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Brazilian Oral Research, Volume: 27, Número: 3, Publicado: 2013
  • Reflection on the teaching of Cariology in Brazil Editorial

    Sampaio, Fabio Correia; Rodrigues, Jonas Almeida; Bönecker, Marcelo; Groisman, Sonia
  • The prevalence of elder abuse in the Porto Alegre metropolitan area Community Dentistry

    Santos, Camila Mello dos; Marchi, Renato Jose De; Martins, Aline Blaya; Hugo, Fernando Neves; Padilha, Dalva Maria Pereira; Hilgert, Juliana Balbinot

    Resumo em Inglês:

    Abuse of the elderly is a form of violence to come to the public's attention. Dental professionals are in an ideal position to identify physical abuse. The aim of this study was to assess the prevalence of elderly abuse and analyze the database of injury reports that can be identified by dental teams. A documentary analysis study developed by the Elderly Protection Police Station of Porto Alegre, Rio Grande do Sul, was carried out. The information used came from 2,304 complaints filed at the aforementioned institution between the years of 2004 and 2006. The records of abuse are categorized as injury, neglect, mistreatment, theft, financial abuse, threat, disturbing the peace, atypical fact, and others. The injuries that could be identified by the dental team were classified according to the injury's location in the area of the head, face, mouth and neck. Descriptive analysis was performed, and chi-square tests were used to evaluate the distributions of the types of elder abuse in relation to sex and age. The most frequent of the different types of abuse was theft, with a prevalence of 17.8%, followed by disturbing the peace at 11.8%. Disturbing the peace, threat, and bodily injury were significantly associated with women. Elder abuse among women and men declines with age. The prevalence of head injury was 25% of the total injuries, most often in females, and in those aged < 70 years. Based on these results, it is necessary that the dental team observe the elderly person's appearance for suspicious physical signs.
  • Association between self-rated oral appearance and the need for dental prostheses among elderly Brazilians Gerodontology

    Vilela, Emília Araújo; Martins, Andréa Maria Eleutério de Barros Lima; Barreto, Sandhi Maria; Vargas, Andréa Maria Duarte; Ferreira, Raquel Conceição

    Resumo em Inglês:

    We investigated the association between poor self-rated oral appearance and the need for dental prostheses among elderly Brazilians. National data from an epidemiological survey on oral health in Brazil conducted from 2002 to 2003 by the Ministry of Health (SB, Brazil) with a multistage random sample of 4,839 individuals aged 65–74 years in 250 towns were analyzed. The dependent variable was self-rated oral appearance, dichotomized into “poor” (poor∕very poor) and “good” (fair∕good∕very good). The main independent variable was the need for an upper or lower dental prosthesis. Other variables included sociodemographic characteristics, approach to dental care, oral health conditions, and self-reported oral disadvantage. Data were analyzed using the chi-square test and Poisson regression models at a 95% significance level. The prevalence of poor self-rated oral appearance was 20.6% and was higher in the elderly who needed a partial or complete upper or lower prosthesis, independent of other variables. This prevalence was associated with age, the use of dental services, access to information about oral disease prevention, number of decayed teeth, self-perception of the need for treatment, dental pain, chewing ability, and the perception that oral health affects relationships with other people. The elderly who needed dental prostheses had a higher prevalence of poor self-rated oral appearance than those who did not need any.
  • Effect of a cordless retraction paste on titanium surface: a topographic, chemical and biocompatibility evaluation Implant Dentistry

    Cooper, Katherine; Bennani, Vincent; Tawse-Smith, Andrew; Reid, Malcolm; Stirling, Claudine; Dias, George

    Resumo em Inglês:

    Good exposure of the preparation margins and haemostasis in the sulcular gingiva are necessary for accurate impressions to produce precise restorations. The use of cordless retraction paste material in implant dentistry is a relatively novel application. However, few studies have been conducted on the use of retraction pastes and their possible interaction with implant surfaces. Recent literature has described remnants on titanium implant surfaces and expressed the need for an assessment of the biocompatibility of the exposed surface (Chang et al.). This in vitro study evaluated the effect of a cordless gingival retraction paste on sterile titanium disks. Surface chemistry was determined using energy-dispersive X-ray spectroscopy (EDS), and further investigated using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS). After exposure to retraction paste, surface chemistry alterations were identified. A fibroblast cell line (L929) was exposed to the disks and the live/dead viability/cytotoxicity assay was used to determine any effects on the proliferation and health of cells. The disks exposed to the retraction paste showed fewer dead cells compared to the unexposed disks. This was statistically significant.
  • Effect of chlorhexidine on the bond strength of a self-etch adhesive system to sound and demineralized dentin Operative Dentistry

    de-Melo, Mary Anne Sampaio; Goes, Diego da Costa; de-Moraes, Maria Denise Rodrigues; Santiago, Sérgio Lima; Rodrigues, Lidiany Karla Azevedo

    Resumo em Inglês:

    This study evaluated the effect of a 2% chlorhexidine-based disinfectant (CHX) on the short-term resin-dentin bond strength of a self-etch adhesive system to human dentin with different mineral contents. Dentinal mineralization was tested at 4 levels (sound, and after 2, 4, or 8 days of demineralization-remineralization cycles) and disinfectant at 2 levels [deionized water (DW, negative control) and CHX]. Dentin demineralization induced by pH-cycling was characterized by cross-sectional hardness (CSH). Each dentin surface was divided into halves, one treated with DW and the other with CHX (5 minutes). Each surface was bonded with a self-etch adhesive system and restored. The specimens were sectioned and subjected to microtensile bond testing. CSH and microtensile bond strength (µTBS) data were analyzed by regression analysis and ANOVA-Tukey tests (α = 5%), respectively. The groups treated with CHX resulted in mean µTBS similar to those found for the groups in which the dentin was exposed to DW (p = 0.821). However, mean µTBS were strongly influenced by dentin mineralization (p < 0.05): the bond strength found for sound dentin was lower than that found for dentin cycled for 8 days, which was even lower than the bond strengths for dentin cycled for 2 or 4 days. The results suggest that the degree of dentin demineralization affects the bond strength of self-etching adhesives, but the use of CHX does not modify this effect.
  • Marginal microleakage of class V resin-based composite restorations bonded with six one-step self-etch systems Operative Dentistry

    Sánchez-Ayala, Alfonso; Farias-Neto, Arcelino; Vilanova, Larissa Soares Reis; Gomes, João Carlos; Gomes, Osnara Maria Mongruel

    Resumo em Inglês:

    This study compared the microleakage of class V restorations bonded with various one-step self-etching adhesives. Seventy class V resin-based composite restorations were prepared on the buccal and lingual surfaces of 35 premolars, by using: Clearfil S3 Bond, G-Bond, iBond, One Coat 7.0, OptiBond All-In-One, or Xeno IV. The Adper Single Bond etch-and-rinse two-step adhesive was employed as a control. Specimens were thermocycled for 500 cycles in separate water baths at 5°C and 55°C and loaded under 40 to 70 N for 50,000 cycles. Marginal microleakage was measured based on the penetration of a tracer agent. Although the control showed no microleakage at the enamel margins, there were no differences between groups (p = 0.06). None of the adhesives avoided microleakage at the dentin margins, and they displayed similar performances (p = 0.76). When both margins were compared, iBond® presented higher microleakage (p < 0.05) at the enamel margins (median, 1.00; Q3–Q1, 1.25–0.00) compared to the dentin margins (median, 0.00; Q3–Q1, 0.25–0.00). The study adhesives showed similar abilities to seal the margins of class V restorations, except for iBond®, which presented lower performance at the enamel margin.
  • Evaluation of bone alterations in the jaws of HIV-infected menopausal women Oral Diagnosis

    Caputo, Bruno Vieira; Traversa-Caputo, Gabriela Cineze; Costa, Claudio; Giovani, Elcio Magdalena

    Resumo em Inglês:

    The advent of highly active antiretroviral therapy (HAART) has caused a reduction in mortality, thus contributing to an increase in the number of women with HIVࢧAIDS who reach the climacteric period, experience decline in ovarian function, and develop complications of viral infection and HAART, which can accelerate bone loss. The aim of this study was to detect possible alterations in the jaws of HIV-infected women by panoramic radiography. The study comprised a total of 120 women above 40 years of age who were divided into the following two groups: women who are HIV positive (Group I) and women with no known HIV infection (Group II). Measurement of the following three radiomorphometric indexes was performed by panoramic radiography: Mental Index (MI), Panoramic Mandibular Index (PMI) and Antegonial Depth (AD). A total of 70% of women in the control group and 50% of women in the HIV group were in the postmenopausal period, and the average values of both MI (p = 0.0054) and AD (p < 0.0001) for this period were lower in the HIV group than in the control group. For patients who were in the premenopausal period, the average AD was lower in the HIV group than in the control group (p = 0.0003). Despite the difference in the average age between groups, greater bone resorption in the mandible was found in the group of HIV-positive women.
  • Influence of disinfectant solutions on test materials used for the determination of masticatory performance Oral Physiology

    Campos, Simone Silvério; Pereira, Cássio Vicente; Zangerônimo, Márcio Gilberto; Marques, Leandro Silva; Pereira, Luciano José

    Resumo em Inglês:

    Masticatory function can be evaluated objectively as the capacity of an individual to fragment solid food after a fixed number of chewing cycles, the so-called masticatory performance (MP). The objective of this study was to evaluate the reliability of four different test materials (Optosil, Optocal, Zetapuls, and Perfil) and five disinfection protocols by aspersion and immersion (no disinfection, 2% glutaraldehyde, 2% chlorhexidine, 5.25% sodium hypochlorite, and 70% alcohol) on the MP, determined at three moments (24 hours, 15 and 60 days) after storing the fragmented blocks. MP was evaluated by calculating X50 through the sieving technique and the Rosim-Ramler equation. The weight and microbiologic count (colony forming units, CFUs) of chewed blocks were measured to identify any variations that would make MP determination unfeasible. Differences in MP were observed among the materials (p < 0.01). Perfil presented the highest X50 value (worst MP determination), followed by Zetaplus (both p < 0.05), Optosil, and Optocal (both p > 0.05). The time and disinfection type had no influence on MP (p > 0.05). The number of CFUs differed between the nondisinfected group and all other disinfection groups at all time points (p < 0.01). No other significant difference in CFU count between disinfection groups was observed. In conclusion, disinfection did not alter the reliability of the test materials for the MP calculation for up to 60 days.
  • Performance of digital radiography with enhancement filters for the diagnosis of proximal caries Oral Radiology

    Belém, Manuella Dias Furtado; Ambrosano, Gláucia Maria Bovi; Tabchoury, Cínthia Pereira Machado; Ferreira-Santos, Rívea Inês; Haiter-Neto, Francisco

    Resumo em Inglês:

    Enhancement filters are potentially supposed to improve the diagnostic performance of digital images. Thus, the aim of this study was to compare the performance of digital radiography with and without enhancement filters for the detection of induced proximal caries lesions. The total sample consisted of 120 sound human teeth (40 premolars, 80 molars). Enamel subsurface demineralization was induced in one of the proximal surfaces of 60 teeth. Standardized radiographs of all teeth were acquired after the demineralization phase using the Digora-Optime® system. Four radiologists examined the digital radiographs and applied the following filters provided by the Digora® for Windows 2.6 package: Negative, Sharpen and both (Negative plus Sharpen). Validation of radiographic diagnosis was carried out by Knoop cross-sectional micro-hardness profiling on the proximal surfaces. Intraobserver agreement was estimated using Kappa statistics (k). Sensitivity, specificity and over-all accuracy were compared using ANOVA/Tukey test (α = 5%). Intraobserver agreement ranged from good to very good/optimal (k: 0.65–0.83). Although not statistically significant, the highest sensitivity (0.68 ± 0.22) and accuracy (0.76 ± 0.16) values were observed using the Sharpen filter as opposed to the Negative filter, which presented the lowest performance indices (0.57 ± 0.13 and 0.70 ± 0.10, respectively). Specificity ranged from 0.84 to 0.85, considering all imaging modalities (p > 0.05). Insofar as the Sharpen filter had the highest performance indices, it may be considered a useful adjunct for detecting subtle proximal caries lesions.
  • Radiodensitometric and DXA analyses for the measurement of bone mineral density after systemic alendronate therapy Oral Radiology

    Lucisano, Marília Pacífico; Nelson-Filho, Paulo; Morse, Leslie; Battaglino, Ricardo; Watanabe, Plauto Christopher Aranha; da Silva, Raquel Assed Bezerra; da Silva, Lea Assed Bezerra

    Resumo em Inglês:

    Precise techniques for the measurement of maxillary bone mineral density (BMD) are useful for the early diagnosis of systemic diseases. The aim of this study was to compare in vivo the efficacy of dual-energy x-ray absorptiometry (DXA) and radiographic densitometry for the measurement of BMD after systemic administration of sodium alendronate. Wistar rats were randomly allocated to a control group (n = 5), which received distilled water, and a sodium alendronate group (n = 8), which received two doses of chemically pure sodium alendronate (1 mg/kg) per week. After 8 weeks, the animals were euthanized, the tibias were removed, and the BMD of the proximal tibial metaphysis was analyzed radiographically and by DXA. The data were subjected to statistical analysis by the Kruskal-Wallis test at a significance level of 5%. Both of the techniques revealed that the alendronate-treated group had a significantly higher BMD (p < 0.05) than the control group after 8 weeks of treatment. Comparing the groups with and without alendronate therapy revealed increases of 14.9% and 29.6% in BMD, as detected radiographically and by DXA, respectively. In conclusion, both of the methods were able to detect an increase in BMD of the proximal tibial metaphysis after alendronate therapy.
  • Factors contributing to the surgical retreatment of mandibular fractures Oral Surgery

    Luz, João Gualberto de Cerqueira; Moraes, Rogerio Bonfante; D'Ávila, Ricardo Pimenta; Yamamoto, Marcos Kazuo

    Resumo em Inglês:

    The purpose of this retrospective study was to evaluate contributing factors in patients requiring surgical retreatment of mandibular fractures. Of all the patients with mandibular fractures who were treated using internal fixation at a trauma hospital over a seven-year period, 20 patients (4.7%) required a second surgery and thus composed the “reoperated” group. The control group comprised 42 consecutive patients with mandibular fractures who were treated at the same clinic and who healed without complications. Medical charts were reviewed for gender, age, substance abuse history, dental condition, etiology, location of fracture, degree of fragmentation, fracture exposure, teeth in the fracture line, associated facial fractures, polytrauma, time elapsed between trauma and initial treatment, surgical approach and fixation system. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0; descriptive statistics and the chi-squared test were used to determine differences between groups. Significant differences in substance abuse (p = 0.006), dental condition (p < 0.001), location of fracture (p = 0.010), degree of fragmentation (p = 0.003) and fracture exposure (p < 0.001) were found. With regard to age and time elapsed between trauma and initial treatment, older patients (31.4 years, SD = 11.1) and a delay in fracture repair (19.1 days, SD = 18.7) were more likely to be associated with reoperation. It was concluded that substance abuse, age, dental condition, location of fracture, degree of fragmentation, fracture exposure and the time between trauma and initial treatment should be considered contributing factors to the occurrence of complications that require surgical retreatment of mandibular fractures.
  • Comparative analysis of preemptive analgesic effect of dexamethasone and diclofenac following third molar surgery Oral Surgery

    Simone, José Leonardo; Jorge, Waldyr Antonio; Horliana, Anna Carolina Ratto Tempestini; Canaval, Talita Girio; Tortamano, Isabel Peixoto

    Resumo em Inglês:

    The objective of the study was to compare the analgesic effectiveness of dexamethasone and diclofenac sodium administered preemptively after surgical removal of third molars. Forty-four ASA (American Society of Anesthesiologists) I patients (19 men, 35 women; 16–28 years old) randomly and double-blindly received diclofenac sodium (50 mg) or dexamethasone (8 mg) or placebo 1 h before surgery. Intensity of pain, measured with a visual analog scale (VAS), was the variable studied at different postoperative times (1 h, 2 h, 3 h, 6 h, 8 h, 12 h, 48 h, 4 d and 7 d). The total amount of rescue medication (TARM) ingested (paracetamol) was another variable of the study. The Kruskal-Wallis statistical test was used. A p value of < .05 was adopted to reject the null hypothesis. The dexamethasone group showed lower pain intensity (p < .05) than the diclofenac sodium and placebo groups (p < .05). No difference in TARM was observed among the groups (p < .05). Preemptively administered, dexamethasone was effective in controlling postoperative pain.
  • Relationship among oral habits, orofacial function and oral health-related quality of life in children Pediatric Dentistry

    Leme, Marina Severi; de Souza Barbosa, Taís; Gavião, Maria Beatriz Duarte

    Resumo em Inglês:

    The objective was to evaluate the relationship among oral habits, oral function and oral health-related quality of life (OHRQoL) in children. Three hundred and twenty-eight subjects (8–14 years old) were assessed for orofacial function using the Brazilian version of the Nordic Orofacial Test-Screening (NOT-S). OHRQoL was assessed using the Child Perceptions Questionnaires (Brazilian versions) for the 8–10 (CPQ8-10) and 11–14 (CPQ11-14) year age groups. The subjects were distributed into a Habit group and a Habit-free group according to domain III (Habits) of the NOT-S. Oral habits were present in 71.3% of the sample (p = .0001), with a higher prevalence in females (62.8%, p = .001). The NOT-S, CPQ8-10 and CPQ11-14 scores were higher in the Habit group (P = .0001, P = .009 and p = .001, respectively). Domain I (Sensory Function) was significantly more affected in Habit group subjects (p = .001). The NOT-S scores were positively correlated with the CPQ8-10 and CPQ11-14 scores only in the Habit group (r = .32, p = .0003 and r = .30, p = .001, respectively). These results indicate that oral habits can impact OHRQoL. Moreover, orofacial dysfunctions were associated with worse OHRQoL in subjects with oral habits.
  • Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial Pediatric Dentistry

    Bonow, Maria Laura Menezes; Azevedo, Marina Sousa; Goettems, Marília Leão; Rodrigues, Célia Regina Martins Delgado

    Resumo em Inglês:

    The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69–3.98). The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19–6.03), but not with sugar intake (PR = 1.06; CI 95% 0.56–2.86) and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49–2.29). The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.
  • Influence of photo-activation source on enamel demineralization around restorative materials Restorative Dentistry

    Ferla, Juliana de Oliveira; Rodrigues, José Augusto; Arrais, César Augusto Galvão; Aranha, Ana Cecília Correa; Cassoni, Alessandra

    Resumo em Inglês:

    This study evaluated the effects of the photoactivation source and restorative material on the development of caries-like lesions on human enamel after an in vitro pH challenge. Enamel cavities were prepared in 36 blocks, which were assigned to two groups according to the restorative material: resin-modified glass ionomer (RMGI) and composite resin (CR). Samples were exposed to quartz-tungsten-halogen lamp, argon-ion laser, or light-emitting diode (n = 6). The Knoop microhardness (KHN) values of the top surface of all materials were evaluated. Restored enamel blocks were thermocycled and subjected to 10 demineralization-remineralization cycles at 37°C. KHN analysis of the superficial enamel was performed by four indentations located 100 mm from the restoration margin. The material KHN was not affected by the photoactivation source. No significant difference in KHN was noted between CR and RMGI. The enamel surface around RMGI exhibited a higher KHN (272.8 KHN) than the enamel around CR (93.3 KHN), regardless of the photoactivation source. Enamel demineralization around the dental restoration was not influenced by the photoactivation source. Less enamel demineralization was observed around the RMGI than around the CR restoration.
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