Effect of stainless-steel wire internal fixation on intracapsular condylar fracture.

OBJECTIVES: The aim of the study was to investigate the clinical effect of stainless-steel wire fixation on the early mouth-opening movement of an intracapsular fracture involving the condylar process. MATERIALS AND METHODS: In this study, patients who underwent mandibular condylar intracapsular fracture surgery in our hospital from 2012 to 2020 were selected as research subjects. A total of 44 patients received steel wire internal fixation treatment, 32 patients received titanium plate-and-nail rigid internal fixation, and 28 patients underwent conservative non-surgical treatment. RESULTS: For the patients in the stainless-steel wire group, the degree of mouth opening reached normal levels of 3.7 cm approximately 10 days after surgery. The recovery time for the patients in the titanium plate-and-nail rigid internal-fixation group was 21 days, while the patients in the conservative treatment group needed 60 days to recover. CONCLUSION: The treatment of fixation with a stainless-steel wire for intracapsular condylar fracture reduced the time taken to perform mouth-opening exercises and improved the recovery rate of patients.

OBJETIVO: Explorar el efecto clínico de la fijación de alambre de acero inoxidable en el movimiento temprano de apertura de la boca en la fractura interna del cóndilo. MÉTODO: Este estudio seleccionó a pacientes que se sometieron a cirugía de fractura intracapsular de cóndilo en nuestro hospital de 2012 a 2020 como sujetos de investigación. Un total de 44 pacientes recibieron tratamiento de fijación interna de alambre de acero, 32 recibieron placa de titanio y fijación interna con clavos, y 28 recibieron tratamiento conservador no quirúrgico. RESULTADOS: En los pacientes del grupo de alambre de acero inoxidable, alrededor de 10 días después de la cirugía el grado de apertura de la boca alcanzó un valor normal de 3.7 cm. El tiempo de recuperación de los pacientes en el grupo de fijación interna con clavos y placa de titanio fue de 21 días, mientras que los pacientes en el grupo de tratamiento conservador tardaron 60 días en recuperarse. CONCLUSIONES: La fijación con alambre de acero inoxidable para el tratamiento de la fractura intracapsular del cóndilo acorta el tiempo hasta la apertura de la boca y mejora la tasa de recuperación de los pacientes.

The value of endoscopic duodenal papilloplasty with titanium clip in improving post-operative complications of choledocholithiasis.

OBJECTIVE: To investigate the value of endoscopic duodenal papillary sphincterotomy combined with balloon dilatation in the treatment of duodenal papilloplasty with titanium clip after choledocholithiasis in post-operative complications. MATERIALS AND METHODS: One hundred and twenty-five patients (69 males and 56 females) with a median age of 65 (32-81) years were included. The treatment plan was randomly divided into Group A (n = 59) and Group B (n = 66) according to the random number table. Patients in Group A were treated with endoscopic sphincterotomy (EST) combined with endoscopic papillary large balloon dilation (EPLBD), followed by a titanium clip for duodenal papilloplasty and then indwelling nasobiliary drainage, whereas those in Group B were treated with EST combined EPLBD to remove stones and then indwelling nasobiliary drainage. RESULTS: In patients with choledocholithiasis or with anatomical changes that make stone extraction difficult, this prospective study attempted to perform duodenal papilloplasty with titanium clips after EST and EPLBD lithotripsy to compare and observe post-operative papillary healing, biliary reflux, and complication rates. CONCLUSIONS: The use of endoscopic duodenal papilloplasty with a titanium clip can improve biliary reflux after lithotripsy and reduce the incidence of post-operative cholangitis complications.

OBJETIVO: Investigar el valor de la esfinterotomía papilar duodenal endoscópica combinada con dilatación con balón en el tratamiento de la papiloplastia duodenal con clip de titanio después de coledocolitiasis en complicaciones postoperatorias. MATERIALES Y MÉTODOS: Se incluyeron un total de 125 pacientes (69 hombres y 56 mujeres) con una mediana de edad de 65 (32-81) años. Los pacientes del Grupo A se trataron con esfinterotomía endoscópica (EST) combinada con dilatación papilar endoscópica con balón grande (EPLBD), seguida de clip de titanio para papiloplastia duodenal y luego drenaje nasobiliar permanente, mientras que los del Grupo B se trataron con EPLBD combinado con EST para eliminar cálculos y luego drenaje nasobiliar permanente. RESULTADOS: En pacientes con coledocolitiasis o con cambios anatómicos que dificultan la extracción de cálculos, este estudio prospectivo intentó realizar papiloplastia duodenal con clips de titanio después de litotricia EST y EPLBD para comparar y observar la cicatrización papilar postoperatoria, el reflujo biliar y las tasas de complicaciones. CONCLUSIÓN: El uso de papiloplastia duodenal endoscópica con clips de titanio puede mejorar el reflujo biliar después de la litotricia y reducir la incidencia de complicaciones de colangitis postoperatorias.

Insertion torque, flexural strength and surface alterations of stainless steel and titanium alloy orthodontic mini-implants: an in vitro study

ABSTRACT Objective: This study aimed to compare the insertion torque (IT), flexural strength (FS) and surface alterations between stainless steel (SS-MIs) and titanium alloy (Ti-MIs) orthodontic mini-implants. Methods: Twenty-four MIs (2 x 10 mm; SS-MIs, n = 12; Ti-MIs, n = 12) were inserted on artificial bone blocks of 20 lb/ft3 (20 PCF) and 40 lb/ft3 (40 PCF) density. The maximum IT was recorded using a digital torque meter. FS was evaluated at 2, 3 and 4 mm-deflection. Surface topography and chemical composition of MIs were assessed by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS). General linear and mixed models were used to assess the effect of the MI type, bone density and deflection on the evaluated outcomes. Results: The IT of Ti-MIs was 1.1 Ncm greater than that obtained for the SS-MIs (p= 0.018). The IT for MIs inserted in 40 PCF test blocks was 5.4 Ncm greater than that for those inserted in 20 PCF test blocks (p < 0.001). SS-MIs inserted in higher density bone (40 PCF) had significantly higher flexural strength than the other groups, at 2 mm (98.7 ± 5.1 Ncm), 3 mm (112.0 ± 3.9 Ncm) and 4 mm (120.0 ± 3.4 Ncm) of deflection (p< 0.001). SEM evidenced fractures in the Ti-MIs. EDS revealed incorporation of 18% of C and 2.06% of O in the loaded SS-MIs, and 3.91% of C in the loaded Ti-MIs. Conclusions: Based on the findings of this in vitro study, it seems that SS-MIs offer sufficient stability and exhibit greater mechanical strength, compared to Ti-MIs when inserted into higher density bone.

RESUMO Objetivo: O objetivo deste estudo foi comparar o torque de inserção (TI), a resistência flexural (RF) e as alterações de superfície em mini-implantes ortodônticos de aço inoxidável (MIs-Ai) e de liga de titânio (MIs-Ti). Métodos: Vinte e quatro MIs (2 x 10 mm; MIs-Ai, n = 12; MIs-Ti, n = 12) foram inseridos em blocos de osso artificial de densidades de 20 lb/ft3 (20 PCF) e 40 lb/ft3 (40 PCF). O torque máximo de inserção foi registrado por meio de um torquímetro digital. A resistência flexural foi avaliada nas deflexões de 2, 3 e 4 mm. Topografia de superfície e composição química dos MIs foram avaliadas por Microscopia Eletrônica de Varredura (MEV) e Espectroscopia de Energia Dispersiva de Raios X (EDS). Modelos lineares gerais e mistos foram utilizados para avaliar o efeito do tipo de MI, da densidade óssea e da deflexão nos desfechos avaliados. Resultados: O TI dos MIs-Ti foi 1,1 Ncm maior do que o obtido para os MIs-Ai (P = 0,018). O TI para MIs inseridos em blocos de teste de 40 PCF foi 5,4 Ncm maior do que para aqueles inseridos em blocos de teste 20 PCF (p < 0,001). MIs-Ai inseridos em osso de maior densidade (40 PCF) apresentaram resistência flexural significativamente maior do que outros grupos, em deflexões de 2 mm (98,7 ± 5,1 Ncm), 3 mm (112,0 ± 3,9 Ncm) e 4 mm (120,0 ± 3,4 Ncm) (p < 0,001). A MEV evidenciou fraturas nos MIs-Ti. A EDS revelou incorporação de 18% de C e 2,06% de O nos MIs-Ai e 3,91% de C nos MIs-Ti, ambos submetidos a testes mecânicos. Conclusões: Com base nos resultados desse estudo in vitro, os MIs-Ai aparentam oferecer adequada estabilidade e maior resistência mecânica, em comparação aos MIs-Ti, quando inseridos em osso de maior densidade.

Formación de biopelícula bacteriana sobre las superficies de pilares de cicatrización de PEEK y titanio

Objetivos. Explorar el efecto de las características de superficie sobre el volumen total y la viabilidad de la biopelícula formada sobre pilares de cicatrización de PEEK y titanio. Métodos. Los parámetros de rugosidad (S a y S k) y la energía superficial de pilares de cicatrización de PEEK y titanio (n=3) fueron determinados mediante microscopía confocal láser de barrido (CLSM) y ángulo de contacto, respectivamente. Se determinó luego el volumen total y la viabilidad de una biopelícula bacteriana multiespecie cultivada por 30 días, mediante CLSM y el reactivo LIVE/DEAD Kit BacLight. El tamaño del efecto se determinó mediante d de Cohen. Resultados. Los pilares de PEEK mostraron una mayor rugosidad que los de titanio (S a 0,41 µm vs 0,17 µm), pero no se observaron diferencias en la energía superficial. Si bien el volumen total de biopelícula fue mayor en titanio que en PEEK (696 µm3 vs 419 µm3), no hubo diferencias en la proporción de bacterias vivas entre ambos materiales. Conclusiones. La viabilidad de la biopelícula bacteriana formada no guarda relación directa con las características superficiales de pilares de cicatrización de PEEK y titanio.

Objetivo. Explorar o efeito das características da superfície no volume total e viabilidade do biofilme formado em PEEK e pilares de cicatrização de titânio. Métodos. Parâmetros de rugosidade (S a e S k) e energia de superfície de PEEK e pilares de titânio (n = 3) foram determinados por microscopia confocal de varredura a laser (CLSM) e ângulo de contato, respectivamente. O volume total e a viabilidade de um biofilme bacteriano multiespécie cultivado por 30 dias foram então determinados usando CLSM e o reagente LIVE/DEAD Kit BacLight. O tamanho do efeito foi determinado usando o d de Cohen. Resultados. Os pilares de PEEK mostraram maior rugosidade do que os de titânio (S a 0,41 µm vs 0,17 µm), mas não foram observadas diferenças na energia de superfície. Embora o volume total de biofilme tenha sido maior no titânio do que no PEEK (696 µm3 vs 419 µm3), não houve diferenças na proporção de bactérias vivas entre os dois materiais. Conclusões. A viabilidade do biofilme bacteriano formado não está diretamente relacionada às características da superfície dos pilares de cicatrização de PEEK e titânio.

Objectives . To explore the effect of surface characteristics on the total volume and viability of a bacterial biofilm developed on the surface of PEEK and titanium healing abutments. Methods. Surface parameters S a and S k, as well as the surface energy of PEEK and titanium healing abutments (n=3) were determined using confocal laser scanning microscopy (CLSM) and contact angle, respectively. The total volume and viability of a multispecies bacterial biofilm cultivated for 30 days were determined using CLSM and the LIVE/DEAD BacLight reactive kit. Effect size was determined using Cohen's d. Results. PEEK healing abutments displayed a higher surface roughness than titanium (S a 0.41 µm vs 0.17 µm), although no differences in surface energy were observed. Despite the higher total volume of the biofilm measured on titanium abutments compared to PEEK (696 µm3 vs 419 µm3), no differences in the live/dead bacterial ratio were observed. Conclusions. Bacterial viability of the biofilm did not show a direct relation to the surface characteristics of PEEK and titanium healing abutments.

Poly ether keton keton polymer deposition on laser surface structured commercial pure titanium using magnetron sputtering / Deposição de polímero de poliéter cetona cetona em titânio comercial puro com superfície estruturada a laser usando pulverização catódica por magnetro

Objective: This study aimed to evaluate the effect of coating titanium (Ti) dental implant with polyether ketone ketone (PEKK) polymer using magnetron sputtering on osseointegration, trying to overcome some of the problems associated with Ti alloys. Material and Methods: Implants were prepared from grade (II) commercially pure titanium (CP Ti), then laser was used to induce roughness on the surface of Ti. PEKK was deposited on the surface of Ti implants by radiofrequency (RF) magnetron sputtering technique. The implants were divided in to three groups: without coating (Ls), with PEKK coating using argon (Ar) as sputtering gas (Ls-PEKK-Ar), and with PEKK coating using nitrogen (N) as sputtering gas (Ls-PEKK-N). All the implants were implanted in the femoral bones of rabbits. After three different healing periods (2, 6, and 12 weeks) the rabbits were sacrificed for a mechanical examination (removal torque) and for histological examination. Results: The results revealed a significant increase in the removal torque mean values when using PEKK coating on Ti implants, with the highest value recorded by Ls-PEKK-N group. Histologically, the study demonstrated the progression of osteogenesis during all the research periods. It was observed that the Ls-PEKK-N group had the highest percentage of new bone formation in all healing periods. Conclusion: The use of PEKK as coating material on the surface of Ti implants by RF- magnetron sputtering results in an increase in the torque required to remove implants and enhance bony tissue formation around the implants especially when using nitrogen as a sputtering gas (AU)

Objetivo: Este estudo teve como objetivo avaliar o efeito do revestimento de implante dentário de titânio (Ti) com polímero de poliéter cetona cetona (PEKK) usando pulverização catódica por magnetron na osseointegração, tentando superar alguns dos problemas associados às ligas de Ti. Material e Métodos: Os implantes foram preparados a partir de titânio comercialmente puro grau (II) (CP Ti), em seguida o laser foi utilizado para induzir rugosidade na superfície do Ti. PEKK foi depositado na superfície de implantes de Ti pela técnica de pulverização catódica por radiofrequência (RF). Os implantes foram divididos em três grupos: sem revestimento (Ls), com revestimento de PEKK utilizando argônio (Ar) como gás de pulverização catódica (Ls-PEKK-Ar) e com revestimento de PEKK utilizando nitrogênio (N) como gás de pulverização catódica (Ls-PEKK -N). Todos os implantes foram implantados em ossos femorais de coelhos. Após três períodos de cicatrização diferentes (2, 6 e 12 semanas), os coelhos foram sacrificados para exame mecânico (torque de remoção) e exame histológico. Resultados: Os resultados revelaram um aumento significativo nos valores médios do torque de remoção quando se utilizou o revestimento de PEKK em implantes de Ti, sendo o maior valor registrado pelo grupo Ls-PEKK-N. Histologicamente, o estudo demonstrou a progressão da osteogênese durante todos os períodos da pesquisa Observou-se que o grupo Ls-PEKK-N apresentou maior percentual de neoformação óssea em todos os períodos de cicatrização. Conclusão: O uso de PEKK como material de revestimento na superfície de implantes de Ti por pulverização catódica RF-magnetron resulta em um aumento no torque necessário para remover os implantes e melhorar a formação de tecido ósseo ao redor dos implantes, especialmente quando se utiliza nitrogênio como gás de pulverização catódica(AU)

Qual a minha sequência preferida de fios ortodônticos durante o tratamento ­ uma escolha baseada em critérios / My favorite sequence of orthodontic wires during the treatment ­ a choice based on criteria

O arco ortodôntico representa o elemento ativo do tratamento e é o principal responsável pela movimentação dentária induzida. O objetivo deste trabalho foi apresentar uma sequência de fios ortodônticos a ser utilizada durante a fase inicial, intermediária e final do tratamento com aparelhos fixos e os critérios a serem observados na seleção destes arcos (AU)

The orthodontic archwire represents the active element for treatment, and it is the main responsible for induced tooth movement. This study aims to present a sequence of orthodontic wires to be used in the early, intermediate and final phases of fixed appliance therapy as well as the criteria to be observed in the selection of these archwires (AU)

Evaluation the scanning accuracy of Blue-Light laboratory scanners in complete edentulous Maxilla with multiple implants with titanium scan bodies / Evaluación de la precisión de escaneado de los escáneres de laboratorio de luz azul en maxilares desdentados completos con implantes múltiples con cuerpos de escaneado de titanio

Abstract To evaluate the accuracy of complete arch scanning with multiple implant titanium scan bodies using laboratory scanners. A master model of an edentulous maxillary arch with 6 implants was fabricated. Titanium scan bodies were inserted into the model. Three laboratory scanners were used: D2000 (3Shape), Vinyl High Resolution (Smart Optics), and inEos X5 (Dentsply Sirona). The master model was consecutively scanned ten times using dental laboratory scanners (LS) without detaching and repositioning the scan bodies. Linear and angular accuracy between adjacent implants was measured using inspection software (Control X, Geomagic). The accuracy of the complete arch scans was calculated. Implant regions were defined as; parallel (R1: #24-26 and #16-14), angled (R2: #22-24 and #14-12), angled to occlusal plane (R3: #12-22), and cross-arch (R4: #16-26). The effect of LS and implant region on accuracy was compared using two-Way ANOVA (α=0.05). Significant greater linear distortion was noted in R4 (61.2±17.9µm) compared to R1 (23.4±15.5µm) and R2 (26±17.7µm) (p<0.01). Greater linear distortions were noted in R4 with D2000 (0.07±0.016 degrees) and Vinyl High Resolution (0.067±0.02 degrees) than inEos X5 (0.032±0.021 degrees) (p>0.05). Greater mean linear precisions were noted in R1 (9±8µm) and R3 (9.3±8.3µm) than R4 (12.6±10.3µm) (p<0.05). The highest linear precision was noted in D2000 (7.2±7.6µm) (p<0.05). The angular precision of D2000 (0.02±0.015 degrees) was the highest (p<0.01). The angular precisión of R4 (0.036±0.018 degrees) was the lowest (p<0.01). This study revealed that the trueness was affected by the implant region and the precision was affected by both LS and implant region.

Resumen Evaluar la precisión del escaneado de la arcada completa con cuerpos de escaneado de titanio de múltiples implantes utilizando escáneres de laboratorio. Se fabricó un modelo maestro de una arcada maxilar edéntula con 6 implantes. Se insertaron cuerpos de escaneo de titanio en el modelo. Se utilizaron tres escáneres de laboratorio: D2000 (3Shape), Vinyl High Resolution (Smart Optics) e inEos X5 (Dentsply Sirona). El modelo maestro se escaneó consecutivamente diez veces usando escáneres de laboratorio dental (LS) sin separar y reposicionar los cuerpos de escaneo. La precisión lineal y angular entre implantes adyacentes se midió utilizando un software de inspección (Control X, Geomagic). Se calculó la precisión de los escaneos completos del arco. Las regiones del implante se definieron como; paralelo (R1: #24-26 y #16-14), angulado (R2: #22-24 y #14-12), angulado al plano oclusal (R3: #12-22) y cruzado (R4: #16-26). El efecto de LS y la región del implante en la precisión se comparó mediante ANOVA de dos vías (α=0,05). Se observó una distorsión lineal significativamente mayor en R4 (61,2±17,9µm) en comparación con R1 (23,4±15,5µm) y R2 (26 ±17,7µm) (p<0,01). Se observaron mayores distorsiones lineales en R4 con D2000 (0,07±0,016 grados) y vinilo de alta resolución (0,067±0,02 grados) que en inEos X5 (0,032±0,021 grados) (p>0,05). Se observaron precisiones lineales medias mayores en R1 (9±8µm) y R3 (9,3±8,3µm) que en R4 (12,6±10,3µm) (p<0,05). La mayor precisión lineal se observó en D2000 (7,2±7,6 µm) (p<0,05). La precisión angular de D2000 (0,02±0,015 grados) fue la más alta (p<0,01). La precisión angular de R4 (0,036±0,018 grados) fue la más baja (p<0,01). Este estudio reveló que la veracidad se vio afectada por la región del implante y la precisión se vio afectada tanto por LS como por la región del implante.

Comparación Placas de Titanio vs. Placas Reabsorbibles en Fracturas de Orbita: Revisión de literatura / Comparison of Titanium Plates vs. Resorbable Plates in Orbital Fractures: Literature Review

RESUMEN Introducción: Los tratamientos para fracturas de órbita se basan en la corrección del defecto de las lesiones orbitarias de tipo blow in y blow out (o de estallido), mediante diversas placas y mallas biocompatibles con el organismo, dándose una cicatrización de primera generación evitando un callo óseo y una fijación más rígida. Para el diagnóstico de este tipo de lesiones tenemos inflamación periorbitaria, enoftalmos, diplopía, equimosis, hemorragia subconjuntival. Existen diversos materiales reconstructivos siendo estos compuestos por distintas materias primas, como son los aloplásticos y autógenos; donde encontramos varios tipos como placas de titanio y las placas reabsorbibles siendo estas las más comunes y usadas actualmente, por su bajo estímulo a reabsorciones óseas y evitando efectos secundarios a largo plazo. Estas placas presentan diversos grados de ductilidad y resistencia. Se informó sobre varias complicaciones según el tipo de placas como es la cicatrización, las cirugías postquirúrgicas en caso de placas de titanio, etc. El objetivo de esta revisión es la evaluación de la eficacia las placas reabsorbibles versus placas de titanio en fracturas de órbita. Materiales y métodos: La investigación es de carácter documental, descriptivo y no experimental. En el cual se emplea una metodología de identificación e inclusión de artículos científicos tipo prisma. Resultados y conclusiones: Se verificaron las ventajas y desventajas tanto de las placas reabsorbibles como las de titanio siendo estas similares en la biocompatibilidad con el organismo humano, así como también varias diferencias como el soporte, fuerzas, resistencia de estas, concluyendo que es debatible el material ideal para tratar fracturas de órbita. Se seleccionaron artículos tomando en cuenta el título y objetivos; considerando estudios comparativos, revisiones sistemáticas, revisiones de literatura, los cuales comprendían criterios con respecto a fracturas de órbita y tratamientos quirúrgicos. La búsqueda arrojó 55 artículos en PubMed, 65 en Google, 4 en Scielo y 29 en Science direct, de los cuales se excluyeron libros, monografías, estudios experimentales, dando como resultado 21 artículos para el desarrollo de esta revisión bibliográfica. Y que fueron leídos y analizados en su totalidad, estudiando los objetivos, metodología y conclusión de cada uno de ellos para la posterior comparación.

ABSTRACT Introduction: Treatments for orbit fractures are based on the correction of the defect of blow in and blow out orbital injuries, by means of various plates and meshes biocompatible with the organism, giving a first-generation healing avoiding a bony callus and a more rigid fixation. For the diagnosis of this type of lesions we have periorbital inflammation, enophthalmos, diplopia, ecchymosis, subconjunctival hemorrhage. There are several reconstructive materials being these composed of different raw materials, such as alloplastic and autogenous, where we find several types such as titanium plates and resorbable plates being these the most common and currently used, for its low stimulus to bone resorption and avoiding long-term side effects. These plates have different degrees of ductility and resistance. Several complications have been reported depending on the type of plates, such as scarring, post-surgical surgeries in the case of titanium plates, etc. The objective of this review is to evaluate the efficacy of resorbable versus titanium plates in orbital fractures. Materials and methods: This research are a documentary, descriptive and non-experimental nature. A prism-type methodology of identification and inclusion of scientific articles was used. Results and conclusions: The advantages and disadvantages of both resorbable and titanium plates were verified, being these similar in biocompatibility with the human organism, as well as several differences such as support, forces, resistance of the same, concluding that it is debatable. The ideal material to treat orbital fractures. Articles were selected considering the title and objectives; considering comparative studies, systematic reviews, literature reviews, which included criteria regarding orbital fractures and surgical treatments. The search yielded 55 articles in PubMed, 65 in Google, 4 in Scielo and 29 in Science direct, from which books, monographs, experimental studies were excluded, resulting in 21 articles for the development of this bibliographic review. The 21 articles were read and analyzed in their entirety, studying the objectives, methodology and conclusion of each one of them for subsequent comparison.

Comparative Assessment of Contact Osteogenesis at the Titanium Implant-Bone Junction in Male Rabbits with Dissimilar Femoral Defects / Evaluación Comparativa de la Osteogénesis de Contacto en la Unión entre el Hueso y el Implante de Titanio en Conejos Macho con Defectos Femorales Diferentes

SUMMARY: Traumatized bone tissue has the capacity to repair itself so that it eventually regains its almost original form, even in the case of artificially inserted implants. The process that stays at the base of the regeneration is represented by osteogenesis or remote osteogenesis. The major difference between the two types of bone formation is the location of the cement line, which is located on the surface of the implant for contact osteogenesis and on the surface of the bone defect for remote osteogenesis. The aim of the present study was to assess the contact osteogenesis in the case of inserted titanium screws in holes with diameters of 1.8 mm and 1 mm respectively. The obtained results show, in the case of the groove with 1.8 mm that the newly proliferated bone represents 73.85 % of the total area, while in the case of the groove with 1 mm in diameter the value of the newly proliferated bone is 26.15 %. In conclusion, the insertion of titanium screws by self-tapping into the hole smaller than the core of the screw is accompanied by bone proliferation by contact osteogenesis much more modest than in the case of insertion into the hole larger than the core of the screw.

El tejido óseo traumatizado tiene la capacidad de reparar en forma espontánea, de modo que eventualmente recupera su forma casi original, incluso en el caso de implantes insertados artificialmente. El proceso que queda en la base de la regeneración está representado por la osteogénesis u osteogénesis a distancia. La principal diferencia entre los dos tipos de formación ósea es la ubicación de la línea de cemento, que se encuentra en la superficie del implante para la osteogénesis de contacto y en la superficie del defecto óseo para la osteogénesis remota. El objetivo del presente estudio fue evaluar la osteogénesis de contacto en el caso de tornillos de titanio insertados en forámenes con diámetros de 1,8 mm y 1 mm respectivamente. Los resultados obtenidos muestran, en el caso del surco de 1,8 mm que el hueso neoproliferado representa el 73,85 % del área total, mientras que en el caso del surco de 1 mm de diámetro el valor del hueso neoproliferado es del 26,15 %. En conclusión, la inserción de tornillos de titanio por autorroscantes en el foramen menor que el núcleo del tornillo se acompaña de una proliferación ósea por osteogénesis de contacto mucho más modesta que en el caso de la inserción en el foramen mayor que el núcleo del tornillo.

Effect of voxel size of Micro-CT on the assessment of root canal preparation

The aim of this study was to assess the influence of micro-computed tomography (micro-CT) voxel size on evaluation of root canal preparation using rotary heat-treated nickel-titanium files. Curved mesial root canals of mandibular molars were prepared using ProDesign Logic 30/.05 (PDL) or HyFlex EDM 25/.08 (HEDM) (n=12). The specimens were scanned using micro-CT with 5μm of voxel size before and after root canal preparation. Images with sub-resolution of 10 and 20μm voxel sizes were obtained. The percentage of volume increase, debris and uninstrumented root canal surface were analyzed in the different voxel sizes. Data were compared using unpaired Student's t-test and ANOVA statistical tests (α=0.05). No differences were observed for percentage of volume increase, debris and instrumented surface between the root canals prepared by PDL and HEDM (p>0.05). Both systems promoted higher percentage of debris in the apical third compared to the middle third (p0.05). PDL and HEDM had similar root canal preparation capacity. Micro-CT images using different voxel sizes did not influence the results of volume increase and debris evaluation. However, images at 5µm showed greater accuracy to evaluate the percentage of uninstrumented surfaces.

El objetivo de este estudio fue evaluar la influencia del tamaño de vóxel de la microtomografía computarizada (micro-CT) en la evaluación de la preparación del conducto radicular utilizando limas rotatorias de níquel-titanio tratadas térmicamente. Se prepararon conductos radiculares mesiales curvos de molares mandibulares usando ProDesign Logic 30/.05 (PDL) o HyFlex EDM 25/.08 (HEDM) (n=12). Las muestras se escanearon usando micro-CT con un tamaño de vóxel de 5μm antes y después de la preparación del conducto radicular. Se obtuvieron imágenes con subresolución de vóxeles de 10 y 20μm. Se analizó el porcentaje de aumento de volumen, residuos y superficie del conducto radicular no instrumentado en diferentes tamaños de vóxel. Los datos se compararon usando la prueba t de Student no pareada y las pruebas estadísticas ANOVA (α=0,05). No se observaron diferencias en el porcentaje de aumento de volumen, detritus y superficie instrumentada entre los conductos radiculares preparados por PDL y HEDM (p>0,05). Ambos sistemas promovieron un mayor porcentaje de detritos en el tercio apical en comparación con el tercio medio (p0,05). PDL y HEDM tenían una capacidad de preparación del conducto radicular similar. Las imágenes de micro-CT que utilizan diferentes tamaños de vóxel no influyeron en los resultados de la evaluación del volumen y los desechos. Sin embargo, las imágenes de 5µm mostraron una mayor precisión al evaluar el porcentaje de superficies no instrumentadas.

UTILIZAÇÃO CLÍNICA DO TETRAFLUORETO DE TITÂNIO NA ODONTOLOGIA: UMA REVISÃO CRÍTICA / CLINICAL USE OF TITANIUM TETRAFLUORIDE IN DENTISTRY: A CRITICAL REVIEW

Objetivo: avaliar a eficácia preventiva e terapêutica do tetrafluoreto de titânio (TiF4) em ensaios clínicos randomizados (ECR) e não randomizados (N-ECR). Materiais e Métodos: estudos sobre a eficácia do tetrafluoreto de titânio em esmalte e dentina, testado em diferentes veículos e formulações, foram obtidos nas seguintes bases de dados: PubMed, Cochrane Library, Scopus, Web of Science, LILACS/BBO e EMBASE, sem limite de ano de publicação ou idioma. Resultados: seis estudos com abordagem preventiva e terapêutica do TiF4 sobre a superfície dentária foram incluídos. Destes, três ECR e três N-ECR. Por meio da tabulação e categorização dos artigos, notou-se que o TiF4 obteve efeito positivo na prevenção da cárie em três estudos; efeito nulo no tratamento de lesões cariosas em dois; e apenas um estudo apresentou efeito negativo no tratamento da erosão quando comparado aos outros compostos fluoretados. Conclusão: Embora haja estudos na literatura, com distintos delineamentos metodológicos comprovando a eficácia do TiF4, tanto na prevenção quanto no tratamento de lesões de cárie e erosivas, ainda é necessário que mais ensaios clínicos randomizados sejam realizados, com o intuito de validar a eficácia da utilização clínica deste composto fluoretado.

Objective: to analyze the preventive and therapeutic efficacy of titanium tetrafluoride (TiF4) in studies with a methodological design based on randomized clinical trials (RCT) and non-randomized (N-RCT). Materials and Methods: data on the behavior of titanium tetrafluoride in enamel and dentin, tested in several vehicles and formulations, were extracted in the following databases: PubMed, Cochrane Library, Scopus, Web of Science, LILACS/BBO and EMBASE, without limitation of publication year or language. Results: six studies were obtained with preventive and therapeutic approach of TiF4 on the dental surface. Three studies were RCT and three were N-RCT. Through tabulation and categorization of articles, it was noticed that TiF4 showed a positive effect in caries prevention in three studies; a null effect in caries treatment was observed in two; and only one study had a negative effect in erosion treatment when compared to the other fluoridated compounds. Conclusion: Although there are several studies in the literature, with different methodological designs, proving the efficacy of TiF4 both in prevention and in therapeutic treatments of caries and dental erosion, it is still necessary that more clinical controlled studies be conducted, in order to validate the clinical use efficacy of this fluoride compound.

Implantes de titanio trabecular en cirugía de revisión acetabular compleja / Trabecular titanium implants in complex acetabular revision surgery

Introducción: La cirugía de revisión acetabular supone un reto quirúrgico sobre todo cuando aparecen los defectos óseos complejos, pues dificultan la fijación primaria y osteointegración de los implantes, lo que condiciona la aparición de complicaciones. Los cotilos de titanio trabecular intentan solventar estos problemas. Objetivos: Valorar los resultados clínico-radiológicos, la supervivencia de los implantes y aparición de complicaciones a medio plazo en cirugía de revisión acetabular en una serie de 37 recambios acetabulares con defectos óseos tipo IIIA y IIIB de Paprosky en los que se utilizó un implante de revisión tipo Cup-Cage de titanio trabecular. Material y método: Realizamos un estudio observacional, descriptivo y retrospectivo de 37 casos con defectos acetabulares complejos (20 tipo IIIA y 17 tipo IIIB, cinco de ellos con discontinuidad pélvica) en los que se realizó recambio del componente acetabular por implantes de titanio trabecular entre los años 2011 y 2019. Analizamos resultados clínicos (dolor y funcionalidad) y parámetros radiológicos (restauración del centro de rotación de la cadera y la movilización de los implantes), así como la aparición de complicaciones. Resultados: El seguimiento medio fue de 61 meses. Obtuvimos una mejoría en la mediana de 8 puntos en la escala de funcionalidad de Merlé D’Aubigné-Postel y de 6 puntos en la escala EVA de dolor percibido por el paciente. Registramos dos casos de aflojamiento acetabular, un caso de inestabilidad y tres infecciones de herida quirúrgica sin afectar al implante. Conclusiones: La utilización de implantes tipo Cup-Cage de titanio trabecular podría constituir una opción válida en cirugía de revisión acetabular con defectos acetabulares complejos, presentando buenos resultados clínico-radiológicos y en cuanto a complicaciones y supervivencia de los implantes, debido a su buena fijación primaria y osteointegración.(AU)

Introduction: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. Objectives: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. Material and method: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. Results: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D’Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. Conclusions: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.(AU)

[Translated article] Trabecular titanium implants in complex acetabular revision surgery / Implantes de titanio trabecular en cirugía de revisión acetabular compleja

Introducción: La cirugía de revisión acetabular supone un reto quirúrgico sobre todo cuando aparecen los defectos óseos complejos, pues dificultan la fijación primaria y osteointegración de los implantes, lo que condiciona la aparición de complicaciones. Los cotilos de titanio trabecular intentan solventar estos problemas. Objetivos: Valorar los resultados clínico-radiológicos, la supervivencia de los implantes y aparición de complicaciones a medio plazo en cirugía de revisión acetabular en una serie de 37 recambios acetabulares con defectos óseos tipo IIIA y IIIB de Paprosky en los que se utilizó un implante de revisión tipo Cup-Cage de titanio trabecular. Material y método: Realizamos un estudio observacional, descriptivo y retrospectivo de 37 casos con defectos acetabulares complejos (20 tipo IIIA y 17 tipo IIIB, cinco de ellos con discontinuidad pélvica) en los que se realizó recambio del componente acetabular por implantes de titanio trabecular entre los años 2011 y 2019. Analizamos resultados clínicos (dolor y funcionalidad) y parámetros radiológicos (restauración del centro de rotación de la cadera y la movilización de los implantes), así como la aparición de complicaciones. Resultados: El seguimiento medio fue de 61 meses. Obtuvimos una mejoría en la mediana de 8 puntos en la escala de funcionalidad de Merlé D’Aubigné-Postel y de 6 puntos en la escala EVA de dolor percibido por el paciente. Registramos dos casos de aflojamiento acetabular, un caso de inestabilidad y tres infecciones de herida quirúrgica sin afectar al implante. Conclusiones: La utilización de implantes tipo Cup-Cage de titanio trabecular podría constituir una opción válida en cirugía de revisión acetabular con defectos acetabulares complejos, presentando buenos resultados clínico-radiológicos y en cuanto a complicaciones y supervivencia de los implantes, debido a su buena fijación primaria y osteointegración.(AU)

Introduction: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. Objectives: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. Material and method: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. Results: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D’Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. Conclusions: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.(AU)

Regulación de la implantología dental en México / Regulation of dental implantology in Mexico

Introducción: los implantes dentales se han convertido en uno de los tratamientos odontológicos con mayor demanda en todo el mundo, no sólo por el nivel máximo de funcionalidad y de estética, sino también debido a su estabilidad, osteointegración y facilidad en su rehabilitación. Es incierto si los implantes dentales se encuentran normados formalmente en México, lo que motiva a la revisión del estado actual. Objetivo: evidenciar el estado actual de la legislación de la práctica de la implantología dental en México a través de una revisión en la literatura. Material y métodos: revisión de las legislaciones existentes en México para la aplicación de implantes dentales y su contraparte en el mundo a través de la evaluación de normas expedidas en América y Europa. Resultados: se contabilizó un total de 17 escuelas de implantes dentales que cuentan con el reconocimiento de la Secretaría de Educación Pública, de las cuales tres son públicas y 14 privadas. Se presentó una discrepancia en los planes de estudio que va de 16 a 36 meses. Las escuelas no contaron con un aval normativo. Las normas internacionales para control de calidad y aplicación de la tecnología en implantes se ubicaron en Canadá, Estados Unidos, España, Reino Unido y Francia. Conclusiones: contar con un antecedente normativo establecido por los países de primer mundo y ausente en México permite evidenciar la necesidad de implementar una Norma Oficial Mexicana que regule la fabricación, distribución y almacenamiento de los implantes dentales en México. A la vez, la revisión sugiere que la Secretaría de Educación Pública norme los créditos mínimos necesarios en las instituciones educativas reconocidas para la formación de recursos humanos que ejercen la implantología dental (AU)

Introduction: dental implants have become one of the dental treatments with the highest demand in the world, not only because of the highest level of functionality and aesthetics, but also because of their stability, osseointegration and ease of rehabilitation. It is uncertain if dental implants are formally regulated in Mexico, which motivates the review of the current status. Objective: to demonstrate the current state of the legislation for the practice of dental implantology in Mexico through a review of the literature. Material and methods: review of the existing legislation in Mexico, for the application of dental implants and its counterpart in the world, through the evaluation of standards issued in America and Europe. Results: a total of 17 dental implant schools that have the recognition of the Ministry of Public Education were counted, of which 3 are public and 14 private. There was a discrepancy in the study plans that ranged from 16 to 36 months. Schools will not have regulatory backing. The international standards for quality control and application of technology in implants were located in Canada, the United States, Spain, the United Kingdom and France. Conclusions: having a normative antecedent established by the countries of the first world and absent in Mexico, allows to demonstrate the need for the implementation of an Official Mexican Standard, which regulates the manufacture, distribution and storage of dental implants in Mexico. At the same time, the review suggests that the Ministry of Public Education regulate the minimum necessary credits in recognized educational institutions, for the training of human resources that practice dental implantology (AU)

Trabecular titanium implants in complex acetabular revision surgery. / Implantes de titanio trabecular en cirugía de revisión acetabular compleja.

INTRODUCTION: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. OBJECTIVES: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. MATERIAL AND METHOD: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analyzed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilization of the implants), as well as the appearance of complications. RESULTS: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D'Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. CONCLUSIONS: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.

[Translated article] Trabecular titanium implants in complex acetabular revision surgery.

INTRODUCTION: Acetabular revision surgery is a surgical challenge, especially when complex bone defects appear. This makes primary fixation and osseointegration of the implants difficult, which conditions the appearance of complications. Trabecular titanium implants attempt to solve these problems. OBJECTIVES: To evaluate our clinical-radiological results, the survival of the implants and the appearance of mid-term complications in acetabular revision surgery in a series of 37 acetabular replacements with Paprosky type IIIA and IIIB bone defects in which a trabecular titanium Cup-Cage revision implant was used. MATERIAL AND METHOD: We conducted an observational, descriptive and retrospective study of 37 cases with complex acetabular defects (20 type IIIA and 17 type IIIB, five of them with pelvic discontinuity) in which the acetabular component was replaced by trabecular titanium cups between 2011 and 2019. We analysed clinical results (pain and functionality) and radiological parameters (restoration of the hip rotation centre and the mobilisation of the implants), as well as the appearance of complications. RESULTS: The mean follow-up was 61 months. We obtained a median improvement of 8 points on the Merlé D'Aubigné-Postel functionality scale and 6 points on the VAS scale of pain perceived by the patient. We recorded two cases of acetabular loosening, one case of dislocation and three surgical wound infections without affecting the implant. CONCLUSIONS: The use of trabecular titanium Cup-Cage implants could be a valid option in acetabular revision surgery with complex acetabular defects, presenting good clinical and radiological results and in terms of complications and survival of the implants, mainly due to their good primary fixation and subsequent osseointegration.

The effects of TiO2 nanotubes on bond strength and radiopacity of a self-adhesive resin cement in self-curing mode / Os efeitos de nanotubos de TiO2 na resistência de união e radiopacidade de um cimento resinoso auto-adesivo no modo auto-polimerizável

Objective: The aim of this in vitro study w as t o analyze the influence of the titanium dioxide nanotubes i n a self-cure mode polymerization of a dual resin luting agent through push out bond strength and radiopacity tests. Material and Methods: After mixed with a commercial du al self-adhesive resin cement, three concentrations o f tit anium dioxide nanotubes (0.3, 0.6, and 0.9% by weight) we re analyzed in self-curing mode. T he bond strength to bovine root dentin and fi berglass posts was assessed with the push out bond str ength t est and was evaluated in three thirds (cervical, middle and apical) (n=10), followed by failure mode analysis (SEM), and the ISO standard 9917-2 was followed for radiopacity test (n=10). Data were statistically analyzed by one-way ANOVA test, followed by Tukey's test (α=0.05). Results: Reinforced self-adhesive resin cement with 0.6% titanium dioxide nanotubes showed significant difference compared to the control gr oup for push out test (p=0.00158). The modified groups did not s how significant difference among thirds (p=0.782). Radiopacity sh owed higher value for group w ith 0.9% titanium dioxide nanotubes in comparison w ith control group (p<0.001). Conclusion: The addition of titanium dioxide nanotubes to a self-adhesive resin cement increased the bond strength to dentin and radiopacity values in the self-cure polymerization mode (AU)

Objetivo: O objetivo deste estudo in vitro foi analisar a influência de nanotubos de dióxido de titânio na polimerização química de um agente cimentante resinoso dual através de testes de resistência à união e radiopacidade. Material e Métodos: Após misturado com um cimento resinoso auto-adesivo comercial, três concentrações de nanotubos de dióxido de titânio (0,3, 0,6 e 0,9% em peso) foram analisadas. A resistência da união para a dentina da raiz bovina e os pinos de fibra de vidro foi avaliada pelo teste de push-out e avaliada em três terços (cervical, médio e apical) (n = 10), seguido pelo análise de modo de falha (MEV) e a norma ISO 9917-2 foi seguido para teste de radiopacidade (n = 10). Os dados foram analisados estatisticamente pelo teste ANOVA um fator seguido do teste de Tukey (α = 0,05). Resultados: O cimento resinoso auto-adesivo reforçado com nanotubos de dióxido de titânio a 0,6% mostrou diferença significativa em comparação com o grupo controle para teste de push-out (p=0,00158). Os grupos modificados não mostraram diferença significativa entre os terços (p=0,782). A radiopacidade mostrou maior valor para o grupo com nanotubos de dióxido de titânio 0,9% em comparação com o grupo controle (p<0,001). Conclusão: A adição de nanotubos de dióxido de titânio a um cimento resinoso auto-adesivo aumentou a os valores de resistência de união à dentina e radiopacidade no modo de polimerização química do agente cimentante (AU)

Intradiploic Epidermoid Cyst of the Posterior Fossa ­ Case Report and Review of the Literature / Cisto epidermoide intradiploico da fossa posterior ­ Caso clinico e revisão da literatura

Intracranial epidermoid cysts represent 0.2 to 1.8% of all intracranial tumors. These tumors are most frequently encountered in the cerebellar pontine angle or in the parasellar region. Rarely, they arise from the cranial diploe, being able to affect every flat bone of the cranium. We report a case of a 63-year-old male who presented with progressively worsening headache and vertigo with 6 months of evolution. Neuroimaging identified a probable occipital intradiploic epidermoid cyst with mass effect on the cerebellar hemispheres. This lesion was approached using a suboccipital craniotomy, followed by total resection of the tumor and cranioplasty with titanium plate placement. The histological evaluation confirmed the diagnosis of intraosseous epidermoid cyst. The patient had a successful recovery, without complications or neurologic dysfunction. Being benign lesions, commonly remaining asymptomatic and rarely presenting as a bony lump in the skull bone, it could be straightforward to assume a conservative management with planned follow-up. On the other side, a more aggressive strategy with surgical excision has been advocated, especially in lesions that tend to enlarge and erode the cranial bone with possible consequent epidural extension and mass effect symptoms. A preoperative diagnosis is extremely helpful in proper surgical planning. Diffusion weighted imaging facilitates a straightforward diagnosis. As was observed in our case, the largest reviews on intradiploic epidermoids available in the literature mostly demonstrated a benign clinical course. However, malignant transformation can occur. Some patients develop permanent neurologic deficits from mass effect or tumor infiltration. However, surgical approach of the tumor is curative in most cases. Nonetheless, from our experience, it is important to maintain clinical and imaging follow-up with regular monitoring to prevent possible tumor recurrences.

Os cistos epidermoides intracranianos representam cerca de 0,2 a 1,8% de todos os tumores intracranianos. Esses tumores são mais frequentemente encontrados no ângulo pontocerebeloso ou na região parasselar. Raramente surgem na diploe, no entanto podem afetar todos os ossos do crânio. Relatamos o caso de um homem de 63 anos que apresentou agravamento progressivo da cefaleia e vertigem e desequilíbrio com 6 meses de evolução. O estudo de imagem realizado identificou um provável cisto epidermoide intradiploico occipital com efeito de massa nos hemisférios cerebelosos. A lesão foi abordada por craniotomia suboccipital, seguida de ressecção total do tumor e cranioplastia com colocação de placa de titânio. A avaliação histológica confirmou o diagnóstico de cisto epidermoide intraósseo. O doente teve uma recuperação bem sucedida, sem complicações ou disfunção neurológica. Sendo lesões benignas, que geralmente permanecem assintomáticas, pode-se assumir um tratamento conserva dor com seguimento clínico. Por outro lado, uma estratégia mais agressiva com excisão cirúrgica tem sido preconizada, principalmente em lesões que tendem a aumentar e invadir as estruturas ósseas cranianas com possível extensão peridural e sintomas causados pelo efeito de massa. Um diagnóstico pré-operatório é extremamente útil no planeamento cirúrgico adequado. A imagem ponderada por difusão facilita um diagnóstico direto. Como observado no nosso caso, as maiores revisões sobre epidermoides intradiploicos disponíveis na literatura demonstraram, na sua maioria, um curso clínico benigno. No entanto, a transformação maligna pode ocorrer. Alguns doentes desenvolvem déficits neurológicos permanentes por efeito de massa ou infiltração tumoral. A abordagem cirúrgica do tumor é curativa na maioria dos casos. Consideramos importante manter o seguimento clínico e imagiológico regular para prevenir possíveis recidivas tumorais.

Influence of traverse and waveone gold glider glide path files on the amount of apically extruded debris / Influência das limas glide path Traverse e Wave One Gold Glider na quantidade de detritos extruídos apicalmente

Objective: The aim of this study was to evaluate the effect of different glide path files on the amount of apically extruded debris. Material and Methods: Sixty single-canaled mandibular premolars were accessed and randomly divided into three groups (n= 20) according to the file used for glid path creation; group A using Traverse file, group B using WaveOne Gold Glider, group C using stainless steel K file. All teeth were then instrumented using the Reciproc system. The debris extruded apically during instrumentation were collected into pre-weighed Eppendorf tubes which were then stored in an incubator at 70 °C for 5 days. The weight of the dry extruded debris was established by subtracting the pre-instrumentation and post instrumentation weights of the Eppendorf tubes. The data were analyzed using one-way ANOVA test, and post hoc analysis. Results: WaveOne Gold Glider produced the least amount of apical extruded debris (0.41±0.25) followed by the Traverse group (0.59±0.20) then the K-file group (0.64±0.16) with a statistically significant difference (p=0.003). Conclusion: Apical extrusion of debris is inevitable during root canal cleaning and shaping. Creation of glide path using engine-driven files produces less amount of apically extruded debris compared to hand-driven K-files. (AU)

Objetivos: O objetivo deste estudo foi avaliar o efeito de diferentes limas glide path na quantidade de detritos extruídos apicalmente. Metodologia: Sessenta pré-molares inferiores com canal único foram acessados e divididos aleatoriamente em três grupos (n= 20) de acordo com a lima utilizada para criação do glid path; grupo A usando lima Traverse, grupo B usando WaveOne Gold Glider, grupo C usando lima K de aço inoxidável. Todos os dentes foram então instrumentados usando o sistema reciprocante. Os detritos extruídos apicalmente durante a instrumentação foram coletados em tubos Eppendorf pré-pesados que foram então armazenados em uma incubadora a 70°C por 5 dias. O peso dos detritos secos extruídos foi estabelecido subtraindo-se os pesos dos tubos Eppendorf antes e após instrumentação. Os dados foram analisados por meio do teste one-way ANOVA e análise post-hoc. Resultados: WaveOne Gold Glider produziu a menor quantidade de detritos apicais extruídos (0,41±0,25) seguido pelo grupo Traverse (0,59±0,20) e depois pelo grupo K-file (0,64±0,16) com uma diferença estatisticamente significativa (p=0,003). Conclusão: A extrusão apical de detritos é inevitável durante a limpeza e modelagem do canal radicular. A criação do glide path usando limas acionadas por motores produz menos quantidade de detritos extruídos apicalmente em comparação com as limas K manuais. (AU)

Recobrimento da resina acrílica ativada termicamente com glaze e nanopartículas de ZnO e TiO2: estudo da ação antifúngica e de características mecânicas / Thermally activated acrylic resin coating with glaze and nanoparticles of ZnO and TiO2: study of antifungical action and mechanical characteristics

A resina acrílica é muito utilizada para a confecção de próteses removíveis parciais ou totais e apresenta uma grande interação com o meio bucal, além de possuir uma superfície que favorece o acúmulo de biofilme. Aplicação de materiais como glaze visam minimizar este efeito indesejável, através de uma ação que controle a formação de biofilme, muito embora esta ação ainda não seja tão efetiva. Neste sentido, o objetivo deste trabalho foi incorporar nanopartículas de dióxido de titânio e óxido de zinco, através da técnica de pulverização no glaze aplicado sob a superfície da resina acrílica ativada termicamente (RAAT), a fim de promover uma ação antimicrobiana. Para isso 4 grupos foram determinados: G: RAAT + glaze (controle); AlG: RAAT + glaze + óxido de alumínio (controle da rugosidade dos demais grupos); TiG: RAAT + glaze + dióxido de titânio; e ZnG: RAAT + glaze + óxido de zinco. Foram realizados testes de caracterização do material (DRX e MEV), teste de resistência a flexão com análise de Weibull e análise fractográfica, mensuração de cor e translucidez, perfilometria, goniometria, análise do efeito antibiofilme da Candida albicans e teste ANOVA um - fator. Os resultados obtidos mostraram que: não houve diferença estatística significante com relação a resistência mecânica destes grupos; existe uma diferença estatística significante na rugosidade, mensuração de cor e translucidez, do grupo controle quando comparado aos demais grupos; nos resultados de goniometria, os grupos com superfície tratada apresentaram maior molhamento, quando comparados com o grupo controle; e no teste de ação antifúngica, não foi possível perceber uma diferença estatística significante entre os grupos. Concluiu-se que a aplicação de nanopartículas melhora o molhamento superficial da resina, o que permite um melhor selamento periférico e uma maior retenção das próteses totais, muito embora não tenha proprocionado ação antifúngica para a metodologia proposta (AU).

Acrylic resin is widely used for the manufacture of partial or total removable prostheses and presents a great interaction with the oral environment, in addition to having a surface that favors the accumulation of biofilm. Application of materials such as glaze aim to minimize this undesirable effect, through an action that controls the biofilm formation, although this action is still not as effective. Therefore, the objective of this work was to incorporate nanoparticles of titanium dioxide and zinc oxide, through the spraying technique in the glaze applied under the surface of the thermally activated acrylic resin (RAAT), to promote an action antifungical. For this, 4 groups were determined: G: RAAT + glaze (control); AlG: RAAT + glaze + aluminum oxide (roughness control of the other groups); TiG: RAAT + glaze + titanium dioxide; and ZnG: RAAT + glaze + zinc oxide. Material characterization tests (DRX and SEM), flexural strength test with Weibull analysis and fractographic analysis, measurement of color and translucency, profilometry (roughness analysis), goniometry, antibiobilm analysis under the fungus C. albicans and ANOVA one ­ factor test. The results obtained showed that: there is no statistically significant difference regarding the mechanical resistance of these groups; there is a statistically significant difference in roughness, measurement of color and translucency, in the control group when compared to the other groups; in the goniometry results, the groups with treated surface showed greater wetting, when compared with the control group; and in the antifungical action test, it was not possible to perceive a statistically significant difference between the groups. It was concluded that the application of nanoparticles improves the surface wetting of the resin, which allows a better peripheral sealing and greater retention of complete dentures, although it did not determine antimicrobial action for the proposed methodology (AU).