The influence of bone quality on the biomechanical behavior of full-arch implant-supported fixed prostheses

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

Non-linear 3D finite element analysis of full-arch implant-supported fixed dentures

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

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social. Objective: Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study. Material and Methods: This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (chi 2) and by discriminant analysis. Results: The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001). Conclusions: The results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.

Data collection on bone density of mandibular alveolar bone on a Hounsfield scale of the dental apex of the cranial root of the first inferior molar in dogs using computed tomography at FMVZ-UNESP

The head is the most important and specialized region in the body because it contains a range of specialized organs and, because it has interconnections between specialized organs, there is a great overlap of images. Thus, computed tomography (CT) helps in diagnosing diseases in this region, such as oral conditions, as they provide millimetric slices or cuts and demonstrate the relationship between the various anatomical structures involved, in volume and depth. Within dentistry, CT helps in the identification of pathological processes such as infection, tumors, visualization of embedded teeth and bone bed. This study aimed to assess the density of the mandibular alveolar bone at a determined point to later predict how periodontal disease is involved in bone resorption. For this, we performed a blind retrospective study (n = 124) of the CT scan files of dog skulls at FMVZ-UNESP in order to determine the density of the jaw bone using a Hounsfield scale, in the region of the dental apex of the cranial root of the first molar tooth in dogs. The results obtained were evaluated using mean and standard deviation (27.28 +/- 9.53 HU) in order to predict the normal density of the mandibular alveolar bone in the studied region. Thus, this data analysis allows a more concise evaluation of bone resorption of mandibular alveolar bone and, therefore, provides an adequate surgical planning in cases of osteosynthesis given mainly by the presence of installed periodontal disease.

Avaliação das dimensões e relacionamento dos arcos dentários após tratamento com Bionator de Balters

The deficiency of data in the literature took us to evaluate the Bionator of Balters appliance in the alterations of the dimensions and the relationship of the dental archs in children with malocclusion Class II, division 1 of Angle. The experimental group was constituted by 36 pairs cast Caucasians patients, aged between 7 years and 10 months - 11 years and 8 months, being 10 females and 8 males. The Levene´s test showed statistical evidences of likeness among the groups. Statistical analysis was preceded and showed significant alterations (p < 0,005) in the variable indicatives of maxillary first molars' distance, overjet, upper arch total length, upper arch anterior length, right molar relationship, left molar relationship, right canine relationship and left canine relationship. On the other hand, there wasn't significant alteration related to the lower arch and maxillary intercanines distance. The Balters' Bionator appliance had a favorable effect in the improvement of the correction of the malocclusion in Class II (foremost in molars and canines relationship) and transversal increase of the upper arch, mainly in the posterior area of arch.

Aplicação clínica da mola T do grupo B para retração dos dentes anteriores

A TAS (Técnica do Arco Segmentado) representa uma alternativa à mecânica de deslizamento, muitas vezes dificultada pela incerteza da quantidade de força de atrito envolvida em cada sistema de forças utilizado. Nesse contexto, sabe-se que poucos cursos de Ortodontia no Brasil têm ensinado efetivamente a filosofia e o modo de trabalhar com a TAS. Portanto, este trabalho procura elucidar a forma de raciocínio das relaçÕes entre força e momento manipuladas na TAS, bem como mostrar a forma de confecção e utilização de mola "T" do grupo B, onde objetiva-se a movimentação recíproca dos segmentos posterior e anterior e, por fim, apresentar um caso clínico tratado com esse tipo de mecânica.

Identification of Candida Spp. In Patients with Denture Stomatitis: Relationship with Gender, Age, Time of Denture use and Newton’s Classification

Epidemiological researches are important to understand the distribution and etiology of oral diseases. The actual researches that show the relationship between patient ages, denture status and denture stomatitis are scarce. So, the aim of this study was to identify of Candida spp. in patients with Denture Stomatitis (DS) and to correlate with gender, age, time of denture use and Newton’s classification. 204 complete denture patients (46 males and 158 females) were selected. DS was classified according to Newton’s classification and it was related to gender, age and time of denture use. Samples from the palatal mucosa and the surface of the upper denture of patients with DS were evaluated using PCR test for identification of Candida species. T-test, chisquare and Fisher’s exact tests were used for statistical analysis. DS was evidenced in 54.4% of the sample. According to gender 41.3% of the males and 58.3% females had the disease and the differences were statistically significant (p = 0.032). The type of DS was directly influenced by the time of denture use (p<0.001), but it was not significantly related to the age of the participants (p>0.05). C. albicans, C. tropicalis, C. glabrata, C. krusei and C. dubliniensis were identified by PCR test. DS is more prevalent in women and the prevalence of DS was influenced by the time of denture use (years). C. albicans was identified as the most frequent specie in patients with DS.

Musculoskeletal disorders in upper limbs in dental students: exposure level to risk factors

Aim: This study assessed the risk factors of undergraduate students to develop musculoskeletal disorders (MSD) in the upper limbs, regarding gender, type of dental clinical procedure, mouth region treated, and the four-handed dentistry practice. Methods: Dental students enrolled in the 8th semester in the Araraquara School of Dentistry, UNESP, Brazil, were photographed while practicing 283 dental procedures. The Rapid Upper Limb Assessment (RULA) method was used to evaluate the working postures of each student. The photographs were evaluated and a final risk score was attributed to each analyzed procedure. The prevalence of risk factors of developing MSD was estimated by point and by 95% confidence interval. The association between the risk factor of developing disorders and variables of interest were assessed by the chi-square test with a significance level of 5%. Results: The risk factors of developing MSD were high, regarding most dental procedures performed by the undergraduate students (score 5: 7.07%, CI95%: 4.08- 10.06%; score 6: 62.54%, CI95%: 56.90-68.18%). There was no significant association between the RULA final score and gender (p=0.559), and type of dental procedure (p=0.205), and mouth regions by arch (p=0.110) or hemi-arch (p=0.560), and the use of four-handed dentistry (p=0.366). Conclusions: It can be concluded that gender, type of dental clinical procedure, mouth region treated, and practice of four-handed dentistry did not influence the risk of developing MSD in the upper limbs among the dental students evaluated; however, they are at a high risk of developing such disorders.

Dentinogenesis imperfecta type II: approach for dental treatment

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Hipomineralização molar-incisivo em escolares da rede municipalde ensino da área urbana e rural de Manaus-AM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Risk factors in the mother-child relationship that predispose to the development of early childhood caries

This study focused on the risk factors in mother-child relationship that predispose babies to the development of dental caries. A prospective cohort study with 80 mother-child pairs was conducted. The mothers responded at 12, 18 and 30 months after their children's birth, to questions about variables related to diet, sucking habits, and oral care. Children were clinically examined to verify caries lesions (white spot lesions or cavitation). Data were analysed using Chi squared or Fisher's exact tests. The significance level was set at 5 %. Of the total, 3.75 % showed cavitated lesions after 18 months; 6.25 and 45 % had spot white lesions, respectively, at 18 and 30 months. The cariogenic diet was high at 12 (63.75 %) and 30 (88.75 %) months. Good oral hygiene was present in a minority of children at 12 months (46.25 %), but increased at 30 months (65 %), helping to prevent cavities and white spot lesions over this period (p = 0.0005). The variables of the blocks sucking habits and diet were not associated with caries. The lack of oral care in children was a risk factor for dental caries development.

Posterior partially edentulous jaws, planning a rehabilitation with dental implants

To discuss important characteristics of the use of dental implants in posterior quadrants and the rehabilitation planning. An electronic search of English articles was conducted on MEDLINE (PubMed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations (bone quantity and density), radiographic techniques, implant selection (number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.

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.

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.

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.