The Influence of Vasoconstritor Use in Local Anesthesia in Individuals with Chronic Renal Failure / A Influência do Uso de Vasoconstritor na Anestesia Local em Indivíduos com Insuficiência Renal Crônica

Individuals with chronic renal failure (CRD) undergo hemodialysis to compensate for systemic-based disease and often develop systemic arterial hypertension (SAH). Such individuals, when needing dental treatment, carry with them the consideration of which type of anesthetic to be used in clinical and surgical interventions. The objective of this study was to evaluate the action of anesthetics with vasoconstrictor (AwV) and without vasoconstrictor (AoV) in individuals with chronic renal failure. Research subjects needed dental treatment, with dental restorations, on the right and left lower dental arch in premolars and / or molars, thus receiving the model of a split-mouth clinical study. In a randomized study, each side of the mandible was subjected to an anesthetic infiltration with only one 1.8 mL tube in two different moments with a minimum interval of 7 days (for one moment with AwV and another AoV moment). The parameters of oxygen saturation (SaO2), heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 5 minutes before anesthesia, 5, 15 and 30 minutes after anesthesia. The results found in this study showed statistical difference only in SaO2 in the time of 5 minutes after the anesthesia in comparison of the AwV and AoV group, this same result was obtained when only those individuals who, besides nephropathies, had a diagnosis of SAH, were evaluated. The findings of this study highlight the safety of the use of anesthetics, with or without vasoconstrictors since in small amounts, in individuals with CRF with or without associated SAH. (AU)

Indivíduos com insuficiência renal crônica (IRC) em geral são submetidos à hemodiálise para compensação da doença de base sistêmica e frequentemente desenvolvem a hipertensão arterial sistêmica (HAS). Tais indivíduos, ao necessitarem de tratamento odontológico, levam consigo a ponderação de qual tipo de anestésico a ser utilizado em intervenções clínicas e cirúrgicas. O objetivo deste estudo foi avaliar a ação de anestésicos com vasoconstritor (ACV) e sem vasoconstritor (ASV) em indivíduos com insuficiência renal crônica. Os indivíduos da pesquisa tinham necessidade de tratamento odontológico, com restaurações dentárias, no arco dentário inferior direito e esquerdo em pré-molares e/ou molares, recebendo assim o modelo de estudo clínico de boca dividida. De forma aleatória, os hemiarcos inferiores foram submetidos, em dois diferentes momentos com intervalo mínimo de 7 dias, a infiltração anestésica com apenas um tubete de 1,8 mL (para um momento com ACV e outro momento ASV). Foi feita aferição dos parâmetros de saturação de oxigênio (SaO2), frequência cardíaca (FC), pressão arterial sistólica (PAS) e diastólicas (PAD), 5 minutos antes da anestesia, 5, 15 e 30 minutos após a anestesia. Os resultados encontrados neste estudo demonstraram diferença estatística apenas na SaO2 no tempo de 5 minutos após a anestesia em comparação do grupo ACV e ASV, esse mesmo resultado foi obtido quando avaliados apenas os indivíduos que, além de nefropatas, apresentavam diagnóstico de HAS. Os achados deste estudo ressaltam a segurança do uso de anestésicos, com ou sem vasoconstritores desde que em pequenas quantidades, em indivíduos com IRC com ou sem HAS associada. (AU)

Clinical and sociodemographic evaluation of peri-implant health of implant retained prostheses fabricated with an immediate oclusal loading protocol / Avaliação clínica e sociodemográfica da saúde peri-implantar de próteses retidas em implantes fabricadas com um protocolo de carga oclusal imediata

ABSTRACT Introduction Dental implant therapy, when well planned, can contribute to the patient's quality of life and is an important tool for solving a serious public health problem in various parts of the world. Objective This study investigated peri-implant health in fixed implants supported by an immediate loading technique and to associate those outcomes with sociodemographic conditions. Material and method After the disassembly of the prostheses on implants with the "Branemark Model" the peri-implant health of 93 patients was evaluated using dental plaque index (DPI), probing pocket depths (PPD), bleeding on probing (BOP), clinical attachment levels (CAL), and presence of gingival hyperplasia. Patients also answered a questionnaire about their gender, age, socioeconomic status (Brazilian Association of Research Companies - ABEP), general health and tobacco use. Result The most constant clinical findings were the presence of plaque, followed by gingival hyperplasia and periimplantitis, which was associated with disease progression. Most of the patients in the study were female, Caucasian, and under 60 years of age, with prostheses located in their lower arch, and they belonged to social classes A and B. Conclusion The presence of dental biofilm occurred in almost all implants and was not related to the presence of periimplantitis. The progression of periimplantitis with bone loss was related to sub gingival bleeding. The sociodemographic characteristics in the study did not present great correlations with the clinical variables of the dental implants studied.

RESUMO Introdução A terapia de implantes dentais, quando bem planejada, pode contribuir para a qualidade de vida do paciente e é uma ferramenta importante para solucionar um sério problema de saúde pública em várias partes do mundo. Objetivo Este estudo investigou a saúde peri-implantar em implantes fixos apoiados por uma técnica de carga imediata e associou esses resultados a condições sociodemográficas. Material e método Após a desmontagem das próteses sobre implantes com o "Modelo de Branemark", a avaliação peri-implantar de 93 pacientes foi avaliada por meio do índice de placa dental (IPD), profundidade de sondagem (PS), sangramento à sondagem (SS), níveis clínicos de fixação (NCF) e presença de hiperplasia gengival. Os pacientes também responderam a um questionário sobre sexo, idade, nível socioeconômico (Associação Brasileira de Empresas de Pesquisa - ABEP), saúde geral e tabagismo. Resultado Os achados clínicos mais constantes foram a presença de placa, seguida de hiperplasia gengival e periimplantite, que esteve associada à progressão da doença. A maioria dos pacientes do estudo era do sexo feminino, caucasiana e com idade inferior a 60 anos, com próteses localizadas na arcada inferior, pertencentes às classes sociais A e B. Conclusão A presença de biofilme dentário ocorreu em quase todos os implantes e não foi relacionado à presença de periimplantite. A progressão da peri-implantite com perda óssea foi relacionada ao sangramento subgengival. As características sociodemográficas do estudo não apresentaram grandes correlações com as variáveis clínicas dos implantes dentários estudados.

Epidemiological Profile of Patients with Hematological Neoplasms in an Oncological Hospital of Mato Grosso / Perfil Epidemiológico de Pacientes com Neoplasia Hematológica em um Hospital Oncológico de Mato Grosso

O objetivo do estudo foi analisar os aspectos epidemiológicos de pacientes adultos com diagnóstico de neoplasia hematológica, no período de 2004 a 2014, em um Hospital Oncológico em Mato Grosso. A coleta de dados foi realizada através de busca e análise de 590 prontuários. Entre os pacientes, 335 (56,8%) eram do sexo masculino (p<0,05). A maioria possuía mais de 50 anos (p<0,05), com idade média de 53,97±16,55 anos. Quanto ao local de procedência, 257 pacientes eram provenientes da região metropolitana de Cuiabá (43,6%) e 333 (56,4%) de outros locais (p<0,05). A maioria eram pacientes não brancos (p<0,05) e solteiros 342 (58%) (p<0,05). Em relação ao tratamento, 537 (91%) pacientes utilizavam quimioterapia (p<0,05), 57 (9,7%) fizeram uso da radioterapia (p<0,05). Cinquenta e quatro (9,2%) pacientes fizeram uso de ambas as terapias de forma associada (p<0,05) e 50 pacientes (8,4%) não fizeram uso de radioterapia e nem de quimioterapia. Referente aos tipos de neoplasia, os diagnósticos mais encontrados na análise foram de: leucemia mielóide crônica 131 (22,2%); linfoma não Hodking 119 (20,2%); mieloma múltiplo 93 (15,8%); trombocitemia essencial 49 (8,3%); linfoma de Hodking 39 (6,6%); leucemia linfocítica crônica 38 (6,4%); policetemia vera 34 (5,8%); leucemia mielóide aguda 27 (4,6%); síndrome mielodisplasica 21 (3,6); leucemia linfocítica aguda 13 (2,2%) e síndrome mieloproliferativa 10 (1,7%) (p<0,05). A partir dos resultados deste estudo, pode-se concluir que, em geral, os pacientes mais acometidos pelas neoplasias hematológicas tinham mais de 50 anos, eram homens, provenientes do interior do Estado, não brancos e solteiros.(AU).

The objective of this study was to analyze the epidemiological aspects of adult patients diagnosed with hematologic neoplasia, from 2004 to 2014, at a Cancer Hospital in Mato Grosso. Data collection was performed through the search and analysis of 590 patient records. Among the patients, 335 (56.8%) were male (p <0.05). The majority was older than 50 years (p <0.05), with a mean age of 53.97 ± 14.95 years. Regarding origin, 257 patients came from the metropolitan region of Cuiabá (43.6%) and 333 (56.4%) from other sites (p <0.05). The majority was non-white patients (p <0.05) and unmarried 342 (58%) (p <0.05). About treatment, 537 (91%) patients used chemotherapy (p <0.05), 57 (9.7%) used radiotherapy (p <0.05). Fifty-four (9.2%) patients used both therapies in an associated way (p <0.05) and 50 patients (8.4%) did not use either radiotherapy or chemotherapy at any time of their treatment. Regarding the types of neoplasia, the diagnoses most found in the analysis were: chronic myelogenous leukemia 131 (22.2%); non Hodking lymphoma 119 (20.2%); multiple myeloma 93 (15.8%); essential thrombocythemia 49 (8.3%); Hodgkin's lymphoma 39 (6.6%); chronic lymphocytic leukemia 38 (6.4%); policetemia vera 34 (5.8%); acute myeloid leukemia 27 (4.6%); myelodysplastic syndrome 21 (3,6); acute lymphocytic leukemia 13 (2.2%) and myeloproliferative syndrome 10 (1.7%) (p <0.05). From the results of this study, it can be concluded that, in general, the most affected patients by hematological malignancies were older than 50 years, were men from the interior of the State, non-white and unmarried.(AU)

Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration.

INTRODUCTION: This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. MATERIALS AND METHODS: Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. RESULTS: The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. CONCLUSION: It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. CLINICAL SIGNIFICANCE: The quality of the root filling and coronal restoration is closely related to periapical health.

Chronic stress associated to contraceptives use on the progression of ligature-induced periodontitis in rats / Avaliação do estresse crônico associado ou não ao uso de contraceptivos na progressão de periodontite induzida por ligadura em ratos

Introduction: Contraceptives are widely used by women in much of the world. The stress associated with their use can lead adverse responses in the body. Objective: The aim of this paper was to evaluate the effects of chronic stress associated with contraceptive use on the progression of ligature-induced periodontitis in female Lewis rats. Material and method: Therefore, forty rats were randomly divided into 5 groups (n = 8): contraceptive and ligature group (CG); stress and ligature group (SG); contraceptive, stress and ligature group (CSG); ligature group (LG); and control group (CtrlG). An injectable contraceptive was administered to the CG and CSG groups at the beginning of the experiment. On the following day, periodontitis was induced in the CG, SG, LG and CSG groups by placing ligatures on the upper-right second molar. On the third day, the SG and the CSG were subjected to a chronic stress model using physical restraint and cold exposure. After 60 days, the animals were euthanized and submitted to histometric measurements. Two parameters were considered: histological attachment loss (CEJ-PL) and bone loss (CEJ-BC). Regarding CEJ-PL/CEJ-BC. Result: The results indicated that the CtrlG (CEJ-PL 0.10 ± 0.00; CEJ-BC 0.34 ± 0.02) showed the lowest values (p<0.05). The SG group (CEJ-PL 0.90 ± 0.24; CEJ-BC 1.30 ± 0.28) presented higher values that were significantly different (p<0.05) from the results of the LG. The other groups exhibited similar statistical results (p>0.05). Conclusion: The present results do not allow an assessment of the susceptibility of animals to ligature-induced periodontitis.

Introdução: Os contraceptivos são amplamente utilizados pelas mulheres em grande parte do mundo. O estresse associado a sua utilização pode conduzir respostas adversas no organismo. Objetivo: O objetivo deste trabalho foi avaliar os efeitos do estresse crônico associado ou não com o uso de contraceptivos na progressão de periodontite induzida por ligadura em ratas Lewis. Material e método: Para tanto, quarenta ratas foram divididas aleatoriamente em 5 grupos (n = 8): Grupo Contraceptivo e Ligadura (CG); Grupo Estresse e Ligadura (SG); Grupo Contraceptivo, Estresse e Ligadura (CSG); Grupo Ligadura (LG); e Grupo Controle (CtrlG). Um contraceptivo injetável foi administrado nos grupos CG e CSG no início do experimento. No dia seguinte, a periodontite foi induzida nos grupos CG, SG, LG e CSG, através da colocação de ligaduras no segundo molar superior direito destes animais. No terceiro dia, o SG e o CSG foram submetidos a um modelo de estresse crônico usando contenção física e exposição ao frio. Após 60 dias, os animais foram sacrificados e submetidos a medidas histométricas. Foram considerados dois parâmetros: perda de inserção histológico (CEJ-PL) e perda óssea (CEJ-BC). Resultado: Os resultados indicaram que o CtrlG (CEJ-PL 0,10 ± 0,00; CEJ-BC 0,34 ± 0,02) apresentaram os valores mais baixos (p<0,05). O grupo SG (CEJ-PL 0,90 ± 0,24; CEJ-BC 1,30 ± 0,28) apresentou valores mais elevados que foram significativamente diferentes (p<0,05) dos resultados do LG. Os outros grupos apresentaram resultados estatísticos semelhantes (p>0,05). Conclusão: Os resultados deste estudo não permitem uma avaliação da susceptibilidade dos animais à periodontite induzida por ligadura. Sendo necessários, portanto, outros estudos que elucidem melhor a questão.

Avaliação de Perdas Dentárias em 1398 Pacientes em uma População na Região Central do Brasil: Estudo Radiográfico / Evaluation of Dental Loss in 1938 Patients in a Population of Central Region in Brazil: Radiographic Study

A perda dentária é um problema multifatorial, que pode englobar hábitos deletérios da saúde bucal, alterações sistêmicas e condição socioeconômica. Avaliar radiograficamente a perda dentária em uma população de 1398 pacientes na cidade de Cuiabá-MT, buscando correlacionar este fator com a idade e o sexo dos mesmos. Foi realizado um estudo transversal avaliando as perdas dentárias a partir de uma amostra de 1398 radiografias panorâmicas, correspondentes a exames realizados em 2011, em uma clínica radiológica situado na referida cidade. A amostra foi constituída de 856 (61,23%) pessoas do sexo feminino e 542 (38,77%) do sexo masculino, sendo a idade média de 34,9 + 13,4 anos. Durante a análise dos dados, observou-se que 80,6% dos indivíduos haviam perdido algum dente. Os dentes mais ausentes nas análises foram os primeiros molares inferiores e os mais presentes na amostra dos indivíduos foram os caninos inferiores. De acordo com as análises estatísticas (Qui Quadrado e Teste de Relação de Risco ­ p<0,05), a idade foi um fator de risco relacionado à perda dentária. Por meio deste estudo conclui-se que a idade é relacionada com maior perda de dentes, e o dente mais acometido por perdas dentárias é o primeiro molar inferior e o menos acometido é o canino inferior.(AU)

The dental loss is a multifactorial problem that can encompasses deleterious oral health habits, systemic changes and socio-economic status. To evaluate radiographically tooth loss in a population of 1398 patients in the city of Cuiaba-MT, seeking to correlate this factor to the age and sex of the same. A cross-sectional study evaluating tooth loss from a sample of 1398 panoramic radiographs, corresponding to tests carried out in 2011, in a radiology clinic located in that city. The sample consisted of 856 (61.23%) females and 542 (38.77%) were male, with a mean age of 34.9 + 13.4 years. During data analysis, it was observed that 80.6% of individuals had lost some teeth. The most common missing teeth in the analyzes were the first molars and the most present in the sample of individuals were the lower canines; according to statistical analysis (chi square and Risk Ratio test - p <0.05), age was a risk factor related to tooth loss. Through this study it is concluded that age is associated with increased teeth loss the tooth most affected by tooth loss is the first molar and the least affected is the lower canine.(AU)

Effect of Simvastatin on induced apical periodontitis in rats: a tomographic and biochemical analysis / Efeito da Sinvastatina sobre a periodontite apical induzida em ratos: análise radiográfica e bioquímica

Introduction: Simvastatin is one of several statins that are used to treat hypercholesterolemia, and in dentistry, few studies have attempted to associate the administration of this compound with bone repair. Objective: To evaluate the effect of simvastatin on the progression of induced apical periodontitis in rats. Material and method: To this end, 36 male Wistar rats were divided into 3 groups (N=12): Induced Apical Periodontitis Associated with Simvastatin Group (APSG N=12), Induced Periodontitis Apical Induced Group (APG N=12) and Negative Control Group (CG). On the first day, APG and APSG were anesthetized, and the coronal opening of the mandibular first molar was performed. For thirty days, the APSG received 6 mg of simvastatin daily via gavage. On the thirty-first day, all groups underwent blood collection and euthanasia. The jaws were removed and fixed in formalin. CT scans were performed to measure the periapical regions. In addition, the body mass and lipid profile were analyzed. The data were subjected to statistical analysis (ANOVA and Tukey’s test). Result: The APG (3.42±0.65) showed the highest perimeters for the space periapical ligament, followed by APSG (1.54±0.78) and CG (0.64±0.24) (p< 0.05). The lipid profile revealed the effect of simvastatin on the amount of glucose, triglycerides, HDL, and VLDL (p< 0.05). Body mass APG showed the most weight gain (264.75±44.11), followed by CG (252.00±44.36) and APSG (245.41±42.56). The three groups showed significant differences in decreasing order (p< 0.05). Conclusion: The use of simvastatin decreased the progression of the increasing periapical ligament space in rats.

Introdução: A sinvastatina é uma das várias estatinas utilizadas no tratamento da hipercolesterolemia e, na odontologia, alguns estudos têm buscado relacioná-la ao reparo ósseo. Objetivo: Avaliar o efeito da sinvastatina na progressão da periodontite apical induzida em ratos. Material e método: Para tanto, 36 ratos Wistar, previamente selecionados, foram divididos em 3 grupos (N=12). Grupo Controle (GC); Grupo Periodontite Apical (GPA); Grupo Periodontite Apical Associada à Sinvastatina (GPAS). No primeiro dia do ensaio o GPA e o GPAS foram anestesiados e submetidos à abertura coronária do primeiro molar inferior direito. Durante trinta dias, o GPAS recebeu diariamente 6mg de sinvastatina, através de gavagem. No trigésimo primeiro dia, todos os grupos foram submetidos à coleta de sangue e a eutanásia. As mandíbulas foram removidas e fixadas em formol. Para a mensuração das regiões periapicais, foram realizadas tomografias. Além disso, avaliou-se a massa corporal, glicemia e o lipidograma. Os dados foram submetidos à análise estatística ANOVA de uma via e teste Post Hoc de Tukey (p< 0,05). Resultado: Os resultados demonstram que o GPA (3,42±0,65) apresentou os maiores perímetros para espaço do ligamento periapical, seguido pelo GPAS (1,54±0,78) e GC (0,64±0,24), respectivamente (p<0,05). Em relação ao lipidograma percebe-se o efeito da sinvastatina avaliando-se a quantidade de glicose, triglicérides, HDL, VLDL (p< 0,05). Para a massa corporal o GPA foi o que mais ganhou peso (264,75±44,11); seguido pelo GC (252,00±44,36); e GPAS (245,41±42,56). Os três grupos apresentaram diferenças estatísticas entre si, de forma decrescente (p< 0,05). Conclusão: O uso da sinvastatina diminuiu a progressão do aumento do espaço do ligamento periapical em ratos.

Experiência do paciente em relação ao medo frente ao atendimento odontológico / Patient experience from fear facing the dental care

Objetivo: Compreender os motivos da sensação de medo relatada pelo paciente em relação à consulta odontológica (CO). Materiais e Métodos: A amostra foi por conveniência e compreendeu 90 pacientes selecionados entre os meses de agosto e setembro de 2013. Aplicou-se um questionário contendo identificação e questões relacionadas ao sentimento de medo dos pacientes frente à CO. Foram aplicados os testes estatísticos de Qui-Quadrado (p<0,05) e Análise de Risco Estimado Relativo. O intervalo de confiança foi de 95% em ambos. Resultados: A idade média dos pacientes foi de 33,9. A maioria foi do gênero feminino (57,8%) e 63,3% relatou presença de dor antes da CO. As causas pretéritas de medo estiveram mais associadas ao tratamento endodôntico (32,2%). Entretanto, 65,6% dos pacientes não tiveram medo em qualquer momento, 21,1% apresentaram sensação do medo e 13,3% não se lembraram. A anestesia aparece como fator de medo para 62,2% dos pacientes, motor de alta rotação para 17,8%, isolamento absoluto 12,2% e 7,8% apontaram outros fatores (p>0,05). No caso da análise de risco, os resultados demonstram que idade inferior a 34 anos - 0,167 (0,065-0,426) - e ausência de dor durante o tratamento - 0,242 (0,065- 0,905) ­ são fatores que contribuem para diminuição do medo do dentista. Conclusão: Conclui-se que a presença de dor antes da CO e a anestesia representam fatores que mais causam medo nos pacientes. Em contrapartida, idade inferior a 34 anos e ausência de dor são fatores que contribuem para a diminuição do relato de medo entre os pacientes submetidos a tratamento odontológico.

Objective: to understand the reasons for the sense of fear reportedby the patient in relation to the dental appointment (DA). Materials and Methods: The sample consisted of convenience and included 90 patients selected between the months of August and September 2013. It was applied a questionnaire containing identification and issues related to the feeling of fear of patients front of the DA. Data were organized and applied statistical tests of chi-square (p <0.05) and Risk Analysis, having as dependent variable the presence of fear, with a 95% confidence interval in both. Results: The mean age of patients was 33.9 (+8.65). Most were female (57.8%) and 63.3% reported presence of pain before DA. Generating preterit causes of fear they were more associated with endodontic treatment (32.2%). However, 65.6% of patients had no fear at any time of care, 21.1% had feeling of fear and 13.3% did not remember. In contrast, anesthesia appears as fear factor to 62.2% of patients, high speed motor to 17.8%, absolute isolation 12.2% and 7.8% indicated other factors (p> 0.05). In the case of estimated risk analysis, having as the dependent variable fear of DA, the results demonstrate that the age of 34 years - 0.167 (0.065 to 0.426) - and no pain during treatment -0.242 (0.065 to 0.905) - are factors that contribute to decrease the fear of the dentist. Conclusion: From the results presented it was concluded that the presence of pain in the moments prior to DA and local anesthesia represent factors that cause fear in patients undergoing dental treatment.

Avaliação da presença de depósitos na superfície de próteses fixas implantossuportadas, em 83 pacientes com pelo menos 12 meses em função: estudo transversal e criação de um escore para uso clínico / Evaluation of deposits onto the intaglio surface of implant-supported fi xed prostheses in 83 patients after 12 months in function: a cross-sectional study with a clinical score proposal

Objetivo: criar um escore para observar a presença de depósitos na superfície das próteses fixas suportadas por implantes, confeccionadas seguindo o protocolo Brånemark. Material e métodos: pacientes portadores de próteses fixas implantossuportadas através do protocolo de Brånemark, com no mínimo 12 meses de uso, foram convidados a participarem da pesquisa e receberem manutenção periódica preventiva periodontal. Durante a consulta, as próteses fixas eram desmontadas utilizando-se um estojo protético e classificadas através de escores, de acordo com o acúmulo de depósitos em sua superfície: 0 ­ entre zero e 25%; 1 ­ entre 26% e 50%; 2 ­ entre 51% e 75%; 3 ­ 76% ou mais. Resultados: foram selecionados 83 pacientes, sendo 25 (31,6%) do sexo masculino e 58 (68,4%) do sexo feminino. A média de idade dos pacientes foi de 62,13 anos (faixa entre 40 e 87 anos). O tempo médio de uso das próteses foi de quase três anos. A maioria das próteses foi classificada com escores 2 e 3, diferindo estatisticamente apenas das próteses classificadas com escores 1 (p < 0,05). As próteses classificadas com escore 2 não demonstraram diferenças estatísticas, quando comparadas às próteses com escores 1 e 3 (p > 0,05). O escore 0 foi o menos prevalente e com diferenças estatísticas, comparado com os demais grupos. Um caso demonstrou presença de corpo estranho (material de moldagem) no interior do sulco peri-implantar, enquanto nos outros houve a formação de cálculos salivares. Inflamação peri-implantar esteve associada ao escore 3. Conclusão: o método apresentado é viável e de fácil execução. Os pacientes têm dificuldades em higienizar suas próteses. O implantodontista deve observar atentamente as estruturas peri-implantares, principalmente para a presença de corpos estranhos.

Objective: to create a score to classify the degree of debris at the intaglio surface of implant-supported prostheses made according the Brånemark protocol. Material and methods: patients wearing their implant-supported fixed prostheses (at least 1 year in function were invited to participate into this study and received preventive periodontal maintenance. The prostheses were unscrewed and classifi ed according to the amount of undersurface deposits as follows: 0) 0-25%; 1) 26% to 50%; 2) 51% to 75%; and 3) 76% or more. Results: 83 patients (25 (31.6%) male and 58 (68.4%) female) were enrolled, with a mean age of 62.13 years-old (range from 40 to 87 years). The mean time of prostheses into function was almost 3 years. Most rehabilitations received scores 2 and 3, being statistically different from those rated with score1 (p < 0.05). Those with score 2 were not different from scores 1 and 3 (p > 0.05). The zero score was the least prevalent compared to the other groups. Interestingly, one case highlighted a foreign residual body (impression material) into the peri-implant sulcus, while salivary calculi were also observed. The peri-implant inflammation was mostly associated to score 3. Conclusion: although the presented score has been user-friendly, all patients presented hygiene diffi culties. Implant practitioners must closely observe all peri-implant structures mainly for the presence of foreign bodies.

Avaliação do Conhecimento da Saúde Bucal Entre Pacientes Cardiopatas Antes da Realização de Cirurgia Cardíaca em um Hospital Universitário / Assessment of Oral Health Knowledge among Cardiac Patients before Heart Surgery in a School Hospital

Os pacientes cardiopatas parecem desconhecer os problemas relacionados com sua saúde bucal e as respectivas repercussões no sucesso de seu tratamento cirúrgico cardiovascular. O objetivo do estudo foi avaliar o conhecimento da saúde bucal entre pacientes cardiopatas internados, aguardando para serem submetidos às cirurgias cardíacas, com indicação de monitoramento na unidade de terapia intensiva (UTI). O estudo utilizou uma amostra composta por 62 pacientes de ambos os gêneros, com idade entre 33 e 87 anos. O instrumento de pesquisa consistiu de um questionário para registro de informações. Foram coletados dados referentes à: anamnese, condição socioeconômica, higiene bucal - escovação, aparatos de higiene, frequência de troca destes aparatos, frequência odontológica e presença de próteses dentais. Como critério de inclusão para o estudo, o indivíduo deveria ser cardiopata, estar internado e no aguardo de cirurgia cardíaca. Os dados foram organizados com auxílio do software IBM® SPSS® utilizando-se o teste estatístico Qui-Quadrado (p<0,05). A maioria dos pacientes era do sexo masculino (64,5%), cor branca (51,6%), idade média de 60,35+11,73,não fumante (91,9%) e não diabético (75,8%). Para os hábitos de higiene, 87,1% escovavam os dentes duas ou três vezes ao dia, destes 98,4% utilizavam escova e creme dental, entretanto 69,4% não utilizam o fio dental. Do total, 56,5% pacientes estavam a mais de um ano sem ir ao dentista; destes, 33,9% tinham procurado este profissional em busca de exodontia. Quanto ao questionamento de como os pacientes consideravam sua saúde bucal, 37,1%, 43,5% e 19,4% disseram ser boa, regular e ruim, respectivamente. Do total, 48,4% dos pacientes perderam todos os dentes superiores e outros 30,6% todos os inferiores. Conclui-se que a maioria dos pacientes tem conhecimento sobre a importância de se escovar os dentes pelo menos duas vezes ao dia para a manutenção da saúde bucal, entretanto os indicadores avaliados demonstram que no geral o estado de saúde bucal é insatisfatório.AU

Cardiac patients are unaware of the problems related to their oral health and its impact on the success of cardiovascular surgery. The aim of the study was to evaluate the knowledge of oral health among hospitalized cardiac patients waiting for cardiac surgery with monitoring indication in the intensive care unit. The study used a sample of 62 patients of both genders aged between 33 and 87 years. The research instruments consisted of a questionnaire for registration information. Data were collected regarding: medical history, socioeconomic status, oral hygiene - brushing, hygiene apparatus, and exchange frequency of these devices, dental attendance, and presence of dental prostheses. As inclusion criteria for the study, subjects could be cardiac, being hospitalized and awaiting heart surgery. Data were organized with the help of IBM SPSS software using the statistical test Chi-square (p <0.05). Most patients were male (64.5%), white (51.6%) aged 60.35 + 11.73, non-smoker (91.9%) and non-diabetic (75.8%). For hygiene, 87.1% brushed their teeth two or three times a day, of which 98.4% used toothbrush and toothpaste; however, 69.4% do not use the floss. A total of 56.5% patients was more than a year without going to the dentist; of these 33.9% had sought this professional looking for extraction. As for the question of how patients rated their oral health, 37.1%, 43.5%, and 19.4% considered it good, fair, and poor, respectively. A total of 48.4% of patients lost all upper teeth, and other 30.6% lost lower teeth. It is concluded that most patients know about the importance of brushing their teeth at least twice daily for the maintenance of oral health, though the appraised indicators show that the oral health status is unsatisfactory.

Model of oral rehabilitation with immediate or delayed implantsupportedcomplete dentures: radiographic evaluation / Modelo de reabilitação oral com próteses totais implanto-suportadas submetidas à carga imediata ou convencional: avaliação radiográfica

Objective: The study aims were to compare the radiographic bone loss of implant-supported complete dentures submitted to immediate or delayed loading and to correlate this loss with different features of the patients involved. Material and Methods: Sixty protocol model implants, in 49 patients, were selected. Thirty-two protocol model implants were submitted to immediate loading, i.e., within 48 h. The remainder were submitted to delayed loading, three to six months later. Questionnaires that collected data on gender, age, location and number of implants, maintenance time and socioeconomic status were analysed. The measurements were obtained from digital panoramic radiographs (ANOVA, MANOVA; Student’s t test, p < 0.05). Results: The radiographic bone loss in the models that underwent immediate and delayed loading was 2.4 mm and 2.5 mm (p > 0.05), respectively; regarding gender and the location and number of implants, the results did not differ (p > 0.05). The average ages of the immediate (62.8 ± 10.1 years old) and the delayed (54.5 ± 5.46 years old) protocol groups were significantly different (p < 0.05). In tests examining multivariate associations with the dependent variable of bone loss >4 mm, there was association with a greater number of sites in the maxilla, older age and female gender. The odds ratio indicated that a loss of more than 4 mm was 17 times more likely in the maxilla. Conclusion: 1 - Well-maintained implant-supported complete denture sunder went little bone loss; 2 - there were no differences in radiographic outcomes between different techniques of rehabilitation; and 3 - there was greater bone loss in the maxilla, compared to the mandible; 4 - there were no correlations between bone loss and social class, age or gender of the patients.

Objetivo: O objetivo deste estudo foi comparar a perda óssea radiográfica das próteses totais implanto-suportadas submetidas à carga imediata ou convencional e correlacionar este dado com diferentes características dos pacientes envolvidos. Materiais e Métodos: Foram selecionados 49 pacientes, que portavam 60 próteses modelo protocolo. Trinta e duas próteses foram submetidas a carga imediata, isto é, dentro de 48 horas. O restante foi submetido a carga entre três e seis meses depois da cirurgia de implante. Questionários sobre gênero, idade, localização e número de implantes, tempo de manutenção e condição socioeconômica foram analisados. As medidas das perdas ósseas foram obtidas a partir de radiografias digitais panorâmicas (ANOVA, MANOVA; teste t de Student, p <0,05). Resultados: A perda óssea radiográfica nas próteses submetidas a carga imediata e a carga convencional foi de 2,4 mm e 2,5 mm, respectivamente (p> 0,05); em relação ao gênero, a localização e ao número de implantes, os resultados não diferiram (p> 0,05). A idade média dos pacientes submetidos a carga imediata foi de 62,8 ± 10,1 anos, e, os pacientes submetidos a carga no tempo convencional apresentaram média de idade igual a 54,5 ± 5,46 anos (p <0,05). Nas análises multivariadas da variável dependente perda óssea >4 mm, houve associação com a maxila, pacientes mais idosos e do sexo feminino. A razão de risco indicou que uma perda óssea >4 mm apresentava 17 vezes mais chances de ocorrer na maxila. Conclusão: 1 - Próteses totais implanto-suportadas, quando submetidas a manutenções periódicas adequadas, geram pequena perda óssea; 2 - Os resultados radiográficos não demonstraram diferenças entre as técnicas de reabilitação analisadas; e 3 - Houve uma maior perda de osso na maxila, em comparação com a mandíbula.

Estudo da ansiedade e da condição socioeconômica em uma subpopulação de acadêmicos do curso de graduação em Odontologia / Study of anxiety and socioeconomic status of a dentistry's students subpopulation

Objetivo: Avaliar, através de questionário validado, o grau de ansiedade dos acadêmicos do curso de Odontologia e correlacioná-lo com a condição socioeconômica, idade, sexo deste alunado. Materiais e Métodos: A amostra foi constituída por 258 acadêmicos, selecionados conforme o desejo de participar da pesquisa, que responderam questionários relativos às características pessoais, condição socioeconômica (ABEP) e à ansiedade (Inventário de Ansiedade de Beck - BAI - Beck Anxiety Inventory). O teste estatístico utilizado foi o diagrama em árvore - Answer Tree que tem como base o teste de Qui-Quadrado com uma significância de 5%. Resultados: Os alunos participantes estiveram em maior número nos semestres iniciais do curso (n=141 ­ 54,7%). A maioria tinha idade entre 17 e 19,5 anos (n=130 ­ 50,4%) e era do sexo feminino (n=174 ­ 67,4%). A maior parcela era da classe social B (n=123 ­ 47,7). No diagrama em árvore, onde a ansiedade foi considerada variável dependente e, as outras variáveis como independentes, pôde-se verificar que a ansiedade foi maior nos alunos com menos de 19,5 anos (1,91+0,88) e da classe social A (2,04+ 0,97). Conclusão: Conclui--se que há uma alteração relevante do estado de ansiedade nos estudantes de Odontologia com idade menor ou igual a 19,5 anos e da classe social A.

Objective: To evaluate, through validated questionnaire, the anxiety of dental students and correlate this with their socioeconomic status, age and gender. Materials and Methods: The sample consisted of 258 students, who responded to Questionnaires on personal characteristics, socioeconomic status (ABEP) and anxiety degree (BAI - Beck Anxiety Inventory). The statistical test used was Answer Tree that is based on the chi-square test with a significance level of 5%. Results: Most participants were in early semesters (n = 141 to 54.7%); between 17 and 19.5 years (n = 130 to 50.4%) and were female (n = 174 to 67.4%). Class B (n = 123 to 47.7) was the most frequent socioeconomic status. In Answer Tree analysis, where anxiety was considered the dependent variable and the other variables as independent, it was observed that anxiety was higher in students under 19.5 years old (1.91 + 0.88) and from class A (2,04+ 0.97). Conclusion: It was conclude that there is an important change in the state of anxiety in the dental students aged less than or equal to 19.5 years and from social class A.

Effect of repeated sterilization cycles on the physical properties of scaling instruments: a scanning electron microscopy study.

BACKGROUND: Repeated sterilizations cycles cause undesirable alterations in the material properties of the instruments, such as corrosion, alterations in the hardness of the metal and the loss of the cutting sharpness of the instrument. This research examined the effect of repeated dry heat sterilization and autoclaves cycles on carbon steel (CS) and stainless steel (SS) curettes during the scaling and root planning. MATERIALS AND METHODS: A total of 77 Gracey curettes were used in this study. Of these, 35 were SS and 42 were CS curettes submitted in different process: Dry heat, autoclave, inhibition of corrosion and autoclave, scaling, root planning and dry heat, scaling, root planning, inhibition of corrosion and autoclave. The inhibition of corrosion used on the carbon curettes (prior to sterilization in the autoclave) was sodium nitrite at 2%. The curettes received 10 consecutive cycles of sterilization and after that the cutting edges were examined in the electronic microscope, at 60 and 100 magnification times. RESULTS: The images were evaluated by three independent examiners, who compared the photographs of each group with the control group. CONCLUSION: The surface corrosion products and a deterioration of the edges were observed and the results showed that the SS curettes suffered little alteration with sterilization, scaling, root planning whereas the CS curettes were visibly affected by sterilization in the autoclave, but when the inhibition of corrosion was used prior to the sterilization, the oxidation was considerably reduced.

Tecidual reaction of calcium hydroxide front chronic stress histological study in rats.

BACKGROUND: The Calcium Hydroxide has been widely used as an intracanal dressing and in combination with restorative and endodontic materials and its main goal is the tissue reparation. However, when the patient has chronic stress, the immunological response and tissue repair decreases in both the epithelial and connective tissue. Therefore, the aim was to analyze the effect of chronic stress on the tissue response in rats exposed to calcium hydroxide (CH). MATERIALS AND METHODS: A total of 60 wistar rats were anesthetized, and a polyethylene tube containing CH was inserted under the skin. After 24 h, they were divided into two groups: Calcium hydroxide + stress (CHSG) n = 30 and calcium hydroxide (CHG) n = 30. They were stressed by physical restraint, for 12 h each day for periods of 7, 15 and 30 days when 10 animals from each group were euthanized. The tissues surrounding the polyethylene tubes were removed, and slides were prepared and stained with hematoxylin and eosin. The analysis was performed with an optical microscope with magnification of 4-400 times by a blinded senior examiner. The sample slides were classified according to the following scores 0 - absent/1 - present/2 - infiltrate to: Inflammatory infiltrate containing fibrous condensation, lymphocytes, plasmacytes, macrophages, neutrophils, and eosinophils. The data were statistically analyzed using the Student's t-test (P < 0.05) for paired samples. RESULTS: The exposure time of 7 days elicited no statistical difference between groups (P > 0.05). The 15 days exposure group had higher averages for CHG to eosinophils and inflammatory infiltrate (P < 0.05). In 30 days, CHG showed higher averages to inflammatory infiltrate and lower averages to FC (P < 0.05). CONCLUSIONS: Some modified patterns of responses in the CHSG were observed at 15 days and 30 days.

Resoluções protéticas para casos com sequelas de perdas de tecido periodontal / Prosthetic resolutions for cases with sequels of periodontal tissue loss

Introdução: as próteses dentogengivais são alternativas na atualidade para os casos de sequelas de grandes perdas de estrutura periodontal, principalmente na região anterior. Objetivo: nestes relatos de casos serão descritos alternativas protéticas diante de casos com grande perda de tecidos periodontais na região anterossuperior. Relatos de Caso: três casos clínicos foram realizados com a técnica da prótese dentogengival. Esse recurso, embora não seja o ideal, garante uma reconstrução estética e funcional satisfatória para os pacientes que apresentam casos com grande perda de tecidos de suporte. Um dos pontos interessantes do trabalho é o planejamento reverso com a presença de uma cera que simula a região a ser construída em critérios como a cor, textura, posição e avaliação da higiene. De posse desse planejamento, há a confecção da cerâmica dentogengival com resultados interessantes dos pontos de vista estético e funcional. Conclusão: as próteses dentogengivais são um recurso interessante e com boa satisfação dos pacientes e dos profissionais envolvidos nesses relatos.

Background: Nowadays, dentogingival prostheses are alternatives for cases of sequels of periodontal structure loss, especially in the anterior region. Aim: In these case reports will be described on prosthetic alternatives for cases with great losses of periodontal tissues in the upper anterior region. Case Reports: Three clinical cases were performed with the technique of dentogingival prosthesis. This resource, although not ideal, ensures satisfactory aesthetic and functional reconstruction for patients who present cases with extensive loss of supporting tissues. One of the interesting points of the paper is the reverse planning in the presence of a wax that simulates the region to be built on criteria such as color, texture, position and assessment of hygiene. Upon this planning, there was the ceramic dentogingival development with interesting aesthetic and functional results. Conclusion: Dentogingival prostheses are an interesting and good device to satisfaction of patients and professionals involved in these reports.

Effect of chronic stress on ligature-induced periodontitis in inbred and noninbred rats: a radiographic study.

AIM: The aim was to compare the effect of chronic stress on ligature-induced periodontitis in inbred and noninbred female rats by means of a radiographic study. MATERIALS AND METHODS: Adult Lewis (inbred) and Wistar (non-inbred) rats were used and divided into the following groups: Ligature/Stress Lewis Group (LSLG, n = 8); Ligature/Stress Wistar Group (LSWG, n = 8); Ligature Lewis Group (LLG, n = 8) and Ligature Wistar Group (LWG, n = 8). The animals were anesthetized and a silk thread was continuously kept around their second upper right molar. Then, groups LSLG and LSWG were subjected to physical stress test (physical restraint for 12 hours). After 15 days of ligature placement, the animals were euthanized. The right hemimaxilla was kept in formalin solution for 48 hours. Radiographs of the hemimaxillae were obtained using the parallelism technique and subsequently submitted to a standardized radiographic processing. The examiner was blinded to the groups and calibrated. The bone height level was measured and the data were subjected to statistical analysis (ANOVA, Tukey, p < 0.05). RESULTS: LSWG showed bone destruction significantly higher than that of LSLG (32.1 ± 1.45 mm and 23.6 mm ± 2.13, respectively). Similarly, LWG showed bone destruction significantly higher than that of LLG (28.6 ± 1.18 mm and 25.2 ± 2.76 mm, respectively). CONCLUSION: Inbred rats (Lewis) are less susceptible to the effects of chronic stress than are noninbred rats (Wistar) in relation to ligature-induced periodontitis. CLINICAL SIGNIFICANCE: Epidemiological studies have shown a relationship between stress and periodontitis. One of the major difficulties of this type of research is the bias of the exact diagnosis of the patient's emotional state. Inbred lines animals have standards-specific neuroendocrine, this allows answers about the susceptibility of periodontal disease, making knowledge applicable in future clinical trials.

Comparative Analysis of Selected Physicochemical Properties of Pozzolan Portland and MTA-Based Cements.

Physicochemical properties of pozzolan Portland cement were compared to ProRoot MTA and MTA BIO. To test the pH, the samples were immersed in distilled water for different periods of time. After the pH analysis, the sample was retained in the plastic recipient, and the electrical conductivity of the solution was measured. The solubility and radiopacity properties were evaluated according to specification 57 of the American National Standard Institute/American Dental Association (ANSI/ADA). The statistical analyses were performed using ANOVA and Tukey's test at a 5% level of significance. Pozzolan Portland cement exhibited pH and electrical conductivity mean values similar to those of the MTA-based cements. The solubilities of all tested materials were in accordance with the ANSI/ADA standards. Only the MTA-based cements met the ANSI/ADA recommendations for radiopacity. It might be concluded that the pH and electrical conductivity of pozzolan Portland cement are similar to and comparable to those of MTA-based cements.

Próteses totais imediatas implantossuportadas na maxila e mandíbula para correção de falsa relação oclusal, Classe III. Acompanhamento clínico e qualidade de vida após cinco anos / Immediate, implant-supported total fixed prostheses in the edentulous jaws to correct false class III occlusal relationships. Clinical and quality of life results after five years

Este relato de caso clínico descreve o tratamento de um paciente com posição mandibular aparentemente avançada tratada através de implantes dentários e próteses bimaxilares imediatas. O paciente tinha como queixa principal a estética afetada pela cárie e doença periodontal extensa. Após a realização do planejamento reverso com guia multifuncional e tomografia computadorizada, os dentes superiores foram extraídos e uma prótese total fixa (confeccionada em liga de Ni-Cr e com dentes artificiais em resina acrílica) foi aparafusada sobre os implantes imediatos (torque final de 45 Ncm). A arcada inferior foi tratada da mesma forma. Após cinco anos de controle, a mucosite foi observada em menos de 30% dos sítios. Ainda, os resultados do questionário OHIP-14 indicaram melhora substancial na qualidade de vida. A correção imediata da falsa relação oclusal Classe III traz benefícios substanciais ao paciente e, quando realizada por profissionais altamente treinados, representa uma alternativa vantajosa de tratamento.

This clinical case report describes treatment of a patient with protruding mandibular position through immediate dental implants and fixed prostheses. The main patient´s concern was the lack of esthetics due to caries and generalized periodontal disease. After reverse planning execution using a multifuncional guide and computerized tomography analysis, all maxillary teeth were deemed compromised and extracted. Then, an implant-supported prosthesis (Ni-Cr framework veneered by artificial acrylic resin teeth) was fastened to immediate implants (final seating torque: 45 Ncm). The inferior arch was treated accordingly. The five-year follow-up revealed mucositis in less than 30% of sites. Also, OHIP-14 results indicated significant improvement on quality of life. The immediate correction of a false Class III occlusal relationship brings substantial benefi ts for patients and, when performed by high-skilled professionals, represents an excellent treatment choice

Lipid Profile Parameters under influence of Periodontitis Associated with Chronic Stress: An Animal Model Study.

BACKGROUND: The present study compared the effect of two chronic stress models associated with periodontitis induced in rats on partial lipid profile parameters. MATERIALS & METHODS: Forty-eight rats were divided into 4 groups: physical stress+periodontitis, variable stress+periodontitis, periodontitis and control. Physical stress and variable stress occurred over 60 days. After the first ten days of the stress test, periodontitis was induced by ligature. After 60 days of experimentation, the animals underwent incision and visualization of the posterior vena cava, and blood punctures were performed under a vacuum. Impartial and trained examiners performed the analysis of the parameters: low-density lipoprotein, high density lipoprotein, triglycerides and cholesterol. RESULTS: The lipid parameters and cholesterol were significantly lower in the variable stress group than in the ligature and control groups. The physical stress group was not statistically different from the other groups. The triglyceride level was highest for the control group and statistically different from the levels in groups variable stress and physical stress. The physical stress group had the lowest triglyceride level, which was statistically different from that of the control group. There was no statistical difference between physical stress and variable stress with respect to low-density lipoprotein; a similar finding was obtained for ligature and control. The variable stress group had the lowest low-density lipoprotein level, which was statistically different from those of the ligature and control groups. High density lipoprotein levels showed no statistical differences between groups. CONCLUSION: Despite the limitations of the methodology, it seems that the stress model variable associated with periodontitis improved lipid parameters in the study. How to cite this article:Porto AN, Borges AH, Segundo AS, Semenoff TA, Pedro FL, Bandeca MC, Cortelli SC. Lipid profile parameters under influence of periodontitis associated with chronic stress: an animal model study. J Int Oral Health 2013; 5(4):8-14.

Effect of chronic stress in newborn rats on the progression of ligature-induced-periodontitis in adulthood.

PURPOSE: To investigate the effect chronic stress in newborn rats on the progression of ligature-induced-periodontitis in adulthood. METHODS: Ten couples of adult Wistar rats were selected for mating. After birth, the female and their respective offsprings were allocated into two groups. Ligature Group (LG): offsprings were only watched during breast-feeding; Stress-ligature Group (SLG): after 24h of live birth, the offsprings were moved away from their mothers every day for four hours during breast-feeding for 20 days; in both approaches, after reaching ± 250g, ten rats were included in the groups. Periodontal disease was induced by a silk suture placed around the maxillary right second molar. The left side was used as control. After 15 days, the animals were subjected to euthanasia, maxillary bones were removed and stored in 10% formaldehyde. After 48h, radiographs were taken and revealed and were used for bone destruction analysis. Examiner was blind and calibrated for measurements. RESULTS: Stress-ligature group presented higher bone loss values in relation to ligature group (p<0.05). CONCLUSION: Exposure to chronic stress imposed on offsprings produced a greater progression of bone loss induced during adulthood.