Multidisciplinary action in a patient with cleft lip and palate: esthetic-functional dentofacial treatment for more than two decades / Atuação multidisciplinar em paciente com fissura lábio palatina: tratamento estético-funcional dento-facial de mais de duas décadas

Cleft lip and palate is a very common congenital defect in which embryonic facial processes do not achieve the ideal facial formation during their development which can cause malformation. Multiple dentistry specializations, especially oral and maxillofacial, orthodontics, oral rehabilitation and dental aesthetics are required in order to correct lip and oral cavity malformations by this congenital defect with the objective of functional and aesthetics improvement. The clinical case reported show the multidisciplinary approach in a patient with cleft lip and palate implementing an aesthetic and functional dentofacial rehabilitation. The case involves a 27-year-old female patient LCLG, Caucasian, with the presence of unilateral congenital cleft lip and palate on the left side, who started rehabilitative and reparative treatment at 3 months of age. She then started pediatric orthodontic treatment for angle class 3 crossbite correction at 7 years of age. After complete replacement of deciduous to permanent dentition at the age of 11, the patient started orthodontic treatment with a fixed appliance for several years and restorative treatment with composite resin reanatomize the anterior teeth due to agenesis of elements 22 and 25. After a few years when the resin restorations were no longer biologically favorable, an aesthetic rehabilitation treatment with ceramic laminates was planned through smile digital planning soon after completing the orthodontic treatment. This case report demonstrates that high aesthetic, functional and psychological expectations of a patient with congenital defect compromise throughout her life were met through a multidisciplinary dental treatment based on correct diagnosis and digital planning (AU)

A fissura labiopalatal é um defeito congênito muito comum, no qual os processos faciais embrionários não atingem a formação facial ideal durante o seu desenvolvimento, podendo causar malformações. Múltiplas especializações da odontologia, principalmente buco-maxilo-facial, ortodontia, reabilitação oral e estética dental são necessárias para corrigir as malformações labiais e da cavidade oral por esse defeito congênito com o objetivo de melhoria funcional e estética. O caso clínico relatado mostra a abordagem multidisciplinar em um paciente com fissura labiopalatal implementando uma reabilitação dentofacial estética e funcional. O caso envolve uma paciente do sexo feminino, 27 anos, LCLG, branca, com presença de fissura labiopalatal congênita unilateral à esquerda, que iniciou tratamento reabilitador e reparador aos 3 meses de idade. Após a substituição completa da dentição decídua pela permanente aos 11 anos de idade, a paciente iniciou tratamento ortodôntico com aparelho fixo por vários anos, e tratamento restaurador com resina composta para reanatomizar os dentes anteriores devido à agenesia dos elementos 22 e 25. Após alguns anos em que as restaurações em resina não eram mais favoráveis biologicamente, foi planejado um tratamento reabilitador estético com laminados cerâmicos através do planejamento digital do sorriso logo após a finalização do tratamento ortodôntico. Este relato de caso demonstra que as altas expectativas estéticas, funcionais e psicológicas de uma paciente com comprometimento de defeito congênito ao longo de sua vida foram atendidas por meio de um tratamento odontológico multidisciplinar baseado em diagnóstico correto e planejamento digital (AU)

Impressão tridimensional na Odontologia: uma revisão de literatura / Three dimensional printing in Dentistry: a literature review

Devido ao avanço tecnológico e a busca da excelência do tratamento, a prototipagem rápida (PR) tornou-se realidade na odontologia com uso de exames de imagem, sendo a tomografia computadorizada a mais utilizada. Assim, é possível analisar com precisão a anatomia do paciente e simular o procedimento nos biomodelos, resultando na otimização do tratamento. O objetivo do trabalho é descrever a aplicação dos processos de impressão tridimensional na odontologia. Foi realizada uma revisão de literatura integrativa utilizando os descritores: Impressão Tridimensional, CAD-CAM e Odontologia Digital nas bases de dados PubMed e Scielo e nos bancos de dados Europe PMC e BVS. Os protótipos vem sendo um marco na odontologia moderna, sendo eles réplicas de estruturas anatômicas que são criados a partir da conversão de imagens 3D obtidas por meio de exames de imagem, como a tomografia computadorizada (TC) e a ressonância magnética (RM), em imagens reais. As imagens adquiridas são reformatadas por meio de softwares específicos que utilizam os sistemas CAD e CAM. O biomodelos permite a simulação do respectivo procedimento, evitando imprevistos no transoperatório, aumentam a segurança e estreita a relação entre o profissional e o paciente, resultando na maior satisfação no resultado final... (AU)

Due to technological advancement and the search for excellence in treatment, the rapid prototyping (RP) becomes reality in dentistry with the imaging exams, being the computed tomography being the most used. Thus, it is possible to accurately analyze the patient's anatomy and simulate the procedure on biomodels, resulting in treatment optimization. The objective of the work is to describe the application of three-dimensional printing processes in dentistry. An integrative literature review was realized using the descriptors: Three-dimensional printing, CAD-CAM and Digital Dentistry in the PubMed and Scielo databases and in the Europe PMC and BVS databank. The prototypes have been a landmark in modern dentistry, they are replicas of anatomical structures that are created from the conversion of 3D images obtained through image exams, such as computed tomography (CT) and magnetic resonance (MR), in real images. The acquired images are reformatted using specific software using the CAD and CAM systems. The biomodel allows the simulation of the respective procedure, avoiding unforeseen circumstances during the operation, increasing safety and strengthening the relationship between the professional and the patient, resulting in greater satisfaction in the final result.. (AU)

Hyaluronic acid for repairing interdental papilla in esthetic area: case report

ABSTRACT: Background: Hyaluronic acid is a treatment option for this deficiency gingival papilla, since it aims to increase tissue volume in the region of loss of interdental papilla, minimally invasive. Aim this study was to describe the application of Hyaluronic acid in a deficient gingival papilla. Case report: Patient presented absence of interdental papilla in the maxillary arch around upper anterior teeth. A comprehensive exam was performed, plus 2D photographs taken with a professional camera coupled to a device for image standardization, and an intraoral scanning with the OMNICAM scanner. Three applications of Hyaluronic acid were performed to fill the black spaces, at an interval of four weeks. The patient was followed-up for three months, and the recovery of papilla was observed. Conclusion: The Hyaluronic acid as gingival filling material can be considered as a treatment option for augmenting interdental papilla in aesthetic area.

Aplicabilidade clínica dos avanços da tecnologia CAD-CAM em odontologia / Clinical applicability of advances in CAD-CAM technology in dentistry

O avanço tecnológico tem se mostrado um grande aliado em diversas áreas, assim como na odontologia. O surgimento da tecnológica CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) na década de 1950 trouxe outra realidade para a prática clínica diária. Previamente todo o processo laboratorial de trabalhos protéticos era demorado e puramente físico, atualmente a fabricação das peças protéticas demanda um menor tempo devido a utilização do meio digital, o que consequentemente diminui as consultas aos Cirurgiões-Dentistas. A adição de ferramentas digitais no planejamento e na execução dos tratamentos odontológicos alterou completamente o workflow, fazendo com que a busca para um aperfeiçoamento seja constante visando sempre o melhor atendimento e qualidade dos tratamentos realizados. Dessa forma este trabalho tem o objetivo de realizar uma revisão crítica da literatura sobre a aplicabilidade clínica da tecnologia CAD-CAM em Odontologia.

The technological advance has been shown to be a greatly in several areas, as well as in dentistry. The emergence of the technological CAD / CAM (Computer Aided Design / Computer Aided Manufacturing) in the 1950s brought another reality to daily clinical practice. Previously, the entire laboratory process of prosthetic work was time consuming and purely physical, currently the manufacture of prosthetic work requires less time due to the use of the digital medium, which consequently decreases the dentist appointments. The addition of digital tools in the planning and execution of dental treatments has completely altered the workflow, making the search for a constant improvement, always aiming at the best care and quality of treatment performed. Thus, this paper has the objective of performing a critical review of the literature on the clinical applicability of CAD / CAM technology in dentistry.

Accuracy of intraoral and extraoral digital data acquisition for dental restorations

ABSTRACT The computer-aided design (CAD) and computer-aided manufacturing (CAM) process chain for dental restorations starts with taking an impression of the clinical situation. For this purpose, either extraoral digitization of gypsum models or intraoral digitization can be used. Despite the increasing use of dental digitizing systems, there are only few studies on their accuracy. Objective This study compared the accuracy of various intraoral and extraoral digitizing systems for dental CAD/CAM technology. Material and Methods An experimental setup for three-dimensional analysis based on 2 prepared ceramic master dies and their corresponding virtual CAD-models was used to assess the accuracy of 10 extraoral and 4 intraoral optical non-contact dental digitizing systems. Depending on the clinical procedure, 10 optical measurements of either 10 duplicate gypsum dies (extraoral digitizing) or directly of the ceramic master dies (intraoral digitizing) were made and compared with the corresponding CAD-models. Results The digitizing systems showed differences in accuracy. However, all topical systems were well within the benchmark of ±20 µm. These results apply to single tooth measurements. Conclusions Study results are limited, since only single teeth were used for comparison. The different preparations represent various angles and steep and parallel opposing tooth surfaces (incisors). For most digitizing systems, the latter are generally the most difficult to capture. Using CAD/CAM technologies, the preparation angles should not be too steep to reduce digitizing errors. Older systems might be limited to a certain height or taper of the prepared tooth, whereas newer systems (extraoral as well as intraoral digitization) do not have these limitations.

Survey on mental health and social support of students majored in stomatology in internship / 中华医学教育探索杂志

Objective To study the mental health conditions of students majored in stomatology and dental technology in internships,and to provide evidences and guidelines for education before and during exercitation.Methods Totally 90 students majored in stomatology and 60 students majored in dental technology in internships were surveyed by the questionnaires of symptom checklist (SCL90)and perceived social support scale (PSSS).Results were analyzed by SPSS 14.0.Measurement data was analyzed using t test comparison between groups,showed as mean ± standard deviation ((x) ± s).Positive screening rate and rate between male and female were analyzed by Mann-Whitney U inspection.The inspection level is α =0.05.Results Scores of somatization,paranoia and anxiety factors among students majored in stomatology were (1.49 ± 0.56),(1.52 ± 0.43),(1.73 ± 0.58),all significantly higher than those of the national norm of youth.Positive rate of mental diseases among students majored in dental technology was 77.59％ and their scores of somatization,constraint,anxiety,psychotic factors were (1.69 ±0.55),(2.07 ±0.5),(1.68 ±0.51) and (1.54 ±0.39),all significantly higher than those of students majored in stomatology.There was no difference in the scores of rest factors between the two groups.Scores of PSSS among students majored in dental technology were significantly lower than those of students majored stomatology.Conclusions Students of different majors all suffer from psychological problems with different degrees.Therefore,education,management and social support before and during exercitation should be emphasized in the prevention of psychological diseases.

Composite resin color stability: influence of light sources and immersion media

OBJECTIVE: This study evaluated the influence of light sources and immersion media on the color stability of a nanofilled composite resin. MATERIAL AND METHODS: Conventional halogen, high-power-density halogen and high-power-density light-emitting diode (LED) units were used. There were 4 immersion media: coffee, tea, Coke® and artificial saliva. A total of 180 specimens (10 mm x 2 mm) were prepared, immersed in artificial saliva for 24 h at 37±1ºC, and had their initial color measured with a spectrophotometer according to the CIELab system. Then, the specimens were immersed in the 4 media during 60 days. Data from the color change and luminosity were collected and subjected to statistical analysis by the Kruskall-Wallis test (p<0.05). For immersion time, the data were subjected to two-way ANOVA test and Fisher's test (p<0.05). RESULTS: High-power-density LED (ΔE=1.91) promoted similar color stability of the composite resin to that of the tested halogen curing units (Jet Lite 4000 plus - ΔE=2.05; XL 3000 - ΔE=2.28). Coffee (ΔE=8.40; ΔL=-5.21) showed the highest influence on color stability of the studied composite resin. CONCLUSION: There was no significant difference in color stability regardless of the light sources, and coffee was the immersion medium that promoted the highest color changes on the tested composite resin.

Avaliação de quatro métodos de digitalização de slides 35 mm em ortodontia / Evaluation of four methods to digitally convert 35 mm slides in orthodontics

Baseado nos grandes benefícios que a utilização das imagens digitais pode proporcionar a Ortodontia, o objetivo deste trabalho foi comparar métodos de digitalização de slides 35 mm. Foram selecionados quatro slides 35 mm com qualidade de imagem variada de pacientes da faculdade de Odontologia da Pontifícia Universidade Católica de Minas Gerais. Os diapositivos foram digitalizados por quatro métodos: 1) scanner profissional de slide; 2) scanner de mesa com adaptador para slide; 3) câmera fotográfica digital fotografando os slides posicionados em um negatoscópio e 4) câmera digital fotografando as imagens projetadas por um projetor de slides. Posteriormente, as imagens foram processadas para serem visualizadas em quatro diferentes situações e submetidas à avaliação de quinze indivíduos, sorteados aleatoriamente. Para cada imagem analisada, os examinadores julgavam se estas eram aceitáveis ou não do ponto de vista clínico e científico e analisavam quatro variáveis: a) brilho e contraste; b) definição e nitidez; c) fidelidade e reprodução de cores e d) nota geral, aferindo uma nota de zero a cinco para cada quesito. Os resultados apontaram valores significativamente superiores em todos os quesitos analisados para as imagens obtidas pelo método da câmera digital com negatoscópio (p < 0,0005). Quanto à aceitabilidade das imagens foi identificado um percentual significativamente superior nos métodos da câmera digital com negatoscópio (86,9%) e do scanner profissional (86,1%) (p = 0,028). Concluiu-se que o método de digitalização de slides 35 mm com câmera fotográfica digital e negatoscópio apresentou os melhores resultados e por isso, encontram-se dentro de padrões plenamente aplicáveis para serem utilizados em Ortodontia.

Since the use of digital images in Orthodontics discloses a lot of advantages, this paper intended to evaluate four methods to digitally convert 35 mm slides. Four 35 mm slides with different quality were selected from the archive of the Minas Gerais Pontifical Catholic University Dental School. The methods used were: 1) professional scanner; 2) amateur scanner; 3) digital photography camera with a light box and 4) digital photographic camera with a slide projector. All images were prepared to be displayed by four methods and evaluated by fifteen people divided into five groups. For each image an evaluation was done to establish if they were clinically and scientifically acceptable and four parameters were also analyzed: a) brightness and contrast; b) sharpness; c) color reproduction and d) general grade, rating all of them a score ranging from zero to five. Results showed higher scores in all parameters for the images digitally converted with the method of the digital photography camera with a light box (p < 0,0005). The level of acceptability of the images obtained with the camera with a light Box method was higher (86,9%) and similar to the professional scanner method (86,1%) (p = 0,028). The results of this study indicate that the method to digitally convert 35 mm slides with a digital photography camera and a light box disclosed excellent quality and therefore are within the standards required for their application to Orthodontics.