Immunohistochemical evaluation of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth

The aim of this study was to evaluate the immunoexpression of MMP-2, MMP-9 and CD31/microvascular density in squamous cell carcinomas of the floor of the mouth and to correlate the results with demographic, survival, clinical (TNM staging) and histopathological variables (tumor grade, perineural invasion, embolization and bone invasion). Data from medical records and diagnoses of 41 patients were reviewed. Histological sections were subjected to immunostaining using primary antibodies for human MMP-2, MMP-9 and CD31 and streptavidin-biotin-immunoperoxidase system. Histomorphometric analyses quantified positivity for MMPs (20 fields per slide, 100?points grade, ×200) and for CD31 (microvessels <50?µm in the area of the highest vascularization, 5 fields per slide, 100?points grade, ×400). Statistical design was composed by non-parametric Mann-Whitney U test (investigating the association between numerical variables and immunostainings), chi-square frequency test (in contingency tables), Fisher's exact test (when at least one expected frequency was less than 5 in 2×2 tables), Kaplan-Meier method (estimated probabilities of overall survival) and Iogrank test (comparison of survival curves), all with a significance level of 5%. There was a statistically significant correlation between immunostaining for MMP-2 and lymph node metastasis. Factors associated negatively with survival were N stage, histopathological grade, perineural invasion and immunostaining for MMP-9. There was no significant association between immunoexpression of CD31 and the other variables. The intensity of immunostaining for MMP-2 can be indicative of metastasis in lymph nodes and for MMP-9 of a lower probability of survival

Importance of periodontal ligament thickness

This study evaluated whether periodontal ligament (PL) thickness varied with root size and examined the possible influence of this variation on orthodontic mechanics. Measurements were taken of the maxillary left first molar in 54 male Wistar rats. Mean mesial and distal PL thicknesses were compared between the intermediate buccal and mesiobuccal roots using paired Student's t-tests with a 5% significance level. Mean values differed significantly between roots (p < 2.2 × 10-16). PL thickness in rats is directly proportional to root dimensions

Biocompatibility and setting time of CPM-MTA and white Portland cement clinker with or without calcium sulfate

To evaluate the biocompatibility and the setting time of Portland cement clinker with or without 2% or 5% calcium sulfate and MTA-CPM. Twenty-four mice (Rattus norvegicus) received subcutaneously polyethylene tubes filled with Portland cement clinker with or without 2% or 5% calcium sulfate and MTA. After 15, 30 and 60 days of implantation, the animals were killed and specimens were prepared for microscopic analysis. For evaluation of the setting time, each material was analyzed using Gilmore needles weighing 113.5 g and 456.5 g, according to the ASTM specification Number C266-08 guideline. Data were analyzed by ANOVA and Tukey's test for setting time and Kruskal-Wallis and Dunn test for biocompatibility at 5% significance level. Histologic observation showed no statistically significant difference of biocompatibility (p>0.05) among the materials in the subcutaneous tissues. For the setting time, clinker without calcium sulfate showed the shortest initial and final setting times (6.18 s/21.48 s), followed by clinker with 2% calcium sulfate (9.22 s/25.33 s), clinker with 5% calcium sulfate (10.06 s/42.46 s) and MTA (15.01 s/42.46 s). All the tested materials showed biocompatibility and the calcium sulfate absence shortened the initial and final setting times of the white Portland cement clinker

Efeito de diferentes gomas de mascar sobre o pH salivar de crianças

Objective: To evaluate the effect of different chewing gum brands on the salivary pH of children with primary dentition. Method: Forty children were selected and assigned to four groups: control (no chewing gum); sugarless chewing gum; chewing gum with casein phosphopeptide-amorphous calcium phosphate; and chewing gum with xylitol. The first saliva collection was made after supervised tooth brushing for stabilization of the oral pH. Next, all children were instructed to drink slowly 100 mL of a cola-based soft drink (Coca-Cola®) and a new saliva collection was made 10 min later. Then, each group chewed on the chewing gum for 5 min and discarded it after this time. Saliva was collected again at 5, 10 and 15 min intervals after start using the chewing gum. Measurement of salivary pH was made with colorimetric test papers and a digital pH-meter. Data were analyzed statistically by analysis of variance and Tukey’s test at a 5% significance level. Results: The use of chewing gums accelerated the increase of salivary pH to considerably alkaline levels after consumption of an acidic beverage, especially within the first minutes. The highest levels were obtained in the groups of children that used chewing gums containing xylitol and casein phosphopeptide-amorphous calcium phosphate. Conclusion: Children that used the chewing gums after ingestion of an acidic soft drink presented an increase in salivary pH, with the best results in the groups that used chewing gums containing casein phosphopeptide-amorphous calcium phosphate and xylitol.

SEM analysis and push-out bond strength of fiberglass posts luted with different cements of glass-ionomer in humid environment: pilot test

The objective of this study was to evaluate the push-out bond strength of fiberglass resin reinforced bonded with five ionomer cements. Also, the interface between cement and dentin was inspected by means of SEM. Fifty human canines were chose after rigorous scrutiny process, endodontically treated and divided randomly into five groups (n = 3) according to cement tested: Group I – Ionoseal (VOCO), Group II – Fugi I (GC), Group III – Fugi II Improved (GC), Group IV – Rely X Luting 2 (3M ESPE), Group V – Ketac Cem (3M ESPE). The post-space was prepared to receive a fiberglass post, which was tried before cementation process. No dentin or post surface pretreatment was carried out. After post bonding, all roots were cross-sectioned to acquire 3 thin-slices (1 mm) from three specific regions of tooth (cervical, medium and apical). A Universal test machine was used to carry out the push-out test with cross-head speed set to 0.5mm/mim. All failed specimens were observed under optical microscope to identify the failure mode. Representative specimens from each group was inspected under SEM. The data were analyzed by Kolmogorov-Smirnov and Levene’s tests and by two-way ANOVA, and Tukey’s port hoc test at a significance level of 5%. It was compared the images obtained for determination of types of failures more occurred in different levels. SEM inspection displayed that all cements filled the space between post and dentin, however, some imperfections such bubles and voids were noticed in all groups in some degree of extension. The push-out bond strength showed that cement Ketac Cem presented significant higher results when compared to the Ionoseal (P = 0.02). There were no statistical significant differences among other cements.

Influence of myofascial pain on the pressure pain threshold of masticatory muscles in women with migraine

Objective: To evaluate the influence of myofascial pain on the Pressure Pain Threshold (PPT) of masticatory muscles in women with migraine. Methods: The sample comprised 101 women, ages ranging from 18 to 60 years, with an episodic migraine diagnosis previously confirmed by a neurologist. All patients were evaluated using Research Diagnostic Criteria for Temporomandibular Disorders to determine the presence of myofascial pain and were divided into 2 groups: group I (n=56), comprising women with a migraine, and group II (n=45), comprising women with a migraine and myofascial pain. Two more groups (49 asymptomatic women and 50 women with myofascial pain), matched for sex and race, obtained from a previous study, were added to this study. The PPT values of masseter and temporalis (anterior, middle, and posterior regions) muscles were recorded bilaterally using a pressure algometer. One-way analysis of variance and the Tukey test for pairwise comparisons were used in statistical analysis with a 5% significance level. Results: We found that all groups had significantly lower PPT values compared with asymptomatic women, with lower values seen in group II (women with migraine and myofascial pain). Women with a migraine and myofascial pain showed significantly lower PPT values compared with women with a migraine only, and also when compared with women with myofascial pain only. Discussion: Migraine, especially when accompanied by myofascial pain, reduces the PPT of masticatory muscles, suggesting the importance of masticatory muscle palpation during examination of patients with migraine.

In vivo evaluation of tissue response to new endodontic sealers

Introduction: The sealers can be in direct contact with the periapical tissues. Thus, these materials must have appropriate physical and biological properties, providing conditions for repair to occur. Objective: The aim of this study was to evaluate the response of rat subcutaneous tissue to endodontics sealers. Material and methods: Three materials comprised the groups: group I – Zinc Oxide, Eugenol and Iodoform paste, group II – Portland cement with propylene glycol, and group III – MTA Fillapex® (Angelus). These materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar rats for seven and 15 days. The specimens were stained with hematoxylin and eosin and evaluated regarding to inflammatory reaction parameters through a light microscope. The data were compared using Kruskal-Wallis test with significance level of 5%. The intensity of inflammatory response against the sealers was analyzed by two blinded and previously calibrated observers for all experimental periods. Results: The histological evaluation showed that all the materials caused a moderated inflammatory reaction at seven days which decreased with time. A greater inflammatory reaction was observed at seven days in group I. The other specimens had significantly less inflammatory cells when compared to this group. Tubes with MTA Fillapex® presented some giant cells, macrophages and lymphocytes after seven days. At 15 days, the presence of fibroblasts and collagen fibers was observed indicating normal tissue healing. The group II showed similar results to those observed in MTA Fillapex® already at seven days. At 15 days the inflammatory reaction presented was almost absent at the tissue, with many collagen fibers indicating normal tissue healing. Statistical analysis showed a significant statistical difference amongst the group I (seven days) and II (15 days) (p < 0.05). In the other groups no (Continue)

Accuracy of five electronic foramen locators with different operating systems: na ex vivo study

Objective: The aim of this study was to evaluate, ex vivo, the precision of five electronic root canal length measurement devices (ERCLMDs) with different operating systems: the Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15, and the possible influence of the positioning of the instrument tips short of the apical foramen. Material and Methods: Forty-two mandibular bicuspids had their real canal lengths (RL) previously determined. Electronic measurements were performed 1.0 mm short of the apical foramen (-1.0), followed by measurements at the apical foramen (0.0). The data resulting from the comparison of the ERCLMD measurements and the RL were evaluated by the Wilcoxon and Friedman tests at a significance level of 5%. Results: Considering the measurements performed at 0.0 and -1.0, the precision rates for the ERCLMDs were: 73.5% and 47.1% (Root ZX), 73.5% and 55.9% (Mini Apex Locator), 67.6% and 41.1% (Propex II), 61.7% and 44.1% (iPex), and 79.4% and 44.1% (RomiApex A-15), respectively, considering ±0.5 mm of tolerance. Regarding the mean discrepancies, no differences were observed at 0.0; however, in the measurements at -1.0, the iPex, a multi-frequency ERCLMD, had significantly more discrepant readings short of the apical foramen than the other devices, except for the Propex II, which had intermediate results. When the ERCLMDs measurements at -1.0 were compared with those at 0.0, the Propex II, iPex and RomiApex A-15 presented significantly higher discrepancies in their readings. Conclusions: Under the conditions of the present study, all the ERCLMDs provided acceptable measurements at the 0.0 position. However, at the -1.0 position, the ERCLMDs had a lower precision, with statistically significant differences for the Propex II, iPex, and RomiApex A-15.

In vivo evaluation of tissue response to new endodontic sealers

Introduction: The sealers can be in direct contact with the periapical tissues. Thus, these materials must have appropriate physical and biological properties, providing conditions for repair to occur. Objective: The aim of this study was to evaluate the response of rat subcutaneous tissue to endodontics sealers. Material and methods: Three materials comprised the groups: group I – Zinc Oxide, Eugenol and Iodoform paste, group II – Portland cement with propylene glycol, and group III – MTA Fillapex® (Angelus). These materials were placed in polyethylene tubes and implanted into dorsal connective tissue of Wistar rats for seven and 15 days. The specimens were stained with hematoxylin and eosin and evaluated regarding to inflammatory reaction parameters through a light microscope. The data were compared using Kruskal-Wallis test with significance level of 5%. The intensity of inflammatory response against the sealers was analyzed by two blinded and previously calibrated observers for all experimental periods. Results: The histological evaluation showed that all the materials caused a moderated inflammatory reaction at seven days which decreased with time. A greater inflammatory reaction was observed at seven days in group I. The other specimens had significantly less inflammatory cells when compared to this group. Tubes with MTA Fillapex® presented some giant cells, macrophages and lymphocytes after seven days. At 15 days, the presence of fibroblasts and collagen fibers was observed indicating normal tissue healing. The group II showed similar results to those observed in MTA Fillapex® already at seven days. At 15 days the inflammatory reaction presented was almost absent at the tissue, with many collagen fibers indicating normal tissue healing. Statistical analysis showed a significant statistical difference amongst the group I (seven days) and II (15 days) (p < 0.05). In the other groups no significant statistical differences were observed. Conclusion: MTA Fillapex® and Portland cement with propylene glycol were more biocompatible than the other tested cements.

Cardiovascular risk in Japanese-Brazilian subjects

OBJECTIVE: To evaluate the prevalence of risk factors for cardiovascular disease in Japanese-Brazilian subjects. SUBJECTS AND METHODS: One hundred thirty-one residents of the Mombuca community were studied. Statistical analysis was based on the X² test, Fisher's Exact test, Student's t test, and ANOVA, at a 5% significance level. RESULTS: The average age was 56.7 years-old; 76.3% had dyslipidemia, 24.4% pre-diabetes (PDM), 10.7% type 2 diabetes mellitus (T2DM), 46.6% hypertension, 52.7% abdominal obesity, and 35.8% metabolic syndrome (MS). There were significant correlations between HOMA-IR and MS diagnosis and obesity, while HOMA-β levels were decreased in T2DM and PDM. The ankle-brachial index was positive for peripheral artery disease in 22.3% of the individuals. Electrocardiograms did not show increased evidence of myocardial ischemia. CONCLUSION: Subjects of this community are exposed to major cardiovascular risk factors, namely high prevalence of MS diagnoses and increased HOMA-IR. Arq Bras Endocrinol Metab. 2012;56(9):608-13

Influence of apical foramen lateral opening and file size on cemental canal instrumentation

Since instrumentation of the apical foramen has been suggested for cleaning and disinfection of the cemental canal, selection of the file size and position of the apical foramen have challenging steps. This study analyzed the influence of apical foramen lateral opening and file size can exert on cemental canal instrumentation. Thirty-four human maxillary central incisors were divided in two groups: Group 1 (n=17), without flaring, and Group 2 (n=17), with flaring with LA Axxess burs. K-files of increasing diameters were progressively inserted into the canal until binding at the apical foramen was achieved and tips were visible and bonded with ethyl cyanoacrylate adhesive. Roots/files set were cross-sectioned 5 mm from the apex. Apices were examined by scanning electron microscopy at ×140 and digital images were captured. Data were analyzed statistically by Student’s t test and Fisher’s exact test at 5% significance level. SEM micrographs showed that 19 (56%) apical foramina emerged laterally to the root apex, whereas 15 (44%) coincided with it. Significantly more difficulty to reach the apical foramen was noted in Group 2. Results suggest that the larger the foraminal file size, the more difficult the apical foramen instrumentation may be in laterally emerged cemental canals.

Correlation between maxillary central incisor crown morphology and mandibular dental arch form in normal occlusion subjects

The aim of this study was to evaluate the correlation between the morphology of the mandibular dental arch and the maxillary central incisor crown. Cast models from 51 Caucasian individuals, older than 15 years, with optimal occlusion, no previous orthodontic treatment, featuring 4 of the 6 keys to normal occlusion by Andrews (the first being mandatory) were observed. The models were digitalized using a 3D scanner, and images of the maxillary central incisor and mandibular dental arch were obtained. These were printed and placed in an album below pre-set models of arches and dental crowns, and distributed to 12 dental surgeons, who were asked to choose which shape was most in accordance with the models and crown presented. The Kappa test was performed to evaluate the concordance among evaluators while the chi-square test was used to verify the association between the dental arch and central incisor morphology, at a 5% significance level. The Kappa test showed moderate agreement among evaluators for both variables of this study, and the chi-square test showed no significant association between tooth shape and mandibular dental arch morphology. It may be concluded that the use of arch morphology as a diagnostic method to determine the shape of the maxillary central incisor is not appropriate. Further research is necessary to assess tooth shape using a stricter scientific basis.

Abrasiveness of conventional and specific denture-cleansing dentifrices

This study analyzed the weight loss and surface roughness caused in Plexiglass specimens by conventional dentifrices (Sorriso, Colgate and Close Up) and specific dentifrices used for cleaning of dentures (Corega and Dentu Creme). Plexiglass specimens were divided into 6 groups (n=6) including: a control (distilled water - DW) and experimental groups. Brushing was performed in a toothbrushing machine with a soft brush and a dentifrice suspension and DW according to different brushing times (50, 100, 200 and 250 min -18,000, 36,000, 72,000 and 90,000 cycles, respectively, calculated to correspond to 1, 2, 4 and 5 years of regular brushing). The results of weight loss and surface roughness were analyzed by ANOVA and Tukey’s test at 5% significance level. In all tested times, the effect of DW was insignificant. Dentifrices differed significantly from DW in the initial period. Corega dentifrice caused greater mass loss in all studied times, followed by Close Up. Dentifrices resulted in a surface roughness similar to the DW at 50 min. In the other times, Sorriso, Colgate and Corega caused more surface roughness than DW. In conclusion, specific dentifrices caused larger mass loss and lower surface roughness as conventional dentifrice.

Reorganization of secondary and tertiary health care levels: impact on the outcomes of oral cancer screening in the São Paulo State, Brazil

This study presents the strategies for prevention and early detection of oral cancer by means of screening in the elderly population of São Paulo, the richest and the most populous state of Brazil. This research was a retrospective longitudinal study based on the analysis of secondary data. The variables - number of participating cities, coverage of screening, and number of suspicious and confirmed cases of oral cancer - were divided into two periods: 2001-2004 and 2005-2008. Data were analyzed statistically by the chi-square test at 5% significance level. The implementation of a nationwide public oral health policy in 2004 and the reorganization of the secondary and tertiary health care were evaluated as mediator factors able to interfere in the achieved outcomes. From 2001 to 2008, 2,229,273 oral examinations were performed. There was an addition of 205 participating cities by the end of the studied period (p<0.0001). The coverage of oral cancer screening increased from 4.1% to 16% (p<0.0001). There was a decrease in the number of suspicious lesions (from 9% in 2005 to 5% in 2008) (p<0.0001) and in the rate of confirmed oral cancer cases per 100,000 examinations (from 20.89 in 2001 to 10.40 in 2008) (p<0.0001). After 8 years of screening, there was a decrease in the number of suspicious lesions and confirmed cases of oral cancer in the population. The reorganization of secondary and tertiary health care levels of oral care seems to have contributed to modify these numbers, having a positive impact on the outcomes of oral cancer screening in the São Paulo State.

Connecting accuracy of interchanged prosthetic abutments to different dental implants using scanning electron microscopy

The present study evaluated the interchangeability of prosthetic components for external hexagon implants by measuring the precision of the implant/abutment (I/A) interface with scanning electron microscopy. Ten implants for each of three brands (SIN, Conexão, Neodent) were tested with their respective abutments (milled CoCr collar rotational and non-rotational) and another of an alternative manufacturer (Microplant) in randomly arranged I/A combinations. The degree of interchangeability between the various brands of components was defined using the original abutment interface gap with its respective implant as the benchmark dimension. Accordingly, when the result for a given component placed on an implant was equal to or smaller then that gap measured when the original component of the same brand as the implant was positioned, interchangeability was considered valid. Data were compared with the Kruskal-Wallis test at 5% significance level. Some degree of misfit was observed in all specimens. Generally, the non-rotational component was more accurate than its rotational counterpart. The latter samples ranged from 0.6-16.9 µm, with a 4.6 µm median; and the former from 0.3-12.9 µm, with a 3.4 µm median. Specimens with the abutment and fixture from Conexão had larger microgap than the original set for SIN and Neodent (p<0.05). Even though the latter systems had similar results with their respective components, their interchanged abutments did not reproduce the original accuracy. The results suggest that the alternative brand abutment would have compatibility with all systems while the other brands were not completely interchangeable.