Buffered 2% articaine in buccal infiltration of mandibular molars: a randomized triple-blind clinical trial

Abstract This crossover study aimed to compare the anesthetic effects of buffered 2% articaine with 1:200,000 epinephrine with that of non-buffered 4% articaine with 1:200,000 epinephrine. Forty-seven volunteers were administered two doses of anesthesia in the buccal region of the second mandibular molars in two sessions using 1.8 mL of different local anesthetic solutions. The onset time and duration of pulp anesthesia, soft tissue pressure pain threshold, and the score of pain on puncture and burning during injection were evaluated. The operator, volunteers, and statistician were blinded. There were no significant differences in the parameters: onset of soft tissue anesthesia (p = 0.80), duration of soft tissue anesthesia (p = 0.10), onset of pulpal anesthesia in the second (p = 0.28) and first molars (p = 0.45), duration of pulp anesthesia of the second (p = 0.60) and first molars (p = 0.30), pain during puncture (p = 0.82) and injection (p = 0.80). No significant adverse events were observed. Buffered 2% articaine with 1:200,000 epinephrine did not differ from non-buffered 4% articaine with 1:200,000 epinephrine considering anesthetic success, safety, onset, duration of anesthesia, and pain on injection.

Correlation between facial types and muscle TMD in women: an anthropometric approach

Temporomandibular disorders (TMD) affecting the articular disc and/or the facial muscles are common among the population, recording a higher incidence in women age 20-40 years. The aim of this study was to investigate the correlation between facial types and muscle TMD in women. This study comprised 56 women age 18 to 49 years, seeking treatment for TMD at the School of Medicine, Federal University of São Paulo. All of the study individuals were diagnosed with muscle TMD, based on the Research Diagnostic Criteria (RDC). Facial type was determined using the Facial Brugsch Index and classified as euryprosopic (short and/or broad), mesoprosopic (average width) and leptoprosopic (long and/or narrow). The data were submitted to the Chi-square test and ANOVA-Tukey’s test to conduct the statistical analysis. The faces of 27 individuals were classified as euryprosopic (48%), 18 as mesoprosopic (32%), and 11 as leptoprosopic (20%). A statistically significant difference (Chi-square, p = 0.032) was found among the facial types, in that leptoprosopic facial types showed the lowest values for muscle TMD. A greater number (p = 0.0007) of cases of muscle TMD were observed in the 20 to 39 year-old subjects than in the subjects of other age segments. In conclusion, women with euryprosopic facial types could be more susceptible to muscle TMD. Further studies are needed to investigate this hypothesis.

Relations between the mandibular canal and I, II and III Angle classes in panoramic radiographs / Relaciones entre el canal mandibular y clases I, II y III de Angle en radiografías panorámicas

To prevent injury to the inferior alveolar nerve during dental procedures, knowledge of its anatomical location and course of the mandibular canal is imperative. The aim of this study was evaluate the location on panoramic radiographs of the mandibular canal in relation to the apices of the permanent mandibular molars and base mandible, and relate the type of mandibular canal with Angle classes I, II and III. We evaluated 748 panoramic radiographs distributed according to sex and occlusal class (Angle I, II and III) of fully dentate individuals, 18­51 age group. The radiographs were divided according to Angle classes based on cephalometric tracing, clinical data from the medical records of each individual and the analysis of of the maxillar and mandibular dental arches models. The same individuals had the mandibular canal bilaterally assessed, and classified according to their location relative to the root apices of the mandibular molars and mandible base. Measurements of the distance from the mandibular canal to the apices of the teeth and mandible base were made on the Software ImageLab2000®. The intra-observer reproducibility of measurements on radiographs was assessed using the coefficient of variation (p<0.0001). Data were submitted to Kruskal-Wallis test, on software BioEstat 5.0. There were statistically significant differences (Kruskal-Wallis test, p <0.0001) between the occlusal classes, with the type of mandibular canal. A larger number of canals types 2 and 3 in class III individuals than in others. In conclusion, the location of the mandibular canal presents morphological changes in relation to the apices of the permanent molars, and the mandibular base according to the Angle classes I, II and III.

Para evitar lesiones del nervio alveolar inferior durante los procedimientos odontológicos, el conocimiento de la localización anatómica y curso del canal mandibular (CM) es imprescindible. El objetivo fue evaluar la localización del CM sobre radiografías panorámicas en relación con los ápices de los molares mandibulares permanentes y la base mandibular, relacionando el tipo de CM con las clases I, II y III de Angle. Se evaluaron 748 radiografías panorámicas distribuidas según sexo y clase oclusal (I, II y III de Angle) en individuos totalmente dentados (edad entre 18-51 años). Las radiografías fueron divididas de acuerdo a las clases de Angle según su trazado cefalométrico, datos clínicos de los registros médicos de cada individuo y el análisis de modelos de sus arcos dentarios mandibulares y maxilares. En los individuos se evaluó el CM bilateralmente y se clasificó de acuerdo a su ubicación en relación con los ápices radiculares de los molares mandibulares y base mandibular. Las mediciones de distancia desde el CM a los ápices radiculares y base mandibular se hicieron con el programa ImageLab2000®. Se evaluó la reproducibilidad intra-observador de las mediciones en las radiografías usando el coeficiente de variación (p<0,0001). Los datos fueron sometidos a la prueba de Kruskal ­Wallis con el programa BioEstat 5.0. Se observaron diferencias estadísticamente significativas (prueba de Kruskal-Wallis, p<0,0001) entre las clases oclusales y el tipo de CM. Hubo mayor número de canales tipos 2 y 3 en los individuos clase III. La ubicación del canal mandibular presenta cambios morfológicos en relación con los ápices de molares permanentes y la base mandibular de acuerdo a las clases I, II y III de Angle.

Correlação entre mordida cruzada posterior e alterações posturais em crianças pós-disjunção palatina / Posterior crossbite and postural changes in children after disjunction palatine

Avaliar a correlação entre mordida cruzada posterior e a melhora na postura global nos planos frontal, lateral e dorsal após disjunção palatina. Métodos: a amostra foi composta por dez crianças com idades entre seis e 13 anos, de ambos os gêneros, que apresentavam mordida cruzada posterior funcional. As crianças foram tratadas ortodonticamente por meio de disjunção palatina utilizando aparelho do tipo Hyrax. A avaliação postural global dos indivíduos foi feita por meio da análise comparativa de imagens fotográficas, realizadas com auxílio de simetrógrafo para observação dos planos: frontal (plano biacromial, cristas ilíacas e birotular); lateral (anteriorização e posteriorização de cabeça) e dorsal (plano biescapular, pregas glúteas e bimaleolar). Ao término do tratamento ortodôntico a postura global foi reavaliada. Resultados: os dados coletados foram submetidos a teste estatístico de Wilcoxon, com índice de significância de 0,05%. Os resultados obtidos pós-tratamento para o plano frontal indicaram que não houve alteração postural na articular biacromial (p=1,00); para o parâmetro articular cristas ilíacas observou-se melhora postural (p=0,016); no parâmetro birotular não houve melhora de simetria nessa articulação (p=1,00). No plano lateral não se obteve melhora na anteriorização de cabeça (p=0,125). No plano dorsal, no parâmetro articular biescapular não houve melhora na simetria desse plano (p=0,25); no parâmetro articular cristas ilíacas houve melhora na simetria dessa articulação (p=0,016); no parâmetro articular bimaleolar não houve melhora de postura nessa articulação (p=0,109). Conclusão: houve melhora postural após tratamento da mordida cruzada posterior por meio de disjunção palatina, para os planos frontal e dorsal no parâmetro cristas ilíacas...

To evaluate correlation between posterior crossbite and improvement in overall posture plans front, side and dorsal after palatal disjunction with the Hyrax appliance. Methods: ten children aged six to thirteen years, both genders, that presented crossbite functional were evaluated. All patients underwent orthodontic treatment by means of disjunction palate using Hyrax appliance. Postural assessment of global subjects was performed by comparative analysis of images using symmetrograph to observ front plans (biacromial plan, iliac crests and birotular); side (anterior and a posterior head) and dorsal (biescapular, folds gluteal and bimalleolar). Wilcoxon statistical test was using with a significance level of 0.05%. Results: the results obtained after treatment for frontal plane showed no postural changes in articular biacromial (p=1.00), for the parameter joint iliac crests obtained an improvement in posture (p=0.016). In parameter birotular were not improved symmetry in this joint (p=1.00). There were no improvement in forward head (p=0.125). On the dorsal plan, the joint parameter biescapular there was no improvement in the symmetry of the plan (p=0.25), the parameter articular iliac crests improvement in the symmetry of this joint (p=0.016), the joint parameter bimalleolar were not improved posture this joint (p=0.109). Conclusion: there was postural improvement after treatment of posterior cross bite using palatal expansion in front and dorsal plans in joint iliac crests parameter...