Uncommon foreign body reaction caused by botulinum toxin.

Botulinum toxin is composed of 7 botulinum toxin antigenic subtypes. It is produced by Clostridium botulinum bacterial fermentation. Several botulinum toxin subtypes are under investigation for clinical use, but only botulinum toxin type A (BTX-A) is currently approved for cosmetic use because of its clinical safety profile and efficacy. The use of BTX-A in cosmetic facial procedures is a reliable way to enhance aesthetics in the face and is becoming commonplace in oral and maxillofacial surgery. This article reports an uncommon complication after Botox injection in the upper lip, for cosmetic reasons, originating a mass in the anterior region of the maxilla, which leads to failure in orthodontic treatment. Knowledge of the site anatomy, pharmacology, and dose of BTX-A before its use in cosmetic surgery should be strengthened.

Mucopolysaccharidosis VI and effects on growth of the apical bases: a case report.

OBJECTIVE: Mucopolysaccharidosis (MPS) VI is a rare disorder caused by an autosomal recessive mutation in the short arm of chromosome 5 (5q12-13) leading to an N-acetylgalactosamine-sulfatase lysosomal enzyme deficiency and numerous systemic clinical changes. The oral and maxillofacial complex may exhibit tooth eruption anomalies, macroglossia, gingival hypertrophy, mouth breathing, increased lower facial height, open bite, retrognathia, and progressive TMJ arthrosis. This report describes craniofacial growth changes in two MPS VI patients, sisters and daughters of outbred parents, who were longitudinally monitored from 11 to 15 years of age. STUDY DESIGN: Skull lateral teleradiography and cephalometric tracings were performed. The measurements were assessed in the anteroposterior and vertical directions based on protocols by McNamara and Usp/Unicamp and compared to the normal reported ranges. RESULTS: A similar skeletal class III malocclusion was observed in both patients. The jaw was retruded, the anterior skull base decreased, and the mandibular body was normal or larger than normal. The vertical growth direction differed between the patients; one was hyperdivergent, while the other was hypodivergent. CONCLUSIONS: By understanding the craniofacial growth changes in MPS VI patients, new treatment options may be developed for affected patients.

Does the bracket composition material influence initial biofilm formation?

CONTEXT: Orthodontic treatment has been reported to contribute to the development and accumulation of dental biofilm, which is commonly found on bracket and adjacent surfaces. AIMS: The aim of this work is to test the hypothesis if there are differences in dental biofilm formation on the surface of orthodontic brackets according to the type of composition material. SUBJECTS AND METHODS: Three bracket types (metallic, composite, and ceramic) had been evaluated. Subjects wore acrylic palatal orthodontic appliances, containing 6 brackets each, for two 3-day cycles. On the end of first cycle, the amount of dental biofilm formed on the samples was extracted using 1.0-M NaOH and analyzed by spectrophotometry for quantification. An additional cycle was carried out to verify the dental biofilm formation using scanning electronic microscope analysis. STATISTICAL ANALYSIS USED: Three-way ANOVA was used to analyze the difference among the materials (metallic, ceramic and composite) concerning the dental biofilm absorbance spectrum. Multiple comparisons were made using the Tukey's test (α =0.05). RESULTS: Composite brackets showed greater values concerning biofilm formation, when compared with the metallic and ceramic ones, both of which presented similar scores. The hypothesis is accepted. There are differences on the biofilm formation according to the type of material. CONCLUSIONS: The in situ model tested was found to be effective in evaluating the accumulation and development of biofilm on orthodontic brackets. In the quantitative analysis, composite brackets showed greater biofilm adhesion values while metallic and ceramic presented similar biofilm absorbance spectrum.

In vitro analysis of shear bond strength and adhesive remnant index comparing light curing and self-curing composites.

OBJECTIVE: To evaluate, in vitro, the shear bond strength of self-curing (ConciseTM - 3M and Alpha Plast - DFL) and light-curing composites (TransbondTM XT - 3M and Natural Ortho - DFL) used in orthodontics bonding, associated to Morelli metal brackets, with further analysis of adhesive remnant index (ARI) and enamel condition in scanning electron microscopy (SEM). METHODS: Forty human premolars, just extracted and stored in physiologic solution 0.9 % were used. Randomly, these samples were divided in four groups: G1 group, the brackets were bonded with ConciseTM - 3M composite; in G2 group, Alpha Plast - DFL composite was used; in G3 group, TransbondTM XT - 3M was used; in G4 group, Natural Ortho - DFL composite was used. These groups were submitted to shear strength tests in universal testing machine, at 0.5 mm per minute speed. RESULTS: Statistical difference between G3 and G4 groups was recorded, as G4 showing higher strength resistance than G3. In the other hand, there were no statistical differences between G1, G2 and G3 and G1, G2 and G4 groups. ARI analysis showed that there was no statistical difference between the groups, and low scores were recorded among then. The scanning electron microscopy (SEM) analysis revealed the debonding spots and the enamel surface integrity. CONCLUSIONS: Shear bond strength was satisfactory and similar between the composites, however Natural Ortho - DFL revealed best comparing to TransbondTM XT - 3M.

Does the time interval after bleaching influence the adhesion of orthodontic brackets?

OBJECTIVE: To test the null hypothesis that no difference exists between the effects of at-home bleaching and in-office bleaching on shear bond strength (SBS) with bracket bonding at 4 different time intervals after dental bleaching. METHODS: Ninety extracted human premolars were randomly divided into 9 groups (n = 10) according to the bleaching methods used (at-home bleaching and in-office bleaching) and the storage time in artificial saliva (30 min, 1 day, 2 weeks, and 3 weeks before bonding). The control group was stored in artificial saliva for 7 days. Brackets were bonded with the Transbond XT adhesive system, and SBS testing was performed. The adhesive remnant index (ARI) was used to assess the amount of resin remaining on the enamel surfaces after debonding. The SBS data were analyzed by analysis of variance (ANOVA) and the Tukey test. For the ARI, the Kruskal-Wallis test was performed. Significance for all statistical tests was predetermined to be p < 0.05. RESULTS: The SBS of the unbleached group was significantly higher (p < 0.05) than that of the bleached groups (except for the group bonded 30 min after at-home bleaching). CONCLUSIONS: The null hypothesis was not totally rejected. All bleaching groups tested had decreased SBS of the brackets to the enamel, except for the group bonded 30 min after at-home bleaching. The SBS returned to values close to those of the unbleached enamel within 3 weeks following bleaching.

Evaluation of ionic degradation and slot corrosion of metallic brackets by the action of different dentifrices.

OBJECTIVE: To evaluate the in vitro ionic degradation and slot base corrosion of metallic brackets subjected to brushing with dentifrices, through analysis of chemical composition by Energy Dispersive Spectroscopy (EDS) and qualitative analysis by Scanning Electron Microscopy (SEM). METHODS: Thirty eight brackets were selected and randomly divided into four experimental groups (n = 7). Two groups (n = 5) worked as positive and negative controls. Simulated orthodontic braces were assembled using 0.019 x 0.025-in stainless steel wires and elastomeric rings. The groups were divided according to surface treatment: G1 (Máxima Proteção Anticáries®); G2 (Total 12®); G3 (Sensitive®); G4 (Branqueador®); Positive control (artificial saliva) and Negative control (no treatment). Twenty eight brushing cycles were performed and evaluations were made before (T0) and after (T1) experiment. RESULTS: The Wilcoxon test showed no difference in ionic concentrations of titanium (Ti), chromium (Cr), iron (Fe) and nickel (Ni) between groups. G2 presented significant reduction (p < 0.05) in the concentration of aluminium ion (Al). Groups G3 and G4 presented significant increase (p < 0.05) in the concentration of aluminium ion. The SEM analysis showed increased characteristics indicative of corrosion on groups G2, G3 and G4. CONCLUSION: The EDS analysis revealed that control groups and G1 did not suffer alterations on the chemical composition. G2 presented degradation in the amount of Al ion. G3 and G4 suffered increase in the concentration of Al. The immersion in artificial saliva and the dentifrice Máxima Proteção Anticáries® did not alter the surface polishing. The dentifrices Total 12®, Sensitive® and Branqueador® altered the surface polishing.