco-supported and implant-retained prosthetic type that allows greater security, stability, and aesthetics, besides presenting a lower cost and easier hygiene. The present study aims to report a clinical case of overdenture with the o-ring retention system. In this case, the patient complained of difficulties during mastication due to instability of the mandibular complete denture, sensitivity from the superficialization of the mental foramina, dissatisfaction with aesthetics, and successive dislocations of the mandibular condyle. After clinical and radiographic evaluation, the treatment proposed was the installation of two osseointegrated implants between the mental foramina and the o-ring attachment overdenture. This prosthetic rehabilitation presents a successful clinical follow-up of 24 months, confirming the effectiveness of the treatment applied. The patient was satisfied because the implant-retained prosthesis provided benefits related to aesthetics, comfort, phonation, and mastication. It is noted that the rehabilitation performed has solved the patient's initial complaints. After the clinical case and literature review, it is concluded that overdentures using the o-ring retention system are viable alternatives and provide adequate function and aesthetics, presenting integration with the stomatognathic system.

Com o aumento da expectativa de vida, houve também o aumento da procura dos pacientes edêntulos por uma forma reabilitadora que lhes proporcione maior eficiência mastigatória. Sendo assim, as sobredentaduras sobre implantes utilizando sistemas de encaixe bola/o'ring e barra-clip representam modalidade protética mucossuportada e implantorretida que possibilita maior segurança, estabilidade e estética, além de apresentarem menor custo e facilidade para higienização. O presente trabalho tem por objetivo relatar um caso clínico de overdenture que utiliza o sistema de retenção o'ring. Neste caso, a paciente queixava-se de dificuldades durante a mastigação devido à instabilidade da prótese total inferior, sensibilidade pela superficialização dos forames mentuais, insatisfação com a estética, além de sucessivas luxações do côndilo mandibular. Após avaliação clínica e radiográfica, o tratamento proposto foi a instalação de dois implantes osseointegráveis entre os forames mentuais e overdenture com encaixes do tipo o'ring. A reabilitação protética em questão apresenta um acompanhamento clínico bem sucedido de 24 meses, comprovando a eficácia do tratamento instituído. A paciente demonstrou estar satisfeita, pois a prótese implanto-retida possibilitou benefícios relacionados à estética, conforto, fonação e mastigação. Nota-se que a reabilitação realizada atendeu às queixas iniciais da paciente. Após a realização do caso clínico e revisão de literatura, conclui-se que overdentures que utilizam o sistema de retenção o'ring são alternativas viáveis e que promovem função e estética adequadas, integrando-se ao sistema estomatognático.

The effects of subcutaneous injection of nicotine on osseointegration of machined and anodized implants in rabbits.

PURPOSE: To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. METHODS: Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. RESULTS: The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively. CONCLUSION: Subcutaneous injection of nicotine following implant insertion didn't have effect on osseointegration, independently from the implant surface.

The effects of subcutaneous injection of nicotine on osseointegration of machined and anodized implants in rabbits

Abstract Purpose: To evaluate the influence of subcutaneous injection nicotine in osseointegration process on different implant surfaces. Methods: Twenty-two male rabbits were distributed into two groups according to the subcutaneous injections: (1) nicotine 3 mg/day/kg and (2) 0.9 % NaCI 3 mL/day/kg, three times a day; subgroups were then designated-machined and anodized implants were placed in the right and left tibia bones, respectively. The animals were submitted euthanasia after periods of eight weeks to determine nicotine and cotinine levels, alkaline phosphatase and biomechanical analysis. Results: The plasmatic levels of nicotine and cotinine were 0.5 ± 0.28 ng/mL and 9.5 ± 6.51 ng/mL, respectively. The alkaline phosphatase analyses in blood levels in control group were observed 40.8 ± 11.88 UI/L and 40.75 ± 12.46 UI/L, for the surfaces machined and anodized, respectively. In the test group was observed levels 37.9 ± 4.84 UI/L, for both implant surfaces. No significant differences were observed between control and test groups and between the implant surfaces regarding alkaline phosphatase blood levels. For biomechanics, no significant differences were observed in control group between the machined (25±8.46 Ncm) or anodized (31.2 ± 6.76 Ncm) implants. However, the treatment with nicotine induced higher torque than control in both machined (38.3 ± 13.52 Ncm) and anodized (35.5 ± 14.17 Ncm) implants, with p = 0.0024 and p = 0.0121, respectively. Conclusion: Subcutaneous injection of nicotine following implant insertion didn't have effect on osseointegration, independently from the implant surface.

Síndromes em Odontologia - revisão de literatura / Syndromes in Dentistry - literature review

Objetivo: o presente trabalho teve por objetivos descrever as principais síndromes de acometimento bucal primário, relatando seus sinais, sintomas, métodos de diagnóstico e tratamento e ressaltar a importância do cirurgião-dentista no diagnóstico de alterações sistêmicas. Métodos: foi realizada uma pesquisa bibliográfica acerca de cinco síndromes de acometimento bucal primário, para isso, realizou-se uma busca de informações nas bases de dados eletrônicas Scielo, Bireme, Pubmed entre 2000 a 2017. Revisão de Literatura: Entende-se por "síndrome" um conjunto de sinais e sintomas que caracterizam determinada enfermidade, essas, podem ocorrer de forma isolada ou manifestar seus primeiros sintomas na cavidade oral, os quais são indícios de alterações sistêmicas que possam estar ocorrendo. Entre tantas, destacam-se a seguir cinco das principais síndromes de acometimento bucal primário: Síndrome de Behçet, Síndrome de Sjögren, Síndrome de Peutz-Jeghers, Doença de Addison, e Síndrome de Gardner. Considerações finais: a partir da revisão de literatura foi possível notar que as síndromes podem ocorrer de forma isolada ou manifestar seus primeiros sintomas na cavidade oral. Como suas primeiras manifestações são orais, é imprescindível que o cirurgião-dentista tenha conhecimento sobre elas para que seja elaborado um diagnóstico e protocolo de tratamento corretos e de rápida execução, já que sua terapia será executada com auxílio de vários profissionais da área da saúde.

Objective: the objective of this study was to describe the main syndromes of primary oral affection, reporting its signs, symptoms, methods of diagnosis and treatment, and to emphasize the importance of the dental surgeon in the diagnosis of systemic alterations. Methods: we carried out a literature search about five syndromes of primary oral affection. For this, a search of information was made in the electronic databases Scielo, Bireme, Pubmed between 2000 and 2017. Literature Review: "Syndrome" is understood as a set of signs and symptoms that characterize a particular disease; these can occur in isolation or manifest their first symptoms in the oral cavity, which are indications of systemic changes that may be occurring. Among so many, five of the main syndromes of primary buccal involvement are: Behçet's Syndrome, Sjögren's Syndrome, Peutz-Jeghers Syndrome, Addison's Disease, and Gardner's Syndrome. Final considerations: from the literature review it was possible to note that the syndromes may occur in isolation or manifest their first symptoms in the oral cavity. Since the first manifestations are oral, it is essential that the dentist know about them so that a correct diagnosis and protocol of treatment is elaborated and fast execution, since its therapy will be executed with the help of several professionals of the health area.

Equipes de saúde bucal na estratégia da saúde da família em polo urbano do sul do Brasil / Oral health teams in the family health strategy in urban pole of southern Brazil

Introdução: a Estratégia da Saúde da Família (ESF) é uma política brasileira recente de gestão e execução dos serviços de saúde. Um dos alvos desta política é promover a saúde bucal. Para tanto, as equipes devem ser constituídas segundo normas do Ministério da Saúde, compostas por cirurgião-dentista e pelo menos um auxiliar. Objetivo: avaliar a composição das equipes de saúde bucal da ESF do município de Passo Fundo/RS/Brasil e comparar com as normas do Ministério da Saúde. Métodos: neste estudo transversal, a composição de 22 ESFs foi avaliada através de consulta ao Sistema de Informação de Atenção Básica (SIAB), referente ao biênio 2013-2014, e por aplicação de questionário para avaliar a estrutura das Equipes da Saúde da Família. Resultados: nenhuma das 22 ESFs apresentou equipe de saúde bucal completa. O único profissional identificado foi o cirurgião-dentista, presente em 17 das 22 ESFs (77%), integralmente pago com verba municipal, sem contrapartida federal. Não há uma padronização na carga horária do profissional odontólogo, diferente dos demais profissionais que compõem a atenção básica. Das ESFs regularizadas no SIAB, 20% não apresentam cirurgião-dentista em sua composição, ficando esta população desassistida em saúde bucal. Conclusões: as equipes de saúde bucal das ESFs do município de Passo Fundo/RS são incompletas e não seguem as normas Brasileiras.

Introduction: the Family Health Strategy (ESF) is a recent Brazilian policy of management and execution from health services. One of its targets is to promote the Oral Health. In order to achieve this the staffs shall be established accordingly to the Health Ministry rules, formed by a dental surgeon and at least one assistant. Objective: to evaluate the oral health teams structure of the ESF in the city of Passo Fundo/ RS/Brazil and contrast it with the Health Ministry rules. Methods: in this cross-sectional study, were valued the structure of 22 ESFs by looking at the Basic Health Care Information System (SIAB), referring to the biennium 2013-2014 and by applying a questionnaire to evaluate the ESF´s teams structure. Results: none of the 22 ESFs reported an Oral Health perfect team. The only professional identified was the dental surgeon, existing in 17 out of 22 ESFs (77%), paid in full by municipal funds with no federal financial reward. There is not a standard at dentists workload oppositely to other professional in SIAB. From the ESFs settled at SIAB 20% have no dental surgeon in its staff leaving people unattended in oral health. Conclusions: the oral health ESFs teams from the city of Passo Fundo/RS are incomplete and don´t obey the Brazilian regulation.

Uso de placas oclusais como tratamento de alterações no sistema estomatognático / Use of occlusal plaques as a treatment of diseases in stomatognathic system

Introdução: as disfunções temporomandibulares (DTMs) e musculares possuem causa multifatorial, sendo necessária a realização de anamnese minuciosa, além de exame clínico detalhado para que seja possível adotar a forma de tratamento mais correta. Objetivo: o presente trabalho visa, através de uma revisão de literatura, descrever o protocolo clínico de confecção, instalação e ajustes de placa miorrelaxante, compreender as indicações e os benefícios do uso das mesmas, além de comparar sua efetividade com outros métodos terapêuticos descritos na literatura. Revisão de literatura: responsável pelo correto funcionamento de nossas funções mastigatórias, deglutição, fonação, entre outras, o sistema estomatognático pode se tornar instável devido às alterações que variam de pequenos hábitos parafuncionais até disfunções na articulação temporomandibular e dores musculares. Geralmente não é possível descobrir qual é o exato fator responsável pelo surgimento dessas alterações, visto que a maioria possui causa multifatorial. Dessa forma, inicialmente são indicados tratamentos que sejam menos invasivos ao sistema. As placas oclusais surgem como alternativa reversível para o tratamento das disfunções temporomandibulares (DTMs) e outras injúrias sofridas pelo sistema e, embora seu exato mecanismo não tenha sido compreendido, elas demonstram efetividade na redução dos sintomas em diversos casos. Considerações finais: foi possível observar que as placas oclusais consistem numa forma de tratamento segura, com poucos efeitos adversos e que apresenta grande melhoria nos sintomas das DTMs.

Introduction: temporomandibular (TMD) and muscular dysfunction have a multifactorial cause, requiring a detailed anamnesis, as well as a detailed clinical examination so that it is possible to adopt the most correct form of treatment Objective: this paper aims to describe, through a literature review, the clinical protocol for confection, installation and adjustments of myorelaxant plaque, to understand the indications and benefits of its use and to compare its effectiveness with other therapeutic methods described in literature. Literature review: Responsible for the correct functioning of our masticatory functions, swallowing, phonation, among others, the stomatognathic system may become unstable due to alterations, ranging from small parafunctional habits to temporomandibular joint dysfunctions and muscular pains. Generally, it is not possible to find out the exact factor responsible for these changes, since most of them have multifactorial causes. Thus, treatments that are less invasive to the system are initially indicated. Occlusal plaques appear as a reversible alternative for the treatment of temporomandibular disorders (TMDs) and other injuries suffered by the system and although their exact mechanism has not been understood, they demonstrate effectiveness in the reduction of symptoms in several cases. Final considerations: it was observed that occlusal plaques consist of a safe form of treatment, with few adverse effects and a great improvement in TMD symptoms.

Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study.

OBJECTIVES: This research evaluated detail registration in peri-implant bone using two different cone beam computer tomography systems and a digital periapical radiograph. METHODS: Three different image acquisition protocols were established for each cone beam computer tomography apparatus, and three clinical situations were simulated in an ex vivo fresh pig mandible: buccal bone defect, peri-implant bone defect, and bone contact. Data were subjected to two analyses: quantitative and qualitative. The quantitative analyses involved a comparison of real specimen measures using a digital caliper in three regions of the preserved buccal bone - A, B and E (control group) - to cone beam computer tomography images obtained with different protocols (kp1, kp2, kp3, ip1, ip2, and ip3). In the qualitative analyses, the ability to register peri-implant details via tomography and digital periapical radiography was verified, as indicated by twelve evaluators. Data were analyzed with ANOVA and Tukey's test (α=0.05). RESULTS: The quantitative assessment showed means statistically equal to those of the control group under the following conditions: buccal bone defect B and E with kp1 and ip1, peri-implant bone defect E with kp2 and kp3, and bone contact A with kp1, kp2, kp3, and ip2. Qualitatively, only bone contacts were significantly different among the assessments, and the p3 results differed from the p1 and p2 results. The other results were statistically equivalent. CONCLUSIONS: The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography.

Influence of nicotine on machined- and anodized-surface implants. Histometric analysis.

BACKGROUND: The nicotine may generate a influence on bone repair and longevity of dental implants. This fact makes studies to improve the surface of the implants are constantly conducted. This study aimed to evaluate the influence of subcutaneous nicotine injection in the osseointegration process on different implant surfaces, through histomorphometric analysis. MATERIAL AND METHODS: Therefore, twenty-two male rabbits were randomly distributed into two groups according to the subcutaneous injections: (1) nicotine, 3 mg/day/kg and (2) 0.9% NaCI, 3 mL/day/kg, three times a day. Subgroups were then designated - machined and anodized dental implants were installed in the right and left tibia bones, respectively. The animals were subjected to euthanasia after periods of eight weeks for histomorphometric analysis. The bone samples with implants were removed and the routine histological processing was performed. Next, the images obtained from the blades were evaluated by the Image Tool™ software, assessing the osseointegrated areas of implants (BIC), in pixels. Data obtained were subjected to intergroup statistical analysis through the Kruskal-Wallis non-parametric test (α=5%). RESULTS: The test result showed no statistically significant difference among the groups studied (p=0.446). CONCLUSIONS: Based on the methodology studied, it is concluded that the daily application of low doses of nicotine did not interfere with the osseointegration of machined and anodized implants. Key words:Bone-implant interface, implants, osseointegration.

Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study

OBJECTIVES: This research evaluated detail registration in peri-implant bone using two different cone beam computer tomography systems and a digital periapical radiograph. METHODS: Three different image acquisition protocols were established for each cone beam computer tomography apparatus, and three clinical situations were simulated in an ex vivo fresh pig mandible: buccal bone defect, peri-implant bone defect, and bone contact. Data were subjected to two analyses: quantitative and qualitative. The quantitative analyses involved a comparison of real specimen measures using a digital caliper in three regions of the preserved buccal bone - A, B and E (control group) - to cone beam computer tomography images obtained with different protocols (kp1, kp2, kp3, ip1, ip2, and ip3). In the qualitative analyses, the ability to register peri-implant details via tomography and digital periapical radiography was verified, as indicated by twelve evaluators. Data were analyzed with ANOVA and Tukey's test (α=0.05). RESULTS: The quantitative assessment showed means statistically equal to those of the control group under the following conditions: buccal bone defect B and E with kp1 and ip1, peri-implant bone defect E with kp2 and kp3, and bone contact A with kp1, kp2, kp3, and ip2. Qualitatively, only bone contacts were significantly different among the assessments, and the p3 results differed from the p1 and p2 results. The other results were statistically equivalent. CONCLUSIONS: The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography.