Resumo em Inglês:

The dental pulp may be exposed to several irritants that are potentially noxious to the health and functions of this tissue. Each type of irritant or injury has different effects on the pulp, which are generally characterized by acute inflammation, chronic inflammation or necrosis. Common examples of irritants are dental caries, cavity preparation procedures, traumatic injuries, and chemical substances like bleaching agents and adhesive systems. The present study aimed to review the current knowledge about the effect of bleaching agents and adhesive systems in the human dental pulp. The review covered literature from 2004 to 2009, and only relevant manuscripts were included. Hand search of the references completed the review. Based on literature review, it may be concluded that all dental procedures associated with bleaching agents or adhesive systems involve risks to cause pulp damage. However, these risks can be minimized if the causal factors were known and avoided.

Resumo em Inglês:

AIM: The aim of this systematic review was to compare the maxillary dental effects of cervical headgear and pendulum appliance during distalization of permanent maxillary first molars. METHODS: A literature survey from databases covering the period from 1956 to August 2008 was carried out. Randomized controlled trials (RCT) and controlled clinical trials (CCT) were included. Two reviewers selected and extracted the data independently, and also assessed the quality of the retrieved studies. RESULTS: The search strategy resulted in 48 articles, of which 3 met the inclusion criteria. Distal molar movement with headgear versus pendulum appliance was identified. In all studies selected, the methods used to detect and analyze the distal molar movement were valid and generally well know. All articles included an error analysis method and considered the risk for confounding factors, but only one study used blinding in measurements. CONCLUSIONS: The studies showed that both cervical headgear with patient compliance and a non-compliance pendulum appliance are very effective in distalizing maxillary molars. However, additional RCTs with larger samples of both molar distalizing appliances are needed to confirm this result and provide further reliable scientific evidence.

Resumo em Inglês:

AIM: To explore the biomechanical effects of the different implantation bone levels of Morse taper implants, employing a finite element analysis (FEA). METHODS: Dental implants (TitamaxCM) with 4x13 mm and 4x11 mm, and their respective abutments with 3.5 mm height, simulating a screwed premolar metal-ceramic crown, had their design performed using the software AnsysWorkbench 10.0. They were positioned in bone blocks, covered by 2.5 mm thickness of mucosa. The cortical bone was designed with 1.5 mm thickness and the trabecular bone completed the bone block. Four groups were formed: group 11CBL (11 mm implant length on cortical bone level), group 11TBL (11 mm implant length on trabecular bone level), group 13CBL (13mm implant length on cortical bone level) and group 13TBL (13 mm implant length on trabecular bone level). Oblique 200 N loads were applied. Von Mises equivalent stresses in cortical and trabecular bones were evaluated with the same design program. RESULTS: The results were shown qualitatively and quantitatively by standard scales for each type of bone. By the results obtained, it can be suggested that positioning the implant completely in trabecular bone brings harm with respect to the generated stresses. Its implantation in the cortical bone has advantages with respect to better anchoring and locking, reflecting a better dissipation of the stresses along the implant/bone interfaces. In addition, the search for anchoring the implant in its apical region in cortical bone is of great value to improve stabilization and consequently better stress distribution. CONCLUSIONS: The implant position slightly below the bone in relation to the bone crest brings advantages as the best long-term predictability with respect to the expected neck bone loss.

Resumo em Inglês:

AIM: To evaluate differences in sociodemographic characteristics (gender, age, educational level and income) between users and nonusers of phytotherapy for dental purposes; the degree of population's knowledge of herbal medicines for dental needs; and whether patients inform the health professional about their use of phytotherapy. METHODS: A questionnaire was applied to 100 patients in waiting rooms of the School of Dentistry of the Federal University of Juiz de Fora, in 2008, to inquire about sociodemographic variables and other factors associated with the use of phytotherapy. Statistical analyses were carried out using the chi square statistical test to calculate association between the variables, with 0.05 as level of significance. RESULTS: It was observed that 64.8% of participants were women with a mean age of 43.9±15.1 years. Phytotheraphy use for treatment of oral problems was reported by 37% of patients interviewed in this study. Significant differences were found between users and non-users of herbal medicines for oral problems, associated with the patient's age (p<0.05) and previous experience with use of phytotherapy to treat general health problems (p<0.001). CONCLUSIONS: The results emphasize the need for more scientific evidence of the efficacy of herbal medicinal products already incorporated in the popular knowledge to treat oral problems in order to make it an accessible and alternative method for prevention and therapy in dentistry.

Resumo em Inglês:

AIM: To measure the fracture resistance of over-flared roots filled with a variety of materials (gutta-percha-nano HA, resilon-epiphany, composite and mineral trioxide aggregate - MTA) using the Instron machine test and micro-computed tomography (Micro CT) Scan. In addition, scanning electron microscopy (SEM) images were used to illustrate the type of fracture patterns of the specimens. METHODS: One hundred and twenty extracted human mandibular single-rooted premolars were selected. A total of 105 out of the selected teeth were prepared to the working length and over-flared, leaving the apical 5 mm undisturbed. Fifteen samples had no treatment and were used as a positive control group (Group +ve). The 105 test teeth were further divided into 7 groups of 15 samples each. One of the 7 groups was designated as negative control (Group -ve) where teeth were over prepared and left without obturation. Remaining groups were filled with gutta-percha-nanoHA (Group1), gutta-percha-nano HA+composite (Group 2), gutta-percha-nano HA+MTA (Group 3), resilon-epiphany (Group 4), resilon-epiphany+composite (Group 5), and resilon-epiphany+MTA (Group 6). Fracture resistance of all samples was measured using the Instron testing machine. Three samples from each group had the depth of their fracture line measured by Micro CT Scan, and 2 samples from each group had their fracture pattern illustrated using SEM. RESULTS: The highest fracture resistance was observed in Group +ve, followed by Groups 3, 6, 5, 2, 4, 1, and Group -ve, with values (in N) of: 1598 (641.0), 1190.5(424.2), 1164.7 (489.4), 821.2 (220.9), 683.4(179), 658.4 (211.3), 658.4 (99.0), 158.3(49.3), respectively. Statistical analysis for root fracture resistance showed highly significant difference between all groups with p value < 001. CONCLUSIONS: Micro CT Scan and SEM analysis indicated the ability of MTA to withstand vertical force.

Resumo em Inglês:

AIM: To evaluate the bond strength of brackets fixed with different materials (two light-cured nanofilled resins - Transbond Supreme LV and Flow Tain LV, a light-cured resin - Transbond XT (control) and two chemically cured resins for indirect bonding - Sondhi Rapid- Set and Custom I.Q.) using the indirect bonding technique after 10 min and 24 h, and evaluate the type of failure. METHODS: One hundred premolars were selected and randomly divided into groups (n=10) according to the material and fixation period. The brackets were bonded through the indirect technique following the manufacturer's instructions and stored in deionized water at 37°C for 10 min or 24 h. After, the specimens were submitted to a shear bond strength (SBS) test (Instron) at 0.5 mm/min and evaluated for adhesive remnant index (ARI). The data were submitted to ANOVA and Tukey's test (p<0.05) and the ARI scores were submitted to the chi-square test. RESULTS: It could be observed a significant difference among the materials (Flow Tain LV = Transbond Supreme LV = Transbond XT> Sondhi Rapid-Set > Custom I.Q.). There was no significant difference in resistance values between 10 min and 24 h, regardless of the materials. Most groups showed adhesive remaining adhered to the enamel (scores 2 and 3) without statistically significant difference (p>0.05). CONCLUSIONS: It was concluded that the light-cured nanofilled materials used in indirect bonding showed greater resistance than the chemically cured materials. The period of fixation had no influence on the resistance for different materials.

Resumo em Inglês:

AIM: To evaluate oral health-related quality of life of preschool children of Bauru, State of São Paulo, Brazil, and associate it with socioeconomic profile of households. METHODS: The sample consisted of 229 preschool children between 3 and 5 years and the dmft (decayed, missing due to caries, filled teeth) index was adopted for assessment children's dental caries in accordance with the standards recommended by the World Health Organization. Questionnaires were used for evaluation oral health-related quality of life (Early Childhood Oral Health Impact Scale) and socioeconomic profile of parents or guardians of the preschool children. Statistical analysis was performed descriptively by relative and absolute frequencies and by Spearman's correlation and Kruskal-Wallis test (p <0.05). RESULTS: A dmft of 1.65 (± 2.87) and a Sic Index 4.88 (± 3.20) were found, indicating the polarization of dental caries in the studied group. It was verified low influence of oral health on quality of life of the children examined. With respect to socioeconomic classification, 66.38% of families were in the lower middle class. Linear and statistically significant correlation was found between dmft and oral health-related quality of life for the overall score and domains of the questionnaire (p<0.001). CONCLUSIONS: It was found low influence of oral health on quality of life of the preschool children and the assessment of socioeconomic conditions of the children's families may guide practices aiming to reducing inequalities in the distribution of dental caries in the population.

Resumo em Inglês:

AIM: In this study, the degree of conversion (DC) was analyzed on the surfaces of dental composite resins cured in different mould materials with different irradiation times. METHODS: Samples of three composite resins (Grandio®, Grandio Flow® [thickness = 2 mm; 4 mm; Ø = 5 mm] irradiated for 10 s, 20 s and 40 s and an experimental composite (EXPM) [thickness = 6 mm; Ø = 5 mm] irradiated for 40 s) were cured in moulds made of polytetrafluorethylene (PTFE), high-density polyethylene (HDPE) and stainless steel (SS). The DC was analyzed by FT-Raman spectroscopy. RESULTS: The DC was significantly lower for the 2-mm-thick samples of Grandio® cured with 20 s in the SS mould than in the PTFE mould. The same trend was found for the 4-mm-thick samples of Grandio Flow® cured with 40 s. The main difference of the DC between Grandio® and Grandio Flow® occurred when 10 s irradiation was used, independently of the mould material and thickness of the samples. The analysis of the DC on the sites around the samples of EXPM showed no significant difference from those at the bottom when cured in each mould material with 40 s irradiation. CONCLUSIONS: The DC was not affected by the mould material, instead, the resin formulation and the irradiation times were the main factors affecting the degree of conversion.

Resumo em Inglês:

AIM: To evaluate the clinical status of permanent first molars and associations with dental caries, gingival bleeding, dental fluorosis and malocclusion. METHODS: An observational study was carried out in a rural community denominated Morro do Saboó in the city of São Roque, state of São Paulo, Brazil. A total of 194 children aged seven to ten years were examined for dental caries using the index proposed by the World Health Organization. Other conditions were determined using the Gingival Alterations Index, Dean's Index and Dental Aesthetic Index. The chi-squared test was used for the statistical analysis of the data. RESULTS: A total of 85.5% of the sample exhibited gingival bleeding and 69.9% exhibited malocclusion. A total of 53.6% had a clinical aspect of normality with regard to dental fluorosis. There was a predominance of sound teeth in the upper arch and teeth with carious lesions in the lower arch. No significant differences were found between sexes regarding gingival bleeding, dental fluorosis or malocclusion. Significant associations were found between tooth status and oral alterations (gingival bleeding, malocclusion and fluorosis) in teeth 16, 26 and 46 and between tooth status and gingival bleeding in tooth 36 (p<0.001). CONCLUSIONS: Caries activity in the permanent first molars was mainly associated with dental fluorosis and malocclusion. Strategies aimed at health promotion should be adopted on a large scale to minimize the prevalence of oral diseases.

Resumo em Inglês:

AIM: Knowledge of enamel thickness is relevant to perform stripping during orthodontic treatment. Thus, proximal enamel measurements of human permanent teeth were compared in this study. METHODS: The measurements were previously obtained on cut sections of mandibular central (n = 30) and lateral (n = 30) incisors, canines (n = 20), first (n = 40) and second (n = 40) premolars; maxillary central (n = 20) and lateral (n = 20) incisors, canines (n = 20), first (n = 40) and second (n = 42) premolars. Comparisons between thicknesses by arch side and proximal surface were carried out using Student's t-tests (α = 0.05). Teeth were compared according to the mesial and distal thicknesses by ANOVA and Tukey's test. RESULTS: No significant differences were found between right and left teeth. For the mesial surface, the mandibular second premolar presented the highest mean value (1.376 mm ± 0.198; p<0.001). The mandibular central incisor had the smallest thickness in relation to the other teeth (0.675 mm ± 0.144), although not significant compared with the mandibular lateral incisor and canine (0.734-0.781 mm). The mandibular second premolar also presented the higher distal thickness in relation to the others (1.450 mm ± 0.172), although not significant compared with the maxillary first premolar (1.322 mm ± 0.195). Mandibular incisors had the lowest means for distal thickness (0.872-0.879 mm), although not statistically different compared with maxillary incisors and mandibular canine (1.002-1.015 mm). Distal thickness was greater than mesial (p<0.001). CONCLUSIONS: Interproximal stripping should be less marked in incisors and mesial surfaces.

Resumo em Inglês:

AIM: This study analyzed and compared the experience of dental caries in 300 children aged 0 to 48 months, who were participants and non-participants of a preventive program 'Dentistry for babies', as well as the correlation between assiduity of dental visits and experience of dental caries. METHODS: The subjects were randomly selected and divided into two groups: G1 'Non participant children of the Program' (n=100) and G2 'Participant Children of the Program' (n=200). Each group was subdivided in two subgroups: 0-24 months and 25-48 months. The collected data from G2 were analyzed, relating the variation of the dmft index (dmft refers to primary teeth: d = decayed, m = missing/extracted due to caries, f = filled, t = teeth) (C) and dental caries prevalence (P) with the influence of assiduity factor in each subgroup. To collect data, clinical examinations were performed using tactile and visual criteria by a single calibrated examiner. The data were statistically analyzed using the 'paired t-test', 'Mann-Whitney' and 'Chi-Squared' tests (p<0.05). RESULTS: It was found that prevalence and dmft index were statistically significant (P=0.0001) with the greatest values observed in G1 (p=0.0001). The values were: PG1 (73%), PG2 (22%), CG1 (3.45±3.84), CG2 (0.66±1.57). Assiduity was significant in G2 (p=0.0001). The values observed were: P-Assiduous (2%), P-Non-assiduous (42%), C-Assiduous (0.04±0.31), and C-Non-assiduous (1.29±2.01). CONCLUSIONS: The participation in the program had a positive influence on the oral health of babies. Complete assiduity to the program resulted in the lowest rates and prevalence of dental caries.

Resumo em Inglês:

AIM: To identify the most important factors involved in dentistry absenteeism since the foundation of the Labor Court in Campinas, SP, Brazil, until December 2008; to verify if there was a decrease in dentistry absenteeism after the introduction of the dental service in the headquarters of the Court; to verify if dentistry absenteeism is greater in the others cities of the region compared with the city of Campinas. METHODS: The information was collected from the dental statements of the archives of the Health Department of the Labor Court. Collected information included: International Classification of Diseases (ICD-10), gender, age, function, origin of the statements, period of the absenteeism and year when the absence occurred. RESULTS: 3,084 health files from server group (2,741) and judges (343) were reviewed. The results indicated: higher prevalence of female gender, higher frequency in the age group from 30 to 40 years old and the smallest frequency in the age group upper from 60 years old. It was found an average sick-leave period of 1.93 days. According to the International Classification of Diseases (ICD)-10, the most prevalent dental problems found in this study were: K01 (25.78%), K04 (10.57%) and K05 (6.37%). CONCLUSIONS: The results of this study pointed to lower rates of absenteeism than the results found in the literature. The introduction of the dental service did not have influence on the rates of absenteeism of the area; however it influenced the absenteeism rates in the city of Campinas (headquarters of the Court).

Resumo em Inglês:

Pediatric angioedema exhibits a different cause and clinical manifestations than does adult angioedema. Unlike angioedema in adults, pediatric angioedema is caused mostly due to food, followed by insect bites, infection and antibiotics. Reactions to insect stings, both allergic and toxic, are commonly seen in medical pediatric practice but uncommonly encountered by pediatric dentists. Here we present two cases of angioedema involving the face mainly in children who presented insect bite in the affected region. Treatment and case resolution are described.

Resumo em Inglês:

Odontomas are the most common benign, slow-growing and nonaggressive odontogenic tumors of the jaws. They are usually clinically asymptomatic and are diagnosed on routine radiological examination in the second decade of life. The eruption and infection of odontomas are uncommon and very few cases are reported in the literature. This paper reports two cases of complex odontomas with such unusual features.

Resumo em Inglês:

Cemento-osseous dysplasia is a group of disorders known to originate from periodontal ligament tissues. Florid cemento-osseous dysplasia clearly appears to be a form of bone and/or cementoid tissues restricted to jaw bones. This lesion is usually asymptomatic and is incidentally detected during routine radiographic examination. The diagnosis is made by clinical and radiographic examinations, and biopsy is not necessary. The patient must manifest the typical changes in at least two quadrants. An asymptomatic individual requires only a periodic follow-up to ensure that there is no change in the disease behavior. Surgical management is indicated only for a progressive lesion that produces orofacial disfigurement. This paper presents a rare case of a 60-year-old female who was clinically and radiographically diagnosed as having florid cemento-osseous dysplasia in the maxilla and mandible. Discussion is presented with emphasis on clinical and radiographic manifestations.