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Journal of Applied Oral Science, Volume: 18, Número: 1, Publicado: 2010
  • Editorial

    Santos, Carlos F.
  • The correct use of the ART approach Review

    Frencken, Jo E.; Leal, Soraya Coelho

    Resumo em Inglês:

    Confusion exists amongst dentists and scientists about the correct use of the caries management approach termed atraumatic restorative treatment (ART). Inconsistent use of the original definition of ART and suggested modifications (mART) have led to misunderstanding, misconception and miscommunication in the dental literature over the last decade. The aim of this paper is to contribute to a uniform understanding and use of the term ART. Adherence to its original description is suggested and two major aspects were addressed: the use of hand instruments only and the use of adhesive materials and systems.
  • A retrospective study of trauma-associated oral and maxillofacial lesions in a population from southern Taiwan Original Articles

    Chen, Jing-Yi; Wang, Wen-Chen; Chen, Yuk-Kwan; Lin, Li-Min

    Resumo em Inglês:

    OBJECTIVE: The aim of this retrospective analysis was to determine the age, gender, frequency and distribution of trauma-associated hard tissue and soft tissue lesions of the oral and maxillofacial region in a population from southern Taiwan. PATIENTS AND METHODS: Approximately 10% of the 27,995 biopsy records of patients with history of trauma resulting in lesions who were treated at our institution between 1991 and 2006 were examined for this study. RESULTS: In the included records, there were 2,762 soft tissue and 26 hard tissue lesions. Mucocele was the most frequent trauma-associated soft tissue lesion (955 cases). The youngest patients were those who presented with mucocele (mean age = 27.3 years), while the oldest patients were those with peripheral giant cell granuloma (58 years). The lower lip was the most frequent site of occurrence of mucocele (676, 64.5%) and was also the predominant site of occurrence of all soft tissue lesions (815, 29.5%), followed by the buccal mucosa (654, 23.4%) and the tongue (392, 14.2%). Trauma-associated hard tissue lesions included only osteoradionecrosis (24 cases) and traumatic bone cysts (2 cases). CONCLUSION: As little data of this nature have been reported from populations of Asian developing countries, the findings of this retrospective analysis is valuable for epidemiological documentation of type of traumatic oral lesions as well as for informing the professionals and the layman about the importance of this category of oral lesions.
  • Effects of different polishing techniques on the surface roughness of dental porcelains Original Articles

    Sarikaya, Işil; Güler, Ahmet Umut

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to evaluate the effects of different polishing techniques on the surface roughness of dental porcelains. MATERIAL AND METHODS: Fifty-five cylindirical specimens (15x2 mm) were prepared for each feldspathic (Vita VMK 95, Ceramco III) and low-fusing dental porcelain (Matchmaker). Fifty-five specimens of machinable feldspathic porcelain blocks (Vitablocs Mark II), (12x14x18 mm) were cut into 2-mm-thick slices (12x14 mm) with low speed saw. The prepared specimens were divided into 11 groups (n=5) representing different polishing techniques including control ((C) no surface treatment), glaze (G) and other 9 groups that were finished and polished with polishing discs (Sof-Lex) (Sl), two porcelain polishing kits (NTI (Pk), Dialite II (Di)), a diamond polishing paste (Sparkle) (Sp), a zirconium silicate based cleaning and polishing prophy paste (Zircate) (Zr), an aluminum oxide polishing paste (Prisma Gloss) (Pg), and combinations of them. The surface roughness of all groups was measured with a profilometer. The data were analyzed with a 2-way analysis of variance, and the mean values were compared by the Tukey Honestly Significant Difference test (a=0.05). RESULTS: For all porcelain material groups, the lowest Ra values were observed in Group Gl, Group Sl, Group Pk, and Group Di, which were not significantly different from each other (p>0.05).When comparing the 4 different porcelain materials, the machinable feldspathic porcelain block group (Mark II) demonstrated statistically significantly less Ra values than the other porcelain materials tested (p<0.05). No significant difference was observed between the VMK 95 and Ceramco III porcelain groups (p=0.919), also these groups demonstrated the highest Ra values. CONCLUSION: Subjected to surface roughness, the surfaces obtained with polishing and/or cleaning-prophy paste materials used alone were rougher compared to the surfaces finished using Sof-lex, Dialite, and NTI polishing kit. Polishing kits and discs were found more effective than the polishing pastes used alone or combined use with Sof-lex discs, thus improving surface smoothness.
  • Mandibular fractures: a comparative analysis between young and adult patients in the southeast region of Turkey Original Articles

    Atilgan, Serhat; Erol, Behçet; Yaman, Ferhan; Yilmaz, Nezih; Ucan, Musa Can

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to review and compare the differences between mandibular fractures in young and adult patients. MATERIAL AND METHODS: Patients treated at the Oral and Maxillofacial Department of Dicle University during a five-year period between 2000 and 2005 were retrospectively evaluated with respect to age groups, gender, etiology, localization and type of fractures, treatment methods and complications. RESULTS: 532 patients were included in the study, 370 (70%) males and 162 (30%) females, with a total of 744 mandibular fractures. The mean age of young patients was 10, with a male-female ratio of 2:1. The mean age of adult patients was 28, with a male-female ratio of 3:1. The most common causes of injury were falls (65%) in young patients and traffic accidents (38%) in adults. The most common fracture sites were the symphysis (35%) and condyle (36%) in young patients, and the symphysis in adults (36%). Mandibular fractures were generally treated by arch bar and maxillomandibular fixation in both young (67%) and adult (39%) patients, and 43% of the adult patients were treated by open reduction and internal fixation. CONCLUSION: There was a similar gender, monthly and type of treatment distribution in both young and adult patients in the southeast region of Turkey. However, there were differences regarding age, etiology and fracture site. These findings between young and adult patients are broadly similar to those from other studies. Analysis of small differences may be an important factor in assessing educational and socioeconomic environments.
  • Risk factors for maxillofacial injuries in a Brazilian emergency hospital sample Original Articles

    Leles, José Luiz Rodrigues; Santos, Ênio José dos; Jorge, Fabrício David; Silva, Erica Tatiane da; Leles, Cláudio Rodrigues

    Resumo em Inglês:

    BACKGROUND: Maxillofacial injuries occur in a significant number of trauma patients. Epidemiological assessments are essential to reaffirm patterns, identify new trends and develop clinical and research priorities for effective treatment and prevention of these injuries. OBJECTIVE: The aim of this study was to identify the epidemiological profile and risk factors associated with maxillofacial trauma treated at a referral emergency hospital for the Public Health System in the State Capital of Goiás, Brazil. MATERIAL AND METHODS: A cross-sectional study was designed including 530 patients with maxillofacial trauma, 76% male, with a mean age of 25.5±15.0 years. Data were collected between May 2003 and August 2004 over weekly shift-working periods. RESULTS: The main causes of trauma were traffic accidents (45.7%) and physical assaults (24.3%), and differences in etiological factors were identified according to gender (p<0.001). The distribution of patients according to age and etiology showed significant differences for traffic accidents (p<0.01), physical assaults (p<0.001), falls (p<0.001) and sport injuries (p<0.01). In the multinomial logistic regression analysis (R² = 0.233; p<0.05), age was associated with injury in traffic accidents and falls (p<0.01), sports-related accidents were associated with males (p<0.05), and alcohol consumption with assaults and traffic accidents (p<0.001). Facial soft tissue lesions were found in 98% of patients and facial fractures in 51%. CONCLUSIONS: The significant association of maxillofacial trauma with young males and alcohol consumption reinforces the need for educational strategies and the development of policies for the prevention and reduction of associated damage in this specific risk group.
  • Effect of temporary cements on the shear bond strength of luting cements Original Articles

    Fiori-Júnior, Marco; Matsumoto, Wilson; Silva, Raquel Assed Bezerra; Porto-Neto, Sizenando Toledo; Silva, Jaciara Miranda Gomes

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to evaluate, by shear bond strength (SBS) testing, the influence of different types of temporary cements on the final cementation using conventional and self-etching resin-based luting cements. Material and Methods: Forty human teeth divided in two halves were assigned to 8 groups (n=10): I and V (no temporary cementation); II and VI: Ca(OH)2-based cement; III and VII: zinc oxide (ZO)-based cement; IV and VIII: ZO-eugenol (ZOE)-based cement. Final cementation was done with RelyX ARC cement (groups I to IV) and RelyX Unicem cement (groups V to VIII). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. RESULTS: Means were (MPa): I - 3.80 (±1.481); II - 5.24 (±2.297); III - 6.98 (±1.885); IV - 6.54 (±1.459); V - 5.22 (±2.465); VI - 4.48 (±1.705); VII - 6.29 (±2.280); VIII - 2.47 (±2.076). Comparison of the groups that had the same temporary cementation (Groups II and VI; III and VII; IV and VIII) showed statistically significant difference (p<0.001) only between Groups IV and VIII, in which ZOE-based cements were used. The use of either Ca(OH)2-based (Groups II and VI) or ZO-based (Groups III and VII) cements showed no statistically significant difference (p>0.05) for the different luting cements (RelyX TM ARC and RelyX TM Unicem). The groups that had no temporary cementation (Groups I and V) did not differ significantly from each other either (p>0.05). CONCLUSION: When temporary cementation was done with ZO- or ZOE-based cements and final cementation was done with RelyX ARC, there was an increase in the SBS compared to the control. In the groups cemented with RelyX Unicem, however, the use of a ZOE-based temporary cement affected negatively the SBS of the luting agent used for final cementation.
  • Influence of different restorative techniques on marginal seal of class II composite restorations Original Articles

    Rodrigues Junior, Sinval Adalberto; Pin, Lúcio Fernando da Silva; Machado, Giovanna; Della Bona, Álvaro; Demarco, Flávio Fernando

    Resumo em Inglês:

    OBJECTIVE: To evaluate the gingival marginal seal in class II composite restorations using different restorative techniques. MATERIAL AND METHODS: Class II box cavities were prepared in both proximal faces of 32 sound human third molars with gingival margins located in either enamel or dentin/cementum. Restorations were performed as follows: G1 (control): composite, conventional light curing technique; G2: composite, soft-start technique; G3: amalgam/composite association (amalcomp); and G4: resin-modified glass ionomer cement/composite, open sandwich technique. The restored specimens were thermocycled. Epoxy resin replicas were made and coated for scanning electron microscopy examination. For microleakage evaluation, teeth were coated with nail polish and immersed in dye solution. Teeth were cut in 3 slices and dye penetration was recorded (mm), digitized and analyzed with Image Tool software. Microleakage data were analyzed statistically by non-parametric Kruskal-Wallis and Mann-Whitney tests. RESULTS: Leakage in enamel was lower than in dentin (p<0.001). G2 exhibited the lowest leakage values (p<0.05) in enamel margins, with no differences between the other groups. In dentin margins, groups G1 and G2 had similar behavior and both showed less leakage (p<0.05) than groups G3 and G4. SEM micrographs revealed different marginal adaptation patterns for the different techniques and for the different substrates. CONCLUSION: The soft-start technique showed no leakage in enamel margins and produced similar values to those of the conventional (control) technique for dentin margins.
  • Geometric and dimensional characteristics of simulated curved canals prepared with proTaper instruments Original Articles

    Martins, Renata de Castro; Bahia, Maria Guiomar de Azevedo; Buono, Vicente Tadeu Lopes

    Resumo em Inglês:

    OBJECTIVE: This study identified which regions of ProTaper instruments work during curved root canal instrumentation. MATERIAL AND METHODS: Twelve ProTaper instruments of each type, S1, S2, F1, and F2, were assessed morphometrically by measuring tip angle, tip length, tip diameter, length of each pitch along the cutting blades, and instrument diameter at each millimeter from the tip. Curved canals in resin blocks were explored with manual stainless steel files and prepared with ProTaper instruments until the apical end following four distinct sequences of instrumentation: S1; S1 and S2; S1, S2, and F1; S1, S2, F1, and F2. Image analysis was employed for measuring canal diameters. The diameters of the canals and diameters of the instruments were compared. Data were analyzed by one-way ANOVA and Tukey's test. RESULTS: No statistically significant difference was found between the canals and instrument diameters (p>0.05). The largest diameters in the end-point of the instrumented canals were obtained with F1 and F2 instruments and in the initial and middle thirds with S1 and S2 instruments. CONCLUSIONS: All instruments worked at the tip and along their cutting blades, being susceptible to fail by torsion, fatigue, or the combination of these two mechanisms.
  • Toxicity of chlorhexidine on odontoblast-like cells Original Articles

    Lessa, Fernanda Campos Rosetti; Aranha, Andreza Maria Fabio; Nogueira, Indri; Giro, Elisa Maria Aparecida; Hebling, Josimeri; Costa, Carlos Alberto de Souza

    Resumo em Inglês:

    Chlorhexidine gluconate (CHX) is recommended for a number of clinical procedures and it has been pointed out as a potential cavity cleanser to be applied before adhesive restoration of dental cavities. OBJECTIVE: As CHX may diffuse through the dentinal tubules to reach a monolayer of odontoblasts that underlies the dentin substrate, this study evaluated the cytotoxic effects of different concentrations of CHX on cultured odontoblast-like cells (MDPC-23). MATERIAL AND METHODS: Cells were cultured and exposed to CHX solutions at concentrations of 0.06%, 0.12%, 0.2%, 1% and 2%. Pure culture medium (α-MEM) and 3% hydrogen peroxide were used as negative and positive control, respectively. After exposing the cultured cells to the controls and CHX solutions for 60 s, 2 h or 60 s with a 24-h recovery period, cell metabolism (MTT assay) and total protein concentration were evaluated. Cell morphology was assessed under scanning electron microscopy. CHX had a dose-dependent toxic effect on the MDPC-23 cells. RESULTS: Statistically significant difference was observed when the cells were exposed to CHX in all periods (p<0.05). Significant difference was also determined for all CHX concentrations (p<0.05). The 60-s exposure time was the least cytotoxic (p<0.05), while exposure to CHX for 60 s with a 24-h recovery period was the most toxic to the cells (p<0.05). CONCLUSION: Regardless of the exposure time, all CHX concentrations had a high direct cytotoxic effect to cultured MDPC-23 cells.
  • Effect of filler particles on surface roughness of experimental composite series Original Articles

    Marghalani, Hanadi Yousif

    Resumo em Inglês:

    OBJECTIVE: The purpose of this study was to evaluate the effect of different filler sizes and shapes on the surface roughness of experimental resin-composite series. MATERIAL AND METHODS: Thirty-three disc-shaped specimens of the series (Spherical-RZD 102, 105, 106, 107, 114 and Irregular-RZD 103, 108, 109, 110, 111, 112) were prepared in a split Teflon mold and irradiated with an halogen light-curing unit (450 mW/cm² for 40 s) at both top and bottom surfaces. The specimens were stored for 3 months in distilled water. The surface roughness values in form of surface finish-vertical parameter (Ra), maximum roughness depth (Rmax) and horizontal roughness parameter (Sm) were recorded using a contact profilometer. The data were analyzed by one-way ANOVA and the means were compared by Scheffé post-hoc test (a=0.05). RESULTS: The lowest surface roughness (Ra) was observed in S-100 (0.079±0.013), while the roughest surface was noted in I-450/700/1000 (0.125±0.011) and I-450/1000 (0.124±0.004). The spherical-shape series showed the smoothest surface finish compared to the irregular-shape ones with higher significant difference (p>0.05). The vertical surface roughness parameter (Ra) values increased as the filler size increased yielding a linear relation (r²=0.82). On the contrary, the horizontal parameter (Sm) was not significantly affected by the filler size (r²=0.24) as well as the filler shape. CONCLUSIONS: Filler particle's size and shape have a great effect on the surface roughness parameters of these composite series.
  • Effect of light-curing units in shear bond strength of metallic brackets: an in vitro study Original Articles

    Retamoso, Luciana Borges; Onofre, Niége Michelle Lazzari; Hann, Luciane; Marchioro, Ernani Menezes

    Resumo em Inglês:

    OBJECTIVES: To determine the influence of the light curing units on the shear bond strength of orthodontic brackets. MATERIAL AND METHODS: Seventy-two premolars were divided into six groups (n=12): Group I: brackets bonded with Transbond and polymerization with halogen light; Group II: Transbond and LED; Group III: Fuji Ortho and halogen light; Group IV: Fuji Ortho and LED; Group V: Fuji Ortho, without acid and halogen light; Group VI: Fuji Ortho, without acid and LED. The groups were tested to shear strength in a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by ANOVA and Tukey's test. RESULTS: The composite resin presented higher shear bond strength than the resin-modified glass ionomer cement (p<0.05). The halogen light and LED sources produced similar shear bond strength (p>0.05). CONCLUSION: The shear bond strength was influenced by the material but not by the light-curing unit. The use of LED reduced the experimental time by approximately 60%, with the same curing efficiency.
  • Evaluation of subcutaneous and alveolar implantation surgical sites in the study of the biological properties of root-end filling endodontic materials Original Articles

    Cintra, Luciano Tavares Angelo; Bernabé, Pedro Felício Estrada; Moraes, Ivaldo Gomes de; Gomes-Filho, João Eduardo; Okamoto, Tetuo; Consolaro, Alberto; Pinheiro, Tiago Novaes

    Resumo em Inglês:

    OBJECTIVE: The aim of this study was to compare two methodologies used in the evaluation of tissue response to root-end filling materials in rats. MATERIAL AND METHODS: Forty rats were divided into 4 groups: in Groups I and II (control groups), empty polyethylene tubes were implanted in the extraction site and in the subcutaneous tissue, respectively; in Groups III and IV, polyethylene tubes filled with ProRoot MTA were implanted in the extraction site and in the subcutaneous tissue, respectively. The animals were killed 7 and 30 days after tube implantation, and the hemi-maxillas and the capsular subcutaneous tissue, both with the tubes, were removed. Specimens were processed and evaluated histomorphologicaly under light microscopy. The scores obtained were analyzed statistically by the Kruskal-Wallis test (p<0.05). RESULTS: There were no statistically significant differences between the implantation methods (p=0.78033, p=0.72039). It was observed that the 30-day groups presented a more mature healing process due to smaller number of inflammatory cells. CONCLUSIONS: The present study showed no differences in tissue responses as far as the implantation site and the studied period were concerned. Alveolar socket implantation methodology represents an interesting method in the study of the biological properties of root-end filling endodontic materials due to the opportunity to evaluate bone tissue response.
  • FGF-2, TGFβ-1, PDGF-A and respective receptors expression in pleomorphic adenoma myoepithelial cells: an in vivo and in vitro study Original Articles

    Miguita, Lucyene; Martinez, Elizabeth Ferreira; Araújo, Ney Soares de; Araújo, Vera Cavalcanti de

    Resumo em Inglês:

    Myoepithelial cells have an important role in salivary gland tumor development, contributing to a low grade of aggressiveness of these tumors. Normal myoepithelial cells are known by their suppressor function presenting increased expression of extracellular matrix genes and protease inhibitors. The importance of stromal cells and growth factors during tumor initiation and progression has been highlighted by recent literature. Many tumors result from the alteration of paracrine growth factors pathways. Growth factors mediate a wide variety of biological processes such as development, tissue repair and tumorigenesis, and also contribute to cellular proliferation and transformation in neoplastic cells. OBJECTIVES: This study evaluated the expression of fibroblast growth factor-2 (FGF-2), transforming growth factor β-1 (TGFβ-1), platelet-derived growth factor-A (PDGF-A) and their respective receptors (FGFR-1, FGFR-2, TGFβR-II and PDGFR-α) in myoepithelial cells from pleomorphic adenomas (PA) by in vivo and in vitro experiments. MATERIAL AND METHODS: Serial sections were obtained from paraffin-embedded PA samples obtained from the school's files. Myoepithelial cells were obtained from explants of PA tumors provided by surgery from different donors. Immunohistochemistry, cell culture and immunofluorescence assays were used to evaluate growth factor expression. RESULTS: The present findings demonstrated that myoepithelial cells from PA were mainly positive to FGF-2 and FGFR-1 by immunohistochemistry and immunofluorescence. PDGF-A and PDGFR-α had moderate expression by immunohistochemistry and presented punctated deposits throughout cytoplasm of myoepithelial cells. FGFR-2, TGFβ-1 and TGFβR-II were negative in all samples. CONCLUSIONS: These data suggested that FGF-2 compared to the other studied growth factors has an important role in PA benign myoepithelial cells, probably contributing to proliferation of these cells through the FGFR-1.
  • Hybrid fixation in the bilateral sagittal split osteotomy for lower jaw advancement Case Report

    Pereira, Felipe Ladeira; Janson, Marcos; Sant'Ana, Eduardo

    Resumo em Inglês:

    Miniplate and screw fixation has been widely used in bilateral sagittal split osteotomy, but some issues remain unclear concerning its lack of rigidity when compared to Spiessl's bicortical technique. This paper demonstrates the hybrid fixation technique in a case report. A 34-year-old female patient underwent a double jaw surgery with counter-clockwise rotation of the mandible fixed using the hybrid fixation technique. The patient evolved well in the postoperative period and is still under follow up after 14 months, reporting satisfaction with the results and no significant deviation from the treatment plan up to now. No damage to tooth roots was done, maxillomandibular range of motion was within normality and regression of the inferior alveolar nerve paresthesia was observed bilaterally. The hybrid mandibular fixation is clearly visible in the panoramic and cephalometric control radiographs. It seems that the hybrid fixation can sum the advantages of both monocortical and bicortical techniques in lower jaw advancement, increasing fixation stability without significant damage to the mandibular articulation and the inferior alveolar nerve. A statistical investigation seems necessary to prove its efficacy.
  • Amalgam tattoo: a cause of sinusitis? Case Report

    Parizi, José Luiz Santos; Nai, Gisele Alborghetti

    Resumo em Inglês:

    Little attention has been paid to the toxicity of silver amalgam fillings, which have been used over the centuries in Dentistry. Amalgam particles may accidentally and/or traumatically be embedded into the submucosal tissue during placement of a restoration and perpetuate in such area. This article presents a case of amalgam tattoo and investigates whether it is related to the patient's repeated episodes of sinusitis. The patient was a 46-year-old woman with a 2 mm diameter radiopaque lesion in the right oral mucosa detected on a panoramic radiograph and presented as a black macula clinically. A complete surgical resection was carried out. The histopathological examination revealed deposits of dark-brownish pigments lining the submucosal tissue with adjacent lymphocytic inflammatory infiltrate and multinucleated giant cells phagocyting pigments. There was a negative staining for both iron and melanin. One year after lesion removal, the patient reported that the sinusitis crises had ceased after repeated episodes for years. It may be speculated that the inflammatory process related to amalgam tattoo seems to lead to a local immune response that causes sinusitis because it enhances the human leukocyte antigen DR (HLA-DR) tissue expression.
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