Comparison of Accuracy and Time Duration Between Direct and Indirect Bonding By Photographic Method: A Short Clinical Study

Introduction: Indirect bonding has been in orthodonticsfor a long time. It has been recognized that accuratebracket positioning is of clinical importance for efficientapplication of biomechanics. Previosly so many methodshave been used for checking accuracy which is verytechnique sensitive, require special equipments, difficultto fabricate and cost effective. Here, to make it moresimplified, photographic method is used for accuracymeasurement. The aim of this study was to compare theaccuracy, and time consuming between direct and indirectbonding by photographic method.Material and methods: Study was performed on 5 patientswith split mouth technique in upper arch where bracketswere bonded on one quadrant of orthodontic modelsfor Indirect bonding one set as predetermined “ideal”bonding. A transfer tray was prepared using biostar sheetand glue gun, then tray is placed into patients mouth andother half quadrant was directly bonded to patients teeth.The accuracy was checked using photographic method inthree parameters Bracket height, Mesiodistal position andAngulation. Time taken for bonding direct and indirectprocedures were calculated.Results Unpaired t test was done which showed statisticalsignificant difference in bracket height and angulation andinsignificant for mesiodistal position. Proving indirectbonding is more accurate and less time consuming than thedirect bonding of braces.Conclusion: There is difference between mean bracketplacement errors for direct and indirect methods, the rangeof errors in the three directions assessed and time takenwere greater for direct than indirect bracket placement.The magnitudes of the findings are of clinically relevantand this method is clinically feasible and cost ineffective.

Desenhos de estudos epidemiológicos boca-dividida e paralelo: uma revisão da literatura / Split-mouth and parallel epidemiological studies designs: a literature review

Os estudos clínicos boca-dividida são muito usados nas pesquisas odontológicas. Esse desenho de estudo epidemiológico tem sido preferível, principalmente por reduzir em grande parte a variabilidade interindividual, bastante presente nos ensaios clínicos do tipo paralelo e que poderia interferir negativamente nos efeitos do tratamento. No entanto, é necessário que tanto o pesquisador clínico quanto o estatístico conheçam claramente todas as características do estudo boca-dividida, incluindo suas vantagens, desvantagens, considerações sobre a análise estatística mais adequada e suas implicações clínicas, para que sua utilização seja feita de maneira correta.

The split-mouth trials are widely used in dental research. This epidemiological study design has been preferred, mainly because it greatly reduces the inter-individual variability, very present in parallel clinical trials and that could negatively interfere in the treatment effects. However, it is necessary that both clinical researches and staticians clearly know all the features of split-mouth trials, include its advantages, disadvantages, considerations on the most appropriate statistical analysis and its clinical implications for their use to be made so correct.

Non-Pedicled Buccal Fat Pad Grafts to Treatment for Class I and II Gingival Recessions: A Clinical Trial

The aim of this study was to analyze the transplant efficiency of non-pedicled buccal fat pad graft (BFPG) for the treatment of Miller Class I or II gingival recessions (GRs) and to compare these results with those of subepithelial connective tissue graft (SCTG), which is considered the gold standard. Twelve patients with Miller Class I or II (≥2 mm) bilateral recessions in maxillary premolars or canines were selected. Recessions were randomly assigned to receive SCTG or BFPG. The clinical parameters evaluated at baseline and at 1, 3, and 6 months postoperatively included gingival index, plaque index, probing depth, GR, clinical attachment level, width of keratinized tissue, thickness of keratinized tissue and gingival margin to the acrylic guide. None of the evaluated clinical parameters differed significantly between the groups. At all evaluated postoperative time-points, both groups exhibited statistically significant differences in GR and gingival margin to the acrylic guide compared to baseline. Six months after surgery, the mean percentages of root coverage were 67.5% and 87.5% in the BFPG and SCTG groups respectively. In both groups, complete root coverage was observed in 50% of cases 6 months after surgery. The results presented herein indicate that the use of BFPG transplant has clinical similarities with SCTG and both may be considered as clinically successful methods for treating Miller Class I and II GRs.

Resumo O objetivo deste estudo foi analisar a eficiência do transplante do enxerto de tecido adiposo bucal não pediculado (ETAB) para o tratamento de recessões gengivais Classe I e II de Miller e comparar seus resultados com o enxerto de tecido conjuntivo (ETC), que é considerado o enxerto padrão ouro. Foram selecionados 12 pacientes com recessões gengivais bilaterais Classe I e II de Miller presentes em canino ou pré-molares maxilares. As recessões foram randomizadas para receber um dos dois tratamentos ETAB ou ETC. Os parâmetros clínicos avaliados no baseline e com 1, 3 e 6 meses de pós-operatório foram o índice gengival, índice de placa, profundidade de sondagem, recessão gengival (RG), nível clinico de inserção, espessura e largura de tecido queratinizado e a medida da margem gengival ao guia de acrílico (MG-GA). Os resultados mostraram que não houve diferença estatisticamente significativa entre os grupos em nenhum dos parâmetros clínicos avaliados. Os parâmetros clínicos de RG e MG-GA, em ambos os grupos, apresentaram diferença estatisticamente significativa nos 3 períodos pós-operatórios em relação ao baseline. Aos 6 meses de pós-operatório, a média percentual de recobrimento radicular foi de 67,5% e 87,5% para o grupo ETAB e ETC respectivamente. Em ambos os grupos o recobrimento radicular completo foi em 50% dos casos após 6 meses de pós-operatório. Pode-se concluir que o transplante do ETAB apresentou similaridades clínicas com o ETC e ambos os tratamentos podem ser considerados de sucesso clínico para o tratamento de RGs Classe I e II de Miller.

The clinical efficacy of laser assisted modified Widman flap: A randomized split mouth clinical trial.

Objective: The objective of the study was to compare the clinical efficacy of use of a diode laser (DL) (810 nm) as an adjunct to modified Widman flap (MWF) surgery to that of MWF alone. Materials and Methods: Twenty‑five patients between the ages of 20 and 50 years with generalized chronic periodontitis were selected for the study. Control sites (Group A) were randomly selected to receive an MWF, and the contralateral test sites (Group B) received MWF in conjunction with low‑level laser therapy. The energy density of 4 J/cm2 was applied to the gingival surface after periodontal treatment. The study tooth/site was treated along with any additional teeth in the quadrant in which the site was located if needed. Randomization was done using a coin flip. The DL was used to de‑epithelialize the inner part of the periodontal flap and photo‑biostimulate the surgical area. Plaque index (PI), papillary bleeding index (PBI), probing depth (PD), and clinical attachment level (CAL) scores were recorded at baseline and at 6 and 9 months. Statistical Analysis: Data were expressed as the mean ± standard deviation. Statistical analyzes were performed using paired Student’s t‑test for intragroup comparisons and unpaired Student’s t‑test for intergroup comparisons. Results: No significant difference was observed in PI scores between the two groups at baseline, 6 and 9 months. PBI scores were significantly lower in Group B versus Group A at 6 months (P < 0.01). However, no significant difference was observed between the two groups in PBI scores at the end of 9 months. PD reduction in Group B versus Group A was statistically significant at the end of 9 months (P < 0.01). Gains in CAL were significantly greater in Group B versus Group A at 6 and 9 months. Conclusion: The use of an 810 nm DL provided additional benefits to MWF surgery in terms of clinical parameters.

Estudo com desenho split-mouth com enxertos onlay de bloco alógeno e autógeno na maxila para futura colocação de implantes osseointegrados: resultados tomográficos e histológicos / A split-mouth study on allogeneic and autogenic onlay bone grafts in the maxillary arch for further dental implant placement: CBCT and histological results

O objetivo deste estudo foi verificar os resultados clínicos e histológicos de blocos onlay de osso autógeno e alógeno colocados na maxila. Um paciente feminino, 45 anos, recebeu, contralateralmente (split-mouth), blocos ósseos autógenos de ramo mandibular e blocos ósseos homógenos frescos congelados, de banco de ossos, e após oito e seis meses, respectivamente, para osso homógeno e autógeno, foi realizada a instalação de seis implantes. Clinicamente, observou-se maior reabsorção óssea nos blocos homógenos, com aspecto superficial mais irregular; já nos blocos autógenos, esta reabsorção foi menor, de aspecto superficial liso e contínuo. No momento da instalação dos implantes, observou-se menor densidade e/ou resistência ao corte nos blocos homógenos, porém, não alterando a estabilidade primária dos implantes; em ambos os blocos obteve-se 40 Ncm. Histologicamente, nos tempos utilizados de oito e seis meses, respectivamente para homógeno e autógeno, o resultado obtido na análise das lâminas foi muito semelhante, com presença de osteócitos aprisionados na matriz óssea, evidenciando tecido vital em ambas as amostras

The aim of this study was to evaluate the clinical and histological outcomes of onlay bone block and allografts placed in the maxillary arch. A female, 45 years-old patient received mandibular autogenous bone blocks and fresh-frozen allogenic grafts in a split-mouth design. After eight and six months for homogenous and autogenous bone, respectively, six dental implants were installed. Clinically, greater bone resorption was observed in the homogenous blocks, with more irregular surface aspect; in the autogenous blocks, the reabsorption degree was lower and smooth with a continuous surface. Upon implant placement, lower density and cutting resistance were seen in homogenous blocks, although not changing the final implant primary stability (40Ncm). Histologically, the obtained results were very similar, with the presence of osteocytes trapped into the bone matrix, showing vital tissue after eight and six months in both groups.

Observação clínica da aplicação de um produto a base de peróxido de hidrogênio a 35% não fotoativado: efeitos na sensibilidade e na alteração de cor / Clinical evaluation of in office dental bleaching with 35% hydrogen peroxide without the use of light-activated agents: effects of hypersensitivity and color change

O objetivo deste trabalho clínico foi avaliar a sensibilidade e a alteração de cor dos elementos dentais, quando submetidos ao clareamento de consultório, com um produto à base de peróxido de hidrogênio a 35%, sem fotoativação. Fizeram parte dessa pesquisa clínica 22 voluntários. Os fatores em estudo foram Tratamento Clareador em dois níveis (gel experimental a base de peróxido de hidrogênio a 35% e placebo) e Tipo de Dente em dois níveis (incisivos e caninos). Os voluntários tiveram suas hemiarcadas superiores direita e esquerda submetidas ao tratamento placebo ou experimental, caracterizando um delineamento tipo split-mouth, ou de boca dividida. Foram realizadas quatro sessões de clareamento, com uma semana de intervalo entre as sessões. A mensuração da variável alteração da cor foi realizada, pelo método visual, previamente ao início do experimento e após a aplicação dos materiais; e da variável sensibilidade durante e após a aplicação da técnica clareadora. De acordo com os fatores clareamento e sessões de clareamento em estudo; assim como com as variáveis de resposta cor e sensibilidade, foram aplicados os testes não paramétricos do sinal, de Mann-Whitney e de Kruskal-Wallis, ao nível de significância de 5%. Foi observado que após a primeira, segunda e terceira sessões, os dentes foram clareados quando tratados com o agente experimental a base de peróxido de hidrogênio a 35%; para a variável sensibilidade, foi verificado após a terceira e quarta sessões de clareamento com o agente experimental peróxido de hidrogênio a 35%, a presença de sensibilidade estatisticamente superior ao tratamento com o produto placebo, em todos os tempos de avaliação. Concluiu-se que a alteração de cor e a sensibilidade dental foram provocadas pelo gel clareado.

This clinical research will be evaluating the sensitivity, the alteration and stability colors dental, on patients when submitted to in-office dental bleaching with 35% HP, without light-activation sources. According to pre-established criteria, 20 patients will be selected. The factors will be Bleaching Procedures in two levels (experimental gel based on 35% HP and placebo) and Teeth in two levels (incisors and canines). According to a randomly draw, the volunteers will be theirs superior hemiarches, right and left, submitted to placebo treatment or experimental treatment, characterizing a split-mouth design. It will be carry out four sessions of the bleaching procedures with a one week break between sessions. The response variables analysed at each session will be: Dental Color, measured previously and immediately after application of the materials and removal of absolute isolation; and Sensitivity, measured during and till 24 hours after the aplication of the bleaching procedures. The results obtained will be submitted to appropriate Statistical analysis. It was observed that after the first, second and third sessions, the teeth were bleached when treated with the experimental agent on hydrogen peroxide 35%. The variable sensitivity was observed after the third and fourth sessions of bleaching agent experimental hydrogen peroxide 35%. It was concluded that the color change and tooth sensitivity are varied depending on the whitening gel.