Effect of method of caries induction on aged resin-dentin bond of primary teeth

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Treatment of condylar fractures with an intraoral approach using an angulated screwdriver: Results of a multicentre study

Background: This multicentre study aimed to investigate long-term radiographic and functional results following the treatment of condylar fractures using an angulated screwdriver system and open rigid internal fixation with an intraoral surgical approach.Methods: Twenty-nine patients with a total of 32 condylar fractures were evaluated. The patients were investigated prospectively based on the following variables: age, sex, aetiology, side, location and classification of the fracture, degree of displacement, associated fractures, surgical approach, oral health status, type of osteosynthesis plate, duration of surgery, mouth-opening, complications, and duration of follow-up.Results: The fractures were classified as subcondylar (n = 25) or condylar neck (n = 7). Mean patient age was 36.38 +/- 16.60 years. The median duration of postoperative follow-up was 24.39 +/- 13.94 months. No joint noise, weakness of the facial nerve, joint pain, or muscle pain was observed. An additional retromandibular approach was necessary to enable the treatment of one subcondylar fracture with medial displacement.Conclusion: Subcondylar or condylar neck fractures with medial or lateral displacement can be treated using an intraoral approach with satisfactory results with the advantages of the absence of visible scarring, the avoidance of facial nerve injury, and the ability to obtain rapid access to the fracture. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Individual and contextual factors related to dental caries in underprivileged Brazilian adolescents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Simplified periodontal record for pregnant women

The assessment using the PSR (Periodontal Screening and Recording) of the prevalence and severity of and the basic treatment needs for periodontal disease in a group of pregnant women who attended the Preventive Dentistry Clinic at the School of Dentistry of Araraquara--UNESP. Forty-one pregnant women of 16 to 37 years of age, were examined. The PSR index was evaluated with a suitable periodontal probe (Trinity-model 621-WHO) with index codes scores of from 0 to 4, capable of indicating the presence of the following conditions: periodontal health, bleeding on probing, calculus, shallow and deep pockets. These codes were attributed to each sextant and could be marked with an asterisk (*) to indicate the presence of gingival recession, furcation lesions, mobility or any other mucogingival alterations. It is shown that 100% of the pregnant women had some kind of gingival alteration, represented mainly by PSR code 2 (56.1%) and * (19.5%). The women in the youngest age groups, 15-19 and 20-24 years, had code 2 as their highest score with no sextant excluded. In the 25-29 age group, the PSR code 2 still prevailed (54.5%) although codes 3 and 4 were already appearing. The code * and the occurrence of excluded sextants tended to increase in the oldest age group (30-37). In general, the affected sextants showed codes 1 and 2 more frequently, corresponding to 41.6% and 39.8% respectively, which represented a mean of 2.49 and 2.39 sextants affected in each pregnant woman. Regarding the treatment needs, 90.2% of the women needed some treatment beyond the preventive measures begun, including scaling and root planning and/or corrections of defective restorative margins (61%), and more complex treatment (29.2%). The meeting of the treatment needs during pregnancy must include special efforts to increase motivation and promote oral health, minimizing the possibility of vertical transmission of pathogenic microrganisms to the child, and thus contributing to the primary prevention of the main oral diseases.

Dental mineralization and salivary activity are reduced in offspring of spontaneously hypertensive rats (SHR)

Several pathologies have been diagnosed in children of hypertensive mothers; however, some studies that evaluated the alterations in their oral health are not conclusive. This study analyzed the salivary gland activity and dental mineralization of offsprings of spontaneously hypertensive rats (SHR). Thirty-day-old SHR males and Wistar rats were studied. The salivary flow was evaluated by injection of pilocarpine, the protein concentration and salivary amylase activity, by the Lowry method and kinetic method at 405 nm, respectively. Enamel and dentin mineralization of the mandibular incisors was quantified with aid of the microhardness meter. The results were analyzed by the ANOVA or Student's t test (p<0.05). It was noticed that the salivary flow rate (0.026 mL/min/100 g ± 0.002) and salivary protein concentration (2.26 mg/mL ± 0.14) of SHR offspring were reduced compared to Wistar normotensive offspring (0.036 mL/min/100 g ± 0.003 and 2.91 mg/mL ± 0.27, respectively), yet there was no alteration in amylase activity (SHR: 242.4 U/mL ± 36.9; Wistar: 163.8 U/mL ± 14.1). Microhardness was lower both in enamel (255.8 KHN ± 2.6) and dentin (59.9 KHN ± 0.8) for the SHR teeth compared to the Wistar teeth (enamel: 328.7 KHN ± 3.3 and dentin: 67.1 KHN ± 1.0). These results suggest that the SHR offspring are more susceptible to development of pathologies impairing oral health, once they presented lesser flow and salivary protein concentration and lower dental mineralization.

Root-supported overdentures associated with temporary immediate prostheses: a case-report

Complete denture fabrication can be a treatment challenge for many dentists, especially when the patient has remaining teeth. So, planning for use of clinical alternatives to improve the treatment prognosis and to enable greater comfort to patient must be considered. This case report describes the use of remaining roots to aid in the stability, support and retention of root-supported overdentures. Thus, immediate prostheses were planned for temporary rehabilitation prior to definitive overdentures. The aim of this study was to demonstrate the planning of root-supported overdentures attached with a ball system for retention associated with immediate dentures between the periods of preparation to fabrication of the definitive overdentures. The proposed treatment met the patient's needs such as being able to carry on normal activities during the sequencing of procedures to be performed over a period of time. The treatment had longevity with patient's knowledge about the necessity of oral hygiene and periodic controls.

Does a mandibular RDP and new maxillary CD improve masticatory efficiency and quality of life in patients with a mandibular Kennedy class I arch?

To evaluate the change in masticatory efficiency and quality of life of patients treated with mandibular Kennedy class I removable partial dentures (RPDs) and maxillary complete dentures at the Department of Dentistry of the Federal University of Rio Grande do Norte. A total of 33 Kennedy class I patients were rehabilitated with maxillary complete dentures, and mandibular RPDs were selected for this non-randomized prospective intervention study. The patients had a mean age of 59.1 years. Masticatory efficiency was evaluated by colorimetric assay using fuchsin capsules. The measurements were conducted at baseline and 2 and 6 months after prosthesis insertion. Quality of life was evaluated using the Oral Health Impact Profile (OHIP-14) at baseline and 6 months after denture insertion. The Kolmogorov-Smirnov normality test was applied. Masticatory efficiency was evaluated by repeated measures ANOVA. Oral health-related quality of life was compared using the paired t test. There was no statistically significant difference in masticatory efficiency after denture insertion (p = 0.101). Significant differences were found (p = 0.010) for oral health-related quality of life. A significant improvement in psychological discomfort (p < 0.01) and psychological disability (p < 0.01) was observed. Mean difference value (95 % confidence interval) was 6.8 (3.8 to 9.7) points, reflecting a low impact of oral health on quality of life, considering the 0-56 range of variation of the OHIP-14 and a Cohen's d of 1.13. According to the results of the present study, rehabilitation with Kennedy class I RPDs and complete dentures did not influence masticatory efficiency but improved oral health-related quality of life. The association between the patient's quality of life and the masticatory efficiency is important for treatment predictability.

Condições de saúde bucal de crianças e adolescentes portadores de síndrome de Down

Patients with Down syndrome have shown different conditions of oral health, and there is a low occurrence of dental caries and a higher susceptibility to periodontal diseases. Thus, this study aimed to evaluate the prevalence of dental caries and periodontal diseases in subjects with Down syndrome. The population was composed of 40 patients with the syndrome, aged 6 to 18 years, of both genders, and an equal number of non-syndromic patients. The periodontal conditions were evaluated by mean of the criteria of PSR and dental conditions were registered following indexes dmft and DMFT. It was found that in children with Down syndrome, the dmft index was 1.17 and DMFT 3.53 while the control group was verified dmft 1.97 and DMFT 2.77. The results of PSR evidenced that 32.5% of children with Down syndrome were periodontally healthy, 65% were gingivitis patients and 2.5% were periodontitis patients, while in the control group, 50% healthy and 50% were gingivitis patients. The results evidenced similar populations of cariogenic cocci between patients with Down syndrome and non-syndromic subjects. It was concluded that the incidence of caries in children with Down syndrome was higher in permanent teeth compared with the control group, while in the occurrence of deciduous teeth caries was slightly higher in the control group, so when children with Down syndrome are subjected to periodic examinations, they present themselves periodontally healthy.

Qual a importância da odontologia hospitalar?

Hospital Dentistry can be understood by the care of the oral abnormalities that require intervention of multidisciplinary team for highly complex treatment. Dentistry integrated into the hospital, allows a better performance in the commitment to patient care and also expanded oral health care to the population. However, even among dentists, opinions differ on the subject. The participation of the dentist in an outpatient or in hospital, aims to collaborate, deliver and add more strength to what characterizes the new identity of the hospital. The aim of this study was to review the literature about the importance of ministering concepts of Hospital Dentistry for the exercise of this profession and how the situation is nowadays.

Impacto do uso de fita adesiva na qualidade de vida de pacientes institucionalizados e usuários de próteses totais convencionais

Objective: Evaluate the impact of the use of strip adhesive over the quality of life of institutionalized patients and wearers of complete dentures. Material and method: Twenty-nine institutionalized patients wearers of complete denture were selected to this study and after a clinical exam, a questionnaire (adjusted and based upon the index of Oral Health Impact Profile and Oral Health-Related Quality of Life, OHIP and OHQOL) was applied to evaluate issues related to epidemiological conditions (gender and age), quality of life (pain, discomfort, functional limitations, phonetic, social, psychological and esthetic), taste and notion of implant treatment. Following this part, the patients received instruction to use the strips adhesives (Corega Fita Adesiva, Glaxo-Smith-Kline, Rio de Janeiro, Brazil), considering three in maxillary prosthesis and two in the lower prosthesis during a period of 30 days. After this period, all the patients were recall and the questionnaire was reapplied; add some adhesive performance questions, to compare the results before and after the adhesive use in terms of percentage. Result: After the adhesive strips use there were improvement of the functional, social and physcological limitation aspects, but without percentual increasement of phonetic and esthetics aspects. The results showed 65.5% of the answers stating adhesive maintenance between 6-12 hours, easy removal (68.9%), and without change the taste (89.6%). The notion for implant treatment was decreased changing from 75.8 to 37.9% after the adhesive use. Conclusion: The results enhanced a positive impact over quality of life of the respondents after the strip adhesive use, showing decrease of pain and discomfort, mainly of inferior dental prosthesis.

O tratamento com implantes dentários para pacientes com hiv é uma realidade?

Patients infected with HIV can present several complications related to oral health. Today, the reduction of morbidity and mortality is evidenttreatment with antiviral enhances the quality of life of patients. The increase in comfort, stability, function and improving quality of life have led these patients to seek treatment with osseointegrated implants. This study aimed to discuss, based on the literature, the rehabilitation treatment with osseointegrated implants in patients HIV positive. For this we carried out a literature review including the subject in the databases: PubMed, Cochrane, ISI Dentistry and Oral Science in the last 20 years. The issue was addressed for the first time in 1998, describing a clinical case, the patient had successful rehabilitation with osseointegrated implants. However, the literature states that the indications must be carefully analyzed (2007), since there are few prospective controlled studies. There is doubt as to the use of dental implant therapy in patients with HIV-positive, and the complications are related to the patient’s systemic condition. It is essential to understand the clinical manifestations and complications of the disease before the implant therapy. It is observed that the dental implant therapy in patients with HIV positive is a predictable treatment option, it´s need an adequate control of oral and systemic conditions, and studies with larger sample, longer follow-up and randomized studies are important for evaluating the success therapy.

Erosão dental e suas implicações sobre a saúde bucal

The concepts of buccal health promotion and the increase of life expectancy have contributed for the highest maintenance of dental elements. Thus, with the new alimentary and behavioral habits the irreversible loss of dental hard tissue of non-carious origin has increased substantially, being divided in attrition, erosion and abrasion. The dental erosion is a chronic pathology defined as the superficial loss of dental hard tissue as a result of a chemical process not involving bacteria caused by acid that could be intrinsic, extrinsic or unknown etiology, causing irreversible loss of mineral tissue and dentinal hypersensitivity. The aim of this paper is to present a review of literature on the main factors that can cause the injuries of erosion, including the different aspects related to its etiology, classification, diagnosis, prevention and treatment.

Relationship between the morphology of the maxillary central incisor and horizontal and vertical measurements of the face

Purpose: In order to assist in the selection of artificial teeth for complete dentures, this study aimed to assess the relationship between horizontal and vertical measurements of the face and the morphology of the maxillary central incisor. Materials and Methods: This was a study of 50 plaster casts and 100 teleradiographs - 50 in lateral norm and 50 in frontal norm, belonging to 50 individuals, Caucasian, with a naturally optimal occlusion, matching at least four of the six keys of Andrews. Images of the upper central incisors were obtained by scanning the plaster casts (three-dimensional) and subjectively classified by three examiners as oval, triangular or quadrangular. Facial measures (vertical and horizontal) were defined by means of teleradiographs. In order to check inter-examiner agreement on the classification of central incisor, the Kappa test was used. To verify whether data had normal distribution, the Kolmogorov-Smirnov test was used ( P > 0.2) was used. One-way analysis of variance was employed to assess the association between variables (P > 0.05). Results: When vertical measurements were compared with the three incisor shapes, there was no statistically significant difference (P > 0.05): Triangular (0.54), oval (0.63) and quadrangular (0.51). Similarly, no difference (P > 0.05) was found for facial width (139.08, 143.37, 141.65), maxillary width (76.68, 78.99, 76.91) and mandibular width (103.47, 105.50, 103.11). Conclusions: The majority of cases showed that horizontal and vertical measurements of the face cannot be used as a reference for determining the morphology of the maxillary central incisor crown. It is relevant to analyze and compare other morphological structures to improve the oral health-related quality of life for the conventional denture wearer.

Relação entre a presença da equipe de saúde bucal na estratégia saúde da família com o nível de conhecimento dos agentes comunitários de saúde

Objective: to identify the relation between the level of knowledge of community health workers on oral health and the presence of the Oral Health Team in the Family Health Strategy. Methods: we performed a survey with 173 community health workers allocated in public health services of five municipalities in the northwest of São Paulo, Brazil, through a self-administered and structured instrument. The survey instrument contemplated questions related to the presence of the Oral Health Team in the Family Health Strategy and questions regarding oral health. Results: the majority of community health workers was inserted in strategies with the presence of Oral Health Teams (60.1%). We found that the oral health knowledge of most participants was good (48%). Conclusion: there is relation between the level of knowledge of community health workers and the presence of the Oral Health Team in the Family Health Strategy.