Comparative Analysis of the Efficacy of Dental Plaque Removal Between Manual and Powered Toothbrushes in Individuals With Syndactyly.

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, P = 0.026). 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.

The role of keratinized mucosa in peri-implant health.

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.

Comparison of periodontal parameters in individuals with syndromic craniosynostosis

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.

Comparison of periodontal parameters in individuals with syndromic craniosynostosis.

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.

Resistência à fratura de dentes tratados endodonticamente, reconstruídos com pinos de fibras de polietileno e com pinos biológicos / Fracture strength of endodontically treated teeth reconstructed with woven polyethylene fiber posts and biological posts

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.

Influência do grau de adaptação de pinos de fibras de vidro ao canal radicular na resistência à remoção por tração / Influence of glass fiber post adaptation in the root canal on the tensile strength

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.

Tratamento protético pós-cirúrgico de ameloblastoma de maxila / Prosthetic treatment postoperative of ameloblastoma of the maxilla

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

Como entender o tratamento odontológico de idosos com deficiências / How to understand dental treatment of elderly people with deficiency

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