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Braz. j. oral sci ; 21: e224809, jan.-dez. 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1354721


Aim: The aim of the present study was to evaluate the microbial contamination in internal and external walls of cone morse implant walls. Methods: Eleven patients with edentulous mandibular posterior area were selected to received dental implants, divided into groups: submerged (S), non-submerged (NS), and immediately loaded (IL). Microbiological evaluations (microorganisms' number, aerobic and anaerobic colony forming units (CFU) number and microorganisms' qualification) were divided into internal and external collection of the implant walls, at different stages: T0 (surgical procedure), T2 (suture removal), T4 (reopening S group), T6 (suture removal S group), and T8 (abutment placement in S and NS). All data were submitted to statistical analyses, with confidence level of 0.05. Results: There was difference in number of microorganisms observed over time within the same group (p < 0.05). A difference was observed in CFU when evaluated within the same group over time (p < 0.05), except for the IL group. In internal collection, a predominance of non-formation of microorganisms was observed at T0 in all groups, while formation of Gram-positive Diplococci and Gram-positive Bacilli was observed at T8 (p>0.05). In external collection, an increase in number of microorganisms was observed at T0. Conclusion: There was no difference in microbial contamination among the evaluated groups. The microorganism's colonization changed over time

Humans , Male , Female , Surgery, Oral , Dental Implants , Actinobacteria
Braz. oral res. (Online) ; 36: e059, 2022. tab, graf
Article in English | LILACS-Express | LILACS, BBO | ID: biblio-1374744


Abstract: This cross-sectional study aimed to assess if genetic polymorphisms in TNF- α are associated with a negative impact on Oral Health-Related Quality of Life (OHRQoL) in children with dental caries. A total of 307 pairs of parents/caregivers and children aged two to five years were selected. The children were clinically evaluated and classified according to caries experience and severity of active caries. The Brazilian Portuguese version of the Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess OHRQoL. Genotyping analysis of genetic polymorphisms in TNF- α (rs1799724, rs1799964, and rs1800629) was performed using real-time polymerase chain reaction. In the recessive model, children with the CC genotype of TNF-α (rs1799964) had a significantly high chance of poor OHRQoL in the symptom domain (pain), in both the caries experience (p = 0.045) and the high-severity active caries phenotypes (p = 0.033) (Mann-Whitney U test). It was concluded that genetic polymorphisms in TNF-α are associated with OHRQoL related to the symptom domain (pain), suggesting that TNF-α could be used as a potential biomarker for OHRQoL. Understanding the genetic aspects associated with OHRQoL will allow the early identification of patients with OHRQoL disparities and provide personalized healthcare.

Braz. oral res. (Online) ; 35: e007, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1132744


Abstract: The aim of this study was to evaluate patient perception of surgical discomfort in third molar surgery and the association with clinical variables and polymorphisms associated with the FKBP5, SLC6A4, and COMT genes. This cross-sectional observational study was carried out on 196 participants aged between 18 and 64 years at the Federal University of Paraná in 11 months. The intensity of surgical discomfort was assessed using the QCirDental questionnaire. Data on surgical and individual procedures were also cataloged. The oral health related quality of life was assessed by the Oral Health Impact Profile questionnaire (OHIP-14). The DNA sample was obtained from cells of the oral mucosa. Five markers of the FKBP5, SLC6A4, and COMT genes were genotyped. The data were submitted to statistical analysis with a significance level of 5%. Women reported greater intensity of discomfort associated with third molar surgery compared to men (p = 0.001). In the recessive model, the AA genotype of the rs3800373 marker was associated with greater surgical discomfort (p = 0.026). Therefore, women and individuals of the AA genotype for the rs3800373 marker in the FKBP5 gene reported greater surgical discomfort associated with third molar surgery.

Humans , Male , Female , Infant , Child, Preschool , Quality of Life , Molar, Third/surgery , Perception , Tooth Extraction , Cross-Sectional Studies , Serotonin Plasma Membrane Transport Proteins
Braz. oral res. (Online) ; 35: e091, 2021. tab
Article in English | LILACS, BBO | ID: biblio-1285726


Abstract The objective of this study was to evaluate if individuals with dentofacial deformities (DFD) who require orthognathic surgery are affected more by depression and pain. A case-control study was performed with 195 individuals. In the DFD group, 145 individuals with Class II and III malocclusion requiring orthognathic surgery were selected. The control group was composed of 50 individuals with no DFD. All patients were diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Data were analyzed with a significance level of 0.05. The DFD group more often presented severe depression (p = 0.020) and chronic pain (p = 0.017). They also presented higher prevalence of Nonspecific Physical Symptoms Including Pain (P = 0.002) and Nonspecific Physical Symptoms Excluding Pain (p = 0.002). Concerning TMD symptoms, the DFD group had more myofascial (p = 0.002) and articular pain (p = 0.041). Therefore, the results of this study suggest that depression and pain are more common in individuals with DFD requiring orthognathic surgery compared with individuals without DFD.

Humans , Temporomandibular Joint Disorders/surgery , Temporomandibular Joint Disorders/epidemiology , Orthognathic Surgery , Case-Control Studies , Arthralgia , Depression/epidemiology
Rev. cir. traumatol. buco-maxilo-fac ; 20(1): 22-26, jan.-mar. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253535


Introdução: A luxação da articulação temporomandibular ocorre quando a cabeça da mandíbula se movimenta para fora da fossa articular, fazendo com que a superfície posterior da cabeça da mandíbula fique à frente da eminência articular. Quando ocorrem episódios frequentes, essa condição é referida como luxação recidivante. Embora existam diferentes tratamentos, a eminectomia apresenta-se como uma opção cirúrgica com resultados satisfatórios e prognóstico favorável. Relato de caso: Este trabalho relata o caso de uma paciente com quadro severo de luxações recidivantes associadas à distonia muscular, tratada cirurgicamente por eminectomia. A paciente apresenta acompanhamento de 36 meses, estável, sem sintomatologia ou novos episódios de luxação. A abordagem multidisciplinar apresenta um alto índice de sucesso, e procedimentos cirúrgicos devem ser considerados quando procedimentos clínicos falham. Considerações finais: A eminectomia mostra bons resultados no tratamento da luxação recidivante de ATM, com chances mínimas de recidiva ou danos articulares. Após a cirurgia, os pacientes mostram uma boa função articular... (AU)

Introduction: Dislocation of the temporomandibular joint occurs when the jaw head moves out of the joint fossa causing the posterior surface of the jaw head to be ahead of the joint eminence. When they occur in frequent episodes, this condition is referred like relapsing dislocation. Although there are different treatments, eminectomy presents as a surgical option with satisfactory results and favorable prognosis. Case report: This paper reports the case of a patient with severe recurrent dislocations associated with muscular dystonia, treated through surgical treatment of eminectomy associated with a clinical treatment protocol. The patient has a 36-month followup, stable, without symptoms or new episodes of dislocation. The multidisciplinary approach has a high success rate and surgical procedures should be considered when clinical procedures fail. Final considerations: Eminectomy shows good results in the treatment of recurrent TMJ dislocation, with minimal chances of recurrence or joint damage. After surgery, patients show good joint function... (AU)

Humans , Female , Adult , Recurrence , Temporomandibular Joint , Joint Dislocations , Dystonia , Jaw , Surgical Procedures, Operative , Joints , Mandible
Braz. dent. sci ; 23(3): 1-6, 2020. ilus
Article in English | LILACS, BBO | ID: biblio-1117372


Introduction: The treatment of atrophic jaw fractures requires extensive knowledge by the maxillofacial surgeon. The correct diagnosis and planning optimize the possibility of oral rehabilitation towards many possible alternatives. The difficulty in repairing these fractures makes the treatment complex, in which normally invasive techniques are used. However; which give us satisfactory and predictable aesthetic-functional results. Objective: The objective of this work is to report an atrophic jaw fracture and posterior dental implants re-habilitation. Case report: A 53 years old female patient, victim of in face aggression referred to the emergency care. At the clinical examination, the patient had laceration in the upper lip region and the left side of the mandibular area, with bilateral mobility and paresis. In the oral examination, total lower and partial upper edentulism. After tomographic evaluation, a bilateral fracture of the mandibular body was confirmed, with significant bone fragments uneven. Surgery was performed with total transcervical access and use of reconstruction plate. After 90 days of follow-up, the oral rehabilitation with osseointegrated implants was performed. Conclusion: Complex atrophic mandible fractures in total edentulous patients can be treated with open reduction and stable fixation, allowing a faster return to normal function, improve of quality of life and assists in increasing safety for implant installation (AU)

Introdução: O tratamento de fraturas em mandíbula atrófica requer amplo conhecimento por parte da cirurgião bucomaxilofacial. O correto diagnóstico e planejamento otimizam a possibilidade de reabilitação, diante das muitas alternativas possíveis. A dificuldade em reparar essas fraturas torna o tratamento complexo, no qual normalmente técnicas invasivas são usadas. Entretanto, é possível alcançar resultados funcionais e estéticos satisfatórios e previsíveis. Objetivo: O objetivo de este trabalho é relatar uma fratura em mandíbula atrófica seguida de reabilitação com implantes dentários em região posterior. Relato de caso: Paciente do sexo feminino, 53 anos, vítima de agressão em face buscou o serviço de emergência. No exame clínico, observou-se laceração na região do lábio superior esquerdo com mobilidade bilateral e paralisia em região mandibular. No exame intra-oral, edentulismo total inferior e parcial superior. Após avaliação tomográfica, a fratura bilateral do corpo mandibular foi confirmada, com presença de significativos fragmentos ósseos. A cirurgia foi realizada com acesso transcervical total e uso de placa de reconstrução. Após 90 dias de acompanhamento foi iniciada a etapa de reabilitação oral com implantes osseointegrados. Conclusão: Fraturas atróficas complexas da mandíbula em pacientes desdentados totais podem ser tratados com redução e fixação estável, permitindo um rápido retorno da função, melhora da qualidade de vida, além de auxiliar no aumento da segurança no momento da instalação dos implantes (AU)

Humans , Female , Middle Aged , Dental Implants , Jaw, Edentulous , Jaw Fixation Techniques
Article | IMSEAR | ID: sea-192289


Masseter traumatic myositis chondro-ossificans (TMCO) is a rare pathological condition that causes severe mandibular function restriction. The aim of the present study is to report a TMCO case after direct masseter muscle injury and correlate it to bone and cartilage biomarkers up-regulation. Caucasian male patient, 38 years old, seeks treatment nine days after trauma with severe mouth opening limitation. Physical examination revealed a circumscribed hardened area connected to masseter muscle on the left side. Cone beam tomography and ultrasonography of masseter region were requested. There was incomplete fracture between the posterior board of inferior jaw and coronoid process as well as calcification within masseter muscle. The proposed treatment was excisional biopsy of calcification, coronoid process removal to enhance mouth opening as well as incomplete condyle fracture monitoring. Material removed was sent for histological analysis in order to confirm diagnosis. Immuhistochemistry was conducted and it was found that chondro-ossification biomarkers such as TGF-b1, Indian Hegdehog (IHH), BMP2, osteopontin (OP) and osteocalcin (OC) were up-regulated. One-year follow-up showed that the patient is stable with increased mouth opening and satisfactory jaw movements. Pathologists and maxillofacial surgeons must be aware of differential diagnosis of TMCO. Understanding cellular mechanisms of muscle tissue after trauma is also important once cellular pathway modifications leads to clinical features that differ from previously described in literature.

Rev. ABENO ; 19(1): 58-65, 2019. tab
Article in English | LILACS, BBO | ID: biblio-1022362


The study aimed to verify the adherence of undergraduate Dentistry students to the hepatitis B and tetanus vaccination campaign in a private Dental school. The hypothesis tested was that the vaccination campaign would be an effective program in prevention of HBV and tetanus infection. The vaccination's card copies and the Anti-HBs exam were analyzed as main outcome. Data were submitted to bivariate and multivariate Poisson regression analyses (0.05). Age, admission year, studying shift, doses of hepatitis B and tetanus vaccinations were independent variables. Out of the 485 students, 318 delivered the vaccination's card, and 295 presented the Anti-HBs exam. The median age of the students was 21 years (76.1% female and 23.9% male). In the univariate and multivariate Poisson regression model, failure to receive the tetanus vaccination was considered as a risk factor. Undergraduate students enrolled in the initial years were more likely to have not received the vaccination than the senior years (p ≤0.001). Out of the total number of students (318) who submitted the documentation for hepatitis B, 86.1% completed the vaccination protocol (3 doses), while 13.9% the incomplete protocol (1 or 2 doses). Older students were more likely to have refrained from taking the vaccinations compared to younger (p ≤ 0.001). In relation to the Anti-HBs, 73.9% had positive protective titer. Vaccination campaigns for undergraduate students may be effective if adherence of the individuals to the schedule can be ensured. Strategies for greater adherence of students, should be thought and planned by Dental Schools (AU).

O estudo objetivou verificar a adesão dos estudantes de graduação em Odontologia à campanha de vacinação contra hepatite B e tétano em uma escola particular de Odontologia. A hipótese testada foi que a campanha de vacinação seria um programa efetivo na prevenção da infecção pelo HBV e tétano. O cartão de vacinação e o exame anti-HBs foram analisados como desfecho principal. Os dados foram submetidos à regressão de Poisson bivariada e multivariada (0, 5). Idade, ano de admissão, turno de estudos, número de doses de vacinas para hepatite B e vacinação para tétano foram variáveis independentes. Dos 485 estudantes, 318 entregaram a cópia do cartão de vacinação e 295 apresentaram o exame anti-HBs. A mediana de idade dos estudantes foi de 21 anos (76,1% do sexo feminino, 23,9% do sexo masculino). Nos modelos de regressão de Poisson univariada e multivariada, a não vacinação contra o tétano foi considerada fator de risco. Os alunos de graduação matriculados nos anos iniciais foram mais propensos a não receberem a vacinação do que aqueles dos anos finais (p≤0,001). Do total de alunos (318) que entregaram a documentação para hepatite B, 86,1% completaram o protocolo de vacinação (3 doses), enquanto 13,9% o protocolo incompleto (1 ou 2 doses). Os estudantes mais velhos foram mais propensos a não terem tomado as vacinas em comparação com mais jovens (p≤0,001). Em relação ao anti-HBs, 73,9% apresentaram título de proteção positivo. As campanhas de vacinação para estudantes de graduação podem ser efetivas se a adesão dos indivíduos ao calendário vacinal puder ser assegurada. Estratégias para maior adesão dos estudantes, como essa campanha, devem ser pensadas e planejadas pelos cursos de Odontologia (AU).

Humans , Male , Female , Adolescent , Adult , Students, Dental , Tetanus/prevention & control , Immunization Programs , Hepatitis B/prevention & control , Brazil , Multivariate Analysis , Regression Analysis , Statistics, Nonparametric
Rev. ABENO ; 19(2): 63-70, 2019. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1023160


O Objective Structured Clinical Examination (OSCE) é uma avaliação que observa e intervém nas inseguranças dos estudantes em uma condição clínica simulada. Essa forma de avaliar competências, habilidades clínicas, conhecimento, atitudes, comunicação e profissionalismo é considerada uma ferramenta importante no processo de ensino-aprendizagem. Nesse contexto, surgiu a necessidade em implementar, no curso de Odontologia, a avaliação de competência clínica OSCE. O objetivo do estudo foi avaliar a percepção do estudante de Odontologia sobre o método OSCE e seu impacto na formação acadêmica deles. Participaram 34 estudantes do último ano do curso. O instrumento de coleta de dados foi um questionário com opções de respostas ("discordo", "concordo", "concordo parcialmente", "indiferente") que foi respondido voluntariamente. Os dados foram submetidos ao teste Qui-quadrado que comparou as respostas das quatro aplicações da metodologia OSCE durante o ano, com nível de significância de 95% (p<0,05). Em relação à mesma pergunta, a diferença também foi significativa na última avaliação (93,1%; p=0,017). Quanto ao método ter contribuído para o futuro na prática profissional, 93,1% (p=0,042) dos estudantes concordaram, na última avaliação do ano. Pode-se concluir, com base na análise de resposta dos questionários nos quatro bimestres, que a percepção dos estudantes de Odontologia do 5á´¼ ano noturno da Universidade Positivo frente à introdução do método OSCE foi bem aceita e positiva, uma vez que a maioria das respostas indicaram que o método contribuiu significativamente para a formação e ofereceu oportunidade de aprendizagem (AU).

The Objective Structured Clinical Examination (OSCE) is used to detect and intervene in the students' lack of confidence in a simulated clinical condition. The OSCE assesses competences, clinical skills, knowledge, attitude, communication, and professionalism, being considered an important tool in the teachinglearning process. This context raised the need to implement the OSCE clinical competence assessment. The objective of the study was to assess the dentistry student's perception of the OSCE method and its impact on their academic training. This study included thirty-four sênior students. The data were collected using a multiple-choice questionnaire ("disagree", "agree", "partially agree", "indifferent") voluntarily answered. The chi-square test was used to analyze the data by comparing the answers of four OSCE methodology applications during the year, with a 95% (p <0.05) significance level. The difference was also significant regarding the same question in the last assessment (93.1%, p = 0.017). As for the method having contributed to their future professional practice, 93.1% (p = 0.042) of the students agreed in the last assessment of the year. Based on the analysis of questionnaire answers in the four bimesters, we concluded that the perception of the students attending the 5th year of dentistry at Positivo University is that the implementation of the OSCE method was well accepted and positive, since most of the answers indicated that the method significantly contributed to their training and provided learning opportunities (AU).

Humans , Students, Dental , Health Knowledge, Attitudes, Practice , Clinical Competence , Education, Dental , Educational Measurement/methods , Perception , Brazil , Chi-Square Distribution , Surveys and Questionnaires , Problem-Based Learning
Braz. dent. j ; 29(5): 435-445, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-974183


Abstract This study aimed to evaluate the effect of two methods of local application of alendronate and parathyroid hormone (PTH) on bone repair and the systemic implications. A critically sized defect (5 mm) was created in the cranial region of twenty-five male Wistar rats, and the bone removed was particulated, and grafted back to the defect with different treatments. The animals were randomly divided into five groups: A1- bone graft immersion in alendronate solution (3 mg/kg) for 5 minutes; P1- bone graft immersion in PTH solution (20 µg); A2- weekly local applications of alendronate 1 mg/kg; P2- weekly local applications of PTH (20 µg); C- no drugs were used. The animals were euthanized 60 days after surgery. Cranial bone blocks were removed for histological, histomorphometric, and immunohistochemical analyses. MMP-2 and MMP-9 were used for immunolabeling. The kidneys, liver, and brain were also removed from all the rats for histological analysis. The data were submitted for statistical analysis with a level of significance of 0.05 (One-way ANOVA). The group C and group P2 presented a higher quantity of viable bone particles than the remaining groups. Groups A1, A2, and P1 presented with fewer viable bone particles than the control group, with a predominance of non-mineralized connective tissue. The histomorphometric analysis revealed no differences in relative bone area or MMP-2 or MMP-9 immunolabeling between the groups (p>0.05). Group A2 showed presence of fat in the liver consistent with hepatic steatosis. Changes in brain tissue were observed in groups A1 and P1.

Resumo Este estudo visou avaliar o efeito de dois métodos de aplicação local de alendronato e de paratormônio (PTH) no reparo ósseo e avaliar as implicações sistêmicas. Um defeito de tamanho crítico (5 mm) foi criado na calota craniana de vinte e cinco ratos Wistar machos, e o osso removido foi particulado e enxertado de volta no defeito com diferentes tratamentos. Os animais foram divididos aleatoriamente em cinco grupos: A1: imersão do enxerto ósseo em solução de alendronato (3 mg/kg) durante 5 min; P1- imersão do osso em solução de PTH (20 μg); A2- aplicações locais semanais de alendronato 1 mg/kg; P2- aplicações locais semanais de PTH 20 μg; C: não foram utilizados medicamentos. Os animais foram eutanasiados 60 dias após a cirurgia. Foram removidos os blocos ósseos envolvendo a região do defeito para realização das análises histológica, histomorfométrica e imuno-histoquímica. MMP2 e MMP9 foram as imunomarcações utilizadas. Os rins, fígado e cérebro também foram removidos de todos os ratos para análise histológica. Os dados foram submetidos à análise estatística com um nível de significância de 0,05 (One-way ANOVA). A análise histológica revelou que o grupo C e o grupo P2 apresentaram maior quantidade de partículas ósseas viáveis do que as apresentadas pelos demais grupos. Os grupos A1, A2 e P1 apresentaram menos partículas ósseas viáveis em comparação com o grupo controle com predominância de tecido conjuntivo não mineralizado. A análise histomorfométrica não revelou diferenças entres os grupos na área óssea relativa ou em MMP2 e MMP9 (p>0,05). O grupo A2 mostrou presença de gordura no fígado consistente com esteatose hepática. Alterações no tecido cerebral foram observadas nos grupos A1 e P1.

Animals , Male , Rats , Osteogenesis/drug effects , Parathyroid Hormone/pharmacology , Skull/surgery , Skull/drug effects , Bone Regeneration/drug effects , Alendronate/pharmacology , Wound Healing/drug effects , Bone Resorption , Brain/drug effects , Immunohistochemistry , Bone Transplantation/methods , Alendronate/administration & dosage , Kidney/drug effects , Liver/drug effects
Rev. ABENO ; 18(3): 53-61, jul.-set. 2018. ilus, tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-964723


O objetivo deste trabalho foi descrever um método de controle de esterilização dos materiais utilizados pelos acadêmicos de Odontologia, bem como comparar a sua eficiência frente ao antigo método de controle. Um software foi criado pela Gestão de Tecnologia da Informação da Universidade Positivo, a partir de uma demanda interna do curso, a fim de aprimorar o controle da central de esterilização. O novo método permite que etiquetas com código de barras sejam colocadas externamente em todas as caixas dos alunos, controlando todo o fluxo de entrada e saída de materiais, gerando maior segurança e agilidade do processo de esterilização. Além disso, o sistema permite que o professor tenha acesso à lista de todo o material esterilizado pelo aluno, bem como a data, horário e número da autoclave na qual o material foi esterilizado. Para avaliar a satisfação com o método foram entregues questionários para os estudantes do último ano do curso de Odontologia, contendo perguntas subjetivas sobre o novo e sobre o antigo método de controle. De acordo com o questionário aplicado, demonstrou-se que novo método utilizado diminui os atrasos para atendimento e o número de materiais danificados e perdidos, aumenta a segurança e acelera o tempo para a colocação e retirada dos materiais (p0,05). Na avalição geral, o método também se mostrou melhor quando comparado ao antigo (p0,001). Assim, conclui-se que o método implantado para o controle da esterilização proporcionou maior satisfação e segurança para os alunos (AU).

This study aims to describe a method for controlling the sterilization of materials used by dentistry students and to compare its efficiency against the former control method. A software was developed by the Information Technology Management Department at the Positivo University, motivated by an internal demand to improve the sterilizing department control. The new method allows the placement of labels with bar codes on the external surface of the students' boxes, controls the entire entrance-and-exit flow of materials and provides greater safety and agility for the sterilization process. Furthermore, the system allows professors to access the list of materials sterilized by students, and the date, time, and number of the autoclave in which the material was sterilized. Questionnaires including subjective questions about the new and former method of control were administered to final-year dentistry students to evaluate their satisfaction toward the methods. The new method decreases delays in patient care and the number of damaged and lost materials, increases safety, and reduces the time spent in material drop-off and withdrawal (p  better when compared to the former one (p  t the method implemented to control sterilization resulted in greater student satisfaction and provided greater safety (AU).

Humans , Male , Female , Software , Brazil , Sterilization/methods , Containment of Biohazards/methods , Education, Dental , Software Validation , Surveys and Questionnaires , Technology, Dental , Statistics, Nonparametric , Consumer Behavior , Information Technology
Article | IMSEAR | ID: sea-192032


Ameloblastoma is an aggressive odontogenic tumor which typically occurs between third and fourth decade of life that often needs resective approach. Immediate reconstruction may show better results. The treatment of multicystic ameloblastoma in the mandible being a rare case that occurred in the late second decade of life, which was surgically removed along with the affected teeth with safety margins, and the region was immediately reconstructed using a vascularized graft, removed from the fibula. Its integration, in combination with osseointegrated dental implants and fixed implant-supported prostheses, restored chewing function and esthetics. After 6 years from fibular graft and 24 months of dental implants, an excellent outcome was observed, with oral health and normal functions properly restored, and the immediate reconstruction of the mandible in resective cases, associated with oral rehabilitation with dental implants, may be considered a suitable treatment option.

Int. j. odontostomatol. (Print) ; 10(2): 325-331, ago. 2016. ilus
Article in English | LILACS | ID: lil-794495


Cleidocranial Dysplasia (CCD) is an autosomal dominant bone disorder caused by a defect in the CBFA1 gene and characterized by skeletal, craniofacial and orodental anomalies. This paper describes the main aspects of a case of CCD from diagnosis and planning to the first step of the interventions. An 11-year-old male patient sought the pediatric dentistry clinic of the Federal University of Paraná (Brazil) with the complaint of the prolonged retention of nearly all his primary teeth. Clinical and imaging exams led to the diagnosis of CCD and the treatment plan was outlined. The first step consisted of the extraction of 4 primary, 2 permanent and 2 supernumerary teeth from the maxilla, followed by palate separation, traction of the impacted teeth and reverse traction of the maxilla. The patient remains in treatment. Clinical follow up as well as the awareness and motivation of the family are important factors in such cases.

La displasia cleidocraneal (CCD) es un trastorno óseo, autosómico dominante, causado por un defecto en el gen CBFA1 y se caracteriza por anomalías esqueléticas, craneofaciales y bucodentales. En este trabajo se describen los principales aspectos de un caso de CCD, desde el diagnóstico y la planificación para la primera etapa de las intervenciones. Un paciente varón de 11 años de edad, concurrió a la Clínica de Odontología Pediátrica de la Universidad Federal de Paraná (Brasil) con un problema de retención prolongada de casi todos sus dientes de leche. Se describen los exámenes clínicos y de imagen dirigidos al diagnóstico de la CCD y el plan de tratamiento. La primera etapa consistió en la extracción de cuatro dientes primarios, dos dientes permanentes y dos dientes supernumerarios del maxilar, seguido de separación del paladar, tracción de los dientes afectados y tracción inversa del maxilar. El paciente permanece en tratamiento. El seguimiento clínico, así como la concientización y motivación de la familia son factores importantes en este tipo de casos.

Humans , Male , Child , Cleidocranial Dysplasia/surgery , Cleidocranial Dysplasia/diagnosis , Tooth, Supernumerary , Radiography, Panoramic
Braz. dent. j ; 27(3): 284-291, May-June 2016. tab, graf
Article in English | LILACS | ID: lil-782814


Abstract The aim of this study was to evaluate the stress and dislodgement resistance by finite element analysis of different types of fixation in mandibular orthognathic surgery. A 3D solid finite element model of a hemi-mandible was obtained. A bilateral sagittal split osteotomy was simulated and the distal segment was advanced 5 mm forward. After the adjustment and superimposing of segments, 9 different types of osteosynthesis with 2.0 miniplates and screws were simulated: A, one 4-hole conventional straight miniplate; B, one 4-hole locking straight miniplate; C, one 4-hole conventional miniplate and one bicortical screw; D, one 4-hole locking miniplate and 1 bicortical screws; E, one 6-hole conventional straight miniplate; F, one 6-hole locking miniplate; G, two 4-hole conventional straight miniplates; H, two 4-hole locking straight miniplates; and I, 3 bicortical screws in an inverted-L pattern. In each model, forces simulating the masticatory muscles were applied. The values of stress in the plates and screws were checked. The dislodgement resistance was checked at the proximal segment since the distal segment was stable because of the screen at the occlusal tooth. The regions with the lowest and highest displacement were measured. The offset between the osteotomized segments was verified by millimeter intervals. Inverted-L with bicortical screws was the model that had the lowest dislodgment and the model with the lowest tension was the one with two conventional plates. The results suggest that the tension was better distributed in the locking miniplates, but the locking screws presented higher concentration of tension.

Resumo O objetivo deste estudo foi verificar o estresse e a resistência ao deslocamento, pela análise de elementos finitos, de diferentes tipos de fixação em cirurgia ortognática mandibular. Um modelo 3D de elementos finitos sólidos de uma hemi-mandíbula foi obtido. Uma osteotomia sagital bilateral foi simulada e o segmento distal foi avançado 5 mm. Após o ajuste e sobreposição dos segmentos, foram simulados 9 diferentes tipos de osteossíntese com miniplacas e parafusos 2.0: A, uma miniplaca reta convencional de 4 furos; B, uma miniplaca reta lock de 4 furos; C, uma miniplaca convencional de 4 furos e um parafuso bicortical; D, uma placa lock de 4 furos e 1 parafuso bicortical; E, uma miniplaca reta convencional de 6 furos; F, uma miniplaca lock de 6 furos; G, duas miniplacas retas convencionais de 4 furos; H, duas miniplacas lock de 4 furos; e I, três parafusos bicorticais em um padrão L invertido. Em cada modelo foram aplicadas forças simulando os músculos mastigatórios. Foram verificados os valores da tensão nas placas e parafusos. A resistência ao deslocamento foi verificada no segmento proximal, uma vez que o segmento distal era estável. Foi medida a região com o maior deslocamento inferior e superior. O deslocamento entre os segmentos osteotomizados foi verificado por intervalos milimétricos. Parafusos bicorticais em L invertido foram o modelo que teve o menor descolamento inferior, e o modelo com a tensão mais baixa foi o de duas placas convencionais. Os resultados sugerem que a tensão foi melhor distribuída nas miniplacas do tipo lock, mas os parafusos de fixação apresentaram maior concentração de tensão.

Humans , Finite Element Analysis , Mandible/surgery , Orthognathic Surgery , Bite Force , Bone Plates , Bone Screws
RSBO (Impr.) ; 13(1): 5-5, Jan.-Mar. 2016.
Article in English | LILACS-Express | LILACS | ID: biblio-842399
RSBO (Impr.) ; 13(1): 18-24, Jan.-Mar. 2016. ilus, tab
Article in English | LILACS-Express | LILACS | ID: biblio-842402


Introduction: Periodontal scaling is the treatment approach most used to remove dental calculus, plaque, and altered cementum from root surface. During root decontamination, the instruments used leave the root rougher and more irregular. Objective: To verify the root surface after mechanical scaling with different Gracey curettes steel through SEM and superficial roughness analyses. Material and methods: Twelve teeth were embedded in acrylic resin. The teeth were instrumented with new Gracey curettes Gracey 5/6 from different brands. The groups (n=2) were divided into: control, no instrumentation (GC); carbon steel (CSN); stainless steel Neumar (SSN); stainless steel Millenium (SSM); premium steel Neumar (PSN); Hu-Friedy (HF). An area measuring 3 x 3 mm2 was marked on the distal surface of the root to guide the Reading of the root topography on SEM and rugosimeter. The data were analyzed by a single examiner previously calibrated. SEM analysis was based on scores of the root surface smoothness after scaling. We analyzed the parameters of mean roughness (Ra) and mean roughness deepness (Rz). SEM data were submitted to statistical analysis through Fisher's exact test (p < 0.002) and roughness data by Anova followed by Student t test. Results: The quality of the active surface of the curette demonstrated by SEM and roughness analyses that it can exert difference in the result regarding to the homogeneity produced after the scaling of root surface. Group SSM demonstrated a homogenous root surface (score 0) in SEM and better smoothness in rugosimeter analysis. Conclusion: According to com the methodology used, the group of curettes that provided better smoothness of root surface after scaling was SSM.

RSBO (Impr.) ; 13(1): 50-54, Jan.-Mar. 2016. graf
Article in English | LILACS-Express | LILACS | ID: biblio-842407


Introduction: Mandibular condyle fractures are, of all facial fractures, those with the greatest controversies in relation to its conduct. Patient systemic condition, location and displacement degree of the fracture, mouth opening amplitude, and occlusion alteration are some factors that influence on the decision on conservative or surgical treatment. Pain, mandibular movement limitation, altered dental occlusion, and facial asymmetry are signs and symptoms that indicate condylar fracture. The surgical treatment consists of surgical fracture reduction and subsequent fixing through titanium miniplates and/or screws. Objective: The aim of this study was to report the case of a patient who had parasymphyseal fracture associated with left mandibular condyle fracture, presenting limited excursive movements of the jaw, pain in function, altered dental occlusion, and bruising on chin region. Case report: Due to the type of fracture and patient systemic condition, we decided to open reduction of fractures and stable internal fixation. Conclusion: At 12-month follow-up, the patient showed significant improvement in both clinical and functional condition, demonstrating the effectiveness of the treatment method and technique.

Braz. oral res. (Online) ; 30(1): e4, 2016. tab, graf
Article in English | LILACS | ID: lil-768264


Dental treatment and surgery is a well-established method of correcting dentofacial deformities, and such treatment has an impact on the quality of life of individuals. The objective of this study was to evaluate the effect of orthognathic surgery on the quality of life of patients receiving treatment at the Universidade Federal do Paraná – UFPR. Clinical data were evaluated for the control group, and a quality-of-life evaluation questionnaire was completed [Oral Health Impact Profile (OHIP-14)]. For the case group, the same data were gathered along with information regarding their dentofacial deformity. The OHIP-14 questionnaire was also completed at three distinct stages of the experiment. The median age in the control group was 23.5 years. In the case group, the predominant gender was female, and the mean age of patients was 29.4 years. There was a statistically significant association between gender and OHIP-14 (p< 0.001). No such association was observed between age and OHIP-14 scores (p= 0.616). In the control group the OHIP-14 median score was 11.5. In the case group, the average OHIP-14 score at was 18 at T0, 21 at T1, and 8 at T2. The results demonstrated a statistically significant association between the three time stages at which OHIP-14 was analyzed (p< 0.001). There was a smaller reduction in the negative impact for transversal deformities of the jaw when compared with other deformities. Orthognathic surgery led to a reduction in the negative effects on the quality of life of patients.

Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Dentofacial Deformities/psychology , Dentofacial Deformities/surgery , Orthognathic Surgical Procedures/psychology , Quality of Life , Case-Control Studies , Oral Health , Patient Satisfaction , Psychometrics , Sex Factors , Sickness Impact Profile , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors
Dental press j. orthod. (Impr.) ; 20(6): 52-59, Nov.-Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-770280


Abstract Introduction: Patients with dentofacial deformities may undergo orthodontic or orthodontic-surgical treatment. Both modalities can affect esthetics. Objective: This study aims to evaluate clinical and radiographic changes in exposure of maxillary central incisors occurring after orthognathic surgery for maxillary advancement. Methods: A total of 17 patients who underwent orthognathic surgery for maxillary advancement between September, 2010 and July, 2011 were selected. Exposure of maxillary central incisors was evaluated clinically and by lateral cephalograms. Measurements were taken one week before and three months after surgery. Data were paired in terms of sex, age, nasolabial angle, height and thickness of the upper lip, the amount of maxillary advancement, clinical exposure and inclination of maxillary central incisor by statistical tests (CI 95%). Results: After maxillary advancement, incisor clinical exposure had increased even with relaxed lips and under forced smile. Moreover, there was a mean increase of 23.33% revealed by lateral cephalograms. There was an inverse correlation between upper lip thickness and incisors postsurgical exposure revealed by radiographic images (p = 0.002). Conclusions: Significant changes in the exposure of maxillary central incisors occur after maxillary advancement, under the influence of some factors, especially lip thickness.

Resumo Introdução: pacientes portadores de deformidades dentofaciais podem submeter-se a tratamento ortodôntico ou ortodôntico-cirúrgico. Ambos podem modificar a estética do paciente. Objetivo: esse estudo tem por objetivo avaliar, clinicamente e radiograficamente, as mudanças na exposição dos incisivos centrais superiores em pacientes submetidos à cirurgia ortognática de avanço de maxila. Métodos: foram selecionados 17 pacientes submetidos à cirurgia ortognática de avanço maxilar no período de setembro de 2010 a julho de 2011. A exposição dos incisivos centrais superiores foi avaliada clinicamente e por meio de radiografias cefalométricas em norma lateral. Essas medidas foram tomadas uma semana antes e três meses depois da cirurgia. Os dados foram, por meio de testes estatísticos (CI 95%), correlacionados por sexo, idade, ângulo nasolabial, altura e espessura do lábio superior, quantidade de avanço maxilar, exposição clínica e inclinação dos incisivos centrais superiores. Resultados: após o avanço maxilar, houve um aumento da exposição clínica dos incisivos tanto com o lábio superior relaxado quanto sob sorriso forçado. Além disso, obteve-se um aumento médio de 23,33% na exposição dos incisivos nas radiografias cefalométricas em norma lateral. Houve correlação inversa entre a espessura do lábio superior e a exposição pós-cirúrgica dos incisivos nas imagens radiográficas (p = 0,002). Conclusão: mudanças significativas na exposição dos incisivos centrais superiores ocorrem após o avanço maxilar, sob influências de certos fatores, especialmente a espessura do lábio superior.

Humans , Incisor , Smiling , Cephalometry , Lip , Maxilla/surgery
RSBO (Impr.) ; 12(2): 209-215, Apr.-Jun. 2015. tab
Article in English | LILACS-Express | LILACS | ID: lil-792046


Introduction: Oral rehabilitation with dental implants becomes limited in patients who make use of sodium bisphosphonate (BF), because this drug inhibits osteoclast activity and thus osteoblastic, fundamental steps to implant osseointegration. Furthermore, this drug can cause osteonecrosis of the jaw (OJ). The dentist has to fully know about this drug and its side effects, to differentiate it from other changes. Objective: This study aimed to review the literature on the influence of bisphosphonates on implant and to evaluate the possible complications resulting from prolonged use, providing subsidies to the dentist to prevent and recognize the patient with osteonecrosis of the jaws Literature review: The BPs are a class of drugs used for the treatment of bone diseases such as osteoporosis, because their mechanism of action inhibits the function of osteoclast. However, these drugs may cause some side effects known as the OJ. Patients undergoing intravenous therapy are more likely to develop these changes than those undergoing oral therapy. OJ is characterized by painful symptoms, leaving the exposed bone in the oral cavity. There are several treatment strategies according to the clinical stage that the patient presents. Conclusion: The installation of dental implants in patients who make use of BPs presents risks, since this drug can cause OJ.