Resumo em Inglês:

The purpose of this study was to evaluate the influence of the internal standard peak on the measured degree of conversion (DC) for methacrylate-based resins analyzed by Fourier-transform infrared spectroscopy (FTIR). The influence of different baseline measurement methods was also determined. Different blends were prepared, mixing BisGMA/BisEMA and BisGMA/TEGDMA at proportions of 0% to 100%, in weight. Camphoroquinone and ethyl-4-dimethylamino-benzoate were used to permit the light activation of blends. Degree of conversion was evaluated using FTIR equipped with an attenuated total reflectance (ATR) device. Samples were dispensed onto ATR crystal and light activated for 40 s. The DC was calculated by relating the height of the peak 1637 cm-1 to the intensity of different internal standard peaks (1715, 1608, or 1582 cm-1), measured using two different baseline methods, before and after polymerization. Data were compared by ANOVA at 5% significance. The relationship between DC and monomer ratio was obtained by regression analysis. Double-bond conversion ranged from 32.75% to 78.50% for BisGMA/BisEMA blends, and from 32.75% to 76.22% for BisGMA/TEGDMA blends. For the BisGMA/BisEMA blends, the DC showed a linear association with the composition of the comonomer blends, independent of the internal standard peak and baseline method used. In contrast, the trends in DC for BisGMA/TEGDMA blends were different for each method of measurement. The internal standard peaks and measurement baseline should be taken into account when using FTIR to calculate the DC of methacrylate-based resins, especially comonomer blends containing a high degree of monomers that lack aromatic rings.

Resumo em Inglês:

The purpose of this study was to evaluate the inflammatory and cure events of acid-based reactions using glass ionomer cement used for cementation of crowns, bridges, onlays and orthodontic bands implanted in subcutaneous tissue, at different time intervals. A total of 48 male Wistar rats were used, distributed into 4 groups (n = 12), as follows: Group C (control, polyethylene), Group ME (Meron), Group KC (Ketac Cem) and Group PR (Precedent). The animals were sacrificed after time intervals of 7, 15 and 30 days, and their tissues were analyzed under an optical microscope for such events as inflammatory infiltrate, edema, necrosis, granulation tissue, multinucleated giant cells, young fibroblasts and collagen. The results was assessed using Kruskal-Wallis and Dunn's tests (p < 0.05). In the initial period, intense inflammatory infiltrate was observed for all the materials with no significant difference among them (p = 0.104). Groups PR and KC showed significant difference in relation to Group C, at 7 days (p = 0.025) and 15 days (p = 0.006). Edema and giant cells were more expressive in Group ME, differing significantly from Groups C (p = 0.023) and KC (p = 0.039), respectively, at 7 days. Group ME showed a statistically significant difference in relation to Groups PR and KC for the presence of young fibroblasts (p = 0.009) and for collagen (p = 0.002), at 7 days. Within the limits of this in vivo study, Precedent and Ketac Cem glass ionomer cements showed better tissue healing with a greater number of fibroblasts and collagen, as compared to Meron.

Resumo em Inglês:

The aim of this study was to evaluate the effect of immediate and delayed photoactivation of self-adhesive resin cements (SARCs) on the retention of glass-fiber posts luted into root canals. Bovine incisors were endodontically treated, and post holes of 9 mm in depth were prepared. Fiber posts were luted using one of two SARCs, BisCem(r) (Bisco Inc., Schaumburg, USA) or RelyX Unicem clicker (3M ESPE, Saint Paul, USA), or a regular (etch-and-rinse) resin cement (AllCem; FGM, Joinvile, Brazil). Photoactivation was performed immediately, or at 5 or 10 min after cementation. Root/post specimens were transversely sectioned 7 days after luting into 1-mm-thick slices, which were submitted to push-out testing in a mechanical testing machine. Bond strength data were analyzed by two-way ANOVA and Student-Newman-Keuls' method (α = 0.05). Immediate photoactivation resulted in the highest bond strength for Unicem. BisCem(r) demonstrated higher bond strength values when photoactivated after a 10-min delay. Immediate photoactivation yielded the lowest bond strengths for AllCem, although no differences in bond strength were observed between photoactivation delayed by 5 and 10 min. In conclusion, the moment of resin cement photoactivation may affect the intraradicular retention of fiber posts, depending upon the resin cement used for luting.

Resumo em Inglês:

The aim of the present study was to evaluate the effect of calcium hydroxide dressing on the bond strength of three commercially available endodontic sealers (MTA Fillapex, Sealapex, and AH Plus) to root canal dentin. Sixty slices of extracted human canines were obtained from cervical, middle, and apical root thirds. Root canals were standardized and specimens were filled and divided into six groups (n = 10): G1, MTA Fillapex; G2, Sealapex; and G3, AH Plus, with prior application of calcium hydroxide dressing; and G4, G5 and G6, without prior application of intracanal dressing. After 7 days, specimens were submitted to a push-out test. The data obtained were analyzed using the ANOVA and Tukey tests (a = 5%). Fracture modes were classified as adhesive, cohesive or mixed. The results of sealer bond strength to root canal dentin varied according to the sealer, root third and prior dressing application. Overall, calcium hydroxide dressing reduced bond strength in all root thirds, but the reduction was significant only for AH Plus, at the cervical (3.25 ± 1.69) and apical (4.43 ± 1.65) thirds (p < 0.05). AH Plus showed the highest bond strength for all root thirds (p < 0.05) compared to the other groups. G1, G2, G4 and G5 showed similar bond strength values for all root thirds (p > 0.05). In conclusion, the calcium hydroxide dressing only had a negative effect on the bond strength of AH Plus, at the cervical and apical thirds. On the other hand, the bond strength values for MTA Fillapex and Sealapex were lower than those for AH Plus and, whereas the mixed failure mode predominated for AH Plus, the adhesive failure mode predominated for MTA Fillapex and Sealapex.

Resumo em Inglês:

The aim of this in vitro study was to evaluate, using the photoelastic analysis method, the stress distribution in mandibular bone surrounding a bar-clip overdenture when 2 implant angulations were simulated. Two mandibular photoelastic models were manufactured, with 2 implants embedded in the interforaminal region: model 1 - PAPI, a photoelastic analysis model with parallel implants; and model 2 - PAAI, a photoelastic analysis model with angled implants. A bar-clip retention system and an overdenture were positioned over the implants, and loads of 1.0, 2.0 and 3.0 bars were applied. The resultant stresses that developed in the supporting structure were photoelastically monitored and were recorded photographically. The results showed that there were no similarities in the areas of stress among the photoelastic resin models when the angulation of the implants was evaluated. Model 1 - PAPI presented a higher stress concentration at the implant apex, while in model 2 - PAAI, there were higher stress concentrations on the mesial and distal implant faces. Within the limitations of this study, it was concluded that the PAPI photoelastic model demonstrated better stress transfer compared to the PAAI model, since the forces oriented along the axis were better absorbed by the bone.

Resumo em Inglês:

This study investigated the clinical effects of using a supragingival biofilm control regimen (SUPRA) as a step prior to scaling and root planing (SRP). A split-mouth clinical trial was performed in which 25 subjects with periodontitis (47.2 ± 6.5 years) underwent treatment (days 0-60) and monitoring (days 90-450) phases. At Day 0 (baseline) treatments were randomly assigned per quadrant: SUPRA, SRP and S30SRP (SUPRA 30 days before SRP). The full-mouth visible plaque index (VPI), gingival bleeding index (GBI), periodontal probing depth (PPD), bleeding on probing (BOP), and clinical attachment loss (CAL) were examined on days 0, 30, 60, 90, 120, 270, and 450. Baseline data were similar among all groups. From days 0 to 60, the groups showed similar significant decreases in VPI and GBI. Reductions in PPD for the SRP (3.39 ± 0.17 to 2.42 ± 0.16 mm) and S30SRP (3.31 ± 0.11 to 2.40 ± 0.07 mm) groups were greater (p < 0.05) than those for the SUPRA group. This pattern was also observed for BOP. Attachment gain was similar and greater for the SRP (3.34 ± 0.28 to 2.58 ± 0.26 mm) and S30SRP (3.25 ± 0.21 to 2.54 ± 0.19 mm) groups compared to the SUPRA group. Results were maintained from day 90 forward. Overall, the S30SRP treatment reduced the subgingival treatment needs in 48.16%. Performance of a SUPRA step before SRP decreased subgingival treatment needs and maintained the periodontal stability over time.

Resumo em Inglês:

The aim was to investigate the impact of cone-beam computed tomography (CBCT) on implant planning and on prediction of final implant size. Consecutive patients referred for implant treatment were submitted to clinical examination, panoramic (PAN) radiography and a CBCT exam. Initial planning of implant length and width was assessed based on clinical and PAN exams, and final planning, on CBCT exam to complement diagnosis. The actual dimensions of the implants placed during surgery were compared with those obtained during initial and final planning, using the McNemmar test (p < 0.05). The final sample comprised 95 implants in 27 patients, distributed over the maxilla and mandible. Agreement in implant length was 50.5% between initial and final planning, and correct prediction of the actual implant length was 40.0% and 69.5%, using PAN and CBCT exams, respectively. Agreement in implant width assessment ranged from 69.5% to 73.7%. A paired comparison of the frequency of changes between initial or final planning and implant placement (McNemmar test) showed greater frequency of changes in initial planning for implant length (p < 0.001), but not for implant width (p = 0.850). The frequency of changes was not influenced by implant location at any stage of implant planning (chi-square test, p > 0.05). It was concluded that CBCT improves the ability of predicting the actual implant length and reduces inaccuracy in surgical dental implant planning.

Resumo em Inglês:

Odontogenic tumors (OTs) are lesions that develop exclusively on maxillary bones, and form a heterogeneous group. They vary from hamartomatous lesions to benign and malign tumors. Although they are rarely observed in dentistry clinics, it is extremely important for the dentist to be aware of them. The aim of this study was to investigate the incidence of odontogenic tumors diagnosed in the population of Florianópolis, Santa Catarina, Brazil. Cases of odontogenic tumors were selected from the anatomopathological diagnostic services at Federal University of Santa Catarina from 1998 to 2011. Clinical data on these cases were collected from biopsy reports and patient files. Seventy-eight cases of odontogenic tumors were surveyed. Of these diagnoses, 51% were keratocystic odontogenic tumors (KCOTs); the remaining cases were mainly ameloblastomas and odontomas. The most frequently observed lesion in this retrospective study was KCOT (more than half of cases). Thus, this study shows that modifying the classification of the OTs altered the frequency of the lesions, possibly making KCOT the most common lesion observed in diagnostic services worldwide.

Resumo em Inglês:

The effect of Candida albicans biofilms and methyl methacrylate (MMA) pretreatment on the bond strength between soft denture liners and polymethyl methacrylate (PMMA) resin was analyzed. Specimens were prepared and randomly divided with respect to PMMA pretreatment, soft liner type (silicone-based or PMMA-based), and presence or absence of a C. albicans biofilm. Samples were composed of a soft denture liner bonded between two PMMA bars. Specimens (n = 10) were incubated to produce a C. albicans biofilm or stored in sterile PBS for 12 days. The tensile bond strength test was performed and failure type was determined using a stereomicroscope. Surface roughness (SR) and scanning electron microscopy (SEM) analysis were performed on denture liners (n = 8). Highest bond strength was observed in samples containing a silicone-based soft liner and stored in PBS, regardless of pretreatment (p < 0.01). Silicone-based specimens mostly underwent adhesive failures, while samples containing PMMA-based liners predominantly underwent cohesive failures. The silicone-based specimens SR decreased after 12 days of biofilm accumulation or PBS storage, while the SR of PMMA-based soft liners increased (p < 0.01). The PMMA-based soft liners surfaces presented sharp valleys and depressions, while silicone-based specimens surfaces exhibited more gentle features. In vitro exposure to C. albicans biofilms reduced the adhesion of denture liners to PMMA resin, and MMA pretreatment is recommended during relining procedures.

Resumo em Inglês:

Adhesion and colonization of the oral cavity by Candida albicans is an initial step in candidosis. Orthodontic and other oral appliances seem to favor candidal presence. The aim of this work was to compare the presence of Candida species in saliva, their adherence to oral epithelial cells, and the levels of anti-C. albicans IgA in children with or without orthodontic appliances. This study included 30 children 5 to 12 years old (9.1 ± 1.7 years old) who were users of removable orthodontic devices for at least 6 months and 30 control children of similar ages (7.7 ± 1.5 years old). The presence of yeast species in the saliva was evaluated by microbiological methods. Candida species were identified using phenotypic methods. Anti-C. albicans IgA levels in saliva were analyzed by ELISA. The yeasts adhering to oral epithelial cells were assessed by exfoliative cytology. No statistically significant differences were observed for saliva yeast counts and anti-C. albicans IgA levels between the studied groups. Children with orthodontic devices exhibited more yeast cells adhering to oral epithelial cells and a higher percentage of non-albicans species relative to the control group. In conclusion, orthodontic appliances may favor the adherence of Candida to epithelial cells but do not influence the presence of these yeasts in saliva, and the levels of anti-C. albicans IgA do not correlate with yeast adherence or presence of Candida in the oral cavity

Resumo em Inglês:

The aim of this study was to assess the validity and reliability of the Fonseca Anamnestic Index (IAF), used to assess the severity of temporomandibular disorders, applied to Brazilian women. We used a probabilistic sampling design. The participants were 700 women over 18 years of age, living in the city of Araraquara (SP). The IAF questionnaire was applied by telephone interviews. We conducted Confirmatory Factor Analysis (CFA) using Chi-Square Over Degrees of Freedom (χ2/df), Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Root Mean Square Error of Approximation (RMSEA) as goodness of fit indices. We calculated the convergent validity, the average variance extracted (AVE) and the composite reliability (CR). Internal consistency was assessed by Cronbach's alpha coefficient (α).The factorial weights of questions 8 and 10 were below the adequate values. Thus, we refined the original model and these questions were excluded. The resulting factorial model showed appropriate goodness of fit to the sample (χ2/df = 3.319, CFI = 0.978, TLI = 0.967, RMSEA = 0.058). The convergent validity (AVE = 0.513, CR = 0.878) and internal consistency (α = 0.745) were adequate. The reduced IAF version showed adequate validity and reliability in a sample of Brazilian women.

Resumo em Inglês:

The aim of the present study was to determine the prevalence of malocclusion and associations with socioeconomic indicators among preschoolers. A cross-sectional study was conducted with 732 children 3 to 5 years of age in the city of Campina Grande, Brazil. Three dentists underwent a calibration exercise (K = 0.85-0.90) and diagnosed malocclusion based on the criteria proposed by Foster & Hamilton and Grabowski et al. Parents/guardians answered a questionnaire addressing sociodemographic aspects. Data analysis involved descriptive statistics and bivariate Poisson regression (PR; α = 5%). The prevalence of malocclusion was 62.4%. The most frequent types were increased overjet (42.6%), anterior open bite (21%) and deep overbite (19.3%). An association was found between malocclusion and age: the prevalence of malocclusion was greater among younger children, with the highest prevalence among 3-year-olds (PR = 1.116; 95%CI = 1.049-1.187). The prevalence of malocclusion was high. Mother's schooling and household income were not associated with malocclusion. Socioeconomic factors were also not associated with the occurrence of malocclusion.

Resumo em Inglês:

The aim of this study was to use cone-beam computed tomography (CBCT) images to evaluate the prevalence and configurations of C-shaped canals in permanent mandibular second molars among members of a Brazilian subpopulation. CBCT exams of 214 patients (406 teeth) were evaluated for: presence of C-shaped root canals, number of canals and direction of the root grooves (buccal or lingual). Of the 214 CBCT images examined, 192 showed intact bilateral molars, which were used to analyze the distribution of unilateral and bilateral occurrences of C-shaped canals. The prevalence of these canals was correlated with gender and age, and the number of canals was correlated with the direction of the root grooves using the chi-squared test (α = 0.05). The prevalence of C-shaped canals was 15.3%. This prevalence did not differ with gender or age. Most of the C-shaped molars had three (43.5%) or two (37.1%) canals; 69.4% of the C-shaped canals were grooved in the buccal direction; 68.3% of the C-shaped cases were unilateral. In conclusion, there was a significant prevalence of C-shaped canals in the mandibular second molars of the population studied; the C-shaped canal system varied in configuration, with a higher prevalence of three and two canals and unilateral occurrence; CBCT is a useful tool for endodontic diagnosis and treatment.

Resumo em Inglês:

This study's aims was to evaluate the stress distribution in a mandibular implant-supported prosthesis and peri-implant bone considering implant quantity, diameter and position using linear 3-D finite element analysis. Models of an anterior jaw comprised 4 groups according to implant quantity, diameter, and position: control group C, 5 regular implants; R, 3 regular implants; W, 3 wide implants; and DTR, 3 regular implants with the distal ones tilted 30º distally. The cantilever was loaded with an axial load of 50 N. Data was evaluated using von Mises stress on implants and maximum principal stress and microstrain on the bone. The W group showed the lowest value of maximum principal stress in peri-implant bone of the loaded side (4.64 MPa) when compared to C (5.27 MPa), DTR (5.94 MPa), and R (11.12 MPa). Lower stress values in the loaded implants were observed in the experimental groups when compared to the C group. However, the unloaded implants presented opposite results. All the screws of the W group presented lower stress values when compared to the C group. However, the R and DTR groups presented an increase in stress values with the exception of the loaded screw. A reduction in the number of implants associated with wider implants reduced the stress in the bone and prosthetic components.

Resumo em Inglês:

The aim of this study was to evaluate the effect of thermocycling and immersion in mouthwash or beverage solutions on the color stability of four different acrylic resin-based dentures (Onda Cryl, OC; QC20, QC; Classico, CL; and Lucitone, LU). The factors evaluated were type of acrylic resin, immersion time, and solution (mouthwash or beverage). A total of 224 denture samples were fabricated. For each type of resin, eight samples were immersed in mouthwashes (Plax-Colgate, PC; Listerine, LI; and Oral-B, OB), beverages (coffee, CP; cola, C; and wine, W), and artificial saliva (AS; control). The color change (DE) was evaluated before (baseline) and after thermocycling (T1), and after immersion in solution for 1 h (T2), 3 h (T3), 24 h (T4), 48 h (T5), and 96 h (T6). The CIE Lab system was used to determine the color changes. The thermocycling test was performed for 5000 cycles. Data were submitted to three-way repeated-measures analysis of variance and Tukey's test (p < 0.05). When the samples were immersed in each mouthwash, all assessed factors, associated or not, significantly influenced the color change values, except there was no association between the mouthwash and acrylic resin. Similarly, when the samples were immersed in each beverage, all studied factors influenced the color change values. In general, regardless of the solution, LU exhibited the greatest DE values in the period from T1 to T5; and QC presented the greatest DE values at T6. Thus, thermocycling and immersion in the various solutions influenced the color stability of acrylic resins and QC showed the greatest color alteration.

Resumo em Inglês:

The aim of this study was to evaluate the effects of Citrus limonum and Citrus aurantium essential oils (EOs) compared to 0.2% chlorhexidine (CHX) and 1% sodium hypochlorite (NaOCl) on multi-species biofilms formed by Candida albicans, Enterococcus faecalis and Escherichia coli. The biofilms were grown in acrylic disks immersed in broth, inoculated with microbial suspension (106 cells/mL) and incubated at 37°C / 48 h. After the biofilms were formed, they were exposed for 5 minutes to the solutions (n = 10): C. aurantium EO, C. limonum EO, 0.2% CHX, 1% NaOCl or sterile saline solution [0.9% sodium chloride (NaCl)]. Next, the discs were placed in sterile 0.9% NaCl and sonicated to disperse the biofilms. Tenfold serial dilutions were performed and the aliquots were seeded onto selective agar and incubated at 37°C / 48 h. Next, the number of colony-forming units per milliliter was counted and analyzed statistically (Tukey test, p ≤ 0.05). C. aurantium EO and NaOCl inhibited the growth of all microorganisms in multi-species biofilms. C. limonum EO promoted a 100% reduction of C. albicans and E. coli, and 49.3% of E. faecalis. CHX was less effective against C. albicans and E. coli, yielding a reduction of 68.8% and 86.7%, respectively. However, the reduction of E. faecalis using CHX (81.7%) was greater than that obtained using C. limonum EO. Both Citrus limonum and Citrus aurantium EOs are effective in controlling multi-species biofilms; the microbial reductions achieved by EOs were not only similar to those of NaOCl, but even higher than those achieved by CHX, in some cases.

Resumo em Inglês:

Just like any other profession, dentistry requires ethical and moral responsibilities that must be fulfilled, and the duty of every professional is to meet his obligations under the law. In light of the Código de Ética Odontológica (CEO - Code of Dental Ethics), this research aims to expound on the ethical violations committed by dentists in their practice, according to the ethical review process proposed by the Conselho Regional de Odontologia do Estado do Espírito Santo (CRO/ES - Regional Council of Dentistry of the State of Espírito Santo). The study is both retrospective and descriptive, using a quantitative approach. Data collection comprised all the ethical proceedings filed at the CRO/ES, between the years 2000 and 2011. Considering the 529 cases examined, the most frequent reason for infringement was illicit advertising (39.7%), followed by technical error (18.7%), irregular registration (16.8%), patient/professional relationship (11.3%) tax lien foreclosure (6.6%), professional/professional relationship (4.0%), irregular/illegal cover up practice (0.9%), consumer relations (0.8%), failure to provide care (0.6%), false certification (0.4%), and disrespect for authority and colleagues (0.2%). Most (59.2%) of the dental surgeons (DSs) involved were male, 35.5% were between 31 and 40 years of age, 85.8% had graduated over five (5) years prior, and 73.2% were general practitioners. Only 22 (4.2%) cases went to trial, resulting in 8 (36.4%) acquittals and 14 (63.6%) convictions. The most commonly applied penalties were private warning + pecuniary penalty (8 or 57.1%). It was concluded that the CEO must be followed with more discipline, and that professionals should seek information about their duties and obligations under the law, on behalf of patient welfare.

Resumo em Inglês:

The present cross-sectional study was designed to investigate the association between sleep bruxism (SB), tinnitus and temporomandibular disorders (TMD). The sample consisted of 261 women (mean age of 37.0 years). The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD and self-reported tinnitus. SB was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine. The results showed an association between painful TMD and tinnitus (OR = 7.3; 95%CI = 3.50-15.39; p < 0.001). With regard to SB, the association was of lower magnitude (OR = 1.9; 95%CI = 1.16-3.26; p < 0.0163). When the sample was stratified by the presence of SB and painful TMD, only SB showed no association with tinnitus. The presence of painful TMD without SB was significantly associated with tinnitus (OR = 6.7; 95%CI = 2.64-17.22; p < 0.0001). The concomitant presence of painful TMD and SB was associated with a higher degree of tinnitus severity (OR = 7.0; 95%CI = 3.00-15.89; p < 0.0001). It may be concluded that there is an association between SB, painful TMD and self-reported tinnitus; however, no relationship of a causal nature could be established.

Resumo em Inglês:

The aim of this study was to evaluate the effectiveness of two retreatment techniques, in terms of the operating time and scanning electron microscopy (SEM) results, in removing three different root canal sealers from root canals that were previously filled with gutta-percha. Sixty extracted single-rooted human premolars were divided into three groups and filled with iRoot SP, MM Seal, and AH Plus sealers, along with gutta-percha, through a lateral compaction technique. Root canal fillings of the samples were removed by ESI ultrasonic tips or R-Endo files. The time to reach the working length was recorded. Longitudinally sectioned samples were examined under SEM magnification. Each picture was evaluated in terms of the residual debris. Data were statistically analyzed with the Kruskall-Wallis test. No statistically significant differences were found in terms of operating time (p>0.05). Significant differences in the number of debris-free dentinal tubules were found among the root canal thirds, but this finding was not influenced by the experimental group (p < 0.05). Resin sealer tags were observed inside the dentinal tubules in the MM Seal group. Under the conditions of this study, it may be established that there was no difference among the sealers and retreatment techniques.

Resumo em Inglês:

The present study investigated the effect of non-surgical periodontal treatment (SRP) on the composition of the subgingival microbiota of chronic periodontitis (CP) in individuals with type 2 diabetes (DM2) with inadequate metabolic control and in systemically healthy (SH) individuals. Forty individuals (20 DM2 and 20 SH) with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01). Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001). At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01). Those in the DM2 group showed significantly higher prevalence and/or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001). However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001) over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months’ evaluation compared with those in the DM2 group with inadequate metabolic control.

Resumo em Inglês:

Epidemiological data on the periodontal health and oral hygiene practices of young individuals in Latin America are limited. This study was conducted in a sample of 355 first-year students randomly selected from 3,251 new students entering the largest university in Colombia. Participants received a periodontal examination and were interviewed about oral hygiene practices. Specifically, this study assessed the relationship between oral hygiene practices (including smoking tobacco) and plaque accumulation and/or periodontal bleeding on probing (BOP). Participants had extensive plaque accumulation and BOP, with a mean O´Leary plaque index of 56% and mean BOP of 37%. Both measures were higher for proximal surfaces. Plaque indices of at least 50% were not associated with any oral hygiene factors; however, plaque index and use of dental floss were associated with a BOP of at least 50%. Frequency of tooth brushing was higher in female than in male participants. Only 5% of participants reported smoking tobacco. On average, participants had 2.7 ± 4.6 pockets of at least 4 mm (18% of participants had ≥ 5 and 9% of participants had ≥ 10 pockets of this depth, respectively). On average, participants had 2.1 ± 4.4 sites with clinical attachment loss of at least 2 mm (15% and 6% of participants had ≥ 5 and ≥ 10 sites with this level of loss). Only 8% of participants were diagnosed with moderate periodontitis, and no participants were diagnosed with severe periodontitis. In conclusion, although participants had high levels of plaque and BOP, signs of advanced destructive periodontal disease were minimal.

Resumo em Inglês:

Oral exfoliative cytology (EC) is a rapid and practical complementary test that can be used in the diagnosis of various diseases. The objectives of this study were to assess dentists’ knowledge of EC and to disseminate information on the technique. The study included 240 dentists from the city of Anápolis (Goiás, Brazil) who answered a questionnaire regarding demographic data and data relating to EC and who then received information on the technique. The data revealed that 26.92% of the dentists did not know about EC. Among those who reported knowledge of EC, 33.91% did not know the procedures for performing the technique, and 85.38% had no experience with EC. In addition, 54.09% of the answers regarding the instrument used to collect the material and 56.82% of the answers concerning suitable fixatives were inappropriate. Although 73.02% of the dentists adequately identified the pathologies for which EC is recommended, it was concluded that the respondents had poor knowledge of EC. There is a need to increase dentists’ awareness of this subject and of EC’s use in diagnostic practices.

Resumo em Inglês:

This cross-sectional study assessed risk factors for dental fluorosis (DF) among 8- to 12-year-old children in southern Brazil. Children attending 20 schools were randomly selected (n = 1,196). They were interviewed and their parents answered a questionnaire that was sent home. Prevalence of DF was 8.53% (modified Dean’s criteria), and the prevalence of severe DF was 0.17%. The results of multiple logistic regression analyses indicated that DF was associated with a higher frequency of tooth brushing and with initial use of fluoride toothpaste at the emergence of the first tooth. DF does not constitute a public health problem in southern Brazil.

Resumo em Inglês:

The aim of this study was to evaluate the reproducibility of the condensation silicone Optosil Comfort® as an artificial test food for masticatory performance evaluation. Twenty dentate subjects with mean age of 23.3 ± 0.7 years were selected. Masticatory performance was evaluated using the simple (MPI), the double (IME) and the multiple sieve methods. Trials were carried out five times by three examiners: three times by the first, and once by the second and third examiners. Friedman’s test was used to find the differences among time trials. Reproducibility was determined by the intra-class correlation (ICC) test (α = 0.05). No differences among time trials were found, except for MPI-4 mm (p = 0.022) from the first examiner results. The intra-examiner reproducibility (ICC) of almost all data was high (ICC ≥ 0.92, p < 0.001), being moderate only for MPI-0.50 mm (ICC = 0.89, p < 0.001). The inter-examiner reproducibility was high (ICC > 0.93, p < 0.001) for all results. For the multiple sieve method, the average mean of absolute difference from repeated measurements were lower than 1 mm. This trend was observed only from MPI-0.50 to MPI-1.4 for the single sieve method, and from IME-0.71/0.50 to IME-1.40/1.00 for the double sieve method. The results suggest that regardless of the method used, the reproducibility of Optosil Comfort® is high.

Resumo em Inglês:

The objective of this study was to evaluate prediction factors for failure to seek treatment following a traumatic dental injury (TDI) to primary teeth among preschool children in the city of Campina Grande, Brazil. A cross-sectional study was carried out involving 277 children 3 to 5 years of age, with TDI, enrolled in public and private preschools. Parents filled out a form addressing demographic data and whether or not they had sought treatment. Clinical examinations were performed by three dentists who had undergone a calibration exercise (Kappa: 0.85 to 0.90) for the evaluation of TDI. Bivariate and multivariate Poisson regression models were constructed (α = 5%). Enamel fracture was the most prevalent type of TDI (48.7%) and the upper central incisors were the most affected teeth (88.4%). The frequency of seeking dental treatment was low (9.7%). The following variables were associated with failure to seek treatment following TDI: a household income greater than one minimum wage (PR = 1.170; 95%CI 1.018-1.341), parents/caregivers’ perception of a child’s oral health as poor (PR = 1.100; 95%CI 1.026-1.176), and the non-perception of TDI by parents/caregivers (PR = 1.250; 95%CI 1.142-1.360). In the present study, the frequency of seeking treatment following TDI was low, and parents/caregivers with a higher income, a poor perception of their child’s oral health and a lack of awareness regarding the trauma were more likely to fail to seek treatment following TDI to primary teeth.

Resumo em Inglês:

Little is known about the effects of stress hormones on the etiologic agents of halitosis. Thus, the aim of this study was to evaluate in vitro the effects of adrenaline (ADR), noradrenaline (NA) and cortisol (CORT) on bacteria that produce volatile sulfur compounds (VSC), the major gases responsible for bad breath. Cultures of Fusobacterium nucleatum (Fn), Porphyromonas endodontalis (Pe), Prevotella intermedia (Pi) and Porphyromonas gingivalis (Pg) were exposed to 50 µM ADR, NA and CORT or equivalent volumes of sterile water as controls for 12 and 24 h. Growth was evaluated based on absorbance at 660 nm. Portable gas chromatography was used to measure VSC concentrations. Kruskal-Wallis and the Dunn post-hoc test were used to compare the groups. For Fn, ADR, NA and CORT significantly reduced bacterial growth after 12 h and 24 h (p < 0.05). All the substances tested increased hydrogen sulfide (H2S) production (p < 0.05). For Pe, all the substances tested reduced bacterial development after 24 h (p < 0.05), and NA significantly increased the H2S concentration after 12 h (p < 0.05). In the Pg and Pi cultures, no effects on bacterial growth were observed (p > 0.05). In the Pi cultures, ADR, NA and CORT increased H2S (p < 0.05). Catecholamines and cortisol can interfere with growth and H2S production of sub-gingival species in vitro. This process appears to be complex and supports the association between stress and the production of VSC.

Resumo em Inglês:

The purpose of this study was to evaluate the influence of buccal and lingual wall thickness on the fatigue resistance of molars restored with CAD/CAM ceramic inlays. Forty human third molars were selected and divided into 4 groups, according to the remaining surrounding wall thickness chosen for inlay preparation (n = 10): G1, 2.0 mm; G2, 1.5 mm; G3, 1.0 mm; G4, 0.5 mm. All inlays were made from feldspathic ceramic blocks by a CAD/CAM system, and cemented adhesively. After 1 week stored in distilled water at 37 °C, the specimens were subjected to fatigue testing under the following protocol: 5Hz; pre-load of 200 N for 5,000 cycles, followed by increasing loads of 400, 600, 800, 1000, 1200 and 1400 N for 30,000 cycles each. The specimens were cycled until failure or completion of 185,000 cycles. The survival rate of the groups was compared using the Kaplan-Meier survival curves (p > 0.05). All specimens withstood the fatigue protocol (185,000 cycles), representing a 100% survival rate. The Kaplan-Meier survival curves showed no difference between groups. It can be concluded that the remaining tooth wall thickness did not influence the fatigue resistance of molars restored with CAD/CAM ceramic inlays.

Resumo em Inglês:

Nifedipine is a widely used anti-anginal and anti-hypertensive agent. It is associated with significant gingival changes attributed more to collagen hyperplasia than to enhancement of protein synthesis. We investigated the influence of nifedipine on morphological changes in the parotid glands of rats in a model of hypertension. Twenty-eight male Wistar rats (8–10 weeks; 200 ± 15 g) were divided into four groups (A–D). Hypertension was induced by surgical means in groups C and D. Animals in groups B and D were treated with nifedipine (0.85 mg/kg) via a gastroesophageal catheter the day after surgery (experimental day-1) for 2 weeks. A significant difference was observed between the control group and nifedipine group and between the control group and hypertension group with regard to the weight of the parotid gland and its surface area. Histological findings demonstrated changes in the parotid glands of hypertensive animals with mild vessel dilatation and infiltration of inflammatory cells. These histological findings seemed to be due more to changes in venous function than to alterations in gland architecture.

Resumo em Inglês:

Root resorption is a variable to be considered in induced tooth movement (ITM). It is related to root morphology and alveolar bone crest, and also to the types of forces exerted by mechanotherapy. This histometric study evaluated the predominance of root resorption among roots of different dimensions, following ITM with different types of forces and at different time intervals. The study was conducted on 54 rats divided into three groups, according to the type of force: continuous (CF), continuous interrupted (CIF) and intermittent (IF), at periods of 5, 7 and 9 days. The percentage of resorption between mesiobuccal roots of larger dimension and intermediate roots of smaller dimension was assessed. The evaluations were performed on the AxioVision software, and the non-parametric analysis of variance for repeated measures in independent groups was further applied, consisting of a scheme of two factors, and complemented by the Dunn test at a significance level of 5%. The intermediate roots presented a higher percentage of resorption, which was gradual at the periods evaluated for the three types of forces, but mainly for CF. Comparing the intermediate roots with the mesiobuccal roots, there was a statistically significant difference (p < 0.05) in the CF group at day 7 and day 9, and in the FI group, at day 9. The intragroup analysis evidenced a statistically significant difference (p < 0.05) between the 5th and the 9th day for the intermediate root in the CF group. The intergroup analysis did not reveal any statistically significant difference (p > 0.05) in individually analyzed roots.

Resumo em Inglês:

The clinical paradigm of evidence-based medicine requires a foundation of good quality research upon which clinical and epidemiological decisions can be based. Several instruments have been designed to assess research quality and validated, though most have limitations. The MINCIR scale was designed to determine the methodological quality (MQ) of clinical research, its psychometric properties for dental research involving large-scale evaluations have not yet been determined. The aim of this study was to determine the validity and reliability of the MINCIR scale for assessment of the MQ of dental therapy studies published in journals indexed in Institute for Scientific Information (ISI) databases. A validation study was performed on a sample of 99 articles from four representative ISI dental journals. Criterion validity was determined in relation to level of evidence (LoE) classification as described by the Oxford Center for Evidence-Based Medicine (OCEBM) ranking system, reliability was determined by calculation of intra-class correlation coefficient (ICC) values, and internal consistency was determined by calculation of Cronbach’s alpha. Very good inter-observer reliability (ICC = 0.93), excellent temporal stability (ICC = 0.97), good internal consistency (Cronbach’s alpha = 0.77), and a strong (inverse) correlation with OCEBM LoEs (-0.807; p < .0001) were obtained. These results indicate that the MINCIR scale has adequate psychometric properties and therefore is a valid option for use in the assessment of MQ in dental therapy research articles.

Resumo em Inglês:

The purpose of this study was to assess the color of layered resin overlays and to test the early microhardness of dual cure resin cement (DCRC) light cured through the layered resin overlays. Resin overlays of 1.5 mm thickness were fabricated with the A3 shade of Z350 (Group 1L), the A3B and A3E shades of Supreme XT (Group 2L), and the A3, E3, and T1 shades of Sinfony (Group 3L) using one, two, and three layers, respectively (n = 7). Each layer of the resin overlays was set in equal thickness. The color of the resin overlays was measured with a colorimeter and compared with an A3 shade resin denture tooth. DCRC was light cured through the resin overlays, and the early microhardness of the DCRC was measured. The ΔE value between the denture tooth and the resin overlays and the Vickers hardness number (VHN) of the DCRC were analyzed with one-way ANOVA and Tukey’s HSD test. The color differences were 8.9 ± 0.5, 5.3 ± 1.0, and 7.3 ± 0.5 and the VHNs were 19.4 ± 1.1, 21.1 ± 0.9, and 29.3 ± 0.6 for Groups 1L, 2L, and 3L, respectively. Therefore, to match the designated tooth color of resin inlays and to increase the early microhardness of DCRC, layered resin inlays are more appropriate than single-dentin-layer resin inlays. However, the translucent layer should be used cautiously because the color difference of resin inlays with a translucent layer was affected more than those without a translucent layer.

Resumo em Inglês:

This study evaluated the effect of cleanser solutions on the color of heat-polymerized acrylic resin (HPAR) and on the brightness of dental alloys with 180 immersion trials. Disk-shaped specimens were made with I) commercially pure titanium, II) nickel-chromium-molybdenum-titanium, III) nickel-chromium molybdenum, and IV) nickel-chromium-molybdenum beryllium. Each cast disk was invested in the flasks, incorporating the metal disk into the HPAR. The specimens (n = 5) were then immersed in solutions containing: 0.05% sodium hypochlorite, 0.12% chlorhexidine digluconate, 0.500 mg cetylpyridinium chloride, a citric acid tablet, one of two different sodium perborate/enzyme tablets, and water. The color measurements (∆E) of the HPAR were determined by a colorimeter in accordance with the National Bureau of Standards. The surface brightness of the metal was visually examined for the presence of tarnish. The results (ANOVA; Tukey test-α = 0.05) show that there was a significant difference between the groups (p < 0.001) but not among the solutions (p = 0.273). The highest mean was obtained for group III (5.06), followed by group II (2.14). The lowest averages were obtained for groups I (1.33) and IV (1.35). The color changes in groups I, II and IV were slight but noticeable, and the color change was considerable for group III. The visual analysis showed that 0.05% sodium hypochlorite caused metallic brightness changes in groups II and IV. It can be concluded that the agents had the same effect on the color of the resin and that the metallic alloys are not resistant to the action of 0.05% sodium hypochlorite.

Resumo em Inglês:

This study evaluated the biomechanical influence of apical bone anchorage on a single subcrestal dental implant using three-dimensional finite element analysis (FEA). Four different bone anchorage designs were simulated on a posterior maxillary segment using one implant with platform switching and internal Morse taper connection as follows: 2 mm subcrestal placement with (SW) or without (SO) the implant apex engaged into the cortical bone or position at bone level with anchorage only in the crestal cortical (BO) bone or with bicortical fixation (BW). Each implant received a premolar crown, and all models were loaded with 200 N to simulate centric and eccentric occlusion. The peak tensile and compressive stress and strain were calculated at the crestal cortical, trabecular, and apical cortical bone. The vertical and horizontal implant displacements were measured at the platform level. FEA indicated that subcrestal placement (SW and SO) created lower stress and strain in the crestal cortical bone compared with crestal placement (BO and BW models). The SW model exhibited lesser vertical and horizontal implant micromovement compared with the SO and BO models under eccentric loading; however, stress and strain were higher in the apical cortical bone. The BW model exhibited the lowest implant displacement. These results indicate that subcrestal placement decreases the stress in the crestal cortical bone of dental implants, regardless of apical anchorage; however, apical cortical anchorage can be effective in limiting implant displacement. Further studies are required to evaluate the effects of possible remodeling around the apex on the success of subcrestal implants.

Resumo em Inglês:

This study examined the effect of cariogenic and erosive challenges (CCs and ECs, respectively) on the degradation of copper-nickel-titanium (CuNiTi) orthodontic wires. Sixty wire segments were divided into four treatment groups and exposed to CCs, ECs, artificial saliva, or dry storage (no-treatment control). CC and EC were simulated using a demineralizing solution (pH 4.3) and a citric acid solution (pH 2.3), respectively. Following treatment, the average surface roughness (Ra) of the wires was assessed, and friction between the wires and a passive self-ligating bracket was measured. CuNiTi wires subjected to ECs exhibited significantly higher Ra values than did those that were stored in artificial saliva. In contrast, surface roughness was not affected by CCs. Finally, friction between the treated wires and brackets was not affected by ECs or CCs. Our results indicate that CuNiTi orthodontic wires may suffer degradation within the oral cavity, as ECs increased the surface roughness of these wires. However, rougher surfaces did not increase friction between the wire and the passive self-ligating bracket.

Resumo em Inglês:

The aim of this study was to evaluate the effect of a commercial lactose-containing stevioside sweetener on biofilm acidogenicity in vivo. Nine volunteers refrained from brushing their teeth for 3 days in five phases. On the 4th day of each phase, the pH of the biofilm was measured by the “Strip method”. Interproximal plaque pH was measured before and up to 60 minutes after a 10 mL mouthrinse for 1 minute with the test solutions: I - sweetener with 93% lactose and 7% stevioside; II - sweetener with 6.8% saccharin, 13.6% cyclamate, and 0.82% stevioside; III - 18% sucrose solution (positive control); IV - mineral water (negative control); and V- 93% lactose solution. The results revealed that the most pronounced pH fall was found with sucrose (positive control), followed by the 93% lactose solution, the sweetener with lactose + stevioside, the sweetener with saccharin + cyclamate + stevioside, and finally water (negative control). According to the area under the curve, the two sweeteners containing stevioside were significantly different, and the sweetener with lactose + stevioside was significantly different from water but not from sucrose. The critical pH for dentin demineralization (pH ≤ 6.5) was reached by all volunteers after rinsing with sucrose solution, lactose solution, and the stevioside + lactose sweetener. Analysis of the data suggests that lactose-containing stevioside sweeteners may be cariogenic, especially to dentin.

Resumo em Inglês:

The aim of this study was to examine the effect of the light source on the microshear bond strength of different composite resins repaired with the same substrate. Thirty cylindrical specimens of each composite resin—Filtek Silorane, Filtek Z550 (3M ESPE), Gradia Direct Anterior (GC), and Aelite Posterior (BISCO)—were prepared and light-cured with a QTH light curing unit (LCU). The specimens were aged by thermal cycling and divided into three subgroups according to the light source used—QTH, LED, or PAC (n = 10). They were repaired with the same substrate and a Clearfil Repair Kit (Kuraray). The specimens were light-cured and aged for 1 week in distilled water at 37 °C. The microshear bond strength and failure modes were assessed. There was no significant difference in the microshear bond strength values among the composite resins, except for the Filtek Silorane group that showed significantly lower bond strength values when polymerized with the PAC unit compared to the QTH or LED unit. In conclusion, previously placed dimethacrylate-based composites can be repaired with different light sources; however, if the composite to be repaired is silorane-based, then using a QTH or LED device may be the best option.

Resumo em Inglês:

Fractured abutment screws may be replaced; however, sometimes, the screw cannot be removed and the entire implant must be surgically removed and replaced. The aim of this study was to compare the fracture resistance of abutment retention screws made of titanium, polyetheretherketone (PEEK) and 30% carbon fiber-reinforced PEEK, using an external hexagonal implant/UCLA-type abutment interface assembly. UCLA-type abutments were fixed to implants using titanium screws (Group 1), polyetheretherketone (PEEK) screws (Group 2), and 30% carbon fiber-reinforced PEEK screws (Group 3). The assemblies were placed on a stainless steel holding apparatus to allow for loading at 45o off-axis, in a universal testing machine. A 200 N load (static load) was applied at the central point of the abutment extremity, at a crosshead speed of 5 mm/minute, until failure. Data was analyzed by ANOVA and Tukey’s range test. The titanium screws had higher fracture resistance, compared with PEEK and 30% carbon fiber-reinforced PEEK screws (p < 0.05). In contrast, no statistically significant difference was observed between the fracture resistance of the PEEK and the 30% carbon fiber-reinforced PEEK screws (p> 0.05). Finally, visual analysis of the fractions revealed that 100% of them occurred at the neck of the abutment screw, suggesting that this is the weakest point of this unit. PEEK abutment screws have lower fracture resistance, in comparison with titanium abutment screws.

Resumo em Inglês:

This study aimed at evaluating how well dentists understand medical emergency/urgency procedures and issues during dental treatment at a hospital specialized in cleft lip and palate. It comprised a hundred dentists from the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Brazil, from different dental specialties. A questionnaire was applied to evaluate their knowledge of medical emergencies/urgencies from June through September 2011. The questionnaire was anonymous, confidential and constructed with closed questions and either yes-no or multiple-choice responses. Results showed that most professionals (87%) were trained in basic life support (BLS), but only 43% considered themselves capable of providing first aid and performing the necessary maneuvers. Most participants (94%) claimed that they knew the difference between medical urgencies and emergencies, and 69% had BLS training in their undergraduate courses, as opposed to 37%, during their specialization. Some participants (23%) mentioned that they had received knowledge of the subject during extracurricular courses and/or graduate courses (12%). Only 9% had not been educated on the subject; however, all participants showed interest in attending a course in BLS. In regard to assessing training that dentists who attended BLS courses received, 49% were satisfied and 42% were dissatisfied. Results of the present study emphasize that dentists from HRAC/USP have little knowledge about BLS procedures to perform them. Dentists must gain adequate education and training to minimize possible technical, ethical and legal problems associated with dental practice. It is necessary to improve both knowledge and practice in order to become well-qualified practitioners.

Resumo em Inglês:

The aim of this prospective clinical study was to evaluate patient rehabilitation with two immediately loaded implants and bar-retained mandibular overdentures after 48 months of follow-up. Twenty patients were treated with two implants each; of these, 17 patients were re-evaluated for comparison. Gender, age, plaque index, gingival inflammation, keratinized mucosa, probing depth, bleeding, and implant loss data were recorded, and periapical radiographs were obtained for measurement of marginal bone loss. The results were statistically analyzed with one-way analysis of variance (ANOVA) followed by Student’s t-test and Pearson’s correlation test. To compare the data at baseline and after 48 months, a Wilcoxon Signed Rank Test was performed (α = 0.05). One implant failed (2.9%) during the first year and was replaced. A total of 35 implants were evaluated. Bone loss values were 0.52–2.89 mm (mean, 1.46 mm). Probing depth was 1.75–3.75 mm (mean, 2.22 mm). Correlations were found between bone loss and plaque index and between bone loss and gender, but bone loss did not correlate with gingival inflammation, keratinized mucosa, probing depth, or age. The overall survival rate of the implants was 97.1%. Based on these results, the use of two immediately loaded splinted interforaminal implants to retain an overdenture with a bar attachment is a clinically viable option with a high survival rate.

Resumo em Inglês:

The aim of this study was to compare the efficacy of chemochemical methods (Carisolv™ and Papacárie®) versus the manual method (excavators) in reducing the cariogenic microbiota in dentine caries of primary teeth. Forty-six healthy children (5 to 9 years old) having at least one primary tooth with a cavitated dentine carious lesion were included in the study. The teeth presented no clinical or radiographic signs of pulpal involvement. The sample of 74 teeth was randomly divided into three different groups: Papacárie® (n = 25), Carisolv™ (n = 27) and Manual (n = 22). Samples of carious and sound dentine were collected with sterile excavators before and after caries removal in the three groups. The dentine samples were transferred to glass tubes containing a 1mL thioglycollate medium used as a carrier and enriched for microbiological detection of mutans streptococci and Lactobacillus spp, after incubation for 6h at room temperature. The minimum detection value for colony forming units (CFU) was 3.3 x 102 CFU/ml, and the results were converted into scores from 0 to 4. A significant difference was observed in relation to the microbiological scores before and after caries removal for all methods (Wilcoxon test; p < 0.001). The use of chemomechanical methods for caries removal did not improve the reduction of cariogenic microorganisms in dentine caries lesions, in comparison with manual excavation.

Resumo em Inglês:

The aim of this study was to evaluate the association between tooth loss and overweight/obesity in an adult Brazilian population. It is a cross-sectional study comprising 3,930 adults [1,744 men and 2,186 women; median age of 40 y (ranging 20-59); 16.9% obese; 7.3% almost all or all teeth missing]. Data were collected using a self-administered questionnaire for tooth loss (4 categories), diet, access and use of health services, socioeconomic factors, health habits and behaviors, demographics and anthropometric measurements. Multiple ordinal logistic regressions were performed. In comparison with adults with BMI < 25 kg/m2, the overweight (BMI ≥ 25 and < 30kg/m2) and obese individuals (BMI ≥ 30 kg/m2) showed a greater odds of tooth loss (OR = 1.6, 95% CI 1.4-1.9 and OR = 2.1, 95% CI 1.8-2.5, respectively). After adjusting for potential confounders, overweight and obesity showed no statistically significant associations with tooth loss, with OR = 0.8 and OR = 0.9, respectively. The results of this study are consistent with the hypothesis that the association between overweight/obesity and tooth loss can be explained by known, common risk factors.

Resumo em Inglês:

The aim of this study was to estimate the reliability, validity and factorial invariance of the Portuguese version of the Geriatric/General Oral Health Assessment Index (GOHAI) as applied to Brazilian women. A total 701 women over 18 years of age participated in this study. Telephone interviews were conducted. We evaluated the construct-related validity through factorial, convergent and discriminant validity. We carried out a confirmatory factor analysis using the χ2/df, CFI, GFI and RMSEA indexes. The invariance of the model in a second independent sample was estimated by multi-group analysis and internal consistency using Cronbach’s alpha coefficient. Items 5 and 9 presented factor weights below the adequate value and were removed. The three-dimensional and unifactorial model presented an adequate fit. We observed strong factorial invariance of the models in two independent samples (three-factor: ρλ = 0.62; pCov = 0.89, one-factor: ρλ = 0.81; pCov = 0.68) and weak factorial invariance between users and nonusers of dental prosthetics (three-factor: ρλ = 0.55; pCov = 0.01, one-factor: ρλ = 0.51; pCov = 0.02). The convergent validity was suboptimal. Internal consistency was adequate. The GOHAI applied to the study sample showed adequate reliability, factorial validity and stability in independent samples and between users and nonusers of dental prosthetics in both the three-dimensional and the unifactorial structures.

Resumo em Inglês:

The aim of this study was to investigate the occurrence of mutations in the amelogenin gene (AMELX) in patients with cleft lip and palate (CLP) and enamel defects (ED). A total of 165 patients were divided into four groups: with CLP and ED (n=46), with CLP and without ED (n = 34), without CLP and with ED (n = 34), and without CLP or ED (n = 51). Genomic DNA was extracted from saliva followed by conducting a Polymerase Chain Reaction and direct DNA sequencing of exons 2 through 7 of AMELX. Mutations were found in 30% (n = 14), 35% (n = 12), 11% (n = 4) and 13% (n = 7) of the subjects from groups 1, 2, 3 and 4, respectively. Thirty seven mutations were detected and distributed throughout exons 2 (1 mutation – 2.7%), 6 (30 mutations – 81.08%) and 7 (6 mutations – 16.22%) of AMELX. No mutations were found in exons 3, 4 or 5. Of the 30 mutations found in exon 6, 43.34% (n = 13), 23.33% (n = 7), 13.33% (n = 4) and 20% (n = 6) were found in groups 1, 2, 3 and 4, respectively. c.261 C > T (rs2106416), a silent mutation, was detected in 26 subjects, and found more significantly (p = 0.003) in patients with CLP (groups 1 and 2 – 23.75%), compared with those without CLP (groups 3 and 4 – 8.23%). In the groups without ED, this silent mutation was also found more significantly (p = 0.032) among subjects with CLP (17.65% in group 2), compared with those without CLP (7.8% in group 4). In conclusion, this study suggested that AMELX may be a candidate gene for cleft lip and palate.

Resumo em Inglês:

This study aimed at assessing the prevalence of soft tissue oral manifestations in children during early childhood, according to age group, gender, and site in the oral cavity, and at correlating these oral manifestations with systemic alterations. A cross-sectional study was conducted involving 586 children from 0 to 3 years of age (12.4 ± 11.8 months), 316 (53.9%) male and 270 (46.1%) female, in the city of Mauá, SP, Brazil. Examination was performed by a single examiner (Kappa Index = 0.90) according to World Health Organization criteria (WHO, 1997).The prevalence of oral manifestations in the soft tissues of children during early childhood was 34.8%. The age group showing statistical significance was 0-1 months old (56.4%). Epstein’s pearls were significantly present (43.2%) in 0-1-month-old babies, and gingivitis in 12-24-month-olds (15.9%). The palate was the most affected region (16.7%). Infectious alterations were the most prevalent systemic alteration (20%). An association was observed between the presence of systemic alterations and the occurrence of oral manifestations. The prevalence of oral manifestations was 34.8%, regardless of gender, and was manifested mostly in 0-1-month-old babies. The palate was the most prevalent region, and the majority of oral manifestations were associated with systemic alterations.

Resumo em Inglês:

Manufacturers offer various prescriptions of preadjusted brackets for use in the “straight-wire” orthodontic technique. However, the need to incorporate bends in the rectangular wires during orthodontic finishing has led to concerns regarding the type of prescription chosen and the credibility of information provided by the manufacturer. The aim of this study was to compare the slot angulations of Roth prescription preadjusted metallic brackets for the maxillary left central incisor and maxillary left canine. For each tooth type, 10 brackets of three commercial brands (GAC, Forestadent and Morelli) were selected. Two individual metal matrices for brackets and tooth positioning were made for each group of teeth. Captured images were obtained by standardized ortho-radial photography with a digital camera. Images were exported and analyzed with the Image J software package. One-way ANOVA and Tukey statistical analyses were performed at the 5% significance level. For brackets of the maxillary left central incisor, differences in mean angulation were observed between the Morelli and GAC groups (p < 0.01) and between the Forestadent and GAC groups (p < 0.01). For brackets of the maxillary left canine, differences in mean angulation were found between the Morelli and GAC groups (p < 0.01) and between the Morelli and Forestadent groups (p < 0.05). In conclusion, despite their same prescription name, the different brands exhibited significantly different angulation measurements.

Resumo em Inglês:

This single-blind, randomized, crossover study aimed at assessing the long-term fluoride concentrations in saliva and in dental biofilm after different home-use fluoride treatments. The study volunteers (n = 38) were residents of an area with fluoridated drinking water. They were administered four treatments, each of which lasted for one week: twice-daily placebo dentifrice, twice-daily fluoride dentifrice, twice-daily fluoride dentifrice and once-daily fluoride mouthrinse, and thrice-daily fluoride dentifrice. At the end of each treatment period, samples of unstimulated saliva and dental biofilm were collected 8 h after the last oral hygiene procedure. Fluoride concentrations in saliva and dental biofilm were analyzed using a specific electrode. The fluoride concentrations in saliva and dental biofilm 8 h after the last use of fluoride products did not differ among treatments. The results of this study suggest that treatments with home-use fluoride products have no long-term effect on fluoride concentrations in saliva and in dental biofilm of residents of an area with a fluoridated water supply.

Resumo em Inglês:

This study investigated the impacts of oral health-related quality of life (OHRQoL) on daily activities and work productivity in adults. A cross-sectional study was conducted in a supermarket chain in the state of São Paulo, which included 386 workers, age-range 20 – 64 years. Participants were examined for oral disease following WHO recommendations, and the oral health impact profile (OHIP) assessment was used to determine OHRQoL. Demographic, socio-economic, use of dental services, and OHRQoL data were obtained. Answers to the OHIP were dichotomized into no impact and some impact, and the relationship to OHRQoL was determined. Poisson regression with robust variance was performed using SPSS version 17.0. Dimensions with highest OHIP scores were physical pain and psychological discomfort. Sex (male: PR = 0.55, 95% CI 0.38 – 0.80), lower family income (PR = 1.49, 95% CI 1.04 – 2.12), visiting a dentist due to pain (PR = 2.14, 95% CI 1.57 – 3.43), tooth loss (PR = 1.59, 95% CI 1.09 – 2.32), and needing treatment for caries (PR = 1.59, 95% CI 1.09 – 2.32) were most likely to impact OHRQoL. Therefore, socioeconomic and demographic status and use of dental services impacted OHRQoL. These results indicate that oral health promotion strategies should be included in work environments.

Resumo em Inglês:

Several studies have indicated an increased resistance of microorganisms resulting from the widespread use of antimicrobial agents. However, few data are available in the dental literature. The aim of this study was to conduct a survey on the patterns of patient usage of antimicrobial prescriptions agents by dentists. A retrospective cross-sectional study was based on the medical records of 223 patients who sought treatment at the Urgency Service, from a Dental School in the South of Brazil, from March 2009 to March 2011. A specific data sheet was used, with questions regarding: patient age and gender; the main complaint; medications used prior to the service; final diagnosis; proposed dental treatment (including prescription medications); and characteristics of the final prescription. Descriptive and inferential statistics were obtained. There was a high frequency of antibiotic use prior to attendance by young patients (Fisher’s exact test, p < 0.05). Toothache of endodontic origin was the most frequent patient complaint (72.6%). Endodontic procedures were the measures most frequently adopted to treat the pain (31.2%). The frequency of patient use of antimicrobials prior to the appointment was 14.3%. According to patient records, 83.9% had no systemic drug prescription after receiving urgency treatment. There were few antimicrobial prescriptions after the urgency treatment. The most frequently prescribed agents were amoxicillin, chlorhexidine, and metronidazole. Local measures were more frequently used than systemic approaches to treat urgencies of dental origin. Antimicrobial agents were not frequently prescribed as adjunctives to local administered at the urgency service.

Resumo em Inglês:

The aim of this study was to measure the publication rate of editorial board members in their board journals and to evaluate associated variables. We evaluated the ten highest-ranked journals according to the 5-year impact factor under ‘Dentistry, Oral Surgery & Medicine’ subject category for 2010, 2011, and 2012. All original research papers with at least one member of the editorial board as author were counted. Final analyses assessed associated variables such as size of the editorial board, number of papers published each year, and each journal’s impact factor. Overall, there was an increase in the average number of articles published from 2010 (115.2 ± 52.2) to 2012 (134.7 ± 47.4). The number and percentage of articles published with editorial board members as authors over the three years did not follow the same pattern, with a slight decrease from 2010 to 2011 and an increase in 2012. The number of articles with editorial board members as authors was significantly higher for journals with impact factors ≥4.0. Journals with a higher impact factor and larger editorial board were associated with higher chances of editorial board members publishing in their respective journals. Participation of editorial board members as authors in publishing varies significantly among journals.

Resumo em Inglês:

This study compared the fluid filtration, adaptation to the root canal walls, and the push-out bond strength of two resin-based sealers and three calcium silicate-based retrograde filling materials. Fifty maxillary canines were shaped using manual instruments and the apical portion was sectioned. Retrograde cavities of 3-mm depth were prepared. The specimens were divided into five groups (n = 10): Sealer 26 (S26); MBPc (experimental); MTA; Portland cement with 20% zirconium oxide (PC/ZO), and Portland cement with 20% calcium tungstate (PC/CT). The fluid filtration was measured at 7 and 15 days. To evaluate the interfacial adaptation, sections of the teeth, 1 and 2 mm from the apex, were prepared and the percentage of gaps was calculated. The push-out bond strength at 2 mm from the apex was evaluated. Statistical analysis was performed using the ANOVA/Tukey’s test (p < 0.05). At 7 and 15 days (p = 0.0048, p = 0.006), the PC/CT group showed higher fluid filtration values when compared to other groups. At 1 mm from the apex, no statistical differences in the adaptation were found among the cements (p = 0.44). At 2 mm from the apex, the PC/ZO group presented statistically lower percentage of gaps than S26, MBPc, and MTA (p = 0.0007). The MBPc group showed higher push-out bond strength than other cements evaluated (p = 0.0008). The fluid filtration and interfacial adaptation of the calcium silicate-based cements were similar to those of the resin-based cements. The resinous cement MBPc showed superior push-out bond strength.

Resumo em Inglês:

The objective of this study was to evaluate the cytological content of ameloblastomas of the jaw. Nine cases of ameloblastoma were punctured, and the intralesional material was processed using the cell block technique. After centrifugation, the pellet obtained from the punctured material was fixed in formaldehyde and routinely processed to inclusion in paraffin. The obtained sections were stained with haematoxylin and eosin (H&E). Immunohistochemical reactions against anti-pan-cytokeratin (AE1/AE3) were performed to measure the presence of epithelial cells. Cytological analyses of the obtained slides revealed the presence of epithelial cells (as evidenced by AE1/AE3 labelling) and acellular amorphous eosinophilic materials. These cytological findings, in light of clinical and imaging data, can be helpful in the presumptive diagnosis of this disease entity by eliminating other possible diagnoses. Nonetheless further studies are needed in order to determine the nature of the acellular amorphous eosinophilic material and to ascertain the immunoprofile of epithelial cells.

Resumo em Inglês:

This study evaluated the ion exchange at the material/enamel interface and the preventive effect of restorative materials submitted to cariogenic challenge against white spot. Restorations in enamel/dentin of bovine teeth were performed with composite resin (Filtek™ Z250 – control group) and glass-ionomers cements - GICs (Ionomaster R™ and Fuji IX™ - experimental groups). Samples were grouped and submitted to neutral saliva (n = 15) or pH-cycling regimen (n = 15). After eight days of pH cycling, material/enamel interfaces were analyzed by EDX in order to determine the differences (p < 0.05) in ionic exchange (Ca, P, F, Al, Sr, and Si) between restorative materials and teeth. In addition, enamel white spot lesion formation was evaluated macroscopically (p < 0.05). Sr content was higher in the enamel of the control group (p > 0.05) versus the experimental groups. Ca and P content were higher in enamel than in restorative materials. After pH cycling, the GIC enamel bulk showed a significantly higher Sr content compared with the composite resin (p < 0.05). Filtek™ Z250 was not able to prevent white spot formation around restorations in comparison with Ionomaster R™ (p < 0.001) and Fuji IX™ (p = 0.004). GICs reduced white spot formation and presented a preventive effect (p = 0.051). GICs presented a greater percentage of fluoride, aluminum, and strontium, and proved effective in white spot lesion prevention around restorations.

Resumo em Inglês:

The aim of this study was to determine the efficacy of pixel value analysis using images generated by the Digora™ and Visualix™ systems for the early detection of external root resorption (ERR). Thirty extracted human lower incisors were radiographed using the Digora and Visualix systems; then, ERR was induced by immersing the teeth in 6 mol L-1 of hydrochloric acid for different periods of time (10, 30 and 60 minutes). ERR was confirmed by calcium quantification with an atomic absorption spectrophotometer. One digital image was acquired per time period at 70 kVp, 7 mA, 2.2 mm filtration, focus-film distance of 30 cm, and with exposure times of 0.09 s in the Digora system and 0.05 s in Visualix system. The region of interest was defined using ImageJ software. Statistical analysis was performed using ANOVA and Pearson’s correlation (p < 0.05). There was no statistically significant difference between the time for ERR induction and the pixel values with either system. A positive correlation between the time of ERR induction and the calcium concentration was observed (r = 0.8892; p < 0.001). In conclusion, independent of the site of ERR induction and the digital system, pixel value analysis was not effective for ERR detection.

Resumo em Inglês:

The aim of this study was to evaluate the influence of a calcium silicate-based sealer (iRoot SP), with or without a core material, on bond strength to radicular dentin, in comparison with various contemporary root filling systems. Root canals of freshly extracted single-rooted teeth (n = 60) were instrumented using rotary instruments. The roots were randomly assigned to one of the following experimental groups: (1) a calcium silicate-based sealer without a core material (bulk-fill); (2) a calcium silicate-based sealer + gutta-percha; (3) a calcium silicate-based sealer + Resilon; (4) a methacrylate resin-based sealer (RealSeal SE) + Resilon; (5) an epoxy resin-based sealer (AH Plus) + gutta-percha, and (6) a mineral trioxide aggregate-based endodontic sealer (MTA Fillapex) + gutta-percha. Four 1-mm-thick sections were obtained from the coronal aspect of each root (n = 40 slices/group). Push-out bond strength testing was performed at a cross-head speed of 1 mm/min, and the bond strength data were analyzed statistically by one-way analysis of variance and Tukey tests (p < 0.05). The highest and lowest debonding values were obtained for the calcium silicate-based sealer bulk-fill and mineral trioxide aggregate-based endodontic sealer + gutta-percha groups, respectively (p < 0.05). It was concluded that the calcium silicate-based sealer showed higher resistance to dislocation in the bulk-filled form than in conjunction with the tested core filling materials. When the calcium silicate-based sealer was placed in bulk, its dislocation resistance was similar to that of commonly used sealer + core root filling systems. Thus, the concept of using a calcium silicate-based sealer in bulk can be more easily advocated in clinical practice.

Resumo em Inglês:

This study aimed to compare the effects of ethylenediaminetetraacetic acid (EDTA) and maleic acid (MA) on the sealing ability of various root canal sealers. Eighty root canals were instrumented and irrigated with either EDTA or MA. They were divided into eight experimental groups and obturated as follows: Group 1: MA + Hybrid Root SEAL/gutta-percha. Group 2: EDTA + Hybrid Root SEAL/gutta-percha. Group 3: MA + iRoot SP/gutta-percha. Group 4: EDTA + iRoot SP/gutta-percha. Group 5: MA + EndoREZ/EndoREZ points. Group 6: EDTA + EndoREZ/EndoREZ points. Group 7: MA + AH Plus/gutta-percha. Group 8: EDTA + AH Plus/gutta-percha. Another ten roots were used as negative and positive controls. The microleakage of each sample was measured at 2-min intervals for 8 min using the fluid filtration method. Data were statistically analyzed with one-way ANOVA, post-hoc Tukey, and paired-samples t tests. The minimum microleakage values were obtained from the teeth obturated with AH Plus and EndoREZ selaers (p < 0.001). The samples with Hybrid Root SEAL showed the maximum leakage (p < 0.001). There were significant differences between the groups irrigated with MA or EDTA in terms of microleakage (p < 0.05). Use of MA resulted in higher microleakage values compared with those using EDTA. The type of final irrigation solution seems to influence the postobturation apical seal. Use of AH Plus and EndoREZ sealers showed better sealing ability compared with IRoot SP and Hybrid Root SEAL.

Resumo em Inglês:

It is known that cetylpyridinium chloride (CPC) has in vitro and in vivo antifungal action against Candida albicans, with advantages over other common antiseptics. A CPC delivery-controlled system, transported in polymer nanofibers (PVP/PMMA), was developed to increase the bioavailability of the drug in contact with the oral mucosa. The objectives of this study were to determine if CPC in nanofiber has antifungal action against C. albicans, and in what concentration it must be incorporated, so that the fraction released can yield an inhibitory concentration. The nanofiber was prepared by electrospinning, and sterilized with gamma irradiation. Nanofiber disks with 0.05%, 1.25%, 2.5% and 5% CPC, with 5% miconazole (MCZ) and with no drug, as well as filter paper disks with 5% CPC, with 5% MCZ and with no drug were used in this study. A Candida albicans suspension (ATCC 90028) was inoculated in Mueller-Hinton Agar plates. The disks were placed on the plates and the inhibition zone diameters were measured 48h later. The nanopolymeric disks contracted in contact with the agar. All the concentrations of CPC incorporated in the nanofiber presented inhibitory action against C. albicans. Concentrations of 2.5% and 5% CPC presented a significant advantage over the nanofiber with no drug, proving the antifungal action of CPC. Under these experimental conditions, 5% CPC has greater inhibitory action against C. albicans than 5% MCZ, both in nanofiber and in filter paper. A modification made in the polymer to decrease the contraction rate may allow a larger inhibition zone to be maintained, thereby increasing the clinical usefulness of the polymer.

Resumo em Inglês:

Conventional tilted implants are used in oral rehabilitation for heavily absorbed maxilla to avoid bone grafts; however, few research studies evaluate the biomechanical behavior when different angulations of the implants are used. The aim of this study was evaluate, trough photoelastic method, two different angulations and length of the cantilever in fixed implant-supported maxillary complete dentures. Two groups were evaluated: G15 (distal tilted implants 15°) and G35 (distal tilted implants 35°) n = 6. For each model, 2 distal tilted implants (3.5 x 15 mm long cylindrical cone) and 2 parallel tilted implants in the anterior region (3.5 x 10 mm) were installed. Photoelastic models were submitted to three vertical load tests: in the end of cantilever, in the last pillar and in the all pillars at the same time. We obtained the shear stress by Fringes software and found values for total, cervical and apical stress. The quantitative analysis was performed using the Student tests and Mann-Whitney test; p ≥ 0.05. There is no difference between G15 and G35 for total stress regardless of load type. Analyzing the apical region, G35 reduced strain values considering the distal loads (in the cantilever p = 0.03 and in the last pillar p = 0.02), without increasing the stress level in the cervical region. Considering the load in all pillars, G35 showed higher stress concentration in the cervical region (p = 0.04). For distal loads, G15 showed increase of tension in the apical region, while for load in all pillars, G35 inclination increases stress values in the cervical region.

Resumo em Inglês:

This study assessed the cross-sectional Knoop microhardness and flexural strength of root dentin exposed to different surface treatments with chemical agents after biomechanical preparation. Root canals from human canines were biomechanically treated and divided into eight groups (n=10) to receive one of the following dentin treatments: I. Deionized water (control); II. 5.25% Sodium hypochlorite (NaOCl); III. NaOCl + 10% Sodium ascorbate (SA); IV. SA; V. 2% Chlorhexidine gel (CHX); VI. 37% Phosphoric acid gel (PA) + CHX; VII. PA; and VIII. PA + NaOCl. The roots were sectioned to obtain specimens that were evaluated for cross-sectional Knoop microhardness and flexural strength using a three-point bending test. ANOVA and Tukey’s test were performed. The microhardness in the control group was significantly higher (p < 0.05) than in the groups exposed to chemical agents, which in turn were statistically similar (p > 0.05) to each other. Regarding flexural strength, PA+NaOCl provided statistical higher values than PA+CHX and CHX. However, there was no significant difference between the control group and those groups subjected to surface treatment (p > 0.05). Dentin microhardness was reduced after exposure to NaOCl, CHX, PA, SA and their associations and the flexural strength of radicular dentin was not affected by the chemical agents.

Resumo em Inglês:

The aim of this study was to evaluate the resorption process during the repair of autogenous bone grafts with or without coverage by an expanded polytetrafluoroethylene (e-PTFE) membrane in female rats with estrogen deficiency using the immunohistochemical technique. Eighty female rats were randomly divided into two groups (OVX and SHAM). The 40 female rats in the OVX group were subjected to ovariectomy, and the 40 female rats in the SHAM group were subjected to simulated ovariectomy. The two groups were further divided in subgroup E, which was subjected to surgery for placement of autogenous bone graft (ABG), and subgroup ME, in which the ABG was covered with an e-PTFE membrane. The animals were killed at 0, 7, 21, 45 and 60 days. The specimens were analyzed using immunohistochemistry for the bone resorption markers RANK, RANK-L and Osteoprotegerin (OPG). A higher remodeling rate was observed at 7 and 21 days after the autogenous bone grafts, when the markers were more intensely expressed. At the final time point, the specimens presented similar characteristics to those observed at the initial time point. The expression of immunohistochemical markers was not altered by the estrogen deficiency. The presence of the e-PTFE membrane delayed the bone resorption process, influencing the immunohistochemical expression of markers.

Resumo em Inglês:

The objective of the present study was to evaluate and compare the influence of cetrimide on decalcifying capability of different irrigating solutions. Fifteen maxillary central incisor teeth has been collected. The canals were prepared in order to obtain four samples from each root. The specimens were randomly divided into 6 experimental groups (n=10) according to tested irrigating agents. Irrigating agents consisted in different composition of EDTA and citric acid solutions, addicted or not with cetrimide. Each specimen was submitted to three successive 5-min immersions in each solution. After exposures, the concentration of Ca2+ extracted was measured by inductively coupled plasma-atomic emission spectrometry (ICP-AES). Data were analysed by means of Kruskal Wallis and Mann Whitney tests. Significance was predetermined at p < 0.05. For all irrigants, the amounts of Ca2+ extracted from root canal dentin samples at 10 minutes were not significantly different from values reported after 15 minutes respectively. Therefore, for all irrigants tested, 10 minutes of application are sufficient to obtain maximum Ca2+ release. Moreover citric acid based agents observed a higher release of Ca2+. The addition of cetrimide did not affect the decalcifying capability of the EDTA and citric acid solutions.

Resumo em Inglês:

Oral mucositis is a chief complication in patients undergoing hematopoietic stem cell transplantation (HSCT). It is considered a toxic inflammatory reaction that interferes with the patient’s recuperation and quality of life. Oral candidiasis is a common fungal infection observed in dental practice, particularly in immunocompromised patients. The aim of this study was to evaluate the presence of oral mucositis and oral candidiasis in patients who underwent HSCT and their correlation with the chemotherapeutic nadir (lowest possible outcome). We evaluated patients with different diagnoses who underwent HSCT at the Hospital Erasto Gaertner. No chemotherapeutic nadir curves could be associated with mucositis, and patients had different presentations of mucositis. No patient developed oral candidiasis during hospitalization. Together with cell counts, we collected demographic data including age, oral hygiene, habits harmful to health, and the use of oral prostheses. It was observed that patients who smoked cigarettes before hospitalization showed less mucositis, resulting in no feeding problems or other comorbid conditions due to the effect of mucositis. However, the nadir of the chemotherapy curve, in isolation, is not a predictive tool for the appearance (or no appearance) of oral mucositis.

Resumo em Inglês:

The aim of this study was to compare the amount of irrigant extrusion in simulated immature permanent teeth when the apical diameter and needle insertion depth were varied. Thirty single-rooted maxillary incisors with straight root canals were selected. The root length was standardized to a length of 9 mm. The teeth were divided into two experimental groups according to the degree of apical enlargement (n = 15). The apices were enlarged to a diameter of 1.10 mm or 1.70 mm by using a #3 or #6 peeso reamer, respectively, to simulate immature teeth. The irrigation solution was applied 2 or 4 mm short of the working length (WL) in each experimental group. The glass vial model was used for the collection of extruded irrigant beyond the root apex. A two-way repeated measures analysis of variance test showed that there was no significant difference between different needle insertion depths (2 and 4 mm short of the WL) in the group with an apical diameter of 1.70 mm (p > 0.05). In the group with an apical diameter of 1.10 mm, a 32% increase in irrigant extrusion was observed when the needle was positioned at 2 mm (p < 0.05). Regarding the effect of apical diameter, the group with a diameter of 1.70 mm showed more apical extrusion of the irrigant (34% increase for the needle positioned at 2 mm and 68% increase for the needle positioned at 4 mm). It was observed that the needle insertion depth and apical diameter have a significant effect on irrigant extrusion in immature permanent teeth.

Resumo em Inglês:

The aim of this study was to evaluate the pH, ultimate tensile strength (UTS), and micro-shear bond strength (µSBS) of two self-adhesive resin cements to enamel and dentin. Sound bovine incisors (n = 10) and two self-adhesive resin cements (i.e., RelyX U-100 and seT PP) were used. The pH of the resin cements was measured using a pH-indicator paper (n = 3). Specimens for UTS were obtained from an hourglass-shaped mold. For µSBS, cylinders with internal diameter of 0.75 mm and height of 0.5 mm were bonded to the flat enamel and dentin surfaces. Bonded cylinders were tested in the shear mode using a loop wire. The fracture mode was also evaluated. The cement seT PP showed a low pH; U-100 showed significantly higher UTS (49.9 ± 2.0) than seT PP (40.0 ± 2.1) (p < 0.05) and high µSBS to enamel (10.7 ± 3.7). The lowest µSBS was found for seT PP to dentin (0.7 ± 0.6); seT PP to enamel (4.8 ± 1.7), and for U-100 to dentin (7.2 ± 1.9), showing an intermediate µSBS value (p < 0.05). Adhesive failure was the most frequently observed failure mode. The resin cement that presented the lowest pH and UTS also presented the lowest micro-shear bond strength to enamel and dentin.

Resumo em Inglês:

This in vitro study aimed to investigate the potential of CO2 lasers associated with different fluoride agents in inhibiting enamel erosion. Human enamel samples were randomly divided into 9 groups (n = 12): G1-eroded enamel; G2-APF gel; G3-AmF/NaF gel; G4-AmF/SnF2 solution; G5-CO2 laser (λ = 10.6 µm)+APF gel; G6-CO2 laser+AmF/NaF gel; G7-CO2laser+AmF/SnF2solution; G8-CO2 laser; and G9-sound enamel. The CO2 laser parameters were: 0.45 J/cm2; 6 μs; and 128 Hz. After surface treatment, the samples (except from G9) were immersed in 1% citric acid (pH 4.0, 3 min). Surface microhardness was measured at baseline and after surface softening. The data were statistically analyzed by one-way ANOVA and Tukey’s tests (p < 0.05). G2 (407.6 ± 37.3) presented the highest mean SMH after softening, followed by G3 (407.5 ± 29.8) and G5 (399.7 ± 32.9). Within the fluoride-treated groups, G4 (309.0 ± 24.4) had a significantly lower mean SMH than G3 and G2, which were statistically similar to each other. AmF/NaF and APF application showed potential to protect and control erosion progression in dental enamel, and CO2 laser irradiation at 0.45J/cm2 did not influence its efficacy. CO2 laser irradiation alone under the same conditions could also significantly decrease enamel erosive mineral loss, although at lower levels.

Resumo em Inglês:

The objective of this study was to evaluate the effect of smoking on response to nonsurgical periodontal therapy using the primary outcome measure of bleeding on probing (BoP). An periodontist performed periodontal therapy on 11 smokers and 14 never smokers with periodontitis. Two examiners assessed visible plaque index, gingival bleeding index, probing pocket depth (PPD), BoP, suppuration on probing and clinical attachment level (CAL), at baseline and three months after therapy. BoP was categorized as 0 (absent), 1 (small bleeding point) and 2 (blood flow from the sulcus). Total BoP value was obtained by summing values of 1 and 2. All subjects had significant reductions in mean PPD and percentages of sites with BoP, with no difference between the groups. Only never smokers presented statistically significant CAL gain. BoP was significantly and consistently reduced at sites with initial PPDs of 1–3 mm and 4–6 mm in both groups. At sites with deep PPD ( ≥ 7mm), never smokers showed a greater mean reduction in the number of sites with BoP than did smokers (p < 0.05). Never smokers had significantly greater reduction in BoP 2 than smokers, at sites with moderate and deep baseline PPDs. The first group had a significant increase of BoP 1, at sites with initial PPDs of 4-6 mm. Thus, periodontal therapy reduced BoP in both groups. However, smoking could negatively affect the BoP reduction at deeper sites after nonsurgical periodontal therapy.

Resumo em Inglês:

MTA has been investigated as a root-end filling material. Its mechanism of action has some similarities to that of Ca(OH)2. The purpose of this study was to evaluate the repair process taking place in the delayed replantation of monkey teeth using calcium hydroxide and MTA as root canal filling materials. Five monkeys had their lateral incisors extracted and bench-dried for 60 minutes. After root canal preparation, the teeth were assigned to two groups according to root canal filling material: I, calcium hydroxide; and II, MTA. The same treatment sequence was followed for both groups: coronal seal, periodontal ligament removal, immersion of the tooth in 2% acidulated-phosphate sodium fluoride, irrigation of the socket with saline and replantation. Both groups exhibited replacement resorption, areas of ankylosis and absence of inflammatory root resorption. Statistically similar results (p > 0.05) were observed for both groups regarding replacement root resorption, but the groups differed significantly (p < 0.05) regarding the occurrence of ankylosis. MTA may be a viable clinical option for filling teeth submitted to delayed replantation, and is an acceptable option for treating replanted permanent teeth in order to prevent tooth resorption, particularly when dressing changes are not possible.

Resumo em Inglês:

This systematic review evaluated the influence played by the number of implants on the results of rehabilitation treatment with mandibular overdentures on 2 or 4 implants. The literature search was conducted using PubMed, Embase and Cochrane databases. Specific terms were used in performing a search from January 1980 to January 2013. The search strategy was applied by two reviewers who extracted the data and compared the results. Discrepancies were resolved by discussion. Great heterogeneity was seen among the selected studies, in regard to survival rates, prosthesis failure and function rates. A medium degree of quality and methodological consistency was found in one study, and no studies showed a high degree. When considering the prosthesis success rate for 2 implants, there was a variation of 23% to 100%. However, when considering the survival rate, the result was 92% to 100%. For 4 implants, prosthesis survival rates showed less variation, i.e., 97.7% to 100%. Ball attachments were the most common type of abutment for 2 implants; however, there was a higher prevalence of bar abutments for 4 implants. Rehabilitations with 2 implants showed more complications and required more maintenance according to the connection type. Given the limitations of this review, mandibular overdentures with 4 implants showed better results with respect to survival and success rates, especially those with a bar connection. Further studies comparing these two treatment types are necessary to improve the scientific evidence in this area.

Resumo em Inglês:

Dental pulp has been identified as a novel and promising stem cell source. The following systematic review presents and summarises in vivo studies that have used stem cells from the dental pulp of permanent and deciduous teeth to repair or regenerate non-dental tissues. An electronic customised search was performed using 4 different databases (Entrez PubMed, Cab Abstracts, Scopus and Web of Science). Only full-text research manuscripts published in English between the years of 2000 and 2012 were included. The manuscripts were retrieved based on the following keywords and/or abbreviations: [Stem Cells from Human Exfoliated Deciduous teeth (SHED)] AND/OR [Dental Pulp Stem Cells (DPSC)] AND [tissue regeneration] AND [tissue repair]. Only manuscripts involving in vivo applications of SHED or DPSC for the repair and/or regeneration of non-dental tissues were included. The search strategy produced 2309 papers, from which 14 were eligible according to the predetermined inclusion and exclusion criteria. Although human tissue was the source of cells in half of the studies included in our review, all of the studies involved transplantation into animals of other species, such as pigs, rats and mice. Most of the manuscripts reported the successful use of DPSCs or SHED for non-dental tissue repair or regeneration. While these cell populations represent promising alternative sources of stem cells for tissue engineering and cell-based regenerative medicine therapies, it is not yet possible to guarantee the appropriate clinical management of this technique.

Resumo em Inglês:

The aim of this study was to determine the frequency of leukemia in parents of patients with nonsyndromic cleft lip and/or cleft palate (NSCL/P). This case-control study evaluated first-degree family members of 358 patients with NSCL/P and 1,432 subjects without craniofacial alterations or syndromes. Statistical analysis was carried out using Fisher’s test. From the 358 subjects with NSCL/P, 3 first-degree parents had history of leukemia, while 2 out of 1,432 subjects from the unaffected group had a family history of leukemia. The frequency of positive family history of leukemia was not significantly increased in first-degree relatives of patients with NSCL/P.