ABSTRACT
OBJECTIVE: To compare the efficacy of dental plaque removal between manual and powered toothbrushes in individuals with syndactyly. MATERIAL AND METHODS: Seventeen patients with Apert syndrome aged 11 to 30 years. The efficacy of toothbrushing was evaluated by the O'Leary plaque index at 2 periods: initial (before toothbrushing) and final (immediately after toothbrushing), using manual toothbrush (Colgate Twister) and powered toothbrush (Colgate Actibrush). Means were compared by the ANOVA test at a significance level of 5%. RESULTS: The reduction in the plaque index was different for each type of toothbrush (interaction factor between manual and powered toothbrushes and initial and final periods, Pâ=â0.026). The powered toothbrush provided greater reduction of dental plaque than the manual toothbrush. CONCLUSION: In individuals with syndactyly, both manual and powered toothbrushes allowed significant plaque reduction on tooth surfaces; however, the powered toothbrush exhibited greater efficacy of plaque removal compared with the manual toothbrush.
Subject(s)
Dental Plaque/prevention & control , Syndactyly , Toothbrushing , Adolescent , Adult , Child , Humans , Toothbrushing/instrumentation , Toothbrushing/methods , Toothbrushing/statistics & numerical data , Young AdultABSTRACT
OBJECTIVE: To evaluate the role of keratinized mucosa around dental implants, correlating with other clinical parameters related to the success of dental implants. DESIGN: Cross-section. SETTING: Institutional tertiary referral hospital. PATIENTS: A total of 202 dental implants fixed in the cleft area of 109 patients with cleft lip and/or palate were evaluated. Interventions: The evaluated clinical parameters were probing depth and gingival and plaque indexes on the buccal surface (three sites). MAIN OUTCOME MEASURES: All clinical parameters were correlated with the width of keratinized mucosa around the implants. RESULTS: The largest probing depths were detected when the width of keratinized mucosa was 2 mm or more, with a statistically significant difference between the means of the probing depth and keratinized mucosa width. CONCLUSION: Even though the present results suggest that peri-implant health can be observed in areas with keratinized mucosa width under 2 mm provided an adequate oral hygiene control is performed, longitudinal randomized studies are necessary to analyze the relationship between the width of keratinized mucosa and the health of peri-implant tissues.
Subject(s)
Cleft Lip/surgery , Cleft Palate/surgery , Dental Implants , Keratins/physiology , Mouth Mucosa/physiology , Adolescent , Adult , Cross-Sectional Studies , Female , Homeostasis/physiology , Humans , Male , Middle AgedABSTRACT
OBJECTIVES: This study evaluates the action of a low-intensity diode laser with gallium-aluminum-arsenide (GaAlAs) active medium on the healing process and analgesia in individuals undergoing free gingival grafts. MATERIAL AND METHOD: Ten individuals needing bilateral gingival graft in the mandibular arch were enrolled in a double-blind study. Each individual had a 30-d interval between the two surgeries. The side receiving application of laser was defined as test side and was established upon surgery; laser application was simulated on the control side. The laser was applied in the immediate postoperative period and after 48 h, and patients rated pain on a scale of 0 to 10, representing minimal and maximal pain, respectively. Photographs were obtained at 7, 15, 30, and 60 d postoperatively and evaluated by five periodontists. RESULTS: No statistically significant difference was found at any postoperative period between control and test sides, even though greater clinical improvement associated with treatment was observed at 15 d postoperative. At 30 and 60 d, some examiners observed the same or greater clinical improvement for the control. Only one individual reported mild to moderate pain on the first postoperative day. CONCLUSIONS: Low-intensity laser therapy did not improve the healing of gingival grafts and did not influence analgesia.
Subject(s)
Gingiva/radiation effects , Gingiva/transplantation , Low-Level Light Therapy , Wound Healing/radiation effects , Adolescent , Adult , Double-Blind Method , Humans , Lasers, Semiconductor , Pain Measurement , Transplants , Young AdultABSTRACT
Craniosynostosis syndromes are characterized by premature closure of one or more cranial sutures, associated with other malformations, the most frequent of which are the Crouzon and Apert syndromes. Few studies in the literature have addressed the oral health of these individuals. The purpose of this study was to compare the periodontal status of individuals with Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes before toothbrushing and compare the efficiency of plaque removal before and after mechanical toothbrushing. The probing depth, plaque index (according to Lõe and O'Leary), clinical attachment level, gingival index (according to Silness and Lõe) and amount of keratinized mucosa were evaluated before toothbrushing, and the O'Leary plaque index was assessed before and immediately after toothbrushing, on the same day, in 27 individuals aged 11 to 36 years. There was statistically significant difference in the mean probing depth and clinical attachment level among regions (p=0.00; p=0.01, respectively). The gingival index did not reveal statistically significant differences. With regard to the plaque index, the left region exhibited higher plaque index values than the right and anterior regions. No significant results were found in the analysis of keratinized mucosa. Comparison of the O'Leary plaque index before and after toothbrushing revealed statistically significant difference for all syndromes except for the Pfeiffer syndrome (p<0.05). In conclusion, there was no difference in the periodontal status among individuals with syndromic craniosynostosis. The posterior region was more affected than the anterior region as to the presence of plaque, loss of insertion and probing depth. Individuals with Pfeiffer syndrome exhibited greater toothbrushing efficiency than individuals with the other craniosynostosis syndromes.
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Craniosynostoses/complications , Periodontal Index , Acrocephalosyndactylia/complications , Craniofacial Dysostosis/complications , Dental Plaque Index , Periodontal Attachment Loss/etiology , Periodontal Pocket/etiology , Syndrome , Toothbrushing , Young AdultABSTRACT
Craniosynostosis syndromes are characterized by premature closure of one or more cranial sutures, associated with other malformations, the most frequent of which are the Crouzon and Apert syndromes. Few studies in the literature have addressed the oral health of these individuals. The purpose of this study was to compare the periodontal status of individuals with Apert, Crouzon, Pfeiffer and Saethre-Chotzen syndromes before toothbrushing and compare the efficiency of plaque removal before and after mechanical toothbrushing. The probing depth, plaque index (according to Löe and O'Leary), clinical attachment level, gingival index (according to Silness and Löe) and amount of keratinized mucosa were evaluated before toothbrushing, and the O'Leary plaque index was assessed before and immediately after toothbrushing, on the same day, in 27 individuals aged 11 to 36 years. There was statistically significant difference in the mean probing depth and clinical attachment level among regions (p=0.00; p=0.01, respectively). The gingival index did not reveal statistically significant differences. With regard to the plaque index, the left region exhibited higher plaque index values than the right and anterior regions. No significant results were found in the analysis of keratinized mucosa. Comparison of the O'Leary plaque index before and after toothbrushing revealed statistically significant difference for all syndromes except for the Pfeiffer syndrome (p<0.05). In conclusion, there was no difference in the periodontal status among individuals with syndromic craniosynostosis. The posterior region was more affected than the anterior region as to the presence of plaque, loss of insertion and probing depth. Individuals with Pfeiffer syndrome exhibited greater toothbrushing efficiency than individuals with the other craniosynostosis syndromes.
Subject(s)
Craniosynostoses/complications , Periodontal Index , Acrocephalosyndactylia/complications , Adolescent , Adult , Child , Craniofacial Dysostosis/complications , Dental Plaque Index , Female , Humans , Male , Periodontal Attachment Loss/etiology , Periodontal Pocket/etiology , Syndrome , Toothbrushing , Young AdultABSTRACT
Objetivo:Avaliar a resistência e o padrão de fratura de dentes tratados endodonticamente com raízes estruturalmente enfraquecidas, reconstruídas com pinos de fibras de polietileno e pinos biológicos. Métodos: Após remoção das coroas, sessenta caninos superiores tratados endodonticamente foram distribuídos em quatro grupos: 1) preparo convencional dos condutos e pinos de fibras de polietileno; 2) preparo convencional dos condutos e pinos biológicos; 3) condutos medianamente alargados e pinos biológicos; 4) condutos amplamente alargados e pinos biológicos. Os pinos foram cimentados com cimento resinoso Enforce (Dentsply Ind. e Com., Petrópolis, Rio de Janeiro, Brasil) e construiu-se a porção coronária com resina composta Ti-Core(Essential Dental Systems, S. Hackensack, NJ, USA). Os espécimes foram testados sob compressão em máquina de ensaios universal. Resultados: Os valores de resistência à fratura obtidos foram: grupo 1 - 45,46kgf; grupo 2 - 53,30kgf; grupo 3 - 58,67kgf; grupo 4 - 47,91kgf, com diferença estatisticamente significante entre os grupos 1 e 3 (p < 0,05). Observou-se o seguinte padrão de fratura: grupo 1 - ampla predominância de fratura da porção coronária do núcleo; grupos 2 e 3 - padrão variado de fraturas; grupo 4 - todas as raízes fraturaram. Conclusão: Ambos os pinos mostraram-se promissores para o uso proposto (adequada resistência à fratura e padrão de fraturas favorável). Os pinos biológicos parecem capazes de promover reforço das raízes, porém 100% das raízes amplamente alargadas fraturaram.
Objective: To investigate the fracture strength and mode of endodontically treated teeth with structurally weakened roots reconstructed withwoven polyethylene fiber posts and biological posts. Methods: After removing the crowns, 60 endodontically treated maxillary canines were distributed into 4 groups: 1) conventional root canal preparation and reconstruction with polyethylene fiber posts; 2) conventional root canal preparation and reconstruction with biological posts; 3) moderately flared root canals and reconstruction with biological posts; 4) widely flared root canals and reconstruction with biological posts. The posts were cemented with resin cement Enforce (Dentsply Ind. e Com., Petrópolis, Rio de Janeiro, Brasil) and the core was constructed with Ti-Core (EssentialDental Systems, S. Hackensack, NJ, USA) resin composite. The specimens were tested under compression in a universal testing machine. Results: The following fracture strength values were obtained: Group 1 - 45.46kgf; Group 2 - 53.30kgf; Group 3 - 58.67kgf; Group 4 - 47.91kgf, with statistically significant differences between Groups 1 and 3 (p<0.05). The following fracture modes were observed: Group 1 - predominance of fracture of the coronal portion of the post; Groups 2 and 3 - various fracture patterns; Group 4 - all roots fractured. Conclusion: Both posts were shown to be promising (adequate fracture strength and favorable pattern of fracture). Biological posts appear to be capable of reinforcing the root to some extent; however, fracture occured in all roots with widely flared root canals.
Subject(s)
Humans , Materials Testing , Post and Core Technique , Case-Control Studies , Tensile StrengthABSTRACT
Este estudo investigoua resistência à remoção por tração de pinos de fibra de vidro e o padrão de falhas ocorrido em função do grau de adaptação dos pinos ao conduto radicular. Foram selecionados quarenta caninos superiores humanos, com uma média de noventa dias de extração. Antes e durante o experimento, armazenaram-se os dentes em condições úmidas (soro fisiológico). Após tratamento endodôntico, seccionou-se a coroa desses dentes para que os remanescentes radiculares fossem padronizados com o comprimento médio de 15 mm, com um diâmetro de 5 a 5,5 mm no sentido mesiodistal e com diâmetro de 7 a 7,5 mm no sentido vestibulopalatino. As raízes foram aleatoriamente distribuídas em quatro grupos (n = 10): no Grupo 1, todo o conduto foi preparado com broca Largo 4®; no Grupo 2, o conduto foi preparado como no Grupo 1 e, após, o terço cervical foi alargado com ponta diamantada 1016 HL; no Grupo 3, após o preparo inicial como feito no Grupo 1, os terços cervical e médio foram alargados com ponta diamantada 1016 HL; no Grupo 4, todo o conduto foi alargado com ponta diamantada 1016 HL. Os condutos foram preparados com 9 mm de profundidade e pinos Reforpost nº 2® foram cimentados com adesivo Scoth Bond Multi-Uso Plus® e cimento resinoso RelyX CRA®. A porção coronária do núcleo foi construída com resina composta Filtek Z250®. Após 24h de armazenamento, os espécimes foram submetidos a testes de resistência à remoção por tração em máquina de ensaios universal Kratos modelo K-2000MP®, na velocidade de 0,5 mm/min. Os seguintes valores foram encontrados: Grupo 1 - 47,67 kgf (d.p. = 12,80); Grupo 2 - 40,92 kgf (d.p. = 9,94); Grupo 3 - 43,63 kgf (d.p. = 9,30); Grupo 4 - 37,57 kgf (d.p. = 8,62). Não houve diferença estatisticamente significativa entre os grupos (p < 0,05). Nos Grupos 1,2 e 3 o padrão de falha mais comum foi adesivo (interface dentina-cimento) e, no Grupo 4, houve 50 por cento de falhas adesivas e 40 por cento de falhas combinadas.
Subject(s)
Dental Cements , Dental Pins , Dental Pulp Cavity , Tensile StrengthABSTRACT
OBJECTIVE: To evaluate the intraoral features of patients with Apert's syndrome in treatment at the Hospital of Rehabilitation and Craniofacial Anomalies of University of São Paulo (HRAC-USP), a national reference center for treatment of craniofacial anomalies in Brazil. STUDY DESIGN: In this retrospective study, of 56,000 patients registered at HRAC-USP, 36 patients were diagnosed with Apert's syndrome and were either examined or had their medical files evaluated, aiming to characterize lip posture, mouth shape, maxillary hypoplasia, palatal morphology, dental anomalies, and malocclusion. RESULTS: Most patients were characterized as mouth breathers for presenting with hypotonic lips and trapezoidal-shaped mouths. Other frequent findings were the presence of highly arched palates and hypoplastic maxilla, with gingival lateral swellings that increased in size with age. Crowding of teeth and malocclusion were commonly observed, and cases of hypodontia were frequent. Contrary to previous studies demonstrating a high incidence of cleft soft palate, in this study only 1 of 23 patients presented a true cleft. CONCLUSIONS: The intraoral features of patients with Apert's syndrome in the population studied match most of the findings in other populations. However, the occurrence of cleft soft palate was unexpectedly low and morphologically normal teeth were found. In addition, hypodontia was frequently observed. Variations in frequency of observations of some characteristics might be related to differences in sample size or population.
Subject(s)
Acrocephalosyndactylia/complications , Mouth Abnormalities/etiology , Palate, Hard/abnormalities , Adolescent , Adult , Anodontia/etiology , Child , Child, Preschool , Female , Humans , Male , Malocclusion/etiology , Maxilla/abnormalities , Mouth Breathing/etiology , Palate, Soft/abnormalities , Retrospective StudiesABSTRACT
O ameloblastoma , embora seja uma neoplasia benigna, costuma ser invasivo e sua remoção cirúrgica acarreta perdas estruturais aliadas à dificuldades biomecânicas para estabilizar os aparelhos protéticos posteriormente confeccionados. Além de ser indicado acompanhamento freqüente, a conduta pós-cirúrgica do ameloblastoma é protética e a reabilitação do paciente visa reparar a mitilação da face ou das estruturas adjacentes, permitindo o rstabelecimento das funções e da qualidade de vida. O sucesso da reabilitação protética depende da seleção adequada de materiais e técnicas, especificos para cada caso. Este artigo descreve a confecção de uma prótese obturadora indicada para reparar um extenso defeito na maxila, secundário à ressecção de um ameloblastoma deste local
Subject(s)
Humans , Male , Middle Aged , Ameloblastoma , Prostheses and Implants , Odontogenic TumorsABSTRACT
The use of teeth-implant, mucosa-supported removable dentures for rehabilitation of partially edentulous patients involves highly complex biomechanical aspects. This type of prosthesis associates 3 kinds of support that react differently to the functional and parafunctional forces developed in the oral cavity. Although the construction of removable partial dentures may seem paradoxical when osseointegrated implants are placed, in some cases, this option is an excellent alternative to solve difficulties related to the anatomic, biologic, psychomotor, and financial conditions of the patient. This article reports on a case in which a teeth-implant, mucosa-supported removable partial denture was the option of choice for a patient with financial and anatomic limitations, having a large structural loss of the residual alveolar ridge caused by trauma by a gunshot injury at the mandible. The 5-year follow-up did not reveal any type of biomechanical or functional problem.
Subject(s)
Dental Prosthesis, Implant-Supported/methods , Denture, Partial , Mandibular Injuries/rehabilitation , Wounds, Gunshot/rehabilitation , Adult , Humans , MaleABSTRACT
Apesar da necessidade de uma maior atenção à odontologia em nosso país, tendo em vista o crescente aumento da população de idosos, a maioria das faculdades de odontologia não incluiu, até o presente momento, esta ciência em seus currículos. De tal forma, a maioria dos profissionais encontra-se ainda despreparada para prestar um atendimento ideal à população de terceira idade, especialmente aos idosos portadores de deficiências. Este artigo irá abordar aspectos importantes sobre pacientes idosos com dificuldades visuais, auditivas, mentais, ortopédicas ou de fonação, além de fornecer indicações para montagem de uma clínica mais adequada para servir estes pacientes com necessidades especiais
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Oral Health , Geriatric Dentistry , Homeopathic Anamnesis , Medically Underserved Area , Geriatric Dentistry/educationABSTRACT
Os autores relatam uma técnica de reconstrução de arcos parcialmente edentados através de Protése Parcial Removível, com o aproveitamento de uma raiz residual, na qual utilizou-se um "attachment" do tipo "o'ring", com a finalidade de prover retenção adicional, suporte e estabilidade. Esta técnica contribui para a preservação do rebordo residual, auxilia a manutenção da propriocepção e distribui melhor as forças mastigatórias, otimizando o conforto fisiológico e psicológico do paciente reabilitado
