Resumo em Inglês:

The Wits appraisal is a common linear cephalometric analytic tool established by Jacobson. It has been reported to be superior to angular cephalometric measures as it is not dependent on pericranial structures and their variations both during growth and orthodontic treatment. AIM: To obtain reference values for the Wits appraisal among Nigerians and assess the effect of the dental base geometry on it. METHODS: Lateral cephalometric radiographs of 100 Nigerian subjects with normal occlusion were analyzed to obtain the Wits appraisal, and the effect of the vertical distance from subspinale to supramentale, length of the palatal and mandibular planes, the mandibular plane angle as well as the palatal plane angle were assessed using the ANOVA and linear regression analysis. RESULTS: The mean age was 20.69 ± 4.9 years. Thirty-four (34%) were males and 66(66%) were females. Mean Wits value of -3.43 ± 3.24 mm was obtained based on the functional occlusal plane (FOP). Linear regression analysis showed that the vertical height from subspinale (A point) to supramentale (B point) caused a significant change in the Wits appraisal reading in participants still undergoing active growth process (less than 16 years of age) (p=0.02). CONCLUSIONS: It is advocated that the Wits appraisal be used as a moderator to the ANB angle among Nigerians. However, as a result of dental height variations its use in growing Nigerian children requires caution.

Resumo em Inglês:

AIM: To investigate the prevalence of dental fractures and their association with risk factors in the permanent dentition of adolescents in Valinhos, SP, Brazil. METHODS: The study population was obtained using the probability sampling method and comprised 379 students between 13 and 19 years old enrolled in the eight State schools of the city, who were examined by nine pairs of calibrated dentists (Kappa>0.80). The presence of dental fractures in permanent anterior incisors, as well as the presence of considerable overjet (> 5mm) and lip seal was evaluated in a clinical-epidemiological examination. RESULTS: The prevalence of dental trauma was 27.1%. The most frequent lesions were enamel fractures (72.6%) of which falls were the main cause (45.7%). No association was found between the presence of considerable overjet and deficient lip seal (chi-square test; p>0.05). CONCLUSIONS: The prevalence of dental trauma in the studied population was expressive when compared with the literature, but the analyzed oral aspects did not contribute to its occurrence.

Resumo em Inglês:

AIM: To investigate the indication of systemic antimicrobial agents used by dental professionals for treatment of patients affected by periodontal diseases. METHODS: Interviews by a questionnaire were held with 225 professionals of different dental specialties and who performed periodontal treatment. RESULTS: Among interviewees, 94% indicated systemic antibiotics as a form of periodontal disease treatment. Their main indication was for periodontal abscesses (80%) followed by aggressive periodontitis (62%) and necrotizing diseases (45%). The most frequently used antibiotics were amoxicillin (81%) and metronidazole (57%). The medications were indicated in association with mechanical therapy by 67% of the professionals. As regards the occasion of indication, 60% indicated systemic antibiotic therapy before and after mechanical periodontal scaling and root planing. Seventy-eight percent of the professionals indicated antibiotics associated with periodontal surgery for access to scaling, and 76% indicated it before and after the surgical procedure. Among the interviewees, 99% took into account systemic involvement for drug administration. CONCLUSIONS: It was concluded that a considerable portion of professionals indicate systemic antibiotic-therapy in an incoherent manner and in situations in which there is no indication for antibiotic use, or with ineffective protocols.

Resumo em Inglês:

AIM: To correlate the tray technique for isolation and counting of Streptococcus mutans over dental restoration with the toothpick technique. METHODS: Forty 18-50-year-old patients of both genders with high cariogenic risk were selected. Inclusion criteria were: occlusal restoration evaluated as alpha, according to the Ryge's criteria (examiner' Cohen-Kappa 0.8) and 2 years old maximum age. Each patient provided a saliva sample (control group S) and two samples of dental biofilm from amalgam or resin-based composite restorations in the same patient, one obtained with the toothpick technique (group TT), and the other from homologous tooth restoration with the tray technique (group TR). This method involves only a direct impression on the occlusal surfaces by a section of a fluoride tray with trypticase yeast extract cysteine sucrose with bacitracin (TYCSB) agar previously prepared and solidified. The samples were incubated at 37 ºC for 48 h and the colony-forming units (CFU) were counted. The results were statistically analyzed with SPSS software using the linear regression method at 95% confidence level. RESULTS: TR was able to isolate S. mutans, and there was a significant positive correlation (r=0.95) with TT. There was no significant correlation between TR and control group S (r=0.47). CONCLUSIONS: TR was able to isolate and count S. mutans from the dental biofilm of dental restorations with a significant correlation with the TT group.

Resumo em Inglês:

AIM: To assess the total cost of direct and indirect materials used in Class III, IV and V composite resin direct restorations. METHODS: The calculation of costs was based on the method of variable costing system. A list of the materials was obtained by a panel of experts and based on the excellence standards established in the literature for dental team treatment. The cost considered for each material was obtained from an average of the costs found in the regional supplier market (US$1.0=R$2.12). The repetitions were obtained from Class III, IV and V cavities in artificial pre-manufactured teeth. The cavities were classified as shallow, medium and deep. The materials were quantified for each type of preparation. Seven brands of composite resins were used and weighed on a precision scale after their insertion in each cavity. The data were analyzed by descriptive statistics and non-parametric Friedman's test (α=0.05). RESULTS: The mean costs were US$7.96 (R$16.88) for Class III restoration, US$8.13 (R$17.24) for Class IV, and US$7.84 (R$16.62) for Class V. There was statistically significant difference in cost between the types of cavities and depth classification. The small cost difference among the different resin brands resulted in no statistically significant differences in the total cost of the restorations. CONCLUSIONS: The costs obtained in this survey may be used in the calculation of the final cost of restorative procedures, helping in the management of public or private dental care services.

Resumo em Inglês:

AIM: Cone beam computed tomography (CBCT) was used to evaluate the ability of three NiTi rotary systems to maintain the original root canal anatomy. METHODS: Sixty mesiobuccal canals of human mandibular first molars were divided into three groups with 20 root canals each. All teeth were scanned by CBCT before instrumentation. The images were captured digitally for further analysis using the Image Tools Software. The images were sectioned in three points, located at 9 mm, 6 mm and 3mm from the apex. In Group 1, the root canals were instrumented with ProTaper UniversalTM rotary system; in Group 2, with Twisted FileTM rotary system; and in Group 3, with MtwoTM rotary system. Instrumented teeth were scanned again using CBCT and the images of the uninstrumented canals were compared with images of the instrumented canals. The results were statistically analyzed using the one-way ANOVA test. A level of significance of 0.05 was adopted. RESULTS: The means of D1 at distances of 9 mm, 6 mm, and 3 mm from the apex were, respectively: Group 1: 0.88±0.257, 1.00±0.000, and 1.00±0.000; Group 2: 0.79±0.745, 0.65±0.669, and 0.25±0; Group 3: 0.50±0.745, 0.33±0.472, and 0.03±0.104. The means of D2 at distances of 9 mm, 6mm, and 3mm from the apex were respectively: Group 1: 1.00±0.00, 1.00±0.00, and 1.00±0.00; Group 2: 0.41±0.299, 0.30±0.428, and 0.50±0.707; Group 3: 0.58±0.910, 0.85±1.857, and 0.31±0.643. CONCLUSIONS: The CBCT analysis revealed that the ProTaper UniversalTM produced centered preparations and while the Twisted FileTM and MtwoTM rotary systems produced canal deviation.

Resumo em Inglês:

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.

Resumo em Inglês:

AIM: To evaluate the radiopacity and microhardness (KHN) of experimental dental adhesives (EX). The experimental adhesive resins of the present study were formulated based on the simplified adhesive system Ambar (FGM). METHODS: Five EX with different concentrations of zirconia nanoparticles [0(EX0), 15(EX15), 25(EX25), 30(EX30) e 50%(EX50)] were incorporated in a UDMA/HEMA adhesive (control). Adper Single BondTM 2 (SB, 3M ESPE) was used as a commercial reference. For the radiopacity (n=5), KHN (n=5), adhesive specimens were fabricated using a stainless steel mold. Data were submitted to one-way ANOVA and Tukey's test (α=0.05). RESULTS: The filler addition on the EX showed radiopacity similar to enamel and higher than SB. The EX25, EX35 and EX50 showed higher KHN values when compared to the commercial SB. EX25, EX35 and EX50 showed higher KHN values when compared to the commercial SB. CONCLUSIONS: The results of the present investigation suggest that the addition of zirconia nanoparticles seems to be a good alternative to produce radiopaque adhesives with increased microhardness.

Resumo em Inglês:

There are few studies that fully characterize the effect of the filler size on the surface, optical and mechanical properties of resin composites. AIM: To determine the influence of the filler size content on surface, optical and mechanical properties before and after accelerated aging. METHODS: Seven resin composites were investigated: Filtek Supreme® (3M/ESPE), Estelite Σ Quick® (Tokuyama), Evolu-X® (Dentsply), Esthet-X HD® (Dentsply), Opallis® (FGM), Herculite XRV Ultra® (Kerr) and Filtek Z250® (3M/ESPE). Elastic modulus (EM) and flexural strength (FS) were determined by three-point bending of specimens immersed or not in absolute ethanol for seven days. Roughness (Ra) and gloss (G.U.) analyses were determined before and after ethanol storage for seven days and CIELAB color change (ΔE*) was obtained with a spectrophotometer. Results were analyzed by two-way ANOVA (general linear model) for EM and FS, with repeated measures for roughness and gloss, and one-way ANOVA for ΔE*. All comparisons were performed by Tukey's test (5%). Pearsons' correlation test was performed to determine the correlation between EM, FS, roughness, gloss, and ΔE* with the mean filler sizes. RESULTS: Mechanical properties decreased for all materials when submitted to immersion in ethanol. Increasing filler size gradually increased EM, FS and roughness values; gloss values decreased and didn't significantly affects ΔE*. Nanofiller composites presented higher gloss values than the others. CONCLUSIONS: It was possible to determine that the average filler size is a good predictor just for FS and gloss retention.

Resumo em Inglês:

AIM: To verify the orofacial and dental complex in individuals affected by leprosy concerning lesions, prevalence of dental caries and biofilm storage. METHODS: This study was performed on 56 patients with leprosy: 28 under treatment and 28 treated for the disease. A clinical form was prepared to include demographic and leprosy data. The prevalence of caries was analyzed using the decayed, missing, filled teeth (DMFT) index and oral hygiene was evaluated using the Plaque Control Record. The statistical significance was measured by chi-square and Student's t-test. RESULTS: The mean age was 56.4 years, and there was predominance of males. The treatment group had more women (Pearson ÷2=12.47, p=0.0004) and younger patients (Pearson ÷2=9.688, p=0.0079) than the healed group. As much as 30.4% of patients had orofacial complaints related to the disease. The most often observed variations of normality as racial melanin pigmentation (67.8%) and lingual varices (32.1%), and lesions such as atrophy of the anterior nasal spine (25%), inflammatory papillary hyperplasia (17.8%), and collapse of the nasal bridge (14.3%). There were no specific oral lesions among leprosy patients. The mean DMFT was 20.8 and the Plaque Control Record was 70.2%. The treated group had higher DMFT than the treatment group (Student's t p=0.003). CONCLUSIONS: The oral health status of individuals with leprosy is poor, with high levels of plaque and DMFT. No oral lesions associated with the disease were seen.

Resumo em Inglês:

Defects similar to Molar-Incisor Hypomineralization (MIH) in second primary molars can be found in the literature, being recently named Deciduous Molar Hypomineralization (DMH). Researchers have stated that the presence of DMH in primary dentition represents a risk for MIH in permanent teeth. The explanation for this association is probably related to the etiological factors. AIM: To investigate prospectively the association between DMH and MIH and the etiologic factors involved in both defects. METHODS: One hundred and thirty four children aged 4 to 6 years from Botelhos, MG, Brazil, were evaluated six-monthly until they completed the eruption of the first permanent molars. A structured questionnaire was developed with questions about the child's health up to the first year of life and the mother's health during pregnancy. RESULTS: It could be noted that, although most children with DMH in the primary dentition had higher incidence of MIH in permanent dentition, this difference was not statistically significant. CONCLUSIONS: None of the possible etiologic factors had associations with the studied enamel defects, even among children who presented two types of enamel defects in the mixed dentition. However, further studies with larger samples should be conducted in order to confirm or refute the findings of the present study.

Resumo em Inglês:

Absenteeism is determined as an absence from work, resulting in the decrease of the company's production and, consequentially, causing profit reduction. The employer must follow closely the employees' quality of life, assuring that they perform all their tasks effectively. Dental health is directly connected to the employee's general health status and cannot be put aside when trying to assure complete physical and mental well being of an individual. AIM: To analyze pre-employment exams of a military company in order to identify, among all the reasons for exclusion, dental problems that ultimately resulted prevented hiring of job applicants. METHODS: Information was collected in 2008 from the dental files of the Health Department archives, which contained data referring to the candidates applying for a specific position and permitted and analytical study of the reasons for exclusion, based on the International Classification of Diseases (ICD-10). RESULTS: 10.24% (720) of the candidates, from a total of 7,029, were excluded for dental reasons, namely dental cavitation, 2.8% (197), and pulpal and periapical diseases, 3.14% (221). CONCLUSIONS: Aside from being limited, the results of this study suggest that dental problems influence a great deal on the quality of life of employees that are able for work, and, that being said, should be managed closely to reduce absenteeism in the workplace.

Resumo em Inglês:

AIM: To compare the use of etoricoxib and dexamethasone for postoperative pain prevention and control after mucogingival surgery. METHODS: Fifty-eight patients with indication for mucogingival surgery took part in this randomized parallel double-blind clinical trial. They were divided into three groups (G): G1 - placebo 1 h before surgery; G2 - 8 mg dexamethasone 1 h before surgery; G3 - 90 mg etoricoxib 1 h before surgery. Pain intensity was assessed in donor and recipient sites separately using the 101-point numerical rating scale NRS - 101, every hour for the first 8 h after surgery and three times a day on the following 3 days. RESULTS: there was a statistically significant difference in the postoperative pain intensity in the donor site between G1 and G3 after 1 h, 2 h, 3 h, 7 h, 8 h and on the second day - in the evening after 32 h; between G1 and G2 after 2 h and 3 h, and between G2 and G3 only after the first hour. Pain intensity in the recipient site was statistically significant between G1 and G3 after 1 and 2 h (p<0.05). In addition, there was a lower ingestion of rescue medication in G2 and in G3 than in G1 (p=0.002). CONCLUSIONS: the use of a pre-emptive single dose of etoricoxib or dexamethasone may be considered an effective protocol for postoperative pain prevention and control after mucogingival surgery.

Resumo em Inglês:

AIM: To assess the dental status of elderly patients examined in the clinical dentistry course of a Brazilian public university. METHODS: An observational and descriptive study based on the analysis of panoramic radiographs. The sample consisted of 60 elderly patients who met the inclusion criteria. Two observers who had been trained in appropriate conditions performed the radiographic analysis. Data were stored in a specific form, recorded in a database and analyzed using descriptive statistics (measures of central tendency and variability) and inferential statistics (Mann-Whitney U test, Kruskal-Wallis test, Chi-square analysis and calculation of the Cramer's V coefficient). RESULTS: Most patients had at least one tooth in the oral cavity (71.7%), while 28.3% were totally edentulous, an average of 10.5 teeth per individual. The average number of teeth was 11.36 in males and 9.89 in females. The number of healthy teeth was 328 (5.47 per patient). In this study, 88.3% of the subjects had periodontal bone loss, with prevalence of moderate (35.0%) and severe (28.3%) bone loss. CONCLUSIONS: Given the high incidence of edentulous individuals, the high number of restored teeth and poor periodontal conditions, it is concluded that the overall oral health status of the evaluated elderly subjects is poor.

Resumo em Inglês:

AIM: To verify the presence of Bolton anterior and total discrepancy in Brazilian individuals with natural normal occlusion and Angle's Class I and Class II, division 1 malocclusions. METHODS: The sample was divided in three groups (n=35 each): natural normal occlusion; Class I malocclusion; Class II, division 1 malocclusion. Of the 105 Caucasian Brazilian individuals, 24 were boys and 81 were girls aged from 13 to 17 years and 4 months. The mesiodistal width of the maxillary and mandibular teeth, from the left first molar to the right first molar, was measured on each pre-treatment dental plaster cast using a digital caliper accurate to 0.01 mm resolution. Values were tabulated and the Bolton ratio was applied. The Kolmogorov-Smirnov test was used to verify if data were normally distributed (p>0.2). For comparison between the values obtained and those from the Bolton standard, Student's t test was used and one-way ANOVA was used for comparisons among the 3 groups, with a significance level of 5% (p<0.05). RESULTS: For groups 1, 2 and 3, respectively, the total ratio found was 90.36% (SD 1.70), 91.17% (SD±2.58) and 90.76% (SD±2.45); and the anterior ratio was 77.73% (SD 2.39), 78.01% (SD 2.66) and 77.30% (SD 2.65). CONCLUSIONS: There was no significant difference among the groups regarding the values indicated in the Bolton ratio.