Uso do aparelho intraoral de avanço mandibular no tratamento da síndrome da apneia obstrutiva do sono / Use of an intra-oral advancement appliance to treat the obstructive sleep apnea syndrome – a case report

Os aparelhos intraorais, desde que bem indicados, podem reduzir o índice de apneia/hipopneia, pois produzem uma significante mudança no posicionamento das vias aéreas superiores, aumentando a passagem para o fluxo de ar. O objetivo deste estudo foi investigar, através de um relato de caso, o uso do aparelho intraoral de avanço mandibular no tratamento da síndrome da apneia obstrutiva do sono, mostrando sua eficácia...

Intraoral appliances, when well-indicated, may reduce the apnea/ hypopnea index, producing a significant change in the positioning of the upper airways by increasing the airflow passage. The aim of this paper is to investigate by means of a case report the use of an intra-oral, use of intra-oral appliance for mandibular advancement to treat the obstructive sleep apnea syndrome and to demonstrate its efficacy...

Avaliação objetiva da estética gengival: validação de um novo índice / Objective evaluation of the gingival esthetics: validation of a new index

A estética gengival tem sido foco de interesse de pesquisadores nas áreas de prótese, implantodontia e periodontia em função do crescente nível de exigência de pacientes e profissionais na busca de otimização de resultados. Entretanto, sendo a estética um parâmetro extremamente subjetivo, torna-se difícil não só avaliar, mas também haver concordância entre avaliadores quanto ao que é e o que não é estético. Por essa razão foi proposto e validado um índice (IesG) para tornar essa avaliação mais objetiva e reprodutível entre os pesquisadores. O índice, baseado na posição e coloração da gengiva marginal, bem como no preenchimento dos espaços proximais pelas papilas, foi aplicado a 65 próteses de 56 pacientes 3 examinadores calibrados. A concordância tanto intraexaminadores como interexaminadores aplicando-se o teste Kappa foi substancial para os 3 indivíduos (entre 0.61 e 0.8). Concluiu-se que o índice é aplicável e reprodutível para análise objetiva da estética gengival.

The esthetics of gingival tissue has been focused by many researchers in the fields of Prosthodontics, Implantology and Periodontics due to the increasing level of patients’ and therapists’ expectations in their search for optimizing results. Nevertheless, as esthetics is an extremely subjective parameter, it becomes difficult not only to evaluate but also to find agreement among evaluators about what can and what cannot be considered esthetic. A new index (IesG) was proposed and validated in order to make this analysis more objective and reproducible. The index was based on the color and position of the gingival margin as well as on the filling of the interproximal spaces with gingival papillae. Three calibrated examiners applied the index to 65 implant-supported prosthesis in 56 patients. The intra and interexaminers agreement measured by the Kappa test was substantial for all the individuals (between 0.61 and 0.8). It was concluded that this index is suitable and reproducible for objective analysis of gingival esthetics.

Surface roughness analysis of ceramic systems after disinfection and sterilization procedures

The surface roughness of prosthodontic materials is an important factor that influences the amount of microbial plaque accumulation, thereby increasing the risk of caries and periodontal inflammation of abutment or adjacent teeth. Few studies exist that have investigated the influence of disinfectant materials on the surface roughness of prosthodontic materials. The purpose of this study is to evaluate the roughness changes in metal-ceramic and IPS Empress 2 ceramic structures, finished by either manual-polishing or glazing, followed by immersion in 2% glutaraldehyde solution for either 30 minutes (disinfection procedure) and 10 hours (sterilization procedure). The study consisted of 26 metalceramic specimens and 26 Empress 2 specimens measuring 10 x 10 x 2 mm. One-half of each group of specimens was polished by using rotatory instruments and the other half was glazed in a glazing oven (subgroups). Afterwards, the specimens were submitted to sterilization and disinfection in 2% glutaraldehyde for either 30 minutes or 10 hours, respectively. 3 specimens from each group were sterilized in autoclave, and for control group, the initial measurement of each specimen before the disinfection and sterilization procedures was obtained. The surface roughness was determined by a Hommel Tester T-1000, using the mean arithmetic Ra as roughness parameter. The results were statistically analyzed using a 4-way analysis of variance (ANOVA) method for individual comparisons among the means and the Tukey test at a significance level of p<.05. The results showed that there were no statistically significant differences of roughness in both groups, after immersion in chemical solution and sterilization in autoclave (p<.05). The mean of ceramic materials ranged from .631mm to 1.687mm in surface roughness. There was a statistically significant difference only among final polishing of ceramics (F=19.00; p<.001) and in the interaction between polishing and material used (F=18.83; p<.00...