In vitro evaluation of conventional and locking miniplate/screw systems for the treatment of mandibular angle fractures

This in vitro study evaluated the influence of the type of miniplate and the number of screws installed in the proximal and distal segments on the stability and resistance of Champy's osteosynthesis in mandibular angle fractures. Sixty polyurethane hemimandibles with bone-like consistency were randomly assigned to four groups (n = 15) and sectioned in the mandibular angle region to simulate fracture. The bone segments were fixed by different osteosynthesis methods using 2.0 mm miniplates and 2.0 mm x 6 mm rnonocortical screws. In groups 1 and 2, two conventional (G1) or locking (G2) screws were installed in each bone segment using a conventional (G1) or a locking (02) straight miniplate; in groups 3 and 4, three conventional (03) or locking (04) screws were installed in the proximal segment and four conventional (G3) or locking (04) screws were installed in the distal segment using a conventional (G3) or a locking (G4) seven-hole straight miniplate. The hemimandibles were loaded in compressive strength until a 4 mm displacement occurred between the segments, vertically or horizontally. Locking plate/screw systems provided significantly greater resistance to displacement than conventional ones (p < .01). Locking miniplates offered more resistance than conventional miniplates. Long locking miniplates provided greater stability than short ones.

Biomechanical evaluation of internal and external hexagon platform switched implant-abutment connections: An in vitro laboratory and three-dimensional finite element analysis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Prevalência de oclusopatias e comparação entre a Classificação de Angle e o Índice de Estética Dentária em escolares do interior do estado de São Paulo - Brasil

INTRODUÇÃO: as oclusopatias estão entre os principais problemas de saúde bucal em todo o mundo, juntamente com a cárie dentária e a doença periodontal, e vários índices têm sido utilizados para registrá-las. OBJETIVOS: verificar a prevalência de oclusopatias utilizando a Classificação de Angle e o Índice de Estética Dentária (DAI), sua severidade e a necessidade de tratamento ortodôntico registradas pelo DAI, e comparar os resultados de ambos os índices, visando correlacionar o padrão dos dados coletados e a viabilidade de utilizá-los de forma conjunta. MÉTODOS: a amostra consistiu de 734 escolares com idade de 12 anos, de ambos os sexos, da rede pública do município de Lins/SP. Foram realizados exames nos pátios das escolas com utilização de sondas IPC a olho nu. RESULTADOS: pela Classificação de Angle, encontrou-se 33,24% das crianças com oclusão normal e 66,76% com má oclusão. Pelo DAI, observou-se que 65,26% das crianças apresentavam-se sem anormalidades ou com más oclusões leves. A má oclusão definida esteve presente em 12,81%, a má oclusão severa foi observada em 10,90% e a muito severa ou incapacitante em 11,03%. A maioria das crianças (70,57%) apresentou relação molar normal, e o overjet maxilar anterior foi a alteração mais frequentemente observada. No cruzamento dos índices houve semelhanças e divergências. CONCLUSÃO: o DAI não foi sensível a alguns problemas de oclusão detectados pela Classificação de Angle, e a recíproca foi verdadeira, demonstrando que ambos os índices possuem pontos distintos na detecção das oclusopatias, podendo ser utilizados de forma reciprocamente complementar.

Tratamento da má oclusão de Classe II, divisão 1 de Angle, com protrusão maxilar utilizando-se recursos ortopédicos

OBJETIVO: o presente trabalho tem o propósito de apresentar uma revisão da literatura acerca do tratamento da má oclusão de Classe II, divisão 1 de Angle, tendo a protrusão maxilar como o principal componente dessa má oclusão, durante a fase de crescimento e desenvolvimento craniofacial. Serão apresentadas as características de cada um desses aparelhos, os seus componentes, a forma adequada de utilização, os seus mecanismos de ação e, principalmente, os seus efeitos em todo o complexo dentofacial. CONCLUSÃO: nos casos em que se verifica apenas a protrusão maxilar, sem envolvimento mandibular, e se faz necessário o controle vertical, pode ser indicado o AEB, conjugado ao aparelho removível derivado do aparelho preconizado por Thurow. Já nas situações de combinação da protrusão maxilar com a retrusão mandibular, uma opção de tratamento é o ativador combinado à ancoragem extrabucal.

Avaliação cefalométrica do tratamento da Classe II, divisão 1, de Angle com os aparelhos extrabucal de Kloehn e fixo edgewise: influência do padrão facial

O presente estudo foi realizado com o propósito de avaliar respostas cefalométricas ao tratamento com aparelho extrabucal de Kloehn associado ao aparelho fixo edgewise convencional. Telerradiografias iniciais (T1) e finais (T2) de dois grupos de 30 pacientes tratados com estes aparelhos foram selecionadas e definidas pelo índice cefalométrico de Jarabak para determinação do padrão esquelético craniofacial. Os grupos foram denominados favorável (hipodivergente) e desfavorável (hiperdivergente). A idade média, no início do tratamento, foi de 11,03 anos e final de 14,72 com o tempo médio de tratamento de 3,6 anos para o grupo favorável. No grupo desfavorável a idade inicial foi de 11,51 anos e final de 15,17 anos com tempo médio de tratamento de 3,4 anos. Foi utilizado um sistema de análise de resposta de tratamento em coordenadas X e Y representativos dos movimentos dentários e das bases ósseas decompondo-os em seus vetores horizontais e verticais. Os resultados e respostas do tratamento foram analisados e comparados entre os grupos favorável e desfavorável utilizando o teste t-Student. Os resultados mostraram não haver diferenças estatisticamente significantes na resposta cefalométrica no tratamento com o aparelho extrabucal de Kloehn associados ao aparelho fixo edgewise quanto aos padrões faciais favorável e desfavorável. O tratamento promoveu uma restrição do deslocamento anterior maxilar e um menor deslocamento anterior mandibular. Quanto à movimentação dentária maxilar, houve uma restrição do movimento mesial e extrusivo dos molares superiores no grupo favorável, enquanto que o movimento dos dentes inferiores foi mínimo no sentido anterior e vertical.

Utilization of autogenous bone, bioactive glasses, and calcium phosphate cement in surgical mandibular bone defects in Cebus apella monkeys

Purpose: the purpose of the present study was to evaluate the histologic results of bone cavities that were surgically created in the mandibles of Cebus apella monkeys and filled with autogenous bone, PerioGlas, FillerBone, or Bone Source. Materials and Methods: Surgical cavities 5 mm in diameter were prepared through both mandibular cortices in the mandibular angle region. The cavities were randomly filled, and the animals were divided into groups according to the material employed: Group 1 cavities were filled with autogenous corticocancellous bone; group 2 cavities were filled with calcium phosphate cement (BoneSource); and group 3 and group 4 cavities were filled with bioactive glass (FillerBone and PerioGlas, respectively). After 180 days the animals were sacrificed, and specimens were prepared following routine laboratory procedures for hematoxylin/eosin staining and histologic evaluation. Results: the histologic analysis showed that autogenous bone allowed total repair of the bone defects; bioactive glasses (FillerBone and PerioGlas) allowed total repair of the defects with intimate contact of the remaining granules and newly formed bone; and the cavities filled with calcium phosphate cement (BoneSource) were generally filled by connective fibrous tissue, and the material was almost totally resorbed. Discussion: the autogenous bone, FillerBone, and PerioGlas provided results similar to those in the current literature, showing that autogenous bone is the best Choice for filling critical-size defects. Synthetic implanted materials demonstrated biocompatibility, but the bioglasses demonstrated osteoconductive activity that did not occur with calcium phosphate (BoneSource). Conclusion: According to the methodology used in this study, it can be concluded that the utilization of autogenous bone and bioactive glasses permitted the repair of surgically created critical-size defects by newly formed bone; the synthetic implanted materials demonstrated biocompatibility, and the bioactive glasses demonstrated osteoconductive activity. The PerioGlas was mostly resorbed and replaced by bone and the remaining granules were in close contact with bone; the FillerBone showed many granules in contact with the newly formed bone; BoneSource did not permit repair of the critical-size defects, and the defects were generally filled by connective fibrous tissue.

Mandibular Angle Fracture Treated With New Three-Dimensional Grid Miniplate

Fractures of the mandibular angle deserve particular attention because they represent the highest percentage of mandibular fractures and have the highest postsurgical complication rate, making them the most challenging and unpredictable mandibular fractures to treat. Despite the evolution in the treatment of maxillofacial trauma and fixation methods, no single treatment modality has been revealed to be ideal for mandibular angle fractures. Several methods of internal fixation have been studied with great variation in complications rates, especially postoperative infections. Recently, new studies have shown reduction of postsurgical complications rates using three-dimensional plates to treat mandibular angle fractures. Nevertheless, only few surgeons have used this type of plate for the treatment of mandibular angle fractures. The aim of this clinical report was to describe a case of a patient with a mandibular angle fracture treated by an intraoral approach and a three-dimensional rectangular grid miniplate with 4 holes, which was stabilized with monocortical screws. The authors show a follow-up of 8 months, without infection and with occlusal stability.

Efficacy of several digital radiographic imaging systems for laboratory determination of endodontic file length

P>AimTo compare the efficacy of different digital radiographic imaging systems for determining the length of endodontic files.MethodologyK-type endodontic files were introduced into the canals of 40 extracted human permanent single-rooted teeth and fixed in place at random lengths. The teeth were radiographed using Digora Optime (R), CygnusRay MPS (R) and CDR Wireless (R) digital imaging systems. Six observers measured every file length in all the images and repeated this procedure in 50% of the image samples, and assigned a score to the level of difficulty found. Analysis of variance for differences between digital systems and Tukey's test were performed. The level of intraobserver agreement was measured by intraclass correlation. The assigned scores were evaluated by Kruskal-Wallis and Dunn's tests.ResultsThe CDR Wireless values did not differ significantly from the actual lengths and the CygnusRay MPS values. The Digora Optime system was significantly different from the others and overestimated the values (P < 0.05). The Digora Optime was significantly easier to use for taking measurements and the CygnusRay MPS the most difficult (P < 0.05). All digital radiographic imaging systems showed excellent agreement with the Intraclass Correlation Coefficient > 0.95.ConclusionsThe three digital radiographic imaging systems were precise. The CDR Wireless system was significantly more accurate in determining endodontic file lengths, and similarly to Digora Optime, was considered the least difficult to use when assessing endodontic file lengths.

Influence of the Angle of Irradiation of the Er,Cr:YSGG Laser on the Morphology, Attachment of Blood Components, Roughness, and Root Wear: In Vitro Study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Use of Rectangular Grid Miniplates for Fracture Fixation at the Mandibular Angle

Purpose: The aim of this study was to evaluate the clinical outcome of patients with mandibular angle fractures treated by intraoral access and a rectangular grid miniplate with 4 holes and stabilized with monocortical screws.Patients and Methods: This study included 45 patients with mandibular angle fractures from the Department of Oral and Maxillofacial Surgery São Paulo State University, Araraquara, Brazil, and from the Clinic of Oral and Maxillofacial Surgery at the University of Frankfurt, Germany. The 45 fractures of the mandibular angle were treated with a rectangular grid miniplate of a 2.0-mm system by an intraoral approach with monocortical screws. Clinical evaluations were postoperatively performed at 15 and 30 days and 3 and 6 months, and the complications encountered were recorded and treated.Results: The infection rate was 4.44% (2 patients), and in 1 patient it was necessary to replace hardware. This patient also had a fracture of the left mandibular body; 3 patients (6.66%) had minor occlusal changes that have been resolved with small occlusal adjustments. Before surgery, 15 patients (33.33%) presented with hypoesthesia of the inferior alveolar nerve; 4 (8.88%) had this change until the last clinical control, at 6 months.Conclusions: The rectangular grid miniplate used in this study was stable for the treatment of simple mandibular angle fractures through intraoral access, with low complication rates, easy handling, and easy adjustment, with a low cost. Concomitant mandibular fracture may increase the rate of complications. This plate should be indicated in fractures with sufficient interfragmentaty contact. (C) 2011 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 69:1436-1441, 2011

Nutritional assessment of hospitalized HIV-infected patients by the phase angle z-score measurement

Background: This study analyzed the phase-angle (PA) values of hospitalized HVI-infected patients by comparing them with those reported for a healthy population and investigated their relation with nutritional parameters.Methods: This is a cross-sectional study including 101 hospitalized patients diagnosed with HIV infection and evaluated by bioimpedance, anthropometry and biochemical tests. The phase angle values, weight loss percentage (%WL), body mass index (BMI), arm muscle circumference (AMC), tricipital skinfold (TSF), body fat percentage (%BF) and albumin were considered. In order to compare with values for the healthy population, the PA z-score of the patients under study was calculated. Spearman's correlation and the multiple linear regression model were used to identify nutritional parameters associated with the PA z-score.Results: The patients showed a mean PA z-score of -2.6 +/- 1.5, and only 6.6% of them with a positive value. The PA z-score values correlated with %WL (r = -0.51; p < 0.0001), albumin (r = 0.49; p < 0.0001), BMI (r = 0.58; p < 0.0001), AMC (r = 0.41; p < 0.0001), TSF (r = 0.47; p < 0.001) and %BF (r = 0.48, p < 0.0001). In multiple analysis %WL (p = 0.008), albumin (p = 0.01), AMC (p < 0.0001) and %BF (p = 0.0003) remained associated with the score.Conclusions: Low PA z-score values were observed, suggesting a worse clinical prognosis for the patients. The inclusion of the PA z-score as a nutritional indicator during care provision to HIV-infected patients is recommended. (Nutr Hosp. 2012;27:771-774) DOI:10.3305/nh.2012.27.3.5684

Stochastic dynamics in exotic and native blowflies: an analysis combining laboratory experiments and a two-patch metapopulation model

In this study we explored the stochastic population dynamics of three exotic blowfly species, Chrysomya albiceps, Chrysomya megacephala and Chrysomya putoria, and two native species, Cochliomyia macellaria and Lucilia eximia, by combining a density-dependent growth model with a two-patch metapopulation model. Stochastic fecundity, survival and migration were investigated by permitting random variations between predetermined demographic boundary values based on experimental data. Lucilia eximia and Chrysomya albiceps were the species most susceptible to the risk of local extinction. Cochliomyia macellaria, C. megacephala and C. putoria exhibited lower risks of extinction when compared to the other species. The simultaneous analysis of stochastic fecundity and survival revealed an increase in the extinction risk for all species. When stochastic fecundity, survival and migration were simulated together, the coupled populations were synchronized in the five species. These results are discussed, emphasizing biological invasion and interspecific interaction dynamics.

Post-larval morphology, growth, and development of Uca cumulanta Crane, 1943 (Crustacea, Decapoda, Ocypodidae) under laboratory conditions

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

Postlarval stages and growth patterns of the spider crab Pyromaia tuberculata (Brachyura, Majidae) from laboratory-reared material

The spider crab Pyromaia tuberculata was introduced into southeastern Brazil; ovigerous material was collected and reared in the laboratory. Morphologic changes and growth patterns of post-larval development are reported. Results show that within-stage size variation is lowest in mature stages, especially in the case of females in which there is an apparent size threshold for the last juvenile stages to undergo the puberty molt. A prepuberty molt taking place at the fourth crab stage is indicated by analyzing the allometric growth of the abdomen in females. In contrast, the same procedure using the allometric growth of chelae failed in detecting both the prepuberty and puberty molts in males. Conversely to females, which develop a complex brood chamber at the puberty molt, the enlargement of chelae was not consistent in all postpuberty males. The short instar sequence of this species, in no case exceeding nine stages, is marked by conspicuous morphologic alterations achieved at each molt. Almost all stages can be identified by examining diagnostic features of rostrum, abdomen, sternum, and pleopods.