Abstract The objective of this study was to evaluate the biocompatibility and mechanical properties of two commercially available and one experimental periodontal dressing materials. The cytotoxicity of Periobond ® , Barricaid ® and one experimental periodontal dressing based on Exothane ® 8 monomer was tested on 3T3/NIH mouse fibroblast. Genotoxicity was assessed by micronuclei formation, and cell alterations were analyzed using light microscopy. Both biological assays were performed using the eluate obtained from specimens after 24, 72, or 168 hours of incubation. Mechanical characterization was assessed through the ultimate tensile strength and the water sorption and solubility tests. The significance level of α = 0.05 was used for all statistical analyses. All the materials promoted a cell viability lower than 60% in all evaluated times. In general, the cell viability was significantly reduced after 72 and 168h of specimens’ incubation. Considering the factor material, there were not statistical differences in the cell viability (p = 0.156). The genotoxicity was not statistically significant among the groups in the different periods of time (p > 0.05). Differences in the ultimate tensile strength values were not statistically significant different among the groups (p = 0.125). Periobond ® showed the higher water sorption values (p < 0.001). Regarding solubility, there were no statistical differences between the groups (p = 0.098). All the periodontal dressing materials evaluated in this study exerted a cytotoxic effect against mouse fibroblasts, and their toxicity became more evident over time. Among the materials evaluated, the experimental light-cure type has shown overall similar properties to the commercial references.

Abstract Several instruments have been used to measure oral health-related quality of life (OHRQoL). The Oral Health Impact Profile (OHIP) questionnaire was based on the concept that sequential events related to oral diseases can cause discomfort, functional limitations and consequently, result in dysfunctions and even disabilities. There are few studies in the literature that structurally analyze the instruments to verify whether they measure the requirements to which they were designed to. The objective of the study was to evaluate the internal structure of the OHIP-Edent questionnaire. The OHIP-Edent was administered to 54 edentulous patients’ wearers of conventional complete dentures. For structural analysis, an exploratory factorial analysis (EFA) was carried out. After determining the internal consistency of the model (Cronbach’s alpha = 0.88), the fit was checked using the root mean square error approach (value 0.04), the comparative fit index (value 0.982) and the Tucker-Lewis index (value 0.976). After analysis of the 19 questions and the seven domains proposed in the OHIP-Edent questionnaire, the hypothetical factorial model showed three dimensions denominated “Physical Impact”, “Psychological Impact” and “Social Impact”. In this sample of conventional complete denture wearers, the OHIP-Edent seems adequate to measure the “Physical Impact”, “Psychological Impact”, and “Social Impact” of the OHRQoL. The confirmatory factorial analysis confirmed the model and, through adjustment indexes, it was verified that the three dimensions have convergence and consistence adequate in order to characterize the OHRQoL construct with validity.

<p>Este estudo avaliou retrospectivamente o efeito do ácido fusídico sobre o manejo da gengivite descamativa (DG). A população do estudo consistiu de 15 pacientes com DG. Os pacientes foram solicitados a fazer aplicação tópica de pomada de ácido fusídico 2% 4 vezes ao dia, durante 6 semanas. As avaliações clínicas foram registradas no início do estudo, em 6 semanas e 12 meses após o início da terapia. O exame dos pacientes envolveu tamanho da área da lesão, intensidade da dor e impacto nas atividades diárias. Todos os pacientes apresentaram lesões na maxila; em 9 pacientes (60,0%) as lesões foram predominantemente na região anterior e em 6 (40,0%) na região posterior da maxila. O tratamento significantemente (p<0,05) reduziu a intensidade da dor (de 5,4±1,12 para 1,16±0,97) e a sua periodicidade (de 53,33% com dor>3x/semana para 13,33%), e o tamanho da lesão em 72,47% (±4,12) imediatamente após 6 semanas de tratamento. As melhorias foram sustentadas por 12 meses, quando comparado aos valores iniciais (p<0,001). Também reduziu o impacto da doença nas atividades diárias (alimentação e desempenho de higiene oral), e melhorou a condição emocional dos pacientes, que relataram melhores relações e hábitos sociais. A aplicação tópica de ácido fusídico pode ser uma alternativa para terapia local paliativa no tratamento de gengivite descamativa.</p>

<p>This study evaluated retrospectively the effect of fusidic acid on the management of desquamative gingivitis (DG). The study population consisted of 15 patients with DG. Patients were requested to make topical application of 2% fusidic acid ointment 4 times a day for 6 weeks. Clinical assessments were recorded at baseline, at 6 weeks and 12 months after beginning the therapy. Patients' examination involved lesion size area, pain score and impact on daily activities. All patients presented lesions in maxilla; in 9 patients (60.0%) lesions were predominately at the anterior region and 6 (40.0%) at the posterior region of maxilla. Treatment significantly (p<0.05) reduced the pain intensity (from 5.4±1.12 to 1.16±0.97) and its periodicity (from 53.33% with pain>3 x/week to 13.33%), and the lesion size in 72.47% (±4.12) immediately after 6 weeks of treatment. Improvements were sustained for 12 months compared to baseline (p<0.001). It also reduced the impact of disease in daily activities (eating and oral hygiene performance), and improved the emotional condition of patients, who reported better social relationships and habits. Topical application of fusidic acid may be a possible alternative local palliative therapy for desquamative gingivitis treatment.</p>

Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

AIM: To assess the combined use of tetracycline (TTC) and ethylenediaminetetraacetic acid (EDTA) on clot formation, considering that EDTA may neutralize TTC acidity.METHODS: Planed human tooth roots were treated with saline solution, EDTA, TTC and their combination (EDTA followed by TTC and TTC before EDTA). Fresh human blood was applied on the conditioned surfaces to check clot adhesion and stabilization. A previously calibrated (kappa = 0.93) and blinded examiner scored scanning electron micrographs of the samples. Statistical analyses were performed using one-way ANOVA and Tukey's test.RESULTS: Application of TTC before EDTA presented the best results with the highest number of cells adhered to the root surface (p=0.046). Use of EDTA alone and EDTA before TTC disturbed clot stabilization when compared to control group (p<0.01).CONCLUSIONS:The use of TTC before EDTA seems to be able to keep blood cells viable to establish an organized clot and could be used by clinicians together with the conventional mechanical root scaling and planing.

AIM: To identify the predominant causes and types of maxillofacial trauma in Brazil. METHODS: Reports of corporal trauma (7,536) between 2009-2010 in the Brazilian Institute of Forensic Medicine were analyzed as to the presence of maxillofacial traumas. Victims' demographic and trauma characteristics were recorded. RESULTS: Data were submitted to chi-square test and to multivariate Poisson regression. 778 reports referred maxillofacial trauma. Most victims were men (50.8%) around 27.6 years. Main causes were physical aggression (88.1%) and traffic accidents (6.7%). The most affected extraoral area was the middle third (60.7%). Risk for trauma in the middle third was significantly higher among patients aged 61-75 (RR 1.32), and non-white patients (black-skinned RR 1.21; brown-skinned RR 1.18); while falls were associated with trauma in the lower third (RR1.79). CONCLUSIONS: Violence was the main cause of maxillofacial trauma. Prevention of interpersonal violence may be a key element to prevent maxillofacial trauma.

OBJECTIVES: The aim of this study was to establish the parameters of concentration, time and mode of application of citric acid and sodium citrate in relation to root conditioning. MATERIAL AND METHODS: A total of 495 samples were obtained and equally distributed among 11 groups (5 for testing different concentrations of citric acid, 5 for testing different concentrations of sodium citrate and 1 control group). After laboratorial processing, the samples were analyzed under scanning electron microscopy. A previously calibrated and blind examiner evaluated micrographs of the samples. Non-parametric statistical analysis was performed to analyze the data obtained. RESULTS: Brushing 25% citric acid for 3 min, promoted greater exposure of collagen fibers in comparison with the brushing of 1% citric acid for 1 minute and its topical application at 1% for 3 min. Sodium citrate exposed collagen fibers in a few number of samples. CONCLUSION: Despite the lack of statistical significance, better results for collagen exposure were obtained with brushing application of 25% citric acid for 3 min than with other application parameter. Sodium citrate produced a few number of samples with collagen exposure, so it is not indicated for root conditioning.

O objetivo deste estudo foi avaliar a presença de aloanticorpos anti-HLA classe I em pacientes infectados pelo HIV-1 e relacioná-la aos diferentes cursos clínicos da doença. Amostras de sangue de 145 indivíduos HIV positivo foram coletadas em tubos com EDTA. A infecção pelo HIV-1 foi confirmada por teste ELISA e a presença de aloanticorpos anti-HLA classe I determinada em seguida. A evolução clínica foi definida como rápida (<1 ano entre diagnóstico e morte), moderada (1-3 anos) ou lenta (>3 anos). A presença de aloanticorpos anti-HLA classe I foi menor em indivíduos saudáveis em relação aos infectados pelo HIV-1 (4,2% contra 32,4%). Porém, a distribuição destes aloanticorpos entre os indivíduos infectados foi igual, independente da evolução clínica. Deste modo, a presença de aloanticorpos anti-HLA classe I não é um fator determinante na piora clínica do paciente.

The aim of this study was to evaluate the presence of class I anti-HLA alloantibodies in patients infected by HIV-1 and relate it with the different clinical courses of the disease. Blood samples were collected in EDTA tubes from 145 individuals. HIV-1 infection was confirmed by ELISA test. The presence of class I anti-HLA alloantibodies and HLA allele's were determined. Clinical evolution was set as fast (<1 year between diagnostic and death), moderate (1-3 years) or slow (>3 years). Class I anti-HLA alloantibodies presence was lower in healthy individuals than in those infected by HIV-1 (4.2% against 32.4%). However, an equal distribution of these alloantibodies was found among the individuals infected, independent on the clinical evolution. Thus, class I anti-HLA alloantibodies was not a determinant factor for patient worsening.

Innocuous biocompatible materials have been searched to repair or reconstruct bone defects. Their goal is to restore the function of live or dead tissues. This study compared connective tissue and bone reaction when exposed to demineralized bovine bone matrix and a polyurethane resin derived from castor bean (Ricinus communis). Forty-five rats were assigned to 3 groups of 15 animals (control, bovine bone and polyurethane). A cylindrical defect was created on mandible base and filled with bovine bone matrix and the polyurethane. Control group received no treatment. Analyses were performed after 15, 45 and 60 days (5 animals each). Histological analysis revealed connective tissue tolerance to bovine bone with local inflammatory response similar to that of the control group. After 15 days, all groups demonstrated similar outcomes, with mild inflammatory reaction, probably due to the surgical procedure rather than to the material. In the polymer group, after 60 days, scarce multinucleated cells could still be observed. In general, all groups showed good stability and osteogenic connective tissue with blood vessels into the surgical area. The results suggest biocompatibility of both materials, seen by their integration into rat mandible. Moreover, the polyurethane seems to be an alternative in bone reconstruction and it is an inexhaustible source of biomaterial.

Como o uso da abrasão a ar tem aumentado em odontopediatria, o objetivo deste trabalho foi avaliar a resistência ao cisalhamento da resina composta Z100 sobre a superfície dentinária de dentes decíduos após abrasionamento a ar associado ou não a técnica de condicionamento total (ácido fosfórico + Scotchbond Multi Purpose) ou "primer" autocondicionante (Clearfil SE Bond). A superfície oclusal de 25 molares decíduos foi removida para exposição completa da superfície dentinária. Após polimento com lixas abrasivas, foram divididos em 5 grupos (5 espécimes em cada) tratados por abrasão + adesivo Scotchbond (G1); condicionamento ácido + adesivo Scotchbond (G2); adesivo Clearfil (G3); abrasão a ar + condicionamento ácido + adesivo Scotchbond (G4); abrasão a ar + adesivo Clearfil (G5). Uma matriz bipartida foi adaptada à superfície dentinária e preenchida com resina composta. Após polimerização, corpos-de-prova de 2 mm x 6 mm foram obtidos. O teste de Duncan mostrou a desigualdade (G1 = G4) < (G2 = G3 = G5). Desse modo, conclui-se que, após o abrasionamento dentinário, deve ser utilizado o sistema de "primer" autocondicionante a fim de se obter maior força de adesão.

Since the use of air abrasion has grown in pediatric dentistry, the aim of this study was to evaluate, by means of shear bond strength testing, the need to use the total etching technique or self-etching primers on dentin of primary teeth after air abrasion. Twenty-five exfoliated primary molars had their occlusal dentin exposed by trimming and polishing. Specimens were treated by: Air abrasion + Scotchbond MultiPurpose adhesive (G1); 37% phosphoric acid + Scotchbond MP adhesive (G2); Clearfil SE (G3); Air abrasion + 37% phosphoric acid + Scotchbond MP adhesive (G4); Air abrasion + Clearfil SE (G5). On the treated surface, a cylinder of 2 mm by 6 mm was made using a composite resin (Z100). Duncan's test showed that: (G2 = G3 = G5) > (G1 = G4). The use of a self-etching primer on air abraded dentin is recommended to obtain higher bond strengths.

O objetivo do presente estudo foi comparar, através de microscopia eletrônica de varredura, a remoção de smear layer de superfícies radiculares após aplicação tópica de gel de EDTA com gel de EDTA-T (Texapon). Foram utilizados dentes humanos que foram submetidos a remoção de cemento radicular e raspagem. As amostras dos dentes foram divididas em 3 grupos: Grupo I- (controle) (n=20); Grupo II- gel de EDTA (pH 7,0) nas concentrações de 5%,10%,15%,20% e 24% (n=100); Grupo II -gel de EDTA-T (pH 7,0) nas concentrações acima descritas (n=100). As fotomicrografias foram avaliadas através de um índice e os dados foram estatisticamente analisados. Ambos os tratamentos com EDTA foram efetivos na remoção de smear layer quando comparados ao grupo controle. O gel de EDTA a 5% demonstrou maior capacidade na remoção de smear layer quando comparado com as concentrações de 15%, 20% e 24% (p<0,05). Não houve diferença entre as concentrações de géis de EDTA-T (p>0,05). Os géis de EDTA foram mais efetivos que o EDTA-T nas concentrações de 5 e 10%. Os resultados sugerem que a aplicação tópica de EDTA ou EDTA-T é efetiva na remoção de smear layer, principamente em baixas concentrações e a adição do Texapon não promove vantagens neste tratamento.

The aim of the present study was to compare root surface smear layer removal following topical application of EDTA and EDTA-T (Texapon). Extracted human teeth had their cementum removed and were mechanically scaled. A total of 220 root specimens were obtained and were randomly assigned to the following groups: I-saline solution (control), II-EDTA; III-EDTA-T. Groups II and III specimens were assigned to different EDTA gel concentrations: 5%, 10%, 15%, 20% and 24%. Smear layer removal score was assessed for each specimen by scanning electron microscopy. The results demonstrated that EDTA and EDTA-T gel led to a higher root surface smear layer removal when compared to the control group. The 5% EDTA gel also showed a higher smear layer removal than the 15%, 20% and 24% EDTA gels (p<0.05). No difference could be found between the different concentrations of EDTA-T gels tested (p>0.05). EDTA gels had statistically significantly lower smear layer scores than the EDTA-T gels for the 5% and 10% concentrations. The results suggested that topical application of EDTA or EDTA-T gel led to significant smear layer removal of the mechanically treated root surfaces. The addition of a detergent to the EDTA gel formula did not improve smear layer removal of the root surface.

A raspagem gera "smear layer", a qual contém microrganismos e toxinas que podem interferir no reparo periodontal. Por esse motivo, diferentes substâncias têm sido empregadas para remover esta camada e expor fibras colágenas da superfície dental. A adesão de elementos sangüíneos a superfícies radiculares desmineralizadas e a estabilização do colágeno pelas fibras colágenas são de extrema importância no sucesso da cirurgia periodontal. O objetivo deste estudo foi avaliar os diferentes padrões de adsorção e adesão de elementos sangüíneos a superfícies radiculares apenas irrigadas com água destilada e após aplicação de um gel de EDTA manipulado ou um industrializado. Trinta amostras foram raspadas, eqüitativamente divididas em 3 grupos e tratadas com água destilada (controle), um gel de EDTA manipulado ou um industrializado. Imediatamente foram expostas a sangue fresco e preparadas para microscopia eletrônica de varredura. As superfícies dentinárias apenas raspadas apresentaram os melhores resultados, com moderada quantidade de células sangüíneas entremeadas em uma fina rede de fibrina. No grupo de EDTA manipulado, a rede de fibrina foi pouco visível com escassas células. Os piores resultados foram observados com o EDTA industrializado, caracterizados pela ausência de elementos sangüíneos. Estatisticamente houve diferença apenas entre os grupos controle e EDTA industrializado. As superfícies apenas irrigadas apresentaram rede de fibrina mais bem organizada com células entremeadas.

Root debridement generates a smear layer which contains microorganisms and toxins that could interfere in periodontal healing. For this reason, different substances have been used to remove it and to expose collagen fibers at the tooth surface. Blood element adhesion to demineralized roots and clot stabilization by collagen fibers are extremely important for the success of periodontal surgery. The aim of this study was to evaluate the different patterns of blood element adsorption and adhesion to root surfaces only irrigated with distilled water and after application of a manipulated or an industrialized EDTA gel. Thirty samples were planed, equally divided into three groups and treated with distilled water (control), a manipulated EDTA gel or an industrialized one. Immediately after, samples were exposed to fresh blood and prepared for scanning electron microscopy. Untreated planed dentin presented the best results with blood cells entrapped in a thick web of fibrin. In the manipulated EDTA group, the web of fibrin was thick with sparse blood elements. The worst result was seen with the industrialized EDTA group, in which no blood elements could be seen. Statistical difference was obtained between control and industrialized EDTA groups. Surfaces only irrigated presented the most organized fibrin network and cell entrapment.