Pain factors related to dental implant surgery: A 7-day observational clinical study

This article aims to associate patient-reported pain intensity in the immediate seven days after dental implant surgery with surgical factors, sex and patient age. The sample was composed of 108 patients from a dental school in southern Brazilian, between 2018 and 2020. The variables torque, pre- and postoperative medication, healing of first and second intention, gender, age, number of quadrants, number of implants and type of surgery were related to the outcome pain. Pain was reported every day by the patient until the seventh day after surgery, using a visual analogic scale (VAS). Univariate Poisson regression models were used to assess the relationship among pain and the factors. Rate ratios were obtained with 95% of confidence intervals. Overall pain was reported as moderate/intense (VAS: 3-10) by 30.56% of patients, mild pain (VAS: 1-3) by 55.56%, and no pain symptoms were reported by 13.89% of patients. Individuals which the implants were installed with high torques (50-80 N) showed more pain (p=0.03) compared to patients which the implants were installed with regular torque (30-45 N). The other factors evaluated were not significant. The torque was the most relevant factor related to pain among the evaluated by the study. High torque generates more postoperative pain than lower torque. The factors gender, age, number of operated quadrants, number of installed implants, type of surgery and pre and postoperative analgesic did not interfere in the patient's pain during the first week after surgery.

Genotoxicity in the oral cells of older people from a Brazilian rural area: a population-based study

Abstract The purpose of this population-based, observational, and cross-sectional study was to evaluate alterations in the oral cells of a population of older people from a Brazilian rural area, using the micronucleus technique to investigate possible associated genotoxic factors. A questionnaire was applied and clinical examination and collection of oral mucosal cells were performed for all older people (≥ 60 years) from a town in southern Brazil. Demographic and socioeconomic variables, deleterious habits (drinking and tobacco use), presence of gastro-oesophageal reflux disease (GERD), and the use of proton pump inhibitors (PPIs) were considered the exposure variables, whereas metanuclear changes (MCs) and the prevalence of cell micronuclei (MN) were considered outcomes. Out of 489 older people, 447 were included in the study, among whom 50.8% were men with a mean age of 70.9 years and 83.9% had a monthly family income greater than US$ 500.00. GERD symptoms were present in 36.2% of the individuals, and 29.1% used PPIs daily, 53.3% consumed alcoholic beverages, and 46.7% used tobacco. The analysis of 1,000 oral mucosal cells per subject showed a MN frequency of 0-2 per individual, and MCs were detected with an average of 15 units per individual (median = 11 per individual). Poisson regression did not show statistical association between the exposure variables and the outcomes (presence of MN and MCs), except for the use of PPIs, which was a protective factor for the prevalence of MN [PR 0.6 (CI 0.3-0,9)]. Age, sex, family income, tobacco use and drinking, and GERD were not associated with the number of MN and MCs in oral mucosal cells of the investigated older people.

Influence of ceramic primers on microshear bond strength to zirconia

This study aimed to investigate the effect of two ceramic primers on the microshear bond strength (µSBS) of yttria-stabilized zirconia (Y-TZP) to two types of self-adhesive resin cement and one BisGMA-based resin cement. Zirconia specimens were sandblasted with 27-µm aluminum oxide and composite cylinders were cemented with resin cement with or without the prior use of ceramic primers. Nine groups (n=12) were randomly distributed according to the cement (self-adhesive RelyX U200/3M ESPE, self-adhesive Maxcem Elite/Kerr, and BisGMA-based dual-cure RelyX ARC/3M ESPE) and ceramic primer (Z-Primer Plus/Bisco and Porcelain Liner M/Sun Medical Co.). After luting, the specimens were stored in distilled water at 37°C for 24 hours and then submitted to the µSBS test. The data were analyzed with two-way ANOVA followed by the Scheffe post hoc test (p<0.05). There were significant differences between RelyX U200 and other groups. There were also significant differences between the RelyX U200 group without ceramic primer and other groups without ceramic primers (p<0.05). Self-adhesive resin cement (RelyX U200 and MaxCem) presented higher microshear bond strength (6.17 and 2.32 MPa) than the conventional resin cement (RelyX ARC) when a porcelain primer was not used (0.43 MPa). When using Porcelain Liner M, the results of RelyX ARC (2.94 MPa) were equivalent to the results of self-adhesive cement (3.93 and 2.11 MPa). When using Z-Prime Plus, the results of MaxCem (5.36 MPa) were lower than those of RelyX U200 (9.59 MPa) but equivalent to those of RelyX ARC (6.07 MPa). When using the RelyX ARC, the use of both ceramic primers improved bond strength to zirconia. When using self-adhesive resin cement, Z-Prime Plus improved microshear bond strength values. It can be concluded that, after 24 hours, the highest µSBS results were obtained when using Z-Prime Plus and RelyX U200 self-adhesive cement.

Evaluation of apical transportation and apical root sealing in root canals prepared with mtwo rotary system with and without apical enlargement ­ an in vitro study

The aim of this study was to evaluate apical transportation and apical root canal sealing after root canal filling in human teeth prepared with MTwo® Rotary System with and without apical foramen enlargement. Twenty mandibular premolars were divided into two groups (n=10). Group 1 had root canals prepared 1mm beyond the apical foramen. Group 2 had root canals prepared 1mm below the root canal length. After chemo-mechanical preparation, samples were submitted to scanning electronic microscopy. Apical foramen images had 75x magnification at standardized positions, allowing measurements from the apical foramen area before and after root canal preparation, and after root canal filling. Apical foramen shape and apical transportation, as well as its level of circumferential filling after root canal preparation were accessed using the Image Subtraction System. Scanning electronic microscopy analysis demonstrated that samples of Group 1 showed larger foraminal diameter than samples of Group 2 (p<0.05). Apical foramen transportation was statistically different between Groups 1 and 2 (p=0.0108). Furthermore, the apical foramen sealing also differed statistically between groups 1 and 2 (p=0.0007) and 100% of samples of Group 1 showed apical root canal sealing. Apical root canal sealing was more effective when the root canal was prepared with apical foramen enlargement, even when the apical transportation was detected.

Effect of reciprocating instrumentation on chlorhexidine substantivity on human dentin: chemical analysis followed by confocal laser microscopy

The present research analyzed the reciprocating instrumentation associated to chlorhexidine (CHX) substantivity as its correlation with E. faecalis viability in ex vivo root canals. Eighty extracted single-rooted human teeth were used, being 40 to high-performance liquid chromatography (HPLC) and 40 to confocal laser scanning microscopy (CLSM). In both, teeth were decoronated and the cervical third was prepared. In the CLSM analysis, the root canals were inoculated with E. faecalis for 14 days. Samples were divided into 4 groups (n=10) according to instrumentation technique: no instrumentation and irrigation with distilled water (control); manual instrumentation (K-File); rotary instrumentation (ProTaper Next); and reciprocating instrumentation (Reciproc R25). Two percent chlorhexidine was applied as irrigating substance in experimental groups. Longitudinal grooves resulted in 2 halves root and 20 proof bodies in each group. Samples were divided by chance in two groups (n=10) and the outcomes were evaluated after two days and one week. The retained chlorhexidine and live cells after instrumentation techniques in each evaluation time was measured by HPLC and CLSM, respectively. Specific analysis was applied for experimental tests (p≤0.05). Both rotary as well as reciprocating techniques significantly reduced the amount of chlorhexidine on dentin in all observation periods (p<0.05). After evaluation times, all experimental groups presented lower live cells compared to control, but without statistically difference. Intragroup comparisons in times of evaluation showed no differences in instrumentation techniques, in chlorhexidine retention and number of live cells (p>0.05). Reciprocating instrumentation does not interfere on chlorhexidine substantivity.

Prevalência de dor odontogênica em um serviço de pronto-atendimento odontológico público do Sul do Brasil / Prevalence of odontogenic pain in a public dental urgency service in Southern Brazil

Objetivo: Identificar as principais causas de dor odontogênica que levam à busca pelo atendimento no Serviço de Pronto Atendimento Odontológico (SPAO) da Faculdade de Odontologia da Universidade de Passo Fundo (UPF), que funciona junto ao Hospital São Vicente de Paulo e está ligado ao Sistema Único de Saúde (SUS). Métodos: Realizou-se um estudo epidemiológico transversal e retrospectivo, baseado em dados de prontuários odontológicos de pacientes atendidos entre novembro de 2016 e outubro de 2017. Os dados foram analisados buscando-se a prevalência das diversas origens de dor odontogênica dos pacientes atendidos no período: pulpar (pulpite reversível, pulpite irreversível, necrose); periapical (pericementite, abscesso periapical); ou periodontal (periodontite, abscesso periodontal). Além disso, foi catalogada a conduta realizada durante os atendimentos de urgência. Resultados: Ao todo, foram analisados 1.275 prontuários. Desses, 868 pacientes (68,1%) apresentavam dor ao atendimento. Dos pacientes que relataram dor, 62,3% apresentavam dor odontogênica pulpar; 11,1%, dor periapical; e 12,2%, dor periodontal. A conduta mais adotada para tratamento da dor foi a terapia com analgésicos e/ou antibióticos (21,0% dos casos), seguida por acessos endodônticos (18,7%) e exodontias (17,9%). Conclusão: No serviço de pronto atendimento analisado, prevaleceram os casos de dor de origem pulpar. Os resultados obtidos contribuem para o desenvolvimento de estratégias de controle da dor odontogênica, bem como para a melhoria dos protocolos clínicos adotados na faculdade em questão (AU).

Objective: To identify the main causes of odontogenic pain that lead to people search for care in the Urgency Service of the School of Dentistry of University, Passo Fundo/RS/Brazil (SPAOH), localized in the Hospital São Vicente de Paulo. Methodology: A cross-sectional and retrospective study, carried out between the period from November 1, 2016 to October 31, 2017, when data from dental care records were collected and tabulated. The data were analyzed looking for the prevalence of several causes of odontogenic pain, with pulp origin (reversible, irreversible pulpitis, necrosis); periapical (pericementitis, abscess); periodontal (periodontitis); and others, in addition to the conduct performed in attendance. Results: A total of 1,275 dental records were analyzed, involving 868 patients, of which 68.1% reported the presence of pulp (62.3%), periapical (11.1%) and periodontal (12.2%) odontogenic pains. Analgesic or antibiotic therapies were the most common approaches, totaling 21.0% of cases, followed by endodontic accesses (18.7%) and extractions (17.9%). Conclusion: In the studied dental urgency service, cases of pulp pain prevail. The results obtained contribute to the development of strategies to control odontogenic pain, as well as to the improvement of clinical protocols (AU).

Gingival Melanin Depigmentation With Diode Laser - Case Report / Despigmentación Melánica Gingival con Láser de Diodo - Relato de Caso

ABSTRACT: The pigmented lesions of the oral cavity may be endogenous or exogenous. Endogenous lesions are benign and usually caused by melanin, and they are called gingival melanin pigmentations. Among the options for depigmenting these areas, laser therapy stands out for being a minimally invasive procedure. This study aims to report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior maxillary region, for the ablation of the pigmented tissue to improve gingival aesthetics. The patient had an aesthetic complaint of the darkened aspect of the gingiva in the anterior maxillary and mandibular portions. After local anesthesia, we started depigmentation with high-power diode laser and performed ablation from the attached gingiva toward the free marginal gingiva. The patient returned after 30 and 180 days presenting healthy gingiva and absence of melanin repigmentation. Thus, we concluded that the diode laser was a good alternative for melanin depigmentation because it is a procedure with lower morbidity and satisfactory postoperative results.

RESUMEN: Las lesiones pigmentadas de la cavidad oral pueden ser endógenas o exógenas. Las endógenas son benignas y generalmente causadas por la melanina, denominándose pigmentaciones melánicas gingivales. Entre las opciones para la despigmentación de estas regiones, se destaca la laserterapia, por ser un procedimiento poco invasivo. Este trabajo tuvo como objetivo relatar un caso clínico de la técnica de despigmentación gingival utilizando láser de diodo de alta intensidad en la región anterior de los maxilares para ablación del tejido pigmentado con la finalidad de mejorar la estética gingival. El paciente presentaba como queja estética el aspecto oscurecido de la encía en la región anterior de la maxila y de la mandíbula. Tras aplicar anestesia local, se inició la despigmentación con láser de diodo de alta intensidad, siendo que la ablación se realizó a partir de la encía insertada hacia la encía marginal libre. El paciente regresó tras 30 y 180 días, presentando encía saludable y con ausencia de repigmentación melánica. Así fue posible concluir que el láser de diodo mostró ser una buena alternativa para la despigmentación melánica, ya que se presentó como un procedimiento con menor morbidad y buen resultado postoperatorio.

Alterações estomatológicas mais frequentes e seu processo diagnóstico ­ revisão de literatura / Most frequent stomatological changes and their diagnostic process ­ literature review

Introdução: os estudos epidemiológicos exercem um importante papel na Saúde Pública, indicando a prevalência e a incidência das lesões do complexo bucomaxilofacial, e revelando fatores associados, como perfil socioeconômico, fatores genéticos e ambientais, e permitindo o direcionamento de ações de promoção e de prevenção de saúde. Objetivo: o objetivo do presente trabalho é realizar uma revisão de literatura acerca dos aspectos mais importantes para o estabelecimento do diagnóstico das alterações estomatológicas. Revisão de literatura: um dos principais obstáculos dos profissionais da saúde diante de um caso de lesão bucal é o estabelecimento de um diagnóstico preciso, devido à grande quantidade de diagnósticos diferenciais que tais condições podem apresentar. É viável, através do auxílio dos estudos de prevalência, reduzir o número de diagnósticos diferenciais, identificando a frequência das lesões para cada região, ao considerar também variáveis, como faixa etária, etnia e gênero. Considerações finais: conhecer a prevalência das lesões e saber identificar as variáveis associadas a cada uma é de suma importância para o estudante de odontologia e mesmo para o profissional, uma vez que este conhecimento contribuirá para o melhor manuseio e proservação de seu paciente.

Introduction: epidemiological studies performs an important role in Public Health, indicating the prevalence and incidence of injuries of the bucomaxillofacial complex, and revealing associated factors such as socioeconomic profile, genetic and environmental factors, and allowing the promotion of prevention and Cheers. Objective: the aim of the present study is to carry out a literature review about the most important aspects for establishing the diagnosis of stomatologic alterations. Literature review: one of the main obstacles faced by health professionals in the case of oral lesions is the establishment of an accurate diagnosis, due to the large number of differential diagnoses that such conditions may be present. It is feasible, through the aid of prevalence studies, to reduce the number of differential diagnoses, identifying the frequency of lesions for each region, as well as variables such as age, ethnicity and gender. Final considerations: knowing the prevalence of lesions and knowing how to identify the variables associated with each one is of paramount importance for the student of dentistry and even for the professional, since this knowledge will contribute to the better handling and proservation of his patient.

Sobredentadura retida por sistema barra-clipe: revisão de literatura / Overdenture retained by bar-clip system: literature review

Introdução: as overdentures são próteses totais removíveis, mucoimplanto-suportadas, estabilizadas por elementos instalados sobre raízes residuais e/ou sobre implantes. Uma variedade de sistemas de encaixe tem sido utilizada para suportar as sobredentaduras, dentre os quais os sistemas barra-clipe, bolas, magnetos e coroas telescópicas. Objetivo: avaliar, por meio de uma revisão de literatura, as sobredentaduras retidas por sistema barra-clipe, expondo um correto planejamento, bem como descrevendo protocolos de confecção de tais aparelhos. Métodos: foi realizada uma revisão de literatura nas bases de dados do Centro Latino-americano e do Caribe de Informações em Ciências da Saúde (LILACS), Medline, Bibliografia Brasileira de Odontologia (BBO), na biblioteca virtual (SCIELO), e no acervo de livros da Universidade de Passo Fundo/RS (UPF). Revisão de literatura: o sistema barra-clipe consiste de uma barra plástica para fundição (ou já em metal) e de um clipe de retenção. Em algumas situações, o sistema de encaixes por barra-clipe é mais indicado do que os demais sistemas, apresentando, todavia, limitações em determinados cenários clínicos. O sistema barra-clipe permite considerável retenção e estabilidade, resultando num restabelecimento da função mastigatória, maior segurança e grande satisfação do paciente. Considerações finais: a maior parte dos estudos mostrou uma melhora da qualidade de vida relacionada à saúde bucal dos pacientes após tratamento com overdenture em comparação com a prótese total removível convencional.

Introduction: overdentures are removable, muco-implantsupported, complete dentures, stabilized by elements installed on residual roots or implants. A variety of docking systems have been used to support overdentures, including bar-clip systems, balls, magnets and telescoping crowns. Objective: to evaluate, through a literature review, the overdentures retained by bar-clip system, exposing a correct planning, as well as describing protocols of making such devices. Methods: a literature review was carried out in the databases of the Latin American and Caribbean Center on Health Sciences Information (LILACS), Medline, Brazilian Dentistry Bibliography (BBO), the virtual library (SCIELO) and the collection of books from the University of Passo Fundo/RS (UPF). Literature Review: the bar-clip system consists of a plastic bar for casting or already metal and a retention clip. In some situations, the clip-on system is more suitable than other systems, although it has limitations in certain clinical scenarios. The bar-clip system allows considerable retention and stability, resulting in a restoration of the masticatory function, greater safety and great patient satisfaction. Final considerations: most of the studies showed an improvement in the quality of life related to the oral health of the patients after treatment with overdenture compared to the conventional total removable prosthesis.

Relationship between dentition, anthropometric measurements, and metabolic syndrome in the elderly / Relação entre dentição, medidas antropométricas e síndrome metabólica em idosos

Abstract Introduction Tooth loss is a health disorder of the elderly population that may lead to masticatory deficiency and nutritional risks, inducing the biochemical changes of metabolic syndrome (MS). Objective To verify the relationship among number of teeth, anthropometric measurements, and MS in a group of elderly people. Material and method The study was developed in Porto Alegre, RS, Brazil, and it was divided into three phases. The first phase collected information from the database of all project participants and the second one collected sociodemographic, anthropometric, and biochemical data. The third phase was divided into two other phases: first, oral health interviews were applied to the elderly (281 patients evaluated by telephone and 23 visited at home) and second, 45 patients were randomly selected and invited to validate the data obtained by telephone with oral clinical examinations performed by a trained dental surgeon. The sample consisted of 304 individuals. The data collected were tabulated and analyzed using statistical tests. Result Elderly women with severe tooth loss present a significantly higher risk of developing MS. Thus, the maintenance of natural teeth in the elderly is a protective factor for the syndrome. Conclusion The findings support the hypothesis that the oral health of individuals, expressed by the number of teeth, may compromise and increase the risk of MS in the elderly.

Resumo Introdução A perda dentária é um distúrbio de saúde dos idosos que pode levar à deficiência mastigatória e riscos nutricionais, induzindo alterações bioquímicas da síndrome metabólica (SM). Objetivo Verificar a relação entre número de dentes, medidas antropométricas e SM em um grupo de idosos. Material e método O estudo foi desenvolvido na cidade de Porto Alegre, RS, Brasil, e foi dividido em três fases. A primeira fase coletou informações do banco de dados de todos os participantes do projeto e a segunda coletou dados sociodemográficos, antropométricos e bioquímicos. A terceira fase foi dividida em duas outras fases: primeiro foram aplicadas entrevistas de saúde bucal aos idosos (281 pacientes avaliados por ligações telefônicas e 23 atendidos em domicílio) e, segundo, 45 pacientes foram selecionados aleatoriamente e convidados a validar os dados obtidos por telefone com exames clínicos orais. A amostra foi composta por 304 indivíduos. Os dados coletados foram tabulados e analisados ​​por meio de testes estatísticos. Resultado Mulheres idosas com perda dentária severa apresentam um risco significativamente maior de desenvolver SM. Assim, a manutenção dos dentes naturais nos idosos é um fator protetor para a síndrome. Conclusão Os achados reforçam a hipótese de que a saúde bucal dos indivíduos, expressa pelo número de dentes, pode comprometer e aumentar o risco de SM em idosos.

Morse taper performance: A finite element analysis study

OBJECTIVES: To evaluate and compare the magnitude and distribution of stresses generated on implants, abutments and first molar metal-ceramic crowns using finite element analysis. METHODS: Preliminary three-dimensional models were created using the computer-aided design software SolidWorks. Stress and strain values were observed for two distinct virtual models: model 1 - Morse taper and solid abutment; model 2 - Morse taper and abutment with screw. A load (250 N) was applied to a single point of the occlusal surface at 15° to the implant long axis. Von Mises stresses were recorded for both groups at four main points: 1) abutment-retaining screws; 2) abutment neck; 3) cervical bone area; 4) implant neck. RESULTS AND CONCLUSION: Model 1 showed a higher stress value (1477.5 MPa) at the abutment-retaining screw area than the stresses found in model 2 (1091.1 MPa for the same area). The cervical bone strain values did not exceed 105 µm for either model.

Síndromes em Odontologia - revisão de literatura / Syndromes in Dentistry - literature review

Objetivo: o presente trabalho teve por objetivos descrever as principais síndromes de acometimento bucal primário, relatando seus sinais, sintomas, métodos de diagnóstico e tratamento e ressaltar a importância do cirurgião-dentista no diagnóstico de alterações sistêmicas. Métodos: foi realizada uma pesquisa bibliográfica acerca de cinco síndromes de acometimento bucal primário, para isso, realizou-se uma busca de informações nas bases de dados eletrônicas Scielo, Bireme, Pubmed entre 2000 a 2017. Revisão de Literatura: Entende-se por "síndrome" um conjunto de sinais e sintomas que caracterizam determinada enfermidade, essas, podem ocorrer de forma isolada ou manifestar seus primeiros sintomas na cavidade oral, os quais são indícios de alterações sistêmicas que possam estar ocorrendo. Entre tantas, destacam-se a seguir cinco das principais síndromes de acometimento bucal primário: Síndrome de Behçet, Síndrome de Sjögren, Síndrome de Peutz-Jeghers, Doença de Addison, e Síndrome de Gardner. Considerações finais: a partir da revisão de literatura foi possível notar que as síndromes podem ocorrer de forma isolada ou manifestar seus primeiros sintomas na cavidade oral. Como suas primeiras manifestações são orais, é imprescindível que o cirurgião-dentista tenha conhecimento sobre elas para que seja elaborado um diagnóstico e protocolo de tratamento corretos e de rápida execução, já que sua terapia será executada com auxílio de vários profissionais da área da saúde.

Objective: the objective of this study was to describe the main syndromes of primary oral affection, reporting its signs, symptoms, methods of diagnosis and treatment, and to emphasize the importance of the dental surgeon in the diagnosis of systemic alterations. Methods: we carried out a literature search about five syndromes of primary oral affection. For this, a search of information was made in the electronic databases Scielo, Bireme, Pubmed between 2000 and 2017. Literature Review: "Syndrome" is understood as a set of signs and symptoms that characterize a particular disease; these can occur in isolation or manifest their first symptoms in the oral cavity, which are indications of systemic changes that may be occurring. Among so many, five of the main syndromes of primary buccal involvement are: Behçet's Syndrome, Sjögren's Syndrome, Peutz-Jeghers Syndrome, Addison's Disease, and Gardner's Syndrome. Final considerations: from the literature review it was possible to note that the syndromes may occur in isolation or manifest their first symptoms in the oral cavity. Since the first manifestations are oral, it is essential that the dentist know about them so that a correct diagnosis and protocol of treatment is elaborated and fast execution, since its therapy will be executed with the help of several professionals of the health area.

Equipes de saúde bucal na estratégia da saúde da família em polo urbano do sul do Brasil / Oral health teams in the family health strategy in urban pole of southern Brazil

Introdução: a Estratégia da Saúde da Família (ESF) é uma política brasileira recente de gestão e execução dos serviços de saúde. Um dos alvos desta política é promover a saúde bucal. Para tanto, as equipes devem ser constituídas segundo normas do Ministério da Saúde, compostas por cirurgião-dentista e pelo menos um auxiliar. Objetivo: avaliar a composição das equipes de saúde bucal da ESF do município de Passo Fundo/RS/Brasil e comparar com as normas do Ministério da Saúde. Métodos: neste estudo transversal, a composição de 22 ESFs foi avaliada através de consulta ao Sistema de Informação de Atenção Básica (SIAB), referente ao biênio 2013-2014, e por aplicação de questionário para avaliar a estrutura das Equipes da Saúde da Família. Resultados: nenhuma das 22 ESFs apresentou equipe de saúde bucal completa. O único profissional identificado foi o cirurgião-dentista, presente em 17 das 22 ESFs (77%), integralmente pago com verba municipal, sem contrapartida federal. Não há uma padronização na carga horária do profissional odontólogo, diferente dos demais profissionais que compõem a atenção básica. Das ESFs regularizadas no SIAB, 20% não apresentam cirurgião-dentista em sua composição, ficando esta população desassistida em saúde bucal. Conclusões: as equipes de saúde bucal das ESFs do município de Passo Fundo/RS são incompletas e não seguem as normas Brasileiras.

Introduction: the Family Health Strategy (ESF) is a recent Brazilian policy of management and execution from health services. One of its targets is to promote the Oral Health. In order to achieve this the staffs shall be established accordingly to the Health Ministry rules, formed by a dental surgeon and at least one assistant. Objective: to evaluate the oral health teams structure of the ESF in the city of Passo Fundo/ RS/Brazil and contrast it with the Health Ministry rules. Methods: in this cross-sectional study, were valued the structure of 22 ESFs by looking at the Basic Health Care Information System (SIAB), referring to the biennium 2013-2014 and by applying a questionnaire to evaluate the ESF´s teams structure. Results: none of the 22 ESFs reported an Oral Health perfect team. The only professional identified was the dental surgeon, existing in 17 out of 22 ESFs (77%), paid in full by municipal funds with no federal financial reward. There is not a standard at dentists workload oppositely to other professional in SIAB. From the ESFs settled at SIAB 20% have no dental surgeon in its staff leaving people unattended in oral health. Conclusions: the oral health ESFs teams from the city of Passo Fundo/RS are incomplete and don´t obey the Brazilian regulation.

Correção de assimetria dentogengival com finalidade estética: Relato de caso clínico / Correction of dentogingival asymmetry with aesthetic purpose in a patient with gingival smile: case report

Introdução: a estética do sorriso pode ser alcançada por um conjunto de fatores que incluem a anatomia dentária, a anatomia gengival e as características faciais do paciente. Um sorriso agradável é baseado na harmonia desses fatores (estética branca-vermelha) e não somente na reabilitação dentária. O sorriso gengival é uma das principais queixas de pacientes que procuram o consultório odontológico, considerando que tal situação pode influenciar na sua vida pessoal ou profissional Objetivo: o propósito deste trabalho foi relatar o caso clínico de uma paciente com sorriso gengival e desarmonia entre a margem gengival e alinhamento das coroas clínicas de dentes anterossuperiores. Relato de Caso: paciente do sexo feminino, 58 anos de idade, com boa saúde geral, procurou consultório odontológico particular com o objetivo de melhorar a estética do sorriso. Ao exame clínico foi constatado sorriso gengival e necessidade de substituição presença de coroas metalo-cerâmicas. Considerações finais: a abordagem multidisciplinar envolvendo a técnica cirúrgica (retalho com osteotomia) e restauradora (confecção de facetas feldspáticas e coroas de porcelana pura na região anterossuperior) proporcionou o sucesso do tratamento reabilitador em questão, devolvendo à paciente um sorriso harmonioso com estética dentária e gengival agradáveis.

Introduction: smile's aesthetics can be achieved by a set of factors that include the dental anatomy, gingival anatomy and facial features of the patient. A pleasant smile is based on the harmony of these factors (white-red aesthetics) and not only on dental rehabilitation. The gingival smile is one of the main complaints of patients who seek the dental office, considering that such a situation may influence their personal or professional life. Objective: the purpose of this study was to report the clinical case of a patient with gingival smile and disharmony between the gingival margin and the alignment of the clinical crowns of anterosuperior teeth. Case Report: a 58-yearold female patient with good general health sought a private dental office with the aim of improving the aesthetics of the smile. The clinical examination revealed gingival smile and the need to replace the presence of metal-ceramic crowns. Final considerations: The multidisciplinary approach involving the surgical technique (restorative flap with osteotomy) and restorative (creation of feldspar facets and pure porcelain crowns in the anterior superior region) provided the success of the rehabilitation treatment in question, giving the patient a harmonious smile with aesthetics tooth and gum.

Uso de placas oclusais como tratamento de alterações no sistema estomatognático / Use of occlusal plaques as a treatment of diseases in stomatognathic system

Introdução: as disfunções temporomandibulares (DTMs) e musculares possuem causa multifatorial, sendo necessária a realização de anamnese minuciosa, além de exame clínico detalhado para que seja possível adotar a forma de tratamento mais correta. Objetivo: o presente trabalho visa, através de uma revisão de literatura, descrever o protocolo clínico de confecção, instalação e ajustes de placa miorrelaxante, compreender as indicações e os benefícios do uso das mesmas, além de comparar sua efetividade com outros métodos terapêuticos descritos na literatura. Revisão de literatura: responsável pelo correto funcionamento de nossas funções mastigatórias, deglutição, fonação, entre outras, o sistema estomatognático pode se tornar instável devido às alterações que variam de pequenos hábitos parafuncionais até disfunções na articulação temporomandibular e dores musculares. Geralmente não é possível descobrir qual é o exato fator responsável pelo surgimento dessas alterações, visto que a maioria possui causa multifatorial. Dessa forma, inicialmente são indicados tratamentos que sejam menos invasivos ao sistema. As placas oclusais surgem como alternativa reversível para o tratamento das disfunções temporomandibulares (DTMs) e outras injúrias sofridas pelo sistema e, embora seu exato mecanismo não tenha sido compreendido, elas demonstram efetividade na redução dos sintomas em diversos casos. Considerações finais: foi possível observar que as placas oclusais consistem numa forma de tratamento segura, com poucos efeitos adversos e que apresenta grande melhoria nos sintomas das DTMs.

Introduction: temporomandibular (TMD) and muscular dysfunction have a multifactorial cause, requiring a detailed anamnesis, as well as a detailed clinical examination so that it is possible to adopt the most correct form of treatment Objective: this paper aims to describe, through a literature review, the clinical protocol for confection, installation and adjustments of myorelaxant plaque, to understand the indications and benefits of its use and to compare its effectiveness with other therapeutic methods described in literature. Literature review: Responsible for the correct functioning of our masticatory functions, swallowing, phonation, among others, the stomatognathic system may become unstable due to alterations, ranging from small parafunctional habits to temporomandibular joint dysfunctions and muscular pains. Generally, it is not possible to find out the exact factor responsible for these changes, since most of them have multifactorial causes. Thus, treatments that are less invasive to the system are initially indicated. Occlusal plaques appear as a reversible alternative for the treatment of temporomandibular disorders (TMDs) and other injuries suffered by the system and although their exact mechanism has not been understood, they demonstrate effectiveness in the reduction of symptoms in several cases. Final considerations: it was observed that occlusal plaques consist of a safe form of treatment, with few adverse effects and a great improvement in TMD symptoms.

Peri-implant assessment via cone beam computed tomography and digital periapical radiography: an ex vivo study

OBJECTIVES: This research evaluated detail registration in peri-implant bone using two different cone beam computer tomography systems and a digital periapical radiograph. METHODS: Three different image acquisition protocols were established for each cone beam computer tomography apparatus, and three clinical situations were simulated in an ex vivo fresh pig mandible: buccal bone defect, peri-implant bone defect, and bone contact. Data were subjected to two analyses: quantitative and qualitative. The quantitative analyses involved a comparison of real specimen measures using a digital caliper in three regions of the preserved buccal bone - A, B and E (control group) - to cone beam computer tomography images obtained with different protocols (kp1, kp2, kp3, ip1, ip2, and ip3). In the qualitative analyses, the ability to register peri-implant details via tomography and digital periapical radiography was verified, as indicated by twelve evaluators. Data were analyzed with ANOVA and Tukey's test (α=0.05). RESULTS: The quantitative assessment showed means statistically equal to those of the control group under the following conditions: buccal bone defect B and E with kp1 and ip1, peri-implant bone defect E with kp2 and kp3, and bone contact A with kp1, kp2, kp3, and ip2. Qualitatively, only bone contacts were significantly different among the assessments, and the p3 results differed from the p1 and p2 results. The other results were statistically equivalent. CONCLUSIONS: The registration of peri-implant details was influenced by the image acquisition protocol, although metal artifacts were produced in all situations. The evaluators preferred the Kodak 9000 3D cone beam computer tomography in most cases. The evaluators identified buccal bone defects better with cone beam computer tomography and identified peri-implant bone defects better with digital periapical radiography.

Ameloblastic fibro-odontoma: case report / Fibro-odontoma ameloblástico: relato de caso

ABSTRACT The ameloblastic fibro-odontoma is a benign, mixed, asymptomatic and rare odontogenic tumor that can easily be confused radiographically and histologically with other diseases. Usually it affects a population between the first and second decades of life, is more frequent in the mandible and shows predilection for males. This lesion, characterized by dental agenesis at the tumor site, has no predilection for anatomical region; however, an increase of intraoral volume may cause mild facial asymmetry. It shows slow but expansive growth, and is a well-defined radiolucent lesion, usually unilocular, with radiopacity inside. Normally surgical removal is conservative and the prognosis is favorable. This article reports a case of ameloblastic fibro-odontoma treated by surgical removal and follow-up of two years. The aim of this work was to study the ameloblastic fibro-odontoma in its entirety, seeking to inform clinicians about the best diagnostic and treatment methods for this type lesion.

RESUMO O fibro-odontoma ameloblástico é um tumor odontogênico misto benigno, assintomático e raro, que pode ser facilmente confundido radiograficamente e histopatologicamente com outras enfermidades. Normalmente atinge uma população entre a primeira e a segunda décadas de vida, sendo mais frequente em mandíbula e com predileção pelo sexo masculino. Este tumor caracteriza-se pela agenesia dentária no local do tumor, sem predileção por região anatômica, e por um aumento de volume intrabucal, podendo causar leve assimetria facial. Apresenta crescimento lento, porém expansivo; revela-se como uma lesão radiolúcida bem definida, normalmente unilocular, com radiopacidades no seu interior. Normalmente a remoção cirúrgica é conservadora e o prognóstico é favorável. O presente trabalho relata um caso clínico de fibro-odontoma ameloblástico tratado por meio de remoção cirúrgica e com acompanhamento de dois anos. O objetivo deste trabalho foi estudar o fibro-odontoma ameloblástico em sua integralidade, buscando expor ao cirurgião-dentista os melhores métodos de diagnóstico e tratamento para tal lesão.

Lesão Cancerizável com aspecto clínico de lesão benigna em paciente tabagista / Malignantly injury with clinical aspect of benign lesion in smoking patients

Introdução: a mucosa bucal e seus anexos são sedes de inúmeras doenças, quer de caráter local, quer representando manifestações bucais de doenças sistêmicas. Neste contexto as lesões com potencial de malignização estão associadas principalmente ao estilo de vida, como hábitos viciosos, consumo de alimentos em temperaturas elevadas e próteses mal-adaptadas. Objetivo: relatar o caso de uma lesão cancerizável com aspecto clínico de lesão benigna. Lesões encontradas na cavidade bucal com caráter de benignidade, devido ao estilo de vida do paciente e hábitos viciosos, podem ter potencial para malignização. O cigarro tem ação química e térmica sobre os tecidos, além de ser um dos principais fatores carcinogênicos com os quais o homem mantém contato por estar presente nas três fases da carcinogênese. Além do tabaco, o gênero, etnia e idade do paciente também estão associados à malignização de lesões bucais, sendo que pacientes masculinos, leucodermas e com mais de 50 anos de idade. são considerados pacientes com risco para malignização de lesões. Relato de caso: Paciente masculino, 65 anos de idade, leucoderma, procurou atendimento odontológico apresentando um nódulo em região de mandíbula, com hipótese diagnóstica clínica de lesão de células gigantes periférica, granuloma piogênico e fibroma de irritação. Optou-se pela biópsia excisional, a qual possibilitou o diagnóstico histopatológico de displasia epitelial severa. O paciente foi encaminhado para cirurgião de cabeça e pescoço e encontra-se em acompanhamento clínico de dois anos sem indícios de recidiva da lesão. Considerações finais: justifica-se a importância do cirurgião-dentista no diagnóstico precoce de lesões cancerizáveis, que por muitas vezes se apresentam sem sintomatologia dolorosa, e apenas ao exame clínico não é possível obter o diagnóstico, necessitando-se de exames complementares, como a biópsia.

Introduction: the buccal mucosa and its annexes are the site of many diseases, both of a local nature or being oral manifestations of systemic diseases. In this context, lesions with malignant potential are associated mainly with lifestyle, such as vicious habits, food consumption at elevated temperatures and maladaptive prostheses. Objective: this study aims to report the case of a cancerous lesion with a clinical aspect of benign lesion. Lesions found in the oral cavity with benignity due to the patient's lifestyle and vicious habits may have potential for malignancy. The cigarette has chemical and thermal action on the tissues, besides being one of the main carcinogenic factors with which the man maintains contact by being present in the three phases of the carcinogenesis. In addition to tobacco, the gender, ethnicity and age of the patient are also associated with the malignancy of oral lesions, and male, leukodermal and over 50-year-old patients are considered patients at risk for malignant lesions. Case report: a 65-year-old male patient, leucoderma, sought dental care presenting a nodule in the mandible region, with clinical diagnosis hypothesis of peripheral giant cell lesion, pyogenic granuloma and irritation fibroma. We chose the excisional biopsy, which made possible the histopathological diagnosis of severe epithelial dysplasia. The patient was referred to a head and neck surgeon and is in clinical follow-up for two years with no evidence of recurrence of the lesion. Final considerations: It is stressed the importance of the dental surgeon in the early diagnosis of cancerous lesions, which often present without pain symptomatology, and only when the clinical examination is not possible to obtain the diagnosis, we need complementary tests, such as biopsy.

Cisto periapical de grandes proporções na região anterior da maxila. Relato de caso / Periapical cyst major in the anterior maxilla. Case report

Introdução: o cisto periapical está relacionado ao ápice de um dente com necrose pulpar, ou seja, de natureza inflamatória e corresponde à frequência de 7% a 54% das imagens periapicais. Objetivo: relatar e discutir um caso de cisto periapical inflamatório invasivo na maxila, bem como as suas formas de tratamento. Relato de caso: paciente do gênero masculino, 48 anos de idade buscou atendimento odontológico relatando sentir dor no elemento dentário 23 e fístulas recorrentes na região do elemento dentário 22. Frente aos aspectos clínico e radiográfico, foram sugeridas as hipóteses diagnósticas de cisto periapical, tumor odontogênico ceratocístico, ou ameloblastoma. Devido ao laudo tomográfico de fratura radicular no elemento 22, a conduta clínica de escolha foi extração da raiz e exérese da lesão, seguidas de curetagem cuidadosa. O espécime foi encaminhado para análise histopatológica, tendo como resultado cisto periapical. Considerações finais: o cisto periapical é similar a outras lesões apicais o que dificulta o diagnóstico. Portanto é importante um exame clínico cuidadoso associado a exames complementares como, tomografia computadorizada, analisando-se assim, o caso minuciosamente a fim de oferecer ao paciente melhores condutas de tratamento.

Introduction: the periapical cyst is related to the apex of a tooth with pulpal necrosis, that is, of an inflammatory nature and corresponds to the frequency of 7% to 54% of the periapical images. Objective: this paper aims to report and discuss a case of invasive periapical inflammatory cyst in the maxilla, as well as its forms of treatment. Case report: a 48-year-old male patient sought dental care, reporting pain in the tooth 23 and recurrent fistulas in the region of the tooth 22. Facing the clinical and radiographic aspects, the diagnostic hypotheses of periapical cyst, tumor Odontogenic keratocystis, or ameloblastoma. Due to the tomographic report of root fracture in element 22, the clinical management of choice was root extraction and excision of the lesion, followed by careful curettage. The specimen was referred for histopathological analysis, resulting in periapical cyst. Final remarks: the periapical cyst is similar to other apical lesions, which makes diagnosis difficult. Therefore, a careful clinical examination associated with complementary exams such as computed tomography is important, and the case is carefully analyzed in order to offer the patient better treatment procedures.

Atenção à saúde bucal do idoso institucionalizado por meio e ações de extensão universitária / Oral health care of institutionalized elderly by means of university extension actions

Introdução: o aumento da expectativa de vida da população brasileira demanda atendimento odontogeriátrico integrado às outras áreas da saúde, com vistas a fornecer melhor qualidade de vida aos idosos, especialmente aos mais vulneráveis. Objetivo: verificar as necessidades em relação à saúde bucal de idosos institucionalizados, e realizar a reabilitação oral e prevenção das doenças bucais, por meio de ações de extensão comunitária. Método: participaram deste estudo 46 idosos, 28 mulheres e 18 homens (média de idade de 76 anos), procedentes de Instituição de Longa Permanência para Idosos (ILPI) localizada na cidade de Passo Fundo - RS. O processo metodológico envolveu exame clínico (anamnese, exame físico extra e intrabucal), diagnóstico/planejamento e tratamento odontológico. Resultados: observou-se que a maior parte dos idosos necessitava confecção de dentaduras superiores e/ou inferiores (50%), exodontias (30,43%), confecção de próteses parciais (15,21%), tratamento periodontal (10,86%) e dentística (6,52%). Discussão e Conclusão: mediante estes resultados as ações de extensão comunitária focalizaram procedimentos odontológicos específicos que associados às orientações de higiene oral e prevenção melhoraram significativamente a mastigação, estética e nutrição dos pacientes, contribuindo também para incrementar a qualidade de vida e a autoestima dos idosos. (AU)

Introduction: increased life expectancy of the population demand integrated odontogeriatric service to other areas of health, in order to provide a better quality of life for older people, especially the most vulnerable. Objective: the aim of this study was to assess the needs in relation to oral health of institutionalized elderly, and perform oral rehabilitation and prevention of oral diseases, through community outreach activities. Method: the study included 46 elderly, 28 women and 18 men, average age 76 years, coming from long-stay institutions for the elderly (LTCF), located in the city of Passo Fundo-RS. The methodological process involved clinical examination (anamnesis, physical examination and intraoral extra), diagnostic/planning and dental treatment. Results: it was observed that most elderly needed making dentures upper and/or lower (50%), tooth extraction (30.43%), making partial dentures (15.21%), periodontal treatment (10.86%) and dentistry (6.52%). Discussion and Conclusion: with these results the community outreach activities focused on specific dental procedures associated with the guidelines of oral hygiene and prevention significantly improved mastication, esthetics and nutrition of patients contributing also to increase the quality of life and self-esteem of the elderly. (AU)