Multidisciplinary treatment approach for crown fracture and crown-root fracture - a case report

The increased incidence of traumatic injuries to anterior teeth is a consequence of leisure activities, where the most common injuries are crown fractures. Treatment of the dental trauma is complex and requires a comprehensive and accurate diagnostic and treatment plan. It is also important to consider the biological, functional, esthetic and economic aspects, as well as the patient's desire. The purpose of this article is to report a case that shows the multidisciplinary approach required to successfully manage the rehabilitation of a maxillary central incisor with a complex crown fracture and a maxillary lateral incisor, that at first presented an oblique crown-root fracture, and after the orthodontic extrusion, suffered a more apical new crown-root fracture.

Dental trauma involving root fracture and periodontal ligament injury: A 10-year retrospective study

The purpose of this retrospective study was to analyze the cases of traumatic dental injuries involving root fracture and/or periodontal ligament injury (except avulsion) treated at the Discipline of Integrated Clinic, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Brazil, from January 1992 to December 2002. Clinical and radiographic records from 161 patients with 287 traumatized teeth that had sustained root fracture and/or injuries to the periodontal ligament were examined. The results of this survey revealed that subluxation (25.09%) was the most common type of periodontal ligament injury, followed by extrusive luxation (19.86%). There was a predominance of young male patients and most of them did not present systemic alterations. Among the etiologic factors, the most frequent causes were falls and bicycle accidents. Injuries on extraoral soft tissues were mostly laceration and abrasion, while gingival and lip mucosa lacerations prevailed on intraoral soft tissues injuries. Radiographically, the most common finding was an increase of the periodontal ligament space. The most commonly performed treatment was root canal therapy. Within the limits of this study, it can be concluded that traumatic dental injuries occur more frequently in young male individuals, due to falls and bicycle accidents. Subluxation was the most common type of periodontal ligament injury. Root canal therapy was the type of treatment most commonly planned and performed.

Survival rate, load to fracture, and finite element analysis of incisors and canines restored with ceramic veneers having varied preparation design

Purpose: To evaluate the survival rate, success rate, load to fracture, and finite element analysis (FEA) of maxillary central incisors and canines restored using ceramic veneers and varying preparation designs.Methods and Materials: Thirty human maxillary central incisors and 30 canines were allocated to the following four groups (n=15) based on the preparation design and type of tooth: Gr1 = central incisor with a conservative preparation; Gr2 = central incisor with a conventional preparation with palatal chamfer; Gr3 = canine with a conservative preparation; Gr4 = canine with a conventional preparation with palatal chamfer. Ceramic veneers (lithium disilicate) were fabricated and adhesively cemented (Variolink Veneer). The specimens were subjected to 4 x 106 mechanical cycles and evaluated at every 500,000 cycles to detect failures. Specimens that survived were subjected to a load to fracture test. Bidimensional models were modeled (Rhinoceros 4.0) and evaluated (MSC.Patrans 2005r2 and MSC.Marc 2005r2) on the basis of their maximum principal stress (MPS) values. Survival rate values were analyzed using the Kaplan-Meier test (alpha = 0.05) and load to fracture values were analyzed using the Student t-test (alpha = 0.05).Results: All groups showed 100% survival rates. The Student t-test did not show any difference between the groups for load to fracture. FEA showed higher MPS values in the specimens restored using veneers with conventional preparation design with palatal chamfer.Conclusion: Preparation design did not affect the fracture load of canines and central incisors, but the veneers with conventional preparation design with palatal chamfer exhibited a tendency to generate higher MPS values.

Quantitative fractography by digital image processing: NIH Image macro tools for stereo pair analysis and 3-D reconstruction

A set of NIH Image macro programs was developed to make qualitative and quantitative analyses from digital stereo pictures produced by scanning electron microscopes. These tools were designed for image alignment, anaglyph representation, animation, reconstruction of true elevation surfaces, reconstruction of elevation profiles, true-scale elevation mapping and, for the quantitative approach, surface area and roughness calculations. Limitations on time processing, scanning techniques and programming concepts are also discussed.

Mechanical Strength and Analysis of Fracture of Titanium Joining Submitted to Laser and Tig Welding

This study compared the tensile strength and fracture mechanism of tungsten inert gas (TIG) welds in cylindrical rods of commercially pure titanium (cp Ti) with those of laser welds and intact samples. Thirty dumbbell-shaped samples were developed by using brass rods as patterns. The samples were invested in casings, subjected to thermal cycles, and positioned in a plasma arc welding machine under argon atmosphere and vacuum, and titanium was injected under vacuum/pressure. The samples were X-rayed to detect possible welding flaws and randomly assigned to three groups to test the tensile strength and the fracture mechanism: intact, laser welding, and TIG welding. The tensile test results were investigated using ANOVA, which indicated that the samples were statistically similar. The fracture analysis showed that the cpTi samples subjected to laser welding exhibited brittle fracture and those subjected to TIG welding exhibited mixed brittle/ductile fracture with a predominance of ductile fracture with the presence of microcavities and cleavage areas. Intact samples presented the characteristic straightening in the fracture areas, indicating the ductility of the material.

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.

The use of software Mapavox for teaching graphics and games to blind and low vision students: a development through practices

Current policies on education to visually impaired point for a growing trend of including students with special educational needs in regular schools. However, most often this inclusion is not accompanied by an appropriate professional trained or infrastructure, which has been presented as a big problem for regular school teachers who have students with visual impairments in their classroom. Based on this situation, the Group of Extension in Tactile Cartography from UNESP - University of the State of São Paulo - Campus de Rio Claro - SP - Brazil has been developing educational material of geography and cartography to blind students at a special school. Among the materials developed in this study highlight the development of graphics and board games provided with sound capabilities through MAPAVOX, software developed in partnership with UFRJ - Federal University from Rio de Janeiro - RJ - Brazil. Through this software, sound capabilities can be inserted into built materials, giving them a multi-sensory character. In most cases the necessary conditions for building specific materials to students with visual impairments is expensive and beyond the reach of features from a regular school, so the survey sought to use easy access and low cost materials like Cork, leaf aluminum, material for fixing and others. The development of these materials was supported by preparation in laboratory and its subsequent test through practices involving blind students. The methodology used on the survey is based on qualitative research and non comparative analysis of the results. In other words, the material is built based on the special students perception and reality construction, not being mere adaptations of visual materials, but a construction focused on the reality of the visually impaired. The results proved were quite successful as the materials prepared were effective on mediating the learning process of students with disabilities. Geographical and cartographic concepts were seized by the students through the technology used, associated with the use of materials that took into account in its building process the perception of the students.

Effects of sex and age on genotype x environment interaction for beef cattle body weight studied using reaction norm models

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dependence of the electrical conductivity and elastomeric properties on sample preparation of blends of polyaniline and natural rubber

Blend films (free-standing) containing 20% in volume of polyaniline (PANI) in 80% of natural rubber (NR) were fabricated by casting in three different ways: (1) adding PANI-EB (emeraldine base) dissolved in N-methyl-2-pyrrolidone (NMP) to the latex (NRL), (2) adding PANI-EB dissolved in in-cresol to NR dissolved in xylol (NRD), (3) overlaying the surface of a pure NR cast film with a PANI layer grown by in situ polymerization (NRO). All the films were immersed into HCl solution to achieve the primary doping (protonation) of PANI before the characterization. The main goal here was to investigate the elastomeric and electrical conductivity properties for each blend, which may be applied as pressure and deformation sensors in the future. The characterization was carried out by optical microscopy, dc conductivity, vibrational spectroscopy (infrared absorption and Raman scattering), thermogravimetry analysis (TGA), differential scanning calorimetry (DSC), dynamic mechanical thermal analysis (DMTA), and tensile stress-strain curves. The results suggest that the NRL blend is the most suitable in terms of mechanical and electrical properties required for applications in pressure and deformation sensors: a gain of conductivity without losing the elastomeric property of the rubber. (c) 2005 Wiley Periodicals, Inc.

Mycosis fungoides and Sézary syndrome: clinical, histopathological and immunohistochemical review and update

O artigo revisa os conceitos diagnósticos e de classificação da micose fungóide e da síndrome de Sézary a luz das publicações normativas mais recentes. Descreve a grande variabilidade de expressão clinica da micose fungóide em seus estágios iniciais assim como os aspectos histopatológicos e imuno-histoquímicos auxiliares ao diagnóstico. São descritos os critérios de diagnósticos exigidos para que se caracterize a síndrome de Sézary e o sistema de estadiamento, utilizado para ambas, micose fungóide e síndrome de Sézary.

Effects of neonatal castration and androgenization on sexual dimorphism in bone, leptin and corticosterone secretion

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Histological evaluation of experimentally induced subluxation in rat molars and its implications on the management of orthodontic treatment

The purpose of this study was to evaluate the histological alterations occurred in the periradicular region of rat molars after intentional subluxation using an experimental method to induce dentoalveolar trauma. Eighteen adult male Wistar rats (Rattus norvegicus albinus) were selected for the study. The dentoalveolar trauma was experimentally induced by the application of an occlusogingival force on the occlusal surface of the maxillary right first molar using a tensiometer secured on a fully articulated support with adjustable steel shafts. The animals were assigned to six groups (n = 3), according to the intensity of the force applied to induce trauma: Group I (GI, control) - no force application; Groups II-VI (GII-GVI) - the animals were subjected to 600, 700, 800, 900 and 1000 cN force, respectively. After experimental induction of trauma, the animals were sacrificed by anesthetic overdose and the right maxillas were removed and processed for histological analysis under light microscopy. In the animals of GII, GIII and GIV, the histological alterations were similar to those described for GI. GVI (1000 cN) presented the most severe alterations, with the occurrence of buccal bone plate fracture, alveolar fracture and root fracture, which are not present in mild traumatic injuries like subluxation. The 900 cN force (GV) was capable to produce clinical and histological alterations in the gingival and periodontal tissues compatible with those observed in subluxation.

Resolution of a titanium implant fracture after a recurrent trauma

Post-traumatic complications occasionally lead to tooth loss as well as the need for future implants. However, rehabilitation with endosseous osseointegrated implants does not protect the patient from the risk of suffering a new trauma. Implant fracture and the damage of the hexagon are post-traumatic complications that guide the clinician to preparing a more intricate treatment plan. The authors present a clinical case of a recurrent trauma of maxillary implant fracture. The treatment plan was to remove the implants followed by autogenous bone grafting to correct the defect. Two titanium implants were replaced, followed by connective tissue graft after allowing complete the healing process of the bone graft to occur. In the postoperative period of 6 months, satisfactory results have been shown as regards soft and hard tissues wound healing.

Influence of thermal and mechanical stresses on the strength of intact and relined denture bases

Statement of problem. Denture bases may become increasingly weaker as a result of thermal stress and flexural cyclic loading. Information regarding this potential problem and its relationship to the denture base reline is limited.Purpose. This study evaluated the influence of thermal and mechanical stresses on the strength of intact and relined denture bases.Material and methods. Twenty-eight microwave-polymerized (Acron MC) intact denture bases were prepared in the shape of a 3-mm-thick maxillary denture. Additionally, fifty-six 2-mm-thick denture bases were relined with 1 mm of autopolymerizing resin (Tokuyama Rebase Fast II or New Truliner) (n = 28). Intact and relined specimens were divided into 4 groups (n = 7) as follows: without stress (control); a mechanical stress at 0.8 Hz for 10,000 cycles; 5000 thermal cycles between 5 degrees C and 55 degrees C; or a combination thermo-mechanical stress. The specimens were vertically loaded in compression with a rounded rod at 5 mm/min until failure, using a universal testing machine. Data on maximum fracture load (N), deflection at fracture (%), and fracture energy (N-mm) were analyzed by 2-way analysis of variance and Student-Newman-Keuls tests (alpha = .05).Results. The strength of the denture bases relined with New Truliner was not significantly affected by any of the experimental conditions, but comparing the control groups, New Truliner exhibited the lowest maximum fracture load values. The maximum fracture load of intact denture bases (P = .002) and those relined with Tokuyama Rebase Fast II (P = .01) showed a significant decrease after thermal stress. Additionally, cyclic loading significantly decreased the maximum fracture load (P < .001), deflection at fracture (P = .025), and fracture energy (P < .001) of intact denture bases and those relined with Tokuyama Rebase (P values of .002, .039, and .001, respectively).Conclusion. Thermal and mechanical stresses exert deleterious effects on the strength of intact and/or relined denture bases, which vary according to the relining material used.

Effect of disinfection by microwave irradiation on the strength of intact and relined denture bases and the water sorption and solubility of denture base and reline materials

This study evaluated the influence of microwave disinfection on the strength of intact and relined denture bases. Water sorption and solubility were also evaluated. A heat-polymerized acrylic resin (Lucitone 550) was used to construct 4-mm-thick (n = 40) and 2-mm-thick (n = 160) denture bases. Denture bases (2mm) were relined with an autopolymerizing resin (Tokuso Rebase Fast, Ufi Gel Hard, Kooliner, or New Truliner). Specimens were divided into four groups (n = 10): without treatment, one or seven cycles of microwave disinfection (650 W for 6 min), and water storage at 37 degrees C for 7 days. Specimens were vertically loaded (5 mm/min) until failure. Disc-shaped specimens (50 min x 0.5 mm) were fabricated (n = 10) to evaluate water sorption and solubility. Data on maximum fracture load (N), deflection (%), and solubility (%) were analyzed by two-way analysis of variance and Student-Newman-Keuls tests (alpha = 0.05). One cycle of microwave disinfection decreased the deflection at fracture and fracture energy of Tokuso Rebase Fast and New Truliner specimens. The strength of denture bases microwaved daily for 7 days was similar to the strength of those immersed in water for 7 days. Microwave disinfection increased the water sorption of all materials and affected the solubility of the reline materials. (C) 2007 Wiley Periodicals, Inc.