Establishment of the epithelial attachment and connective tissue adaptation to implants installed under the concept of "platform switching": a histologic study in minipigs

Aim: To validate the platform switching concept at oral implants with respect to the preservation of the alveolar crestal bone levels in an animal model. Material & methods: Five minipigs received three implants each with a 0.25mm implant/ abutment mismatch and were placed flush (T(0)), 1 mm below (T(1)) and 1 mm above (T(+1)) the alveolar bony crest, and as a control, one conventionally restored implant placed at the bone level. The implants were randomly inserted flapless into the mandible. Four months after implant insertion, the animals were sacrificed, and undecalcified block sections were obtained and used for histological analyses. Results: The mean values for peri- implant bone resorption were 1.09 +/- 0.59mm (Control), 0.51 (+/- 0.27 mm, T(0)), 0.50 (+/- 0.46 mm, T(1)) and 1.30 (+/- 0.21 mm, T (+1)), respectively. Statistically significant differences (P< 0.05) were found among the test (T(0), T(-1)) and the control sites. Control implants presented an average biologic width length of 3.20mm (+/- 0.33), with a connective tissue adaptation compartment of 1.29mm (+/- 0.53) and an epithelial attachment of 1.91 mm (+/- 0.71). T(0), T(1) and T(+1) implants presented with a mean biologic width of 1.97mm (+/- 1.20), 2.70 mm (+/- 1.36) and 2.84mm (+/- 0.90), respectively, with a connective tissue adaptation compartment of 1.21mm (+/- 0.97), 1.21 mm (+/- 0.65) and 1.50 mm (+/- 0.70) and an epithelial attachment of 0.84 mm (+/- 0.93), 1.66 mm (+/- 0.88) and 1.35 mm (+/- 0.44), respectively. Differences between the configurations were mainly associated with the length of the epithelial attachment. The epithelial attachment was significantly longer in the C sites than in T(0) (P = 0.014). However, no other differences between configurations were detected. Conclusion: If the implants are positioned at the level of the alveolar bony crest, the platform switching concept may have a minor impact on the length of the epithelial attachment (0.84 vs. 1.91 mm), while the connective tissue adaptation compartment remains relatively unaffected. Moreover, platform switching resulted in less resorption of the alveolar crest (0.58 mm).

Estudo da infiltração marginal em restaurações de resinas compostas para dentes posteriores. Efeito do material, preparo cavitário e condicionamento do esmalte a nível cervical.

The purpose of this in vitro study was to investigate the cervical marginal leakage in class II restorations with chemically cured resin (P10) and light-cured resin (P30) in two types of cavities: conventional and adhesive. The effect of acid-etching in this area was also observed. Dentine adhesive Scotchbond was used in all experimental groups. Leakage was evidenced by Rodamina B dye penetration after thermocycling procedure between 10 degrees C and 50 degrees C temperature and analysed by using Zeiss Stereoscopic Magnifying Glass (10 X). According to the results obtained marginal leakage occurred in all experimental groups, with lower percentage for adhesives cavities when enamel acid-etching and light-cured resin P30 was used.

Psychological evaluation of patients scheduled for orthognathic surgery.

Using a questionnaire, 41 patients scheduled for orthognathic surgery were evaluated pre- and postoperatively to determine some of their psychological characteristics and treatment outcome from the patient's standpoint. Among other conclusions, the results showed that some patients may not fully understand the details of their deformity, despite a full explanation by the orthodontist and surgeon. Expectations regarding treatment outcome may be unrealistic even in patients with valid self-motivation for surgery. Social adjustment usually improves after treatment. Functional changes were noticed by over 80% of the patients and esthetic changes in over 90%.

Qualitative analysis of two reconstruction techniques and their application in dentistry

Although visualization in the field of dentistry has some of the same requirements as the medicine field, the differences in goal demand specific approaches. This paper reports on the implementation of two fundamentally different approaches to reconstruction of structures from planar cross sections and their application to dentistry data. One of the approaches was an implementation of a distance-based sampling technique, and the other is a new algorithm, based on the Delaunay triangulation. Both were tested using contour data of teeth and the results are compared here in the light of the target applications, which are teaching and training dentistry, as well as simulation of dental procedures and illnesses. Widely mentioned problems encountered in local reconstruction methods such as marching cubes for these cases are clearly illustrated in this paper, and a very satisfactory alternative is given. © 2000 SPIE and IS&T.

Intrauterine dentistry: an integrated model of prevention.

Intrauterine Dentistry is a highly relevant subject of our time. The use of preventive measures in the intrauterine stage can avoid several diseases, among these, dental caries. The WHO advises that from the 4th month of pregnancy, women should avoid the intake of sugar, so that the fetus, future child, does not develop an exaggerated attraction for these types of foods, thus being susceptible to caries. Through questionnaires sent to gynecologist-obstetricians and dentists, this research investigated the information they have about this subject and how they instruct their patients. Questionnaires were also sent to pregnant women requesting information about the instructions they had received for the prevention of oral diseases of their fetus. Seventy-one percent of the dentists and 80% of the gynecologist-obstetricians reported having instructed the pregnant women to reduce the intake of sugar. However, only 13.6% of the dentists and no gynecologist-obstetrician instructed the reduction of sugar intake between the 12th and 18th week of pregnancy. A total of 42.2% of the pregnant women referred to these instructions, but none received instruction as to the specific period of the 12th and 18th week. An ideal model of treatment for pregnant women must include integrated and multiprofessional treatment, in which general dentists and gynecologist-obstetricians work together with the participation of the patient.

Dentistry for babies: Why do parents seek dental care?

This study investigated what are the main reasons that led parents to enroll children in a clinic for infants. This was studied by consulting 1368 records during the period from July 1996 to August 2001. The predominant reason for enrolling was orientation/prevention followed by other and treatment. This study demonstrated that a program for children from the first year of life encourages parents to have a new vision of dentistry.

Effects of dentin collagen removal on microleakage of bonded restorations

Purpose: To evaluate the effects of removing dentin collagen exposed by acid etching on the microleakage of bonded restorations with and without flowable composite application and submitted to thermocycling and long-term water storage. Materials and Methods: Standardized Class V cavities were prepared in 180 bovine incisors. They were randomly assigned to three groups according to the adhesive technique used. Conventional group (C): Single Bond was applied according to the manufacturer's instructions and Z250 composite was placed. Hypochlorite group (H): After acid etching a 10% NaOCl aqueous solution was applied for 1 min, then Single Bond and Z250 were applied. Hypochlorite and Flowable group (HF): Similar to group H, but following adhesive application, a thin layer of Natural Flow flowable composite was applied before the Z250. Each group was divided into three subgroups (0, 6, 12), which remained immersed in distilled water for 24 h or 6 or 12 months and underwent 500, 1500 or 2500 thermal cycles, respectively. At the end of each storage time, the specimes were stained with silver nitrate, decalcified, immersed in methyl salicylate for clearing and observed under a stereomicroscope to determine microleakage (scores 0 to 4). The data were analyzed using the Kruskal-Wallis and the Multiple Comparison Tests (α = 0.05). Results: After 12 months, every group showed significant increases in microleakage. There was no significant difference between Groups H and HF for the three different periods of time, but they showed statistically less microleakage than Group C. Conclusion: The removal of dentinal collagen reduced the marginal microleakage when compared to the conventional technique. The use of the flowable composite did not produce significant effects. No technique was completely effective in preventing microleakage.

Odontomas in pediatric dentistry: Report of two cases

Odontomas are developmental disturbances which manifest in the form of denticles or amorphous informes masses comprising all dental tissues, especially enamel and dentin, with variable amounts of pulp and cement. We describe here two clinical cases of odontomas in children, focusing on diagnostic means and the importance of early treatment of these lesions. The standard treatment for the two present cases was surgical removal.

Maxi-K channels contribute to urinary potassium excretion in the ROMK-deficient mouse model of Type II Bartter's syndrome and in adaptation to a high-K diet

Type II Bartter's syndrome is a hereditary hypokalemic renal salt-wasting disorder caused by mutations in the ROMK channel (Kir1.1; Kcnj1), mediating potassium recycling in the thick ascending limb of Henle's loop (TAL) and potassium secretion in the distal tubule and cortical collecting duct (CCT). Newborns with Type II Bartter are transiently hyperkalemic, consistent with loss of ROMK channel function in potassium secretion in distal convoluted tubule and CCT. Yet, these infants rapidly develop persistent hypokalemia owing to increased renal potassium excretion mediated by unknown mechanisms. Here, we used free-flow micropuncture and stationary microperfusion of the late distal tubule to explore the mechanism of renal potassium wasting in the Romk-deficient, Type II Bartter's mouse. We show that potassium absorption in the loop of Henle is reduced in Romk-deficient mice and can account for a significant fraction of renal potassium loss. In addition, we show that iberiotoxin (IBTX)-sensitive, flow-stimulated maxi-K channels account for sustained potassium secretion in the late distal tubule, despite loss of ROMK function. IBTX-sensitive potassium secretion is also increased in high-potassium-adapted wild-type mice. Thus, renal potassium wasting in Type II Bartter is due to both reduced reabsorption in the TAL and K secretion by max-K channels in the late distal tubule. © 2006 International Society of Nephrology.

A biodiversidade bentônica em lagoa marginal ao rio Paranapanema na zona de sua desembocadura, na represa de Jurumirim

Coqueiral lake is a marginal lake located at the southeast São Paulo State, in the mouth zone of the Paranapanema river into Jurumirim Reservoir and it has high connectivity with the Paranapaneina river. This work aimed to verify the benthic biodiversity in areas of the lake bottom. 18 sampling sites in the lake were selected, including shallow and deep areas. The samples were taken every three months during one year. Physical and chemical water variables (level, transparency, dissolved oxygen, pH, and electric conductivity) were analyzed. Sediment samples were picked up in triplicate for fauna and abiotic factors analysis (granulometric composition and sediment organic content), using Petersen dredge. The material was sorted out and analyzed under stereoscopic microscope. Counting and identification of the organisms were accomplished and diversity, relative abundance, taxonomic richness and dominance index were calculated. The analysis revealed a fauna with low species diversity and, with Chironomidae and Ephemeroptera dominance. Ephemeroptera, Campsurus, dominated in the hottest period and with low lake depth. Organisms' distribution had as main factors depth, transparency, pH, and water temperature. In the comparison between shallow and deep areas, a small density of organism in the deep regions was observed.

Dentistry and HIV: University professors' role in establishing a basis for judgment

The aim of this study was to determine whether there are differences in the attitudes of Dentistry School Professors from two universities, one private and one public concerning HIV-positive patients or HIV-positive health care professionals. A questionnaire Was handled to all profession at the Araçatuba Dental School of São Paulo State University - FOA-UNESP (public) and Lins Dental School of the Piracicaba Methodist University - FOL-UNIMEP (private). When asked if they would be willing to be treated by an HIV-infected health care professional, 38.9% of the 77 professors at FOA-UNESP replied that they would accept only non-invasive treatments and 13% would not accept any kind of treatment; the same applied to 42.4% and 15.2% of the 33 FOL-UNIMEP professors. Among the 54 professors at FOA-UNESP and 27 at FOL-UNIMEP providing clinical service, only 31.5% and 18.5% stated that they treat HIV-infected persons like any other patient. The results were very similar in both schools. Although they reported that they taught their students not to act in a discriminatory manner towards HIV-positive patient the professors themselves showed prejudice towards infected patients and professionals. Consequently, this topic trust be further debated in the academic milieu.

Effect of cast rectifiers on the marginal fit of UCLA abutments

Objectives: This study assessed the effect of cast rectifiers on the marginal misfit of cast UCLA abutments compared to premachined UCLA abutments. The influence of casting and porcelain baking on the marginal misfit of these components was also investigated. Methods: Two groups were analyzed: test group - 10 cast UCLA abutments, finished with cast rectifier and submitted to ceramic application; control group - 10 premachined UCLA abutments, cast with noble metal alloy and submitted to ceramic application. Vertical misfit measurements were performed under light microscopy. In the test group, measurements were performed before and after the use of cast rectifiers, and after ceramic application. In the control group, measurements were performed before and after casting, and after ceramic application. Data were submitted to statistical analysis by ANOVA and Tukey's test (α= 5%). Results: The use of cast rectifiers significantly reduced the marginal misfit of cast UCLA abutments (from 25.68μm to 14.83μm; p<0.05). After ceramic application, the rectified cylinders presented misfit values (16.18μm) similar to those of premachined components (14.3 μm). Casting of the premachined UCLA abutments altered the marginal misfit of these components (from 9.63 μm to 14.6 μm; p<0.05). There were no significant changes after porcelain baking, in both groups. Conclusion: The use of cast rectifiers reduced the vertical misfit of cast UCLA abutments. Even with carefully performed laboratory steps, changes at the implant interface of premachined UCLA abutments occurred. Ceramic application did not alter the marginal misfit values of UCLA abutments.

Internal adaptation of cast titanium crowns

As the adaptation of titanium crowns obtained by Rematitan Plus investment, specific for titanium, is not recognized to be suitable, this study evaluated the effect of the concentration of the specific liquid and the temperature of the mold of investments on the internal misfit of crowns cast on commercially pure titanium. Individual dies of epoxy resin were obtained, representing teeth prepared for full-crown restoration with a 6-degree axial surface convergence angle and shoulder (1.0 mm). For the waxing of each crown, a ring-shaped stainless steel matrix (8.0mm internal diameter; 7.5 mm height) was adapted above the individual dies of epoxy resin. The Rematian Plus investment was mixed according to the manufacturer's instructions using two different concentrations of the specific liquid: 100%, 75%. Casting was performed in a Discovery Plasma Ar-arc vacuum-pressure casting machine with molds at temperatures of 430°C, 515°C and 600°C. The crowns were cleaned individually in a solution (1% HF + 13% HNO3) for 10 min using a ultrasonic cleaner, with no internal adaptations, and luted with zinc phosphate cement under a 5 kg static load. The crown and die assemblies were embedded in resin and sectioned longitudinally. The area occupied by cement was observed using stereoscopic lens (10X) and measured by the Leica Qwin image analysis system (mm2). The data for each experimental condition (n=8) were analyzed by Kruskal-Wallis non-parametric test (á=0.05). The results showed that liquid dilution and the increase in mold temperature did not significantly influence the levels of internal fit of the cast titanium crowns. The lowest means (±SD) of internal misfit were obtained for the 430°C/100%: (7.25 mm2 ±1.59) and 600°C/100% (8.8 mm2 ±2.25) groups, which presented statistically similar levels of internal misfit.