Comparative Study of Oral Mucosa Micronuclei in Smokers and Alcoholic Smokers

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

Oral Exfoliative Cytology for the Diagnosis of Paracoccidioidomycosis in a Patient with Human Immunodeficiency Virus A Case Report

BackgroundParacoccidioidomycosis is not the most common fungal disease in patients infected with human immunodeficiency virus (HIV), except for endemic regions in Latin America countriesCaseA 33-year-old man with HIV presented with mulberry-like lesions on the palate The diagnosis was made by exfoliative cytology and Papanicolaou staining Microscopic analysis revealed fungal structures with birefringent walls and exosporulation conferring an airplane radial motor appearance, or even bowel-like or goblet-like forms compatible with Paracoccidioides brasiliensisConclusionThis process spares the immunosuppressed patient from under going invasive biopsy procedures (Acta Cytol 2010,54 1127-1129)

Evaluation of Staining Methods for Cytologic Diagnosis of Oral Lesions

ObjectiveTo compare the efficacy of Papanicolaou, hematoxylin-eosin (H-E), Leishman and periodic acid-Schiff (PAS) staining for Cytologic diagnosis of oral lesions.Study DesignPatients from the Discipline of Stomatology, Sao Jose dos Campos Dental School, from the wards of Hospital Heliopolis and from the dentistry outpatient clinic of the University Hospital, University of São Paulo Medical School, with the following diseases, were selected: erythematous candidiasis (n = 9), pseudomembranous candidiasis (n = 10), squamous cell carcinoma In = 19), herpes simplex (n = 8), paracoccidioidomycosis In = 8) and pemphigus vulgaris (n = 1).ResultsThe different staining methods were compared regarding the quality of definition of cytoplasmic and nuclear morphologic characteristics and the identification of bacteria, fungi, inflammatory cells and secretions. Papanicolaou and H-E staining were considered better methods. In cases of fungal infections, PAS staining is useful and should be applied as a complementary method.ConclusionWithin the limitations of this study, it can be concluded that the cytologic diagnosis of oral lesions along with different staining methods is a useful tool for oral diagnosis. (Acta Cytol 2008;52:697-701)

Evaluation of varying amounts of thermal cycling on bond strength and permanent deformation of two resilient denture liners

Statement of problem. Two problems found in prostheses with resilient liners are bond failure to the acrylic resin base and increased permanent deformation due to material aging.Purpose. This in vitro study evaluated the effect of varying amounts of thermal cycling on bond strength and permanent deformation of 2 resilient denture liners bonded to an acrylic resin base.Material and methods. Plasticized acrylic resin (PermaSoft) or silicone (Softliner) resilient lining materials were processed to a heat-polymerized acrylic resin (QC-20). One hundred rectangular specimens (10 X 10-mm(2) cross-sectional area) and 100 cylindrically-shaped specimens (12.7-mm diameter X 19.0-mm height) for each liner/resin combination were used for the tensile and deformation tests, respectively. Specimen shape and liner thickness were standardized. Specimens were divided into 9 test groups (n=10) and were thermal cycled for 200, 500, 1000, 1500, 2000, 2500, 3000, 3500, and 4000 cycles. Control specimens (n=10) were stored for 24 hours in water at 37degreesC. Mean bond strength, expressed as stress at failure (MPa), was determined with a tensile test using a universal testing machine at a crosshead speed of 5 mm/min. Analysis of failure mode, expressed as a percent (%), was recorded as either cohesive, adhesive, or both, after observation. Permanent deformation, expressed as a percent (%), was determined using ADA specification no. 18. Data from both tests were examined with a 2-way analysis of variance and a Tukey test (alpha=.05).Results. For the tensile test, Softliner specimens submitted to different thermal cycling regimens demonstrated no significantly different bond strength values from the control; however, there was a significant difference between the PermaSoft control group (0.47 +/- 0.09 MPa [mean +/- SD]) and the 500 cycle group (0.46 +/- 0.07 MPa) compared to the 4000 cycle group (0.70 +/- 0.20 MPa) (P<.05). With regard to failure type, the Softliner groups presented adhesive failure (100%) regardless of specimen treatment. PermaSoft groups presented adhesive (53%), cohesive (12%), or a combined mode of failure (35%). For the deformation test, there was no significant difference among the Softliner specimens. However, a significant difference was observed between control and PermaSoft specimens after 1500 or more cycles (1.88% +/- 0.24%) (P<.05).Conclusions. This in vitro study indicated that bond strength and permanent deformation of the 2 resilient denture liners tested varied according to their chemical composition.

Effect of rotary or manual instrumentation, with or without a calcium hydroxide/1% chlorhexidine intracanal dressing, on the healing of experimentally induced chronic periapical lesions

Objective. To evaluate the healing of experimentally induced chronic periapical lesions in dogs at 30, 75, and 120 days after root canal instrumentation with rotary NiTi files or manual K-files, with or without a calcium hydroxide/1% chlorhexidine paste intracanal dressing.Study design. The second, third, and fourth mandibular premolars and the second and third maxillary premolars of 5 dogs (12 to 18 months of age, weighing 8 to 15 kg) were selected for treatment (a total of 82 root canals). After pulp removal, the root canals were left exposed to the oral cavity for 7 days to allow microbial contamination, after which the root canals were sealed with ZOE cement until periapical lesions were confirmed with radiography. Group I and II teeth were instrumented with manual K-files using the crown-down technique. In group III and IV teeth, NiTi rotary files were used. The apical delta was perforated by using #20 to #30 K-files at the length of the tooth, thus creating a standardized apical opening. The apical stop was enlarged to size 70, with 2.5% sodium hypochlorite irrigation at each file change. Teeth in groups II and IV were dressed with calcium hydroxide (Ca(OH)(2))/1% chlorhexidine (CHX) paste for 15 days before root filling. Group I and III teeth did not receive an intracanal dressing. The access openings of the teeth were permanently restored with silver amalgam condensed on a glass ionomer cement base. Pairs of standardized periapical radiographs were taken at the beginning of the treatment (0 days) and at 30, 75, and 120 days after filling.Results. There was no significant difference in the rate of radiographic healing of the periapical lesions between manual and rotary instrumentation. Radiographs taken at 120 days showed that the treatment with Ca(OH)(2)/1% CHX paste resulted in a significant reduction in mean size of the periapical lesions in comparison to single-session treatment. These findings were also true for histologic observations.Conclusion. The findings support the hypothesis that, regardless of the instrumentation technique (manual or rotary), the use of an intracanal dressing is important in the endodontic treatment of dog's teeth with experimentally induced chronic periapical lesions.

Genotoxicity and cytotoxicity of mineral trioxide aggregate and regular and white Portland cements on Chinese hamster ovary (CHO) cells in vitro

Objective. Recently, mineral trioxide aggregate (MTA) and Portland cement have been used in dentistry as root-end-filling materials. However, the reported results concerning the biocompatibility of these materials are inconsistent. The goal of this study was to examine the genotoxicity and cytotoxicity of MTA and Portland cements in vitro by the single-cell gel (comet) assay and trypan blue exclusion test.Study design. Chinese hamster ovary (CHO) cells were exposed to MTA and regular and white Portland cements at final concentration ranging from 1 to 1000 mu g/mL for 1 h at 37 degrees C.Results. All compounds tested did not show genotoxic effects in all concentrations evaluated. No significant differences (P > .05) in cytotoxicity were observed for all compounds tested.Conclusions. Taken together, our results suggest that MTA and Portland cements are not genotoxins and are not able to induce cellular death.

Effect of thermocycling on bond strength and elasticity of 4 long-term soft denture liners

Statement of problem. Two problems found in prostheses with soft liners are bond failure to the acrylic resin base and loss of elasticity due to material aging.Purpose. This in vitro study evaluated the effect of thermocycling on the bond strength and elasticity of 4 long-term soft denture liners to acrylic resin bases.Material and methods. Four soft lining materials (Molloplast-B, Flexor, Permasoft, and Pro Tech) and 2 acrylic resins (Classico, and Lucitone 199) were processed for testing according to manufacturers' instructions. Twenty rectangular specimens (10 X 10-mm(2) cross-sectional area) and twenty cylinder specimens (12.7-mm diameter X 19.0-mm height) for each liner/resin combination were used for the tensile and deformation tests, respectively. Specimen shape and liner thickness were standardized. Samples were divided into a test group that was thermocycled 3000 times and a control group that was stored for 24 hours in water at 37degreesC. Mean bond strength, expressed in megapascals (Wa), was determined in the tensile test with the use of a universal testing machine at a crosshead speed of 5 mm/min. Elasticity, expressed as percent of permanent deformation, was calculated with an instrument for measuring permanent deformation described in ADA/ANSI specification 18. Data from both tests were examined with 1-way analysis of variance and a Tukey test, with calculation of a Scheffe interval at a 95% confidence level.Results. In the tensile test under control conditions, Molloplast-B (1.51 +/- 0.28 MPa [mean SD]) and Pro Tech (1.44 +/- 0.27 MPa) liners had higher bond strength values than the others (P < .05). With regard to the permanent deformation test, the lowest values were observed for Molloplast-B (0.48% +/- 0.19%) and Flexor (0.44% +/- 0.14%) (P < .05). Under thermocycling conditions, the highest bond strength occurred with Molloplast-B (1.37 +/- 0.24 MPa) (P < .05) With regard to the deformation test, Flexor (0.46% +/- 0.13%) and Molloplast-B (0.44% +/- 0.17%) liners had lower deformation values than the others (P < .05).Conclusion. The results of this in vitro study indicated that bond strength and permanent deformity values of the 4 soft denture liners tested varied according to their chemical composition. These tests are not completely valid for application to dental restorations because the forces they encounter are more closely related to shear and tear. However, the above protocol serves as a good method of investigation to evaluate differences between thermocycled and control groups.

Different methods of finishing and polishing enamel

Statement of problem. Highly polished enamel surfaces arc recommended for axial tooth surfaces that will serve as guiding planes and be contacted by component parts of a removable partial denture. There is little evidence to support the assumption that this tooth modification will provide accurate adaptation of the framework and prevent build-up of plaque.Purpose. The aim of this investigation was to evaluate the surface roughness of the tooth enamel, prepared to serve as guiding planes, with different polishing systems.Material and methods. Four different methods (designated A, B, C, and D) for finishing and polishing the prepared enamel surfaces of 20 freshly extracted third molar teeth were studied. Each method involved 3, 4, or 5 different steps. The roughness of each specimen was measured at the start of each method before recontouring, after recontouring, and after each step of the 4 finishing and polishing procedures. The 4 experimental finishing methods were applied after recontouring the axial surfaces (buccal, lingual, and proxinial) of each tooth. Thus the 20 teeth (60 surfaces) were finished and polished by use of 1 of the experimental methods. Surface roughness was measured with a profilometer (mum); the readings of the unpolished enamel Surfaces were recorded as control measurements. Results were statistically analyzed with one-way analysis of variance followed by Tukey's test at the 95% level of confidence.Results. The highest roughness mean values (14.41 mum to 16.44 mum) were found when the diamond bur was used at a high speed for tooth preparation. A significant decrease in roughness values was observed with the diamond bur at a low speed (P<.05). Analysis of the roughness values revealed that all polishing methods produced surface roughness similar to that of the corresponding control teeth.Conclusion. Within the limitations of this study, all finishing procedures tested effectively promoted an enamel surface similar to the original unpolished enamel.

Shear bond strengths of a ceramic system to alternative metal alloys

Statement of problem. The success of metal-ceramic restorations is influenced by the compatibility between base metal alloys and porcelains. Although porcelain manufacturers recommend their own metal systems as the most compatible for fabricating metal-ceramic prostheses, a number of alloys have been used.Purpose. This study evaluated the shear bond strength between a porcelain system and 4 alternative alloys.Material and methods. Two Ni-Cr alloys: 4 ALL and Wiron 99, and 2 Co-Cr alloys: IPS d.SIGN 20 and Argeloy NP were selected for this study. The porcelain (IPS d.Sign porcelain system) portion of the cylindrical inetal-ceramic specimens was 4 mm thick and 4 mm high; the metal portion was machined to 4 x 4 mm, with a base that was 5 nun thick and 1 mm high. Forty-four specimens were prepared (n=11). Ten specimens from each group were subjected to a shear load oil a universal testing machine using a 1 min/min crosshead speed. One specimen from each group was observed with a scanning electron microscope. Stress at failure (MPa) was determined. The data were analyzed with a 1-way analysis of variance (alpha=.05).Results. The groups, all including IPS d.Sign porcelain, presented the following mean bond strengths (+/-SD) in MPa: 4 ALL, 54.0 +/- 20.0; Wiron, 63.0 +/- 13.5; IPS d.SIGN 20, 71.7 +/- 19.2; Argeloy NP, 55.2 +/- 13.5. No significant differences were found among the shear bond strength values for the metal-ceramic specimens tested.Conclusion. None of the base metal alloys studied demonstrated superior bond strength to the porcelain tested.

The acid-base impact of free water removal from, and addition to, plasma

Water, compared with plasma at a pH of 7.4, is a weak acid. The addition of free water to a patient should have an acidifying effect (dilutional acidosis) and the removal of it, an alkalinizing effect (concentrational alkalosis). The specific effects of free water loss or gain in a relatively complex fluid such as plasma has, to the authors' knowledge, not been reported. This information would be useful in the interpretation of the effect of changes in free water in patients. Plasma samples from goats were either evaporated in a tonometer to 80% of baseline volume or hydrated by the addition of distilled water to 120% of baseline volume. The pH and partial pressure of carbon dioxide, sodium, potassium, ionized calcium, chloride, lactate, phosphorous, albumin, and total protein concentrations were measured. Actual base excess (ABE), standard bicarbonate, anion gap, strong ion difference, strong ion gap, unmeasured anions, and the effects of sodium, chloride, phosphate, and albumin changes on ABE were calculated. Most parameters changed 20% in proportion to the magnitude of dehydration or hydration. Bicarbonate concentration, however, increased only 11% in the evaporation trial and decreased only -2% in the dehydration trial. The evaporation trial was associated with a mild, but significant, metabolic alkalotic effect (ABE increased 3.2 mM/L), whereas the hydration trial was associated with a slight, insignificant metabolic acidotic effect (ABE decreased only 0.6 mM/L). The calculated free water ABE effect (change in sodium concentration) was offset by opposite changes in calculated chloride, lactate, phosphate, and albumin ABE effects.