Analysis of the crown fractures and crown-root fractures due to dental trauma assisted by the Integrated Clinic from 1992 to 2002

The purpose of this study was to analyze crown fractures and crown-root fractures due to dentoalveolar trauma, treated in the Integrated Clinic comprehensive dental care at Aracatuba School of Dentistry (UNESP), from January 1992 to July 2002. The data were obtained from files of trauma cases. on the analysis period, 293 patients had crown fractures or crown-root fractures, in 605 teeth. Sixty-nine percent were males and 31% were females. Adolescents between 11 and 18 years old were the most prevalent group (41.6%) and the maxillary arch was the most commonly traumatized (83%). The most commonly affected tooth was the maxillary central incisor (58.3%). The most frequent causes were falls from bicycles (30.8%). It was concluded that the reality of the local service is similar to the published data.

Treatment of posterior crossbite in mixed dentition with a removable appliance: Reports of cases

A posterior crossbite malocclusion is defined as an abnormal buccolingual relationship. One or more maxillary teeth improperly occludes with one or more mandibular teeth in centric relation. This alteration develops early and is seldom self-correcting. This study is a report of the benefits of treating posterior crossbite malocclusions in mixed dentitions using removable appliances.

CHARACTERISTICS OF ARTERIAL-HYPERTENSION IN RESPONSE TO BOLUS INJECTION OF PHENYLEPHRINE IN ATROPINIZED PATIENTS

The changes of arterial pressure promoted by bolus injection of 50 mg phenylephrine (PHE) were studied in 20 atropinized patients (5 normal subjects, 13 patients with mitral valve disease, 1 patient with essential arterial hypertension and 1 patient with hypertrophic cardiomyopathy) submitted to routine catheterism. Patients with aortic valve disease, left ventricular outflow tract obstruction and intracardiac shunt were excluded from the study. All patients were in sinus rhythm, without heart failure. Arterial pressure started to increase at 14.8 +/- 5.4 s (range, 5.6 to 27 s; mean +/- SD) after PHE. There was an increase of 37.8 +/- 16.7 mmHg (range, 12.5 to 70 mmHg) in systolic pressure and of 26.6 +/- 11.1 mmHg (range, 7.5 to 42.5 mmHg) in diastolic pressure. Peak hypertension was attained at 36.6 +/- 16.4 s (range, 10.8 to 64.9 s) and hypertension continued for 176 +/- 92 s (range, 11 to 365 s). Heart rate was 114 +/- 21 bpm before PHE and 111 +/- 21 bpm (P<0.05) after PHE. There were no adverse events associated with intravenous PHE injection in any patient, in accordance with the general view that bolus injection of PHE is a safe and practical maneuver to promote arterial hypertension.

Comparison of accuracy between compression- and injection-molded complete dentures

Statement of problem. A clinically significant incisal pin opening may occur after processing complete dentures if a compression molding technique is used. To recover the proper vertical dimension of occlusion, a time-consuming occlusal adjustment is necessary that often destroys the anatomy of the artificial teeth. A new injection molding process claims to produce dentures that require few, if any, occlusal adjustments in the laboratory after processing.Purpose. This laboratory study compared incisal pin opening, dimensional accuracy, and laboratory working time for dentures fabricated by this new injection system with dentures constructed by the conventional compression molding technique.Material and methods. Two groups of 6 maxillary and 6 mandibular dentures were evaluated as follows: group 1 (control), Lucitone 199, compression molded with a long cure cycle; and group 2, Lucitone 199, injection molded with a long cure. Incisal pin opening was measured with a micrometer immediately after deflasking. A computerized coordinate measuring machine was used to measure dimensional accuracy of 3-dimensional variations in selected positions of artificial teeth in 4 stages of denture fabrication. Analysis of variance (ANOVA) and t tests were performed to compare the groups.Results. A significant difference was found in pin opening between groups (t test). Horizontal dimensional changes evaluated with repeated measures ANOVA revealed no significant differences between groups. However, analysis of vertical dimensional changes disclosed significant differences between the groups. There was no appreciable difference in laboratory working time for flasking and molding denture bases between the injection and compression molding techniques when polymethyl methacrylate resin was used.Conclusion. The injection molding method produced a significantly smaller incisal pin opening over the standard compression molding technique. The injection molding technique, using polymethyl methacrylate, was a more accurate method for processing dentures. There were no appreciable differences in laboratory working time between the injection and compression molding techniques.

Consequences of crown fractures with pulpal exposure: histopathological evaluation in dogs

When a crown fracture involving pulpal exposure is produced, the therapeutic treatment to be applied depends to a great extent on the general histopathological condition of the exposed pulp. Hence, the objective of this study was to evaluate histopathological and bacteriological changes occurring in dental tissue and periradicular tissue of crown-fractured teeth with pulpal exposure. Twenty-four anterior teeth (central and lateral incisors) from the maxillary teeth of four young, adult Mongrel dogs were used. At 48 and 72 h after performing the crown fractures, the animals were sacrificed and the results evaluated. Both observation periods revealed the existence of an area of superficial inflammation with the formation of hyperplastic tissue towards the external surface. Intense neutrophilic infiltrate was observed below it. Mean depth of inflammation was greater at 48 h (4633.33 mum) than at 72 h (3933.33 mum), perhaps coinciding with the bigger pulp chamber opening (x1332.14 mum at 48 h vs. x479.52 mum at 72 h). Upon approaching the cervical portion, the inflammation became less. Bacterial contamination was constant in all the cases evaluated, worsening the histopathological findings with exposure time. This study demonstrates that when a crown fracture with pulpal exposure is produced, the success in treating it depends partly on how quickly therapeutic treatment is administered.

Comparative study of the Frankel (FR-2) and bionator appliances in the treatment of Class II malocclusion

The purpose of this investigation was to compare the dentoalveolar and skeletal cephalometric changes produced by the Frankel (FR-2) and bionator appliances in persons with Class 11 malocclusion. Lateral cephalograms were available for 66 patients of both sexes, who were divided into 3 groups of 22. The control group included untreated Class 11 children, with an initial mean age of 8 years 7 months; they were followed without treatment for 13 months. The FR-2 appliance group had an initial mean age of 9 years; those children were treated for a mean period of 17 months. The bionator group initially had a mean age of 10 years 8 months; on average, they were treated for 16 months. The results demonstrated no significant changes in maxillary growth during the evaluation period. Both appliances showed statistically significant increases in mandibular growth and mandibular protrusion, with greater increases in patients treated in the bionator group. Both experimental groups showed an improvement in the maxillomandibular relationship. There were no significant changes in growth direction, while the bionator group had a greater increase in posterior facial height. Both appliances produced similar labial tipping and protrusion of the lower incisors, lingual inclination, retrusion of the upper incisors, and a significant increase in mandibular posterior dentoalveolar height. The major treatment effects of bionator and FR-2 appliances were dentoalveolar, with a smaller, but significant, skeletal effect.

Periodontal changes in patients undergoing radiotherapy

Background: the purpose of this study was to evaluate changes in the periodontium in patients who received head and neck radiation therapy.Methods: Periodontal clinical parameters (probing depth, clinical attachment level, gingival recession, plaque index, and bleeding on probing) were assessed on 27 patients before and 6 to 8 months following radiation therapy in the head and neck area.Results: the greatest changes occurred in clinical attachment level: overall, 70.3% of the patients showed a loss, with 92% evincing loss in the mandible. Attachment loss was directly related to the field of radiation and was greater when the jaws were actually included in the irradiated area.Conclusion: Periodontal status should be evaluated prior to and following radiation therapy in the oral-maxillary-facial region to help ensure that periodontal health is maintained in oncology patients.

Transverse skeletal base adaptations with Bionator therapy: A pilot implant study

The purpose of this randomized, controlled trial was to evaluate transverse skeletal base adaptations to Bionator therapy. The sample included 25 patients (15 male, 10 female) aged 6.9 to 11.2 years with Class II Division 1 malocclusion. The patients were randomly allocated to either a control (n = 11) or treatment (n = 14) group and followed longitudinally for approximately 12 months. Treatment consisted of a Bionator only, constructed to remain approximately 2 mm from the buccal dentition. Transverse maxillary and mandibular changes were evaluated cephalometrically according to 4 bilateral maxillary and 2 bilateral mandibular implants. Untreated Class II controls exhibited significant increases between posterior maxillary implants but no significant changes between the anterior maxillary or mandibular implants. There were no significant width differences between the control and treated groups before treatment. Posterior maxillary implant widths increased significantly (P < .05) in both groups, but the treated group showed significantly greater width increases than the control group. The treated group also showed greater increases between mandibular implants, but the differences were not statistically significant. These results suggest that transverse skeletal base adaptations occur as a result of Bionator therapy.

Apoptosis in the epithelial cells of the rests of Malassez of the periodontium of rat molars

Background and Objectives: Epithelial rests of Malassez are clusters of cells derived from Hertwig's root sheath that remain in the periodontal ligament throughout life. Although it is known that the cells of Malassez proliferate, there are no studies showing that they undergo programmed cell death, i.e. apoptosis. In most tissues, proliferation is balanced by apoptosis. Thus we examined regions of the periodontium of young and adult rat molars in the hope of detecting apoptosis.Methods: Wistar rats aged 29, 45 and 120 days were killed with chloral hydrate (600 mg/kg). Fragments containing maxillary molars were removed and fixed in formaldehyde, decalcified, and embedded in paraffin and glycol methacrylate. Sections were stained with hematoxylin/eosin and the Terminal deoxynucleotidyl transferase-mediated dUTP Nick End Labeling (TUNEL) method for detection of apoptosis. Specimens were also fixed in glutaraldehyde-formaldehyde, decalcified and processed for transmission electron microscopy.Results: Epithelial rests of Malassez containing round/ovoid basophilic dense bodies and TUNEL-positive structures were found in all specimens examined. Ultrastructural examination revealed that some cells of Malassez contained masses of condensed peripheral chromatin and a shrunken cytoplasm exhibiting intact organelles - images typical of apoptosis. Moreover, round/ovoid electron-opaque structures appeared to be in the process of being engulfed by neighboring epithelial cells of Malassez.Conclusions: Our results demonstrate that epithelial cells of Malassez's rests undergo apoptosis in the developing and adult periodontium. Apoptosis may, together with proliferation, be part of the mechanism of turnover/remodelling of the cells of Malassez.

Assessment of electrocardiographic parameters in healthy dogs undergoing dobutamine stress testing

The electrocardiographic effects of dobutamine stress testing (10 to 40 mu g/kg/minute) were investigated in five conscious healthy dogs. We studied the changes in the duration and amplitude of P wave, PR interval, duration of QRS complex, R wave amplitude, QT interval, and heart rate. Development of arrhythmias and ST segment abnormalities were also recorded. It was observed that dobutamine significantly affects atrioventricular-nodal conduction and total electrical systole time at higher infusion rates. Only a single episode of sustained ventricular tachycardia was observed, which was promptly restored to sinus rhythm shortly after dobutamine infusion was discontinued. No ST segment abnormalities were detected. Dobutamine stress testing was concluded to play a role in some ECG parameters at higher infusion rates.

Mineral trioxide aggregate as a root canal filling material in reimplanted teeth. Microscopic analysis in monkeys

This study analyzed mineral trioxide aggregate (MTA) as a root canal filling material for the immediate reimplantation of monkey teeth. Four adult capuchin monkeys Cebus apella were used, which had their maxillary and mandibular lateral incisors on both sides extracted and reimplanted after 15 min. During the extra-alveolar period, the teeth were kept in saline solution and after reimplantation retention was performed with a stainless steel wire and composite resin for 14 days. After 7 days, the reimplanted teeth were submitted to endodontic treatment with biomechanics up to file n. 30 and irrigation with a saturated solution of calcium hydroxide [Ca(OH)(2)], and then divided into two study groups: group I - root canal filled with a Ca(OH)(2) paste, and group II - root canal filled with MTA. Radiographic follow up was performed at 30, 60 and 90 days postoperatively, and after 180 days the animals were killed and specimens were processed for histomorphological analysis. The results revealed that most specimens of both groups presented organized periodontal ligament with no inflammation. The resorptions observed were surface resorptions and were repaired by cementum. Both MTA and Ca(OH)(2) were good root canal filling materials for immediately reimplanted teeth, providing good repair and also allowing biological sealing of some lateral canals. There was no significant difference between the study groups (alpha = 29.60%).

Visual communication in Brazilian species of anurans from the Atlantic forest

Visual communication is widespread among several anuran families, but seems to be more common than currently thought. We investigated and compared visual communication in six species of an anuran community in the Brazilian Atlantic forest. Four are nocturnal species: Hyalinobatrachium uranoscopum (Centrolenidae), Hyla albomarginata, Hyla sp. (aff. ehrhardti), and Scinax eurydice (Hylidae), and two are diurnal species: Hylodes phyllodes and Hylodes asper ( Leptodactylidae). For H. uranoscopum, H. albomarginata, S. eurydice, and H. phyllodes, this is the first record of visual communication. Observations were made at Nucleo Picinguaba, Parque Estadual da Serra do Mar, in the Municipality of Ubatuba, State of São Paulo, Brazil. Descriptions of behaviour were based on individuals observed in the field, using sequence sampling with continuous tape recording for behavioural observations. Eight new behaviours are described: body wiping, face wiping, jump display, leg kicking, limb lifting, mouth opening, toe flagging, and vocal sac display. of the 42 anuran species known from Nucleo Picinguaba, at least six ( approximately 14%) display visual communication. The evolution of visual signals in these species may be related to the availability of ambient light, the structural complexity of the habitat, and/or the ambient noise. They may also have evolved to aid in the location of the individual, to avoid physical combat, and/or may be a by-product of seismic communication.

Influence of surgical repositioning of mature permanent dog teeth following experimental intrusion: a histologic assessment

The aim of this study was to evaluate, through histologic examination, the effect of surgical repositioning of intruded dog teeth upon the pulpal and surrounding tissues. Thirty teeth in 10 adult dogs, aged 2-3 years, were used. Fifteen teeth were intruded, surgically repositioned and fixed using orthodontics wire, composite resin, and enamel acid conditioning. All these teeth served as the experimental group. The remaining intruded teeth were not treated ( control group). The animals were sacrificed to allow observations at 7,15, and 30 post-operative days. The maxillary and mandibular archs were removed and processed for histologic exam. Based on the methodology and observed results, we concluded that: pulpal necrosis, external root resorption and ankylosis were common sequelae to severe traumatic intrusion; a careful immediate surgical repositioning of severed intruded permanent tooth with complete root formation has many advantages with few disadvantages.

Osteoblasts engulf apoptotic bodies during alveolar bone formation in the rat maxilla

During bone formation, as in other tissues and organs, intense cellular proliferation and differentiation are usually observed. It has been described that programmed cell death, i.e., apoptosis, takes place in the control of the cellular population by removing of the excessive and damaged cells. Although it is generally accepted that apoptotic bodies are engulfed by professional phagocytes, the neighboring cells can also take part in the removal of apoptotic bodies. In the present study, regions of initial alveolar bone formation of rat molars were examined with the aim to verify whether osteoblasts are capable of engulfing apoptotic bodies, such as professional phagocytes. Rats aged 11-19 days were sacrificed and the maxillary fragments containing the first molar were removed and immersed in the fixative solution. The specimens fixed in glutaraldehyde-formaldehyde were processed for light microscopy and transmission electron microscopy. For the detection of apoptosis, the specimens were fixed in formaldehyde, embedded in paraffin, and submitted to the TUNEL method. The results revealed round/ovoid structures containing dense bodies on the bone surface in close contact to osteoblasts and in conspicuous osteoblast vacuoles. These round/ovoid structures showed also positivity to the TUNEL method, indicating that bone cells on the bone surface are undergoing apoptosis. Ultrathin sections showed images of apoptotic bodies being engulfed by osteoblasts. Occasionally, the osteoblasts exhibited large vacuoles containing blocks of condensed chromatin and remnants of organelles. Thus, these images suggest that osteoblasts are able to engulf and degrade apoptotic bodies. (c) 2005 Wiley-Liss, Inc.

Analysis of Apical Root Transportation Associated with Protaper Universal F3 and F4 Instruments by Using Digital Subtraction Radiography

Introduction: The aim of this study was to assess the occurrence of apical root transportation after the use of Pro Taper Universal rotary files sizes 3 (F3) and 4 (F4). Methods: Instruments were worked to the apex of the original canal, always by the same operator. Digital subtraction radiography images were produced in buccolingual and mesiodistal projections. A total of 25 radiographs were taken from root canals of human maxillary first molars with curvatures varying from 23-31 degrees. Quantitative data were analyzed by intraclass correlation coefficient and Wilcoxon nonparametric test (P = .05). Results: Buccolingual images revealed a significantly higher degree of apical transportation associated with F4 instruments when compared with F3 instruments in relation to the original canal (Wilcoxon test, P = .007). No significant difference was observed in mesiodistal images (P = .492). Conclusions: F3 instruments should be used with care in curved canals, and F4 instruments should be avoided in apical third preparation of curved canals. (J Endod 2010;36:1052-1055)