Self-perceived oral health: a study with patients wearing removable dentures

Aim: This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods: Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results: Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p > 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873- 0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085- 8.602). Conclusions: The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures

Effect of frozen storage on preservation of a silicone-based test food material

Aim: This study aimed to evaluate the effect of frozen storage on the physical properties of a silicone-based test food material, highly used to evaluate the masticatory performance in research settings. Methods: A total of 1,666 silicone cubes of Optosil Comfort® with 5.6-mm edges were shaped and stored at -18°C. The cubes were subsequently tested for flexural strength (maximum force, displacement, stress, and strain) before breaking (n = 136), changes in weight and size (n = 170), and masticatory performance (n = 1360) at eight timepoints: immediately after cube preparation (baseline, no freezing), and 1, 2, 3 and 4 weeks, and 2, 4 and 6 months after frozen storage. The cubes were thawed 8 h before each assessment. Results: The maximum force, stress, maximum displacement, and deformation values for the cubes were not affected by freezing (P > 0.05). At all of the time points, the cubes exhibited similar weight (P = 0.366) and size (identical values). The masticatory performance for the cubes also showed no differences from baseline through 6 months (P = 0.061). Conclusion: Freezing Optosil Comfort® silicone cubes did not alter the physical and mechanical properties of the material, being suitable to optimize the assessment of masticatory parameters for research purposes

Patients' perception about the outcomes of prosthetic treatment in Southern Brazil - a cross sectional study

Aim: this study assessed the patients' perception of the outcomes of prosthetic treatment in a University of Southern Brazil. Methods: patients seeking for prosthetic treatment were invited to answer a questionnaire with 41 items about the potential risks, benefits, and consequences of no treatment. Answers were obtained according to a five-item Likert-scale varying from 1 (completely disagree) to 5 (completely agree). Sociodemographic data was included in the comparison. Mann-Whitney or Kruskal-Wallis (95%) compared data depending on the variable. Results: two-hundred twenty-five patients answered the questionnaire. Median age of participants was 45-54 years. The potential benefits were similar among participants irrespective of the variable adopted. The perception of risks was significant influenced by variables gender, age, education level, type of edentulous space, prior treatment with prosthodontics, type of prosthodontics, and prosthodontics usage in years. Consequences of no treatment were affected by age, prior treatment with prosthodontics, and prosthodontics usage in years. Conclusions: the study showed the fundamental importance of correct elucidation about the potential risks (negative perception) in the initial appointment for the studied population. Elucidation about the consequences of no treatment are relevant because some differences were seen into the variables. Prosthodontics patients from the city of Passo Fundo seem well informed about the benefits of the prosthetic treatment, besides the significant influence of some sociodemographic and prosthetic conditions

O emprego do mock-up na Odontologia: trabalhando com previsibilidade / The use of mock-up in Dentistry: working with predictability

A Odontologia baseada em evidência engloba a necessidade de resultados previsíveis nos diversos tratamentos odontológicos, o que, consequentemente, deve conduzir a uma relação de confiança entre o paciente e o cirurgião dentista. O objetivo do presente trabalho é descrever, através de três casos clínicos, a técnica do mock-up e discutir no decorrer do manuscrito sua importância como ferramenta de diagnóstico e planejamento do tratamento reabilitador estético. Através domock-up, assegura-se o atendimento às expectativas estéticas do paciente em relação ao futuro tratamento, bem como resguarda o profissional de possíveis intercorrências. Esta técnica é bastante simples e eficiente, permitindo a visualização tridimensional do tratamento definitivo. Assim, o mock-up determina a previsibilidade dos resultados ao atuar como guia das decisões terapêuticas...

The evidence-based Dentistry encompasses the need for predictable results in the various dental treatments, which should therefore lead to a relationship of trust between patient and dentist. The objective of the present work was to describe through three clinical cases, the technique of mock-up and discuss throughout the manuscript its importance as a diagnostic and planning tool for aesthetic rehabilitation treatment. Through the mock-up, it can to ensure compliance the aesthetic expectations of the patient regarding the future treatment and protect the professional of possible complications. This technique is very simple and efficient, allowing three-dimensional visualization of definitive treatment. Thus, mock-up determines the predictability of results by guiding the therapeutic decisions...

Rapid denture fabrication for institutionalized patients / Confecção rápida de prótese total para pacientes institucionalizados

PURPOSE: Edentulism is a common condition among the elderly population. However, it is difficult for elderly subjects who are institutionalized, hospitalized, or bedridden to visit dental offices for the repair or replacement of broken dentures. This paper describes a fast technique with minimum clinical sessions to fabricate a new maxillary denture. CASE DESCRIPTION: An institutionalized 78-year-old man with an extremely damage broken maxillary denture complained about repairing his denture. With the impossibility of repairing, the technique described was proposed so as to offer a treatment that would maximize the comfort of the patient. The maxilla-mandibular relationship was done at the first clinical session, after fabricating the maxillary resin baseplate in mouth, by fixing the old complete mandibular denture with the maxillary wax plane. At the second clinical session, the esthetics and function of artificial teeth was checked and final impression was made to the denture installation at next session. CONCLUSION: The reduced number of clinical sessions is a convenient option for clinicians to provide a more comfortable treatment for institutionalized or bedridden patients. This technique is also particularly useful when a replacement denture is urgently required, allowing its installation within few hours.

OBJETIVO: O edentulismo é uma condição comum dentre a população idosa. Entretanto, quando estes indivíduos encontram-se institucionalizados, hospitalizados ou acamados, consultar um cirurgião-dentista para reparo ou substituição de próteses totais pode ser uma situação difícil. Neste caso, é relatada uma técnica mais rápida para confecção de uma prótese total superior em um número mínimo de sessões clínicas. DESCRIÇÃO DO CASO: Indivíduo institucionalizado de 78 anos de idade, apresentando uma prótese extremamente danificada após deixá-la cair sobre o chão, queixava de necessidade de reparo na mesma. Na impossibilidade de reparo, foi proposta esta técnica descrita para oferecer um tratamento com maior conforto para o paciente. O relacionamento maxilo-mandibular foi feito na primeira sessão clínica, após confeccionar a base de prova diretamente em boca, fixando a própria prótese inferior do paciente com o plano de cera. Na segunda sessão clínica, a prova estética e funcional é feita e a moldagem final realizada para instalação da prótese na sessão seguinte. CONCLUSÃO: O número reduzido de sessões clínicas é uma opção conveniente para os clínicos e gera um tratamento mais confortável para indivíduos institucionalizados ou acamados. Esta técnica também pode ser útil para substituição de prótese total em caráter de urgência, onde a prótese pode ser instalada no mesmo dia ou no dia seguinte.

Eficacia del proceso adhesivo en dentina escerótica: revisión de literatura / Effectiveness of sclerotic dentin adhesive process: literature review

The purpose of this review was to evaluate witch adhesive system and technique are the most suitable to be used at non carious cervical lesions with sclerotic dentine. The search was carried out in the electronic databases PubMed, Embase and Bireme/Medline, including studies published from 1990 to 2009. The inclusion criteria were: randomized clinical trials with sclerotic dentine treated with different types of adhesive systems and adhesive techniques, randomized in-vitro studies concerning to microtensile bond strength, contraction gap and dentine/adhesive interface evaluation. In total, 1807 papers were identified and only thirteen studies met the inclusion criteria, which showed high complex structure of sclerotic dentine, with high mineral content and sclerotic casts that obstruct the entrance of dentine tubules, reducing the dentin permeability and altering their adhesive properties. The hybrid layer formed at sclerotic dentin is smaller than at sound dentin and without resin tags and the use of high concentration of acids conditioners for longer periods or the remove of the superficial hipermineralyzed layer showed to be inefficient to increase the bond strength. It is also suggest that the use of self-etching adhesive systems has to be avoided at sclerotic dentine

La propuesta de esta revisión sistematizada fue evaluar cuál sistema adhesivo y cuál técnica son los más indicados para ser usados en lesiones cervicales no cariosas con dentina esclerótica. La búsqueda de los estudios fue realizada en las bases de datos electrónicas PubMed, Embase y Bireme/Medline, incluyendo estudios entre los años 1990 y 2009. Los criterios de inclusión fueron: ensayos clínicos randomizados utilizando dentina esclerótica tratada con diferentes tipos de sistemas e técnicas adhesivas, estudios randomizados in-vitro con respecto a resistencia adhesiva a la microtracción, gaps de contracción, y evaluación de la interface adhesiva utilizando microscopia electrónica de barrido o transmisión. Desde 1807 artículos identificados, trece estudios cumplieron los criterios de inclusión, los cuales describieron alta complejidad estructural de la dentina esclerótica, con alto contenido mineral y cast escleróticos que obstruían la entrada de los túbulos dentinarios, reduciendo la permeabilidad dentinária y alterando sus propiedades adhesivas. La capa hibrida formada fue reducida sin tags resinosos, siendo que la aplicación de acondicionadores ácidos en altas concentraciones o en periodos prolongados de tiempo, así como la remoción de la capa superficial de dentina esclerótica, fueron ineficientes para incrementar la resistencia adhesiva. Los resultados también sugieren que la utilización de sistemas adhesivos auto-acondicionantes en dentina esclerótica debe ser evitada

Relationship among malocclusion, number of occlusal pairs and mastication

This study evaluated the relationship among malocclusion, number of occlusal pairs, masticatory performance, masticatory time and masticatory ability in completely dentate subjects. Eighty healthy subjects (mean age = 19.40 ± 4.14 years) were grouped according to malocclusion diagnosis (n = 16): Class I, Class Class II-2, Class III and Normocclusion (control). Number of occlusal pairs was determined clinically. Masticatory performance was evaluated by the sieving method, and the time used for the comminute test food was registered as the masticatory time. Masticatory ability was measured by a dichotomic self-perception questionnaire. Statistical analysis was done by one-way ANOVA, ANOVA on ranks, Chi-Square and Spearman tests. Class II-1 and III malocclusion groups presented a smaller number of occlusal pairs than Normocclusion (p < 0.0001), Class I (p < 0.001) and II-2 (p < 0.0001) malocclusion groups. Class I, and III malocclusion groups showed lower masticatory performance values compared to Normocclusion (p < 0.05) and Class II-2 (p < 0.05) malocclusion groups. There were no differences in masticatory time (p = 0.156) and ability (χ2 = 3.58/p= 0.465) among groups. Occlusal pairs were associated with malocclusion (rho = 0.444/p < 0.0001) and masticatory performance (rho = 0.393/p < 0.0001), but malocclusion was not correlated with masticatory performance (rho = 0.116/p= 0.306). In conclusion, masticatory performance and ability were not related to malocclusion, and subjects with Class I, II-1 and III malocclusions presented lower masticatory performance because of their smaller number of occlusal pairs.

Reproducibility, reliability and validity of measurements obtained from Cecile3 digital models

The aim of this study was to determine the reproducibility, reliability and validity of measurements in digital models compared to plaster models. Fifteen pairs of plaster models were obtained from orthodontic patients with permanent dentition before treatment. These were digitized to be evaluated with the program Cécile3 v2.554.2 beta. Two examiners measured three times the mesiodistal width of all the teeth present, intercanine, interpremolar and intermolar distances, overjet and overbite. The plaster models were measured using a digital vernier. The t-Student test for paired samples and interclass correlation coefficient (ICC) were used for statistical analysis. The ICC of the digital models were 0.84 ± 0.15 (intra-examiner) and 0.80 ± 0.19 (inter-examiner). The average mean difference of the digital models was 0.23 ± 0.14 and 0.24 ± 0.11 for each examiner, respectively. When the two types of measurements were compared, the values obtained from the digital models were lower than those obtained from the plaster models (p < 0.05), although the differences were considered clinically insignificant (differences < 0.1 mm). The Cécile digital models are a clinically acceptable alternative for use in Orthodontics.

Adição de própolis ao hidróxido de cálcio e sua influência na ação antibacteriana / Addition of propolis to calcium hydroxide and its influence on antibacterial action

O objetivo deste estudo foi avaliar o efeito de duas diferentes concentrações de própolis em extrato etanólico sobre aação antibacteriana do hidróxido de cálcio (Ca(OH)2). Foram preparadas suspensões contendo 108 células/mL das bactérias Gram positivas Enterococcos faecalis; Staphylococcus aureus; Staphylococcus saprophyticus e Gram negativas Pseudomonas aeruginosa e Escherichia coli. Alíquotas de 0,1 mL das suspensões foram semeadas em duplicata, em agarMuller Hinton. Discos de papel de filtro foram embebidos em extratos etanólicos de própolis a 20 e 40%; em Ca(OH)2preparado com os referidos extratos de própolis e Ca(OH)2 preparado em solução fisiológica, sendo em seguida posicionados sobre o ágar. As placas foram incubadas a 37°C/24h e após este período, os halos de inibição do crescimento bacteriano foram medidos. Através do teste de ANOVA one way verificou-se que Ca(OH)2 em solução fisiológica mostrou maior halo de inibição do crescimento bacteriano (p<0.001) em comparação com o hidróxido de cálcio preparado comprópolis. A presença de própolis diminuiu a ação antibacteriana do Ca(OH)2 puro em pó tanto frente a bactérias Gram positiva quanto Gram negativa (p<0.001). Os resultados sugerem e estudos posteriores devem verificar se a característicaresinosa da própolis pode ter dificultado a difusão e conseqüente ação antibacteriana do Ca(OH)2.

Estado oclusal y rendimiento masticatorio / State occlusal and masticatory performance

El propósito del estudio fue evaluar el rendimiento masticatorio a través del estado oclusal. Fueron evaluados 100 sujetos. El rendimiento masticatorio fue evaluado a través del grado de trituración de pastillas de silicona y análisis de tamizado. El estado oclusal fue medido a través de la contabilización de pares oclusales anteriores y posteriores, y convertidos a unidades oclusales, asignando un valor agregado a cada tipo de par oclusal. Los resultados fueron evaluados a través de las pruebas de Kruskal Wallis, U-Mann Whitney, Spearman, y regresión múltiple stepwise. Se encontrón diferencias estadísticamente significativas entre los grupos de pares y unidades oclusales con respecto al rendimiento masticatorio (p<.001). El rendimiento masticatorio presentó una correlación muy fuerte con los pares oclusales (+.930) y unidades oclusales (+.919); considerable con los pares oclusales posteriores (+.877), pares molares (+.835) pares premolares (+.796); moderada con los pares anteriores (+.757) y la edad (-.679). Bajo las condiciones de este trabajo, aquellos sujetos con menor número de pares y unidades oclusales presentaron menor rendimiento masticatorio. La valorización de los pares como unidades oclusales ofrece una mejor descripción del potencial masticatorio de los dientes según el rendimiento obtenido

The aim of this study was to assess masticatory performance through occlusal state. One hundred subjects with general health were evaluated. The masticatory performance was evaluated through the degree of crushing of pills of silicone and sieving test. The oclusal state was measured through the accounting of occlusal anterior and posterior pairs, and turned to occlusal units, assigning an aggregate value to each type of occlusal pair. The results were evaluated through the tests of Kruskal Wallis, U-Mann Whitney, Spearman, and stepwise multiple regression. There were statistically significant differences between the groups of occlusal pairs and units with respect to the masticatory performance (p<.001). The masticatory performance presented very hard correlation with the occlusal pairs (+.930) and occlusal units (+.919); considerable with the posterior occlusal pairs (+.877), molar pairs (+.835) and premolar pairs (+.796); and moderate with the anterior pairs (+.757) and with the age (- 679). Under the conditions of this work, those subjects with less number of occlusal pairs and units presented less masticatory performance. The valuation of the occlusal pairs as occlusal units offers one better description of the masticatory potential of the teeth according to the masticatory performance obtained