Radiographic study of ossification of the pterygospinous and pterygoalar ligaments by the Hirtz axial technique.

The correct radiographic identification of ossification of the pterygospinous and pterygoalar ligaments plays an important role in surgical procedures for the treatment of trigeminal neuralgia. Most of these procedures are performed through the foramen ovale, a site where these ligaments can be found to be partially or completely ossified. We studied the radiographic features of these ossified ligaments and their location in relation to the foramen ovale by the Hirtz axial technique. For this purpose, 93 dry skulls from the Discipline of Anatomy, São José dos Campos Dental School, UNESP, which presented partial or complete ossification of these ligaments, were radiographed. The pterygospinous ligament was detected on 27.97% of radiographs and was partially ossified in 19.36% of cases and completely ossified in 8.61%. The pterygoalar ligament was present in 62.35% of radiographs, being partially ossified in 49.44% and completely ossified in 12.91%. The pterygospinous ligaments was found to be partially and completely ossified on the same radiograph in 3.23% of cases, whereas the pterygoalar ligament appeared partially and completely ossified on the same radiograph in 6.45%. Furthermore, the pterygospinous ligament was thinner than the pterygoalar ligament and located more medially in relation to the foramen ovale. The pterygoalar ligament formed a large bone bar lateral to the foramen ovale, often obliterating the lumen of the latter. The Hirtz axial technique is an excellent tool for the observation of complete or partial ossification of the pterygospinous and pterygoalar ligaments in surgical procedures for the treatment of trigeminal neuralgia performed through the foramen ovale.

A CAD/CAM flapless surgical technique and immediate prosthesis: A clinical report

Background: This article describes a clinical report with a new system for guided surgical treatment and immediate load prosthesis in the flapless surgical technique. Case report: Based on a computed tomography (CT) of a 64 - year-old edentulous patient, the cross sections were reformatted and used to construct a virtual planning of the implants and a guide template in Dental Slice. Six dental implants were placed in the maxilla and mandible using a Slice Guide System. Following a 30-month in maxilla and 24-month in mandible healing period, the clinical and radiographic evaluation and computed tomography (CT) showed good clinical stability. The Slice Guide System proved satisfactory for the Flapless Surgical Technique in dental implants.

Effects evaluation of remaining resin removal (three modes) on enamel surface after bracket debonding

Introduction: An appropriate selection of instruments is essential to perform a correct debonding technique, by properly removing orthodontic brackets and the remaining resin. Objective: The aim of this study was to evaluate three methods of remaining resin removal on enamel surface after bracket debonding, by means of Scanning Electron Microscopy (SEM). Methods: Eighteen bovine incisors were selected and divided into three groups (A, B and C) of six teeth each. Before bracket bonding, epoxy resin casts were obtained by impression of the teeth with addition silicon, in order to register baseline enamel characteristics and representing the control group. The methods for remaining resin removal were: Group A - gross and medium granulation Soflex discs; Group B - carbide bur in low-speed; Group C - carbide bur in high-speed. Soflex polishing system fine and ultrafine granulation discs were used for Group A, rubber tips for Groups B and C, and polishing paste for all groups. After polishing, impression of teeth were taken and casts were analyzed by means of SEM. The baseline enamel characteristics (Control Group) were compared to the final aspect of enamel to determine the method that generated less enamel abrasion. Results and Conclusion: The remaining resin removal by carbide bur in low-rotation, and enamel polished with rubber tips followed by polishing paste produced the smaller damage to the enamel.

Ligature of external carotid artery as an optional technique in a patient with von Willebrand disease

The von Willebrand disease (vWD) is a hereditary coagulopathy. There is no gender predilection. Clinically characterized by mucocutaneous bleeding, especially nose bleeding, menorrhagia and bleeding after trauma. This article reports a case of a 52-year-old Caucasian male patient with vWD, who presented with extensive bleeding in the tongue after a lacerating injury caused by accidental biting, and describes some clinical, pathological and treatment aspects of vWD. After repeated attempts to suture the wound and replace clotting factors, a decision was made to perform the ligature of the external carotid artery ipsilateral to the injury. There was favorable resolution of the case, with a good aspect of the scar 2 months after ligation. This case reinforces that it is extremely important to make a thorough review of medical history of all patients, searching for possible bleeding disorders or previous family history.

Implant removal by means of an expansion of the alveolar bony crest: Report of a clinical technique

Aim: To describe the adaptation of the Edentulous Ridge Expansion (E.R.E.) technique for implant removal. Material and Methods: The E.R.E. technique for the removal of failed implants is described in detail. A clinical case is also reported. In a patient carrying a full arch removable prosthesis in the upper jaw, sustained by two bars, two out of five implants were found to be fractured. Bucco-lingual partial-thickness flaps were used to access the fractured implants. The implants were subsequently removed applying the E.R.E. technique. Two recipient sites were prepared in the same position, using bone expanders, and two new implants were installed. Results: After 4 months of healing, the implants were integrated and a new bar was fabricated, and the old prosthesis readapted. Conclusion: The ERE technique may be successfully applied for the removal of failed implants, and the immediate or delayed reinstallation of new implants. © 2012 John Wiley & Sons A/S.

Influence of polishing procedures on the surface roughness of dental ceramics made by different techniques

The aim of this study was to evaluate the influence of 2 different surface polishing procedures - glazing (GZ) and manual polishing (MP) - on the roughness of ceramics processed by computer-aided design/computer-aided manufacturing (CAD/CAM) and conventional systems (stratification technique). Eighty ceramic discs (diameter: 8 mm, thickness: 1 mm) were prepared and divided among 8 groups (n = 10) according to the type of ceramic disc and polishing method: 4 GZ and 4 MP. Specimens were glazed according to each manufacturer's recommendations. Two silicone polishing points were used on the ceramic surface for manual polishing. Roughness was measured using a surface roughness tester. The roughness measurements were made along a distance of 2 mm on the sample surface and the speed of reading was 0.1 mm/s. Three measurements were taken for each sample. The data (μm) were statistically analyzed using analysis of variance (ANOVA) and Tukey's test (α = 0.05). Qualitative analysis was performed using scanning electron microscopy (SEM). The mean (± SD) roughness values obtained for GZ were: 1.1 ± 0.40 μm; 1.0 ± 0.31 μm; 1.6 ± 0.31 μm; and 2.2 ± 0.73 μm. For MP, the mean values were: 0.66 ± 0.13 μm; 0.43 ± 0.14 μm; 1.6 ± 0.55 μm; and 2.0 ± 0.63 μm. The mean roughness values were significantly affected by the ceramic type (P = 0.0001) and polishing technique (P = 0.0047). The SEM images confirmed the roughness data. The manually polished glass CAD/CAM ceramics promoted lower surface roughness than did the glazed feldspathic dental ceramics.

Guided implant surgery: What is the influence of this new technique on bone cell viability?

Purpose: To evaluate the effect of implant osteotomy on immediate bone cell viability, comparing guided surgery for implant placement with the classic drilling procedure. Materials and Methods: For this study, 20 rabbits were used. The animals were divided into a guided surgery group (GG) and a control group (CG) and were then divided into 4 subgroups - subgroups 1, 2, 3, and 4 - corresponding to drills used 10, 20, 30, and 40 times, respectively. All animals received 5 osteotomies in each tibia, by use of the classic drilling procedure in one tibia and guided surgery in the other tibia. The osteotomized areas were removed and processed immunohistochemically for detection of osteocalcin, receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and caspase 3. Results: Immunohistochemical analysis showed that osteocalcin expression was initially higher in the CG and remained constant after drill reutilization. Although the expressions of RANKL and OPG were not statistically different for the GG and CG, the RANKL/OPG ratio tended to be higher for the GG. Moreover, caspase 3 expression was elevated in the GG, proportionally to the number of osteotomies, indicating an increase in the apoptosis index in the GG. Conclusions: The classic drilling procedure is more favorable to cell viability than guided surgery.© 2013 American Association of Oral and Maxillofacial Surgeons.

Short dental implants in posterior mandible

The rehabilitation with oral implants is, without any doubt, a consecrated technique. But often we face situations of high bone atrophy where the conventional installation of dental implants is not possible. The posterior mandible, when severely resorbed, generally requires complex techniques to be rehabilitated with implants, such as the lateralization of the inferior alveolar nerve. As an option for these cases, this paper proposes the use of short implants for the rehabilitation of severely resorbed posterior mandible. Copyright © 2013 by Mutaz B. Habal, MD.

CCL3 and CXCL12 production in vitro by dental pulp fibroblasts from permanent and deciduous teeth stimulated by Porphyromonas gingivalis LPS

Objective: The aim of this study was to compare the production of the chemokines CCL3 and CXCL12 by cultured dental pulp fibroblasts from permanent (PDPF) and deciduous (DDPF) teeth under stimulation by Porphyromonas gingivalis LPS (PgLPS). Material and Methods: Primary culture of fibroblasts from permanent (n=3) and deciduous (n=2) teeth were established using an explant technique. After the fourth passage, fibroblasts were stimulated by increasing concentrations of PgLPS (0 - 10 pg/mL) at 1, 6 and 24 h. The cells were tested for viability through MTT assay, and production of the chemokines CCL3 and CXCL12 was determined through ELISA. Comparisons among samples were performed using One-way ANOVA for MTT assay and Two-way ANOVA for ELISA results. Results: Cell viability was not affected by the antigen after 24 h of stimulation. PgLPS induced the production of CCL3 by dental pulp fibroblasts at similar levels for both permanent and deciduous pulp fibroblasts. Production of CXCL12, however, was significantly higher for PDPF than DDPF at 1 and 6 h. PgLPS, in turn, downregulated the production of CXCL12 by PDPF but not by DDPF. Conclusion: These data suggest that dental pulp fibroblasts from permanent and deciduous teeth may present a differential behavior under PgLPS stimulation.

Efeito da ativação química do gel de peróxido de carbamida a 10% no clareamento dental

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da alteração de cor, difusão de peróxido de hidrogênio e citotoxicidade trans-amelodentinária causadas por diferentes técnicas de clareamento dental

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

Avaliação de um aparelho de luz halógena e um dispositivo Leds na técnica de fotoativação trans-dental: estudo da profundidade de polimerização pelos testes de dureza e espectroscopia de fluorescência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação in vitro da eficácia da fotoativação no clareamento dental utilizando a técnica em consultório

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação da performance da inspeção visual, sondagem, radiografia interproximal, separação dental e laser de fluorescência no diagnóstico de lesões cariosas proximais

Pós-graduação em Odontologia - FOA

One-Year Evaluation of a Simplified Ethanol-Wet Bonding Technique: A Randomized Clinical Trial

O objetivo deste ensaio clínico randomizado foi avaliar o comportamento clínico das restaurações adesivas, usando um adesivo convencional de três passos (CTP), um adesivo autocondicionante de um passo (AUP) e uma técnica simplificada da adesão úmida por etanol (AUET) antes da aplicação de uma resina composta em lesões cervicais não-cariosas. Noventa e três restaurações (31 para cada grupo) foram realizadas em 17 pacientes por um único operador. Nenhum preparo cavitário foi realizado. Depois de 6 e 12 meses, as restaurações foram avaliadas por 2 examinadores previamente treinados, utilizando critérios de Ryge modificados para retenção (kappa=1,00) e adaptação/manchamento marginal (kappa=0,81), e os resultados foram analisados pelos testes Exato de Fisher e Kruskal-Wallis, respectivamente. Não foram observadas diferenças significativas entre os grupos aos 6 e 12 meses para qualquer um dos critérios avaliados (p≥0,05). A análise intra-grupo feita pelos testes Q de Cochran (para retenção) e Wilcoxon (para adaptação/manchamento marginal) revelou diferenças significativas entre os intervalos de tempo baseline/12 meses para a adaptação marginal no AUP (p=0,0180) e manchamento marginal no CTP (p=0,0117). A análise de sobrevivência para o critério retenção realizada utilizando o teste de log-rank não apresentou diferenças significantes (p≥0,05). As restaurações feitas utilizando a técnica simplificada da adesão úmida por etanol comportaram-se igualmente às outras estratégias adesivas empregadas.