Análise das proporções faciais e sua relação com o formato dentário e com a dimensão vertical de repouso e de oclusão entre discentes institucionalizados

Considering the importance of the esthetic and the adequate register of vertical dimension (VD) to the oral rehabilitation, this study had as aims the analysis and comparison of two methods to get VD (Pleasure and Willis), functional space (FE), acquisition and correlation of facial and dental measurements. To do this, rest (RVD) and occlusal vertical dimension (OVD) and FE were achieved from the 30 students of the Federal University of Goias College of Dentistry. Following that, dental measurements of height and of the superior central incisors (SCI) and canine distance were registered. A facial analysis was performed to get the intercomissura, interalar, interpupilar, intercantal distance, besides register parameters as coincidence of dental and facial line, type of smile, face and SCI forms, and mastication type. The collected data were tabulated, compared by medias and standard deviations, and submitted to non-parametrical statistical analysis of Kruskal-Wallis and .Mann-Whitney with 5% of probability. The results doesn’t indicated statistical significant difference between FE of the two techniques. The measures of facial analysis are comparable with literature published data’s, but can’t be used as a parameter to the selection of intercanine distance. In 56.7% of the cases, there were coincidences of face and SCI forms, which could be a viable parameter in the selection of acrylic resin artificial tooth.

Halitose na geriatria: diagnóstico, causas e prevalência

Halitosis is the unpleasant odor of exhaust air through the mouth and lungs. There are over 50 causes, and approximately 90% of cases, is of oral origin. May have physiological origin (stress, breath of morning, fasting, and inappropriate diets), local reasons (bad oral hygiene, bacterial plaque retained on the tongue and/or tonsils, lower production of saliva, gum disease) or systemic reasons (diabetes, kidney or liver problems, constipation, etc.). In the Third Age, this problem tends to increase significantly. Thus, the aim of this study was to detect the presence of halitosis in the geriatric group attended in the dental clinic of UNIRP, identifying their incidence and principal causes. The sample consisted of 48 volunteer patients aged 60 years or older and included more than 90% of patients treated in this age group. It was performed a anamnesis and physical examination. The intra-oral halitosis was detected using a breath meter (halimeter). In the group studied, approximately 54.16% had halitosis, 84.61% of these were users of the prosthesis. The tongue coating was present in 80.76% of individuals with halitosis. After brushing the tongue, 88.46% of patients with halitosis have had the initial index oral malodor decreased. Based on the results of this study it was concluded that factors as dental prostheses and tongue coating are critical factors in causing halitosis.

A utilização de abutment de zircônia na reabilitação oral: aspectos protéticos e periodontais

Zirconia abutments are used to obtain satisfactory aesthetic results in implant fixed anterior prostheses when metal abutments promote a grayish mucosal discoloration of the peri-implant soft tissues. However, there is a lack of studies to confirm the clinical performance of the peri-implant soft tissues surrouding zirconia abutments. This study described a case report of a patient treated with implant fixed all-ceramic crown made out on zirconia abutment after 3 years of followup. A 47-year-old female patient was admitted to the dental clinic (Aracatuba Dental School) complaining about the fracture of her implant fixed single crown in the region of the left lateral incisor. The patient chose the replacement of the fractured prosthesis for an allceramic crown. After 3 years of follow-up it was observed that maintenance of the aesthetic results and the peri-implant soft tissue without any inflammation or gingival recessions. Within the limitations of a case report, it can be conclude that zirconia abutments is a effective rehabilitation treatment because it preserves the aesthetics and function through the maintenance of peri-implant tissues.

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.

Odontologia baseada em evidências: otimizando a prática e a pesquisa

Clinical decisions in dentistry are often based on the knowledge obtained during graduation, clinical experience, information shared with colleagues and professor, textbooks, seminars, conferences and continuing education courses. However, it is necessary to know if this information is derived from scientifically validated researches since too much information may complicate this process. Initially in medicine and later in other health areas a method which enables a critical evaluation of scientific papers related to a specific issue and also, whenever it is possible, an evaluation of the results by meta-analysis,was developed by Cochrane in order to reduce the bias towards all information obtained. The aim of this work is to present some aspects of the Evidence Based Dentistry (EBD) and to show how this methodology can be used to better substantiate scientifically the clinical decision of the dentist and improve researches design with scientific validity. The paper discusses editorial trends focused on the EBD, shows the differences between a systematic and a conventional review, describes data about Cochrane and the advantages of scientific evidence synthesis and the implications of EBD for clinical practice and research as well as recommendation grades and evidence levels of general scientific studies.

A oclusão nas próteses totais implantossuportadas mediatas e imediatas

Rehabilitation of edentulous patients has been a challenge for professionals since the primary concepts and fundaments of occlusal rehabilitation. However, this philosophy has been improved by implant-supported fixed dentures that represent a predictable clinical modality on modern dentistry. Nevertheless, considering that the traditional protocol requires a long period for bone healing and definitive rehabilitation, immediate loading of implants has been advantageous for functional and esthetic rehabilitation of patients in a reduced period. The aim of this study is to discuss the biomechanical and functional fundaments of occlusion for implant-supported fixed dentures with mediate and immediate loading to provide clinical evidences for longevity of this treat ment modality based on the current literature. According to this, some prerequisites as proper bone quality, excellent primary stability, sufficient number of implants, rigid splinting, and control and mastering of biomechanical fundamentals of static and dynamic occlusion are mandatory for treatment predictability and longevity.

Regeneração óssea guiada em implantodontia: relato de caso

Objective: The use of methods for tissue regeneration has been widely applied in Implantology, in clinical situations with disabilities or anatomical limitations that prevent the placement of osseointegrated dental implants. The evolution of the development of biomaterials revolutionized this therapeutic modality, facilitating the resolution of clinical cases with tissue deficiencies. Thus, this study aimed to describe a clinical case approaching the methods, techniques, and materials used in guided bone regeneration applied to Implantology. Case report: A clinical case of a patient who received a Morse taper dental implant (region 15) is described. The use of biomaterial and membrane on the buccal wall of the socket was required. After the osseointegration period, a reopening surgery was performed, and an immediate provisional implant was produced. After 2 months of follow-up, the final prosthesis was made involving other adjacent elements. Final considerations: The guided bone regeneration technique employed showed satisfactory performance. The patient was positive regarding esthetics and function. However, more controlled studies with longer follow-up period are needed for analyses of predictability

Princípios de redução das fraturas panfaciais: revisão de literatura

Are called panfacial fractures when the upper, middle and lower facial thirds present fractures concurrently. In clinical practice, came to imply the involvement of two facial thirds. Panfacial fractures are usually accompanied by other systemic lesions that impair the patient's life and therefore require primary treatment. Almost invariably are associated with damage to soft tissues and severe losses of bone structures which may lead to severe facial deformations and malocclusions. The panfacial fractures treatment is complex because often there isn’t a stable bone structure to guide the reduction of various fractures. Several orders of treatment have been proposed, but they are variations of the two classical approaches "bottom to top and inside-out" and "top to bottom and out-inside". The aim of this paper is to discuss the principles of management and panfacial fractures treatment, emphasizing the sequence of fracture reduction and highlighting its indications, advantages and disadvantages, through literature review and reports of surgical clinic cases. We conclude that the exact sequence of fracture reduction is not as important as developing a treatment plan that allows accurate positioning of the fractured segments.

Relation between bruxism and dental implants

OBJECTIVE: The aim of this study was to gather information and discuss the predictability of implant-supported prostheses in patients with bruxism by performing a literature review. METHODS: In order to select the studies included in this review, a detailed search was performed in PubMed and Medline databases, using the following key words: bruxism, dental implants, implant supported prosthesis, and dental restoration failure. Items that were included are: case reports, randomized controlled trials, in vitro studies, literature and systematic reviews, with or without meta-analysis, of the last 20 years that addressed the theme. Articles without abstracts, animal studies, articles in languages other than English and articles from journals unrelated to the dental field were excluded. RESULTS: after analysis according to inclusion and exclusion criteria, 28 articles were selected from a total of 54. It is known from the array of scientific articles which have assessed, either through retrospective, prospective or experimental studies, that the biomechanical and biological impact of bruxism on implant-supported prostheses is small, and that the literature has contributed little to exemplify the prosthetic limits of safety for the specialist from a clinical point of view. CONCLUSION: Although there is still no general consensus on this matter, most of the literature review articles do provide clinical guidelines that contribute to implant supported prostheses longevity and stability in patients with bruxism.

Temporomandibular disorders in females: acupuncture compared to occlusal splint

To compare the effect of acupuncture and occlusal splint in the treatment of temporomandibular disorders (TMD) in female patients.Method: Forty-eight female patients (mean age of 39.3±6.8 years) with diagnosed pain in muscles or joint according to RDC/TMD criteria were attended at UNESP - Aracatuba Dental School. Including criteria were reported pain in the chewing muscles and/or in the temporomandibular joint measured by a visual analogue scale (range from 0 to 10) and a reported reduction of the maximum mouth opening. Excluding factors were major occlusal problems, systemic diseases, pregnancy and age below 18 years. After randomization, the first group was treated with acupuncture performed by instructed dentist. The second group was treated with occlusal splint. The outcome variables were assessed at baseline (prior to the first treatment session) and after 1, 3 and 6 months. Primary criteria of success were improvement of mouth opening and pain reduction.Result: Acupuncture group exhibited chewing pain decrease from 5 (at baseline) to 1, 2 and 1 after 1, 3 and 6 months, respectively. In the splint group, chewing pain decreased from 4 to 2, 1 and 2 after 1, 3 and 6 months, respectively. The mouth opening (in mm) increased from 28 (at baseline) to 42, 44 and 46 after 1, 3 and 6 months, respectively in the acupuncture group. In the splint group, mouth opening improved from 29 to 40 after 1 month, and to 43 and 42 after 3 and 6 months. A significant pain reduction was noted for both groups when compared to the baseline (p<.001; Wilcoxon test). Acupuncture group had a significant clinical improvement of opening mouth (Mann-Whitney). Conclusion: The present outcomes suggest a positive association among acupuncture and occlusal splint on the reduction of chewing pain. Acupuncture was more effective in the mouth opening increase.

A experiência da saúde coletiva na formação profissional: retrato da extensão universitária

The guidelines of National Curriculum for Dental courses highlights the necessity in providing for the professional the ability to analyze and assess community’s problems and needs, and to create solutions for the society. The continuing education may be considered a useful tool for the teaching and learning because it favors the diversification of learning environments, which allows the insertion of undergraduate and graduate students into the real scenarios. This current study aimed to assess the Public Health projects and programs of the UNESP – Araçatuba Dental School, by describing the interaction experiences between faculty and health services in the professional career development. Historical, documentary and descriptive searches were performed based on the faculty archives such as official documents, reports, databases from the Pro-rector of continuing education and published papers in the period between 1964 and 2011. The following experiences were noted: the Extra-Muro Dental Service (SEMO), established in 1964, that focused in providing dental treatment to the rural population, highlighted the social inclusion of discriminated society groups since that time. In 1972, this service was expanded to several specific populations living in the urban areas. In the '60s, many educational campaigns were performed as homemade water filter and construction of wells and septic tanks which demonstrate the concern with the determinants of healthdisease process. At that time, the campaign of fluoridation of public water supplies in several counties started as Araçatuba, Birigui, Penápolis, Guararapes, Valparaíso and so on. The Campaign of “Good Teeth” from the '70s became wider over time and it was transformed in the "Oral Health Education Program" and it was continuously developed in all public schools of Araçatuba and some neighboring towns, benefiting children aged from 6 to 10 years-old. Several epidemiological studies of caries, periodontal diseases, malocclusion and fluorosis were conducted in cooperation with local governments, and counted with the participation of undergraduate and graduate students. Pereira Barreto – SP was the precursor city in Brazil to carry out fluorosis study. Currently, 12 projects of Public Health from the Institution of Higher Education in the Pro-rector of continuing education are being developed. The concern in qualifying the human resources in health is confirmed with the development of training courses and workshops for professionals, highlighting the training for people enrolled in the Family Health program; Community Health Agent training - Solidarity University, and Municipal Health Counselors training. The Graduate Program in Social and Preventive Dentistry, created in 1993, has an important role to train several professionals for the Unified Health System, and provides education to create researchers, professors and administrators, and enucleates research groups in several Brazilian states. In all activities showed herein, a dynamic participation of undergraduate and graduate students has been observed, and several books, guidelines, articles, brochures and booklets have been published as a result of the continuing education activities.. It was concluded that different projects and programs have been developed by the Public Health of UNESP –Araçatuba Dental School, which allow the exchange of experience between the university and health services, and benefit all participants enrolled in these activities.

Percepção de acadêmicos de odontologia sobre o envelhecimento

The changes on learning space where Dentistry Students stay in front of social reality, by university extension, represent a strategy to form dentists according to Brazilian Curricular Directresses. In Araçatuba Dental School (FOA-UNESP), one of alternatives to add students on real locals of dentistry practices is the “Always Smiling Project – Dental Attention for institutionalized elderly in Araçatuba City, São Paulo State – Brazil”. The aim of this study was to verify the self-perception of dentistry students about aging before and after participation in this Project during one school year. To data collection, an instrument with 3 opened questions was performed and applied on 45 students, in the beginning of activities in 2009 and after 8 months. The answers were analyzed by content categorization. The results showed that the perception of students about old people was negative relating them with frail person that needs help and the students’ expectations were higher about clinical aspects of attention. In the end of school year was clear the difference of students’ comprehension about aging and their thoughts demonstrated the empathy resulting from relation. Besides, students related knowledge gain and noted that health attention involve others aspects that are over than biological space. It was possible to conclude that insertion of students in “Always Smiling” contributed to reflection and learn about aging process and suggest that practices like these should be added in Brazilian Universities.

Fluoretação das águas de abastecimento público em um município com diferentes fontes de captação

Maintaining the levels of fluoride ion in public water supply within the parameters of adequacy it becomes essential so the measure carries a greater impact on caries prevention and control, without increasing the prevalence of dental fluorosis. Thus, it is necessary a rigorous control of the process, avoiding the undesired effects at levels above recommended levels, as well as avoiding levels below the recommended that do not offer the highest benefit. The aim of this study was to analyze the content of fluoride in public water supply in the city of Birigui, SP, with different sources of supply, checking if the fluoride levels are within the recommended. The samples were collected monthly from points previously established, with the knowledge of the distribution network of water and identifying the amount and location of supply sources and water treatment plant. Analyses were performed in duplicate in the period from January to December of 2009, in the laboratory - NEPESCO - of the Dental School of Araçatuba, Univ Estadual Paulista – UNESP, using an ion analyzer coupled to a specific electrode for fluoride. Of the total samples (n = 512), 44% (n = 224) had adequate levels and 56% (n = 288) inadequate levels, 10% (n = 49) lower levels and 46% (n = 239) showed levels above the recommended. There were differences in results when comparing the analysis of different sources. The fluoride concentration in the majority of the samples from deep wells was classified as inadequate not offering the desired benefit, or exposing the population to the risk of dental fluorosis.

A dental caries preventive program applied to children aged 5 to 8 years attending since the first year of age at the Baby Clinic of the Araçatuba Dental School, Brazil

Objective: Tooth decay is one of the more common diseases of childhood. Several studies recommend that early preventive measures must be implemented since the first years of life and continue throughout childhood and adolescence. The aim of the this study was to present results of a preventive dental program considering oral health maintenance, dental caries experience and the prevalence of dental caries relation with follow-up compliance visits. Material end method: Intraoral and interproximal radiographic exams were performed on 171 patients participants of a preventive dental program. Data regarding age, gender, previous caries experience and the frequency at which the patients attended return visits were obtained from the records. The data were analyzed statistically by the McNemar test, with the level of significance set at 1%. Result: Clinical and radiographic examination revealed that most children participating in the program had sound teeth (77.2 and 84.8%, respectively). The past dental history of the dental caries from patients included in this study showed statistical relevance when associated with the present dental caries experience and a statistical relationship was found from the absence of compliance to clinical visits and the dental caries presence. Conclusion: The preventive strategy had a positive influence on oral health maintenance in the children examined. Previous caries experience and the lack of compliance with return visits influenced the clinical oral condition of the children during participation in the preventive program.

Saúde bucal e educação infantil: avaliação do desgaste e do acondicionamento de escovas dentárias utilizadas por pré-escolares

Introduction: Early childhood is an essential phase of life for the future of oral health. The link between educational and health sectors can facilitate incorporating educational and preventive oral health practices in daily teaching in pre-schools. The main measure is manual tooth-brushing, which is the most accessible method for most of the population. Objective: The objective of this study is to evaluate macroscopically the wear on the bristles, form of storage, and identification of tooth brushes. Material and method: 345 toothbrushes used by children between the ages of 2 and 5 were evaluated in 4 pre-schools, by 2 participants from the oral health program. The Rawls et al. index was used to evaluate the bristles. Result: There were statistically significant differences (p = 0.020 - Mann-Whitney U test) between the frequency of toothbrushes, with the highest being (n = 205) stored at participating school; and, between adequate and inadequate brushes (p < 0.05 - X2 test) with 31.7 and 60%, respectively, classified as unfit for tooth-brushing. Of the toothbrush holders evaluated 100% were used collectively. Regarding identification, 18% of the toothbrushes were not identified in participating schools, and 37% in the others. Conclusion: The toothbrushes exhibited marked wear, and storage was inadequate; however, the schools participating in the oral health program showed toothbrushes with bristles less worn. It is suggested that training of educators regarding correct storage and evaluation of toothbrushes for wear of the bristles should be undertaken in all early childhood schools.