Abstract in English:AIM: This study compared the resistance to fracture of endodontically treated teeth restored with different intraradicular posts with different lengths and full coverage metallic crowns. METHODS: Sixty extracted human canine teeth were randomly divided into 6 groups. Groups CP5, CP75 and CP10 were restored using custom cast post and core (CP) and groups PF5, PF75 and PF10 were restored with provisional pre-fabricated tin post (PF) and composite resin core at 5 mm, 7.5 mm and 10 mm of intraradicular length, respectively. The specimens were submitted to dynamic cyclic loading and those that resisted to this load were submitted to load compression using a universal testing machine. Compressive load was applied at a 45-degree angle to the long axis of the tooth until failure. RESULTS: Kruskal-Wallis one-way analysis of variance by ranks showed statistically significant differences among the groups (p<0.0001). However, when the means were compared using the Tukey's test, significant differences were noted between groups CP5 and CP10 and between groups CP10 and PF5. All groups presented root fractures and post displacements during mechanical cycling. All teeth in groups CP5 and PF5 failed the dynamic cycling test. CONCLUSIONS: This study showed that increasing intraradicular post length also increases resistance to fracture of endodontically treated teeth. On the other hand, most endodontically treated teeth restored with pre-fabricated tin posts (provisional posts) failed in the dynamic cycling test.
Abstract in English:AIM: To evaluate the objective oral health conditions and self-perception of edentulous individuals wearing functional complete dentures (FCD) and non-functional complete dentures (NFCD) and completely edentulous non-denture wearers, and identify the factors that influence self-evaluation and the impact on quality of life. METHODS: The convenience sample was selected at the integrated clinic of a Dentistry Course (n=193) and was divided into 3 groups: FCD wearers (n= 54); NFCD wearers (n= 65); 3- edentulous non-denture wearers (n= 74). Data collection was performed by means of interviews, application of the Geriatric Oral Health Assessment Index (GOHAI) and clinical exams. Data were submitted to univariate analysis and logistic regression, considering dichotomization of the sample by the median value of GOHAI (=30). RESULTS: Individuals with NFCD are 4.5 times more likely to show a low GOHAI score than individuals with FCD; edentulous individuals are 7.5 times more likely to show a low GOHAI score than individuals with FCD; individuals that consider their oral health as regular, poor or bad are 3.1 times more likely to show a low GOHAI score than individuals who consider their oral health as good or excellent. CONCLUSIONS: Being completely edentulous or wearing NFCD, and having oral health classified as regular, poor or extremely bad were important features for a negative self-perception of oral health, with impact on quality of life.
Abstract in English:AIM: To assess the influence of dental etching on the shear strength of different glass ionomer cements. METHODS: The crown of 60 bovine incisors was prepared to obtain a flat, smooth surface, were attached to a PVC tube and randomly divided into six groups: Group 1 - Riva Self Cure without etching; Group II - Riva Self Cure with pre-etching; Group III - Maxxion R without etching; Group IV - Maxxion R with pre-etching; Group V - KetacTM Molar Easymix without etching; and Group VI - KetacTM Molar Easymix with pre-etching. Etching was performed with 10% polyacrylic acid for 30 s. A standardizing device was used for preparation of the test specimens (SBS Test Method). Following preparation, the specimens were stored in distilled water at 37° C for 24 h. The shear test was performed on a Kratos universal testing machine at a crosshead speed of 0.5 mm/min. The specimens were then viewed under a stereomicroscope at a magnification of x90 for analysis of fractures. RESULTS: The results revealed that pre-etching increased the shear strength of Riva glass ionomer cement (SDI) alone, whereas no statistically significant differences were found with regard to the other materials tested. CONCLUSIONS: Pre-etching with 10% polyacrylic acid for 30 s increased the shear strength of Riva glass ionomer cement.
Abstract in English:AIM: To compare panoramic radiography and cone beam computed tomography (CBCT) in the diagnosis of bifid mandibular condyle. METHODS: The sample consisted of 350 individuals who underwent panoramic radiography and CBCT. In the panoramic radiographs and CBCT images, the presence or absence of bifid mandibular condyle was determined. RESULTS: Presence of bifid mandibular condyle was detected in four cases (1.1%). In all cases, the relation of one condylar process to the other was mediolateral and history of trauma was reported. None of the individuals had symptoms. In two cases, panoramic radiography did not reveal the presence of bifid mandibular condyle. CONCLUSIONS: Initial screening for bifid mandibular condyle can be performed by panoramic radiography; however, CBCT images can reveal morphological changes and the exact orientation of the condyle heads.
Abstract in English:AIM: To examine whether the depression is associated with periodontitis in elderly and to evaluate oral hygiene of these patients. METHODS: One hundred and ninety one individuals aged 60 years or more were randomly selected. Periodontal examination was performed in full mouth by probing depth and clinical attachment loss in 6 sites for each tooth. The Simplified Oral Hygiene Index (OHI-S) per individual was also obtained. Depression was assessed by the Geriatric Depression Scale (GDS-15) to show how the elderly have been feeling during the last week. RESULTS: Only SOHI was statistically significant (t = 4.7169, p<0.001), which better explains the variance in periodontal status. The variable GDS-15 revealed no significant values (t=0.3901, p=0.6971). CONCLUSIONS: There was no association between periodontitis and depression in elderly, but there was association between periodontitis and oral hygiene.
Abstract in English:AIM: To assess clinicopathological features of patients with keratocystic odontogenic tumor (KCOT) associated with nevoid basal cell carcinoma syndrome (NBCCS) in a single Brazilian institution. METHODS: After histopathological analyses of KCOT related to NBCCS, the medical charts of 14 patients were assessed. These patients presented a total of 31 primary and 8 recurrent KCOT. RESULTS: Out of 14 patients, 8 presented a single KCOT, 4 showed synchronous tumors, 1 had 3 metachronous lesions and another patient had 2 synchronous lesions at initial evaluation and then developed other 3 metachronous lesions. Besides the 31 primary KCOTs, 18 lesions were located in mandible and 13 in maxilla. Most tumors presented unilocular pattern and association with a tooth. CONCLUSIONS: KCOT is a frequent manifestation of NBCCS and can be its first sign, mainly in young patients. In contrast to a previously published series, most patients presented a single lesion.
Abstract in English:AIM: To evaluate the morphological aspects of coronal dentinogenesis in the first molars of 1- and 5-day-old rats whose mothers were treated with fluoxetine hydrochloride during pregnancy. METHODS: Twelve pregnant Wistar rats were divided randomly into three groups: group C (control), group FL (fluoxetine administered at 10 mg/kg bodyweight), and group FX (fluoxetine administered at 20 mg/kg bodyweight). Saline (0.9%) solution or fluoxetine hydrochloride was administered subcutaneously for the first 21 days of pregnancy. Subsequently, the offspring of these animals was subdivided into subgroups according to age of tooth germ development to be studied: 1 and 5 days of life. C1 and C5 (control group 1 and 5 days of age); FL1 and FL5 (groups treated with 10 mg/kg fluoxetine at 1 and 5 days of age); FX5 and FX1 (groups treated with 20 mg/ kg fluoxetine at 1 and 5 days of age). RESULTS: No structural changes in the dentin-pulp complex of rats whose mothers were treated with fluoxetine hydrochloride were observed at either dose. CONCLUSIONS: Fluoxetine, at the doses administered during pregnancy in this study, did not alter the morphological development of the coronal dentin-pulp complex in their offspring.
Abstract in English:AIM: To compare two main methods of two-dimensional measurement of fit at the implant prosthodontic interface, testing the hypothesis that optical microscopy (OM) can reliably and efficiently scanning electronic microscopy (SEM). METHODS: Four frameworks with four titanium abutments joined with titanium bars were used. The implant-abutment interfaces were examined by three different methods, forming 3 groups: analysis by OM (40x), and analysis by SEM at 300x and 500x. Readings were taken at the mesial and distal proximal surfaces on the horizontal and vertical axes of each implant (n=32). One-way ANOVA with a significance level of 5% was used for statistical analysis. RESULTS: Neither the horizontal fit nor vertical fit values of the 3 groups presented statistically significant differences (p=0.410 and p=0.543). CONCLUSIONS: OM was found to be an accurate two-dimensional method for abutment-framework or implant-abutment interface measurements, with lower costs than SEM. SEM micrographs at 500x presented technical difficulties for the readings that might produce different results.
Abstract in English:AIM: To evaluate the frictional force between the archwire and orthodontic bracket generated by elastomeric ligatures with polymer coating (Super slick, TP Orthodontics) and conventional ligatures (Morelli) using two types of insertion techniques. METHODS: Forty elastomeric ligatures, 20 with polymer coating and 20 conventional, were evaluated. Each type of ligature was separated into two groups (n=10), according to the insertion mode: conventional or crossed (from mesial to distal region crossed in front). To analyze friction, 40 5-cm-long segments of stainless steel orthodontic archwire 0.019" x 0.025" (Morelli) and Edgewise brackets (slot 0.022" x 0.028"; Morelli) were used. Each set (bracket, wire and elastic) was submitted to frictional testing in a universal test machine (Instron 4411) at a crosshead speed of 5 mm/min. Each bracket was moved 5 mm on the wire, with maximum friction and mean friction being recorded by software. Three readouts were taken for each bracket. Data were submitted to two-way ANOVA and Tukey's test (p<0.05). RESULTS: It was shown that for maximum and mean friction, the polymer-coated ligature did not differ statistically from the conventional type in a dry environment condition. Ligatures placed in crossed mode promoted significantly greater friction than those placed in conventional mode, irrespective of the type of elastomeric ligature. CONCLUSIONS: Friction depended on the insertion mode, but not on the type of elastomeric ligature.
Abstract in English:The aim of this paper is to describe an efficient clinical protocol used in admittance dental examinations, highlighting the importance of this evaluation in the diagnosis of oral pathologies. Two admission case reports in which gingival abscess and radiopaque apical lesion were found during the examination are presented for illustration purposes. A clinical examination in the admission inspection is the main factor for a good selection of treatment and prevention of future difficulties. The admission dental examination by means of a standardized clinical approach including clinical interview, physical examination and complementary exams, avoids the person to be admitted to the public service while having some pathology that might compromises his/her capacity of handling the selected function, preventing absenteeism for dental reasons and consequently a cost to the state and functional repercussion to the server.
Abstract in English:The purpose of this paper is to present two cases of dentigerous cyst associated to permanent teeth in children treated by conservative techniques. Dentigerous cyst is the most common developmental cysts of the jaws. Conservative treatment is very effective to this entity and aims at eliminating the cystic tissue and preserving the permanent tooth involved in the pathology. Two techniques are described as conservative treatment for these cysts, marsupialization and the decompression. Two children presented with dentigerous cysts. A female child was affected by a large lesion at the right side of the mandible associated to tooth 45. The other lesion arose at the left maxilla associated to tooth 21 of a male child. Each dentigerous cyst promoted severe tooth displacement. The first patient was treated with decompression and the second with marsupialization.
Abstract in English:Post-poliomyelitis syndrome (PPS) is characterized by the delayed appearance of new neuromuscular symptoms in patients several years after their acute poliomyelitis paralysis. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. The diagnosis is essentially clinical after excluding other neurological, orthopedic or rheumatologic problems. Temporomandibular disorders (TMD) are usually diagnosed by means of comprehensive review of patient history and clinical examination and the symptoms are pain/ discomfort in the jaw, mainly in the region of the temporomandibular joints (TMJs) and/or masticatory muscles, limitation of mandibular function and/or TMJ sounds. In the same way as PPS, the diagnosis of TMD is challenging. This study reports the case of a patient that presented the symptoms of both conditions in the stomatognathic system, and discusses how to achieve the differential diagnosis for proper management of the cases.
Abstract in English:Dens invaginatus, also known as "dens in dente", is a developmental dental anomaly resulting in an invagination of the enamel organ into the dental papilla. These cases present technical difficulties to the root canal treatment. Apexification using an apical plug of mineral trioxide aggregate (MTA) has been indicated as an alternative to long-term intracanal use of calcium hydroxide in immature permanent teeth. It is considered as a simple and rapid technique. This paper reports a case of Oehlers' Type 1 dens invaginatus in an immature permanent maxillary right lateral incisor, which presented pulp necrosis secondary to dental trauma and was treated by apexification with white MTA apical plugging followed by conventional root canal therapy. The operative procedures are described and the technique is discussed. The physical and biological properties of MTA, associated with appropriate instrumentation and obturation techniques, make this material an excellent option in the endodontic therapy of immature permanent teeth with dens invaginatus.
Abstract in English:Biomaterials such as membrane barriers and/or bone grafts are often used to enhance periapical new bone formation. A combination of apical surgery and these biomaterials is one of the latest treatment options for avoiding tooth extraction. In case of periapical lesions, guided tissue regeneration (GTR) is attempted to improve the self-regenerative healing process by excluding undesired proliferation of the gingival connective tissue or migration of the oral epithelial cells into osseous defects. In many cases, GTR is necessary for achieving periodontal tissue healing. This report describes the healing process after surgery in a challenging case with a long-term follow-up. In this case report, endodontic surgery was followed by retrograde sealing with mineral trioxide aggregate (MTA) in the maxillary right central incisor and left lateral incisor. Apicectomy was performed in the maxillary left central incisor and a 1-mm filling was removed. The bone defect was filled with an anorganic bone graft and covered with a decalcified cortical osseous membrane. No intraoperative or postoperative complications were observed. After 13 years of follow-up, the patient showed no clinical signs or symptoms associated with the lesion and radiographic examination showed progressive resolution of radiolucency. In conclusion, the combination of apical surgery and regenerative techniques can successfully help the treatment of periapical lesions of endodontic origin and is suitable for the management of challenging cases.
Abstract in English:The orthokeratinized odontogenic cyst (OOC) is a rare developmental jaw cyst. Recognition of OOC as a unique entity has long been due, yet its inexplicable radiographic presentation resembling dentigerous cyst, histological likeness to odontogenic keratocyst (OKC) and inconsistent cytokeratin expression profiles overlapping with both as well as with the epidermis, makes it rather confounding. Diagnosis of OOC is important as the pathologic behavior, clinical outcome and the surgical management of OOC is disparate. This is the report of a case of OOC in relation to an impacted mandibular third molar and critical review of this entity with an emphasis on its biologic characteristics is highlighted.