Fixed partial dentures in adult patients with cleft lip and palate and their relationship with the quality of life: A cross-sectional clinical study.

STATEMENT OF PROBLEM: Reports on the impact of fixed partial denture treatments on the quality of life of patients with cleft lip and palate are lacking. PURPOSE: The purpose of this cross-sectional clinical study was to assess the impact of fixed partial dentures on the quality of life of adults with cleft lip and palate. MATERIAL AND METHODS: A total of 52 participants (23 women and 29 men) with cleft lip and palate, aged between 20 and 50 years old, and who required treatment with fixed partial dentures were enrolled in the study. They responded to the Oral Health Impact Profile (OHIP)-14 questionnaire before and 30 days after the fixed prosthodontic treatment. The final value from the OHIP-14 was generated by totaling the 14 answers, giving a range from 0 to 56, with higher values indicating a worse relationship between oral health and the quality of life. Nonparametric statistical analysis was performed with the Wilcoxon test (α=.05). RESULTS: Forty-six participants reported some negative experience before the fixed partial denture, and 48 indicated an improved quality of life 30 days after delivery. All domains assessed showed significant quality of life improvements between the periods compared (P≤.014). CONCLUSIONS: Oral treatment with fixed partial dentures improved the quality of life in adults with cleft lip and palate.

Quantifying the facial proportions in edentulous individuals before and after rehabilitation with complete dentures compared with dentate individuals: A 3D stereophotogrammetry study.

STATEMENT OF PROBLEM: Facial collapse is associated with edentulism, and while the provision of complete dentures promotes masticatory function and esthetics, whether complete dentures restore facial proportions to the natural appearance found in dental individuals is unclear. PURPOSE: The purpose of this clinical study was to assess the facial profiles of edentulous individuals before and after treatment with complete dentures and compare these profiles with those of dentate individuals matched by age as the control. MATERIAL AND METHODS: Sixty White participants were recruited as 2 groups: 30 edentulous participants provided with complete dentures in both arches and 30 participants with natural teeth and normal occlusion. Facial analysis was performed through 3D stereophotogrammetry. Linear, angular, surface, and perimeter facial measurements were made and statistically analyzed with paired and independent t tests (α=.05). RESULTS: The mean age ±standard deviation was 63.16 ±7.33 years for the edentulous participants and 60.43 ±5.34 years for the dentate controls, without statistical differences between ages (P=.105). The facial profiles of the edentulous group with and without complete dentures were statistically different (P<.05) in 6 linear and 5 angular measurements. After quantifying the facial collapse by comparing edentulous individuals without complete dentures and the control dentate group, the results showed that the majority of differences occurred in the middle and lower third of the face, evidencing shortening in these areas with differences in facial measures of around 2 to 5 mm less in the edentulous group. However, statistically significant differences between the participants with complete dentures and the control dentate group were found in only 2 linear measurements (the distance between the right and the left exocanthion to cheilion), in the sealed lip angle and the left gonial angle, and in the surface and perimeter (P<.05). CONCLUSIONS: Tooth loss affected the facial proportions in the lower third of the face. The provision of complete dentures restored their facial appearance but not precisely to the facial proportions of individuals with a natural dentition, as considerable differences were detected in surface and perimeter measurements.

Arch Asymmetry in Patients With Cleft Lip and Palate After Rehabilitation Treatment Using Stereophotogrammetry.

ABSTRACT: Arch asymmetry in cleft patients is a current problem that interdisciplinary treatment aims to solve. This research proposed to analyze the final rehabilitation, according to the arch symmetry of these patients. Thirty-five patients aged between 18 and 30 years, rehabilitated with a fixed partial denture or implants in the cleft area. The analysis was performed using digitalized dental casts with a laser model scanner (R700TM; 3Shape A/S, Holmens Kanal 7, 1060, Copenhagen/Denmark), analyzed with a Vectra Analysis Module software program (VECTRA H1; Canfield Scientific, 4 Wood Hollow Road, Parsippany, NJ 07054). Three linear measurements were evaluated, incisal-canine, canine-molar, and incisal-molar distance. The Student t test was applied to test the significance (P = 0.05) of an observed sample by correlation coefficient test (r-value). Female patients showed a significant correlation in arch symmetry. According to the rehabilitation treatment, patients who received implants showed a high correlation and significant symmetry at all maxillary distances. Finally, according to the cleft side in the maxillary dimensions, even though the majority of patients had clefts on the left side, only patients with a cleft on the right side showed symmetry in this area. Patients rehabilitated with implants in the cleft area showed a more symmetrical maxillary arch than those restored with fixed partial dentures.

Simplified occlusal replica adapted technique with glass ionomer cement for molar-incisor hypomineralization-affected molars: An 18-month follow-up.

BACKGROUND AND OVERVIEW: Molar-incisor hypomineralization (MIH) is a qualitative developmental defect of enamel, which has been a daily concern in clinical practice owing to its difficult treatment. CASE DESCRIPTION: An 11-year-old girl was admitted to the pediatric dental clinic with a symptom of severe hypersensitivity in the permanent molars owing to MIH. The treatment consisted of a simplified occlusal replica adapted technique with conventional glass ionomer cement in the MIH-affected molars, which involved laboratory and clinical stages. The patient was reexamined every 3 months, and after 18 months there was no additional tooth structure loss, restoration failure, or pain. This technique may be considered a feasible alternative to restore hypomineralized teeth owing to its reduced procedure time and good performance in the follow-up period of 18 months. CONCLUSIONS AND PRACTICAL IMPLICATIONS: The technique successfully restored the function and shape of the affected teeth, decreasing the sensitivity by means of covering the demarcated MIH opacities.

Acquired Enamel Pellicle Engineered Peptides: Effects on Hydroxyapatite Crystal Growth.

The aim of this study was to test the hypothesis that duplication/hybridization of functional domains of naturally occurring pellicle peptides amplified the inhibitory effect of hydroxyapatite crystal growth, which is related to enamel remineralization and dental calculus formation. Histatin 3, statherin, their functional domains (RR14 and DR9), and engineered peptides (DR9-DR9 and DR9-RR14) were tested at seven different concentrations to evaluate the effect on hydroxyapatite crystal growth inhibition. A microplate colorimetric assay was used to quantify hydroxyapatite crystal growth. The half-maximal inhibitory concentration (IC50) was determined for each group. ANOVA and Student-Newman-Keuls pairwise comparisons were used to compare the groups. DR9-DR9 increased the inhibitory effect of hydroxyapatite crystal growth compared to single DR9 (p < 0.05), indicating that functional domain multiplication represented a strong protein evolution pathway. Interestingly, the hybrid peptide DR9-RR14 had an intermediate inhibitory effect compared to DR9 and DR9-DR9. This study used an engineered peptide approach to investigate a potential evolution protein pathway related to duplication/hybridization of acquired enamel pellicle's natural peptide constituents, contributing to the development of synthetic peptides for therapeutic use against dental caries and periodontal disease.

Occlusal, chewing, and tasting characteristics associated with orofacial dysfunctions in children with unilateral cleft lip and palate: a case-control study.

OBJECTIVE: The objective of this study is to assess the associations between orofacial dysfunctions with malocclusion, masticatory performance, and taste in children with and without unilateral cleft lip and palate (UCLP). MATERIAL AND METHODS: A patient-based, matched, case-control study was conducted involving 108 8- to 10-year-old children divided in UCLP and control groups. Orofacial dysfunctions were evaluated using the Nordic Orofacial Test-Screening (NOT-S). Orthodontic treatment need was evaluated using the Goslon Yardstick Index (GYI) and the Index of Orthodontic Treatment Need (IOTN) of patients and controls, respectively. Masticatory performance was assessed using a chewable test material to determine median particle size (X 50) and distribution of particles in different sieves (b value). Taste perception was evaluated using four solutions (sweet, salty, bitter, or acid) in three different concentrations. RESULTS: More than half of the patients needed orthodontic surgery. UCLP group presented higher median particle size and needed more chewing cycles to comminute the artificial test into particles smaller than the median than those of controls. UCLP group had less perception of salty flavor than controls. There was a positive correlation between b value and NOT-S examination score for patients. In regression analysis, a significant interrelationship was observed between NOT-S examination score and b value. CONCLUSIONS: In the UCLP patients, masticatory performance was compromised probably as a result of facial asymmetry and speech disturbance; whereas, taste was less perceived only for salty flavor. CLINICAL RELEVANCE: These findings provide preliminary evidence that mastication and taste are altered in children with UCLP, so these factors must be followed up to ensure oral and general health in growing individuals.

Orthognathic Surgery or Overlay Prosthesis: Quality of Life in Bilateral Cleft Lip and Palate Patients.

BACKGROUND: The concern to restore and evaluate bilateral cleft lip and palate (BCLP) patients' quality of life, after rehabilitation, is an issue that has been discussed in the literature because it is the ultimate goal of any proposed treatment. OBJECTIVE: To evaluate the overall and oral quality of life of BCLP patients who had completed their treatment with orthognathic surgery (OrSg) compared to those who completed theirs with prosthetic rehabilitation in the form of overlay prosthesis (OP). MATERIALS AND METHODS: The study comprised 40 patients, 20 in OrSg group and 20 in OP group. Epidemiological survey and application of two questionnaires (World Health Organization Quality of Life-brief [WHOQOL-bref] and Oral Health Impact Profile-14 [OHIP-14]) were done. The final results were evaluated statistically by the Mann-Whitney test. RESULTS: Regarding the comparison with the WHOQOL-bref, no significant statistical differences between groups were found. In the analysis of the OHIP-14, only in "psychological limitation" field difference could be observed, where OrSg group showed more negative impact when compared to the OP group. CONCLUSION: Both rehabilitations provide a satisfactory quality of life for patients.

Delayed Treatment of Traumatized Primary Teeth with Distinct Pulp Response: Follow-Up until Permanent Successors Eruption.

Complicated crown fracture and crown-root fracture with pulp involvement expose dental pulp to the oral environment. The pulp outcome is often unpredictable because the patient and injury which are related to variables can influence the treatment of choice and the prognosis of the case. This report presents the case of a 4-year-old boy with complicated crown fracture with pulp polyp in the primary right maxillary central incisor (51) and crown-root fracture with pulp involvement in the primary left maxillary central incisor (61), which was treated only 3 months after the tooth injuries. The treatment of choice was extraction of tooth (61) due to a periapical lesion with disruption of the dental follicle of the permanent successor and pulpotomy (MTA) of the tooth (51), because the pulp presented signs of vitality. At the follow-up visits, no clinical, symptomalogical, and radiographic changes were observed until the primary tooth's exfoliation. However, at 3-year follow-up, the permanent successors showed hypocalcification and the position of the permanent right maxillary central incisors (11) was altered. Besides the conservative and adequate delayed treatment, the sequelae on the permanent successors could not be avoided.

In situ effect of a commercial CPP-ACP chewing gum on the human enamel initial erosion.

OBJECTIVE: This study evaluated the in situ rehardening effect of a commercial chewing gum containing casein phosphopeptide - amorphous calcium phosphate (CPP-ACP) on initial erosion lesions. METHODS: Seventy-two human enamel blocks, after selection (initial surface hardness - SHi) and in vitro short-term acidic exposure (cola drink for 3 min - SHd) were randomly assigned to three groups. The factors under study were treatment (3 levels: GI chewing gum with CPP-ACP, GII chewing gum without CPP-ACP and GIII control group without gum) and intraoral period (2 levels: 2 and 24h). Twelve volunteers wore intraoral palatal devices for 24h in 3 crossover phases. On each phase, after 2h the surface hardness was assessed (SHf1) and the blocks were reinserted and the devices were used for additional 22 h (SHf2). In phases of GI and GII volunteers chewed the respective gum during 30 min, for 4 times with an interval of 4h. Percentage of surface hardness recovery (%SHR) was calculated after 2 and 24 h. The data were analysed by repeated measures ANOVA and Tukey's test. RESULTS: Chewing gum with CPP-ACP (2h=50.0%<24h=95.9%) showed higher hardness recovery than chewing gum without CPP-ACP (2h=30.0%<24 h=71.1%) and control (2 h=15.7%<24 h=40.9%) (p<0.05). CONCLUSIONS: The results suggest that saliva increased hardness of softened enamel after the use of conventional chewing gum (GII) and this effect was enhanced by the prolonged intraoral period (24 h) and by the use of CPP-ACP chewing gum (GI). CLINICAL SIGNIFICANCE: Since chewing gum is an alternative to enhance salivary defenses after erosive challenges, CPP-ACP chewing gum might be a supplementary strategy to potentiate the mineral precipitation of initial erosion lesions.

Photodynamic inactivation of Candida albicans mediated by a low density of light energy.

Shorter times and lower energies of application of light sources are desirable to use photodynamic antimicrobial chemotherapy (PACT) to the clinical control of candidiasis, especially among babies and children. Light energies ranging from 39.5 to 100 J/cm(2) were previously applied to kill Candida albicans by PACT. The present study evaluated the efficacy of a combination of 0.05 mg/mL toluidine blue O (TBO) and a short time of application (60 s) and a low density of light energy (18 J/cm(2)) of a red light-emitting diode (LED) in killing C. albicans planktonic cells. Standard suspensions of C. albicans were randomly assigned for four treatment groups: control (L-P-), LED alone (L+P-), TBO alone (L-P+), and PACT (L+P+). After treatments, serial dilutions of suspensions were prepared and streaked on Sabouraud dextrose agar to determine colony-forming units of C. albicans per milliliter (CFU/mL). The results were analyzed by ANOVA and Tukey's post-hoc test (P < 0.05). PACT significantly reduced CFUs of C. albicans in comparison to other three treatments. Our results demonstrated a fungicidal effect of PACT mediated by a shorter time of application of LED on C. albicans planktonic cells. Further in vivo studies are needed to elucidate the efficacy of PACT to treat human fungal infections.

Risk factors for dental erosion in a group of 12- and 16-year-old Brazilian schoolchildren.

BACKGROUND: Dental erosion is a multifactorial disease and is associated with dietary habits in infancy and adolescence. AIM: To investigate possible associations among dental erosion and diet, medical history and lifestyle habits in Brazilian schoolchildren. DESIGN: The sample consisted of a random single centre cluster of 414 adolescents (12- and 16-years old) of both genders from private and public schools in Bauru (Brazil). The O'Brien [Children's Dental Health in the United Kingdom, 1993 (1994) HMSO, London] index was used for dental erosion assessment. Data on medical history, rate and frequency of food and drinks consumption, and lifestyle habits were collected by a self-reported questionnaire. Odds ratios with 95% confidence intervals were used to assess the univariate relationships between variables. Analysis of questionnaire items was performed by multiple logistic regression analysis. The statistical significance level was set at 5%. RESULTS: The erosion present group comprised 83 subjects and the erosion absent group 331. There were no statistically significant correlations among dental erosion and the consumption of food and drinks, medical history, or lifestyle habits. CONCLUSION: The results indicate that there was no correlation between dental erosion and the risk factors analysed among adolescents in Bauru/Brazil and further investigations are necessary to clarify the multifactorial etiology of this condition.