Maxillary ulceration resulting from using a rapid maxillary expander in a diabetic patient

One of the characteristics of diabetes mellitus is the exaggerated inflammatory response. The present report shows the reaction from the use of a rapid maxillary expander in a diabetic patient. A 9-year-old child presented an uncommon reaction to the treatment with a rapid maxillary expander, and on follow-up examination, it was discovered that the patient had diabetes mellitus. After controlling the disease, the proposed treatment was used without further incidents. The case calls attention to the presence of uncommon responses to treatment and the need for the orthodontist to suspect a patient's systemic compromise. (Angle Orthod. 2011;81:546-550.)

Penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel.

PURPOSE: To evaluate the penetration of a light-cured glass ionomer and a resin sealant into occlusal fissures and etched enamel. MATERIALS AND METHODS: Forty-eight maxillary and mandibular caries-free premolars scheduled for extraction for orthodontic reasons were isolated, the occlusal surfaces subjected to prophylaxis and acid-etched with orthophosphoric acid prior to the application of the VariGlass VLC glass ionomer and Concise resin sealants. The teeth were extracted, two longitudinal median sectiors from each tooth were ground to a thickness of 80-100 microns, and the sealant penetration into the fissures evaluated. The sections were placed in nitric acid to dissolve the enamel so the lengths of the tags which had penetrated into the etched enamel could be measured at different sites on the walls of the fissures. RESULTS: Both sealants adapted well to the fissures but penetrated deeper into shallow, open fissures than into deep, constricted fissures. The VariGlass VLC tags into etched enamel were generally longer than the Concise projections.

Immediate replantation of maxillary incisors in rats: effects of tooth immersion in sodium fluoride and subsequent removal of the periodontal ligament.

The advantages and disadvantages of maintaining the periodontal ligament (PDL) in immediate replantation as well as chemical treatment of the root surface have been a matter of discussion because the vitality of such tissue in surgery is always questioned. This study evaluated the effects of conserving the tooth in sodium fluoride and the removal of the PDL before replantation of incisors in rats. There was more cementum-dentin resorption in the group with the PDL. The group without the PDL showed more discreet resorption, repair occurred through the newly formed bone tissue in the PDL space and ankylosis was more extensive than in the group with the PDL.

Maxillary and mandibular width changes studied using metallic implants.

The purpose of this implant study was to evaluate the transverse stability of the basal maxillary and mandibular structures. The sample included 25 subjects between 12 and 18 years of age who were followed for approximately 2.6 years. Metallic implants were placed bilaterally into the maxillary and mandibular corpora before treatment. Once implant stability had been confirmed, treatment (4 first premolar extractions followed by fixed appliance therapy) was initiated. Changes in the transverse maxillary and mandibular implants were evaluated cephalometrically and two groups (GROW+ and GROW++; selection based on growth changes in facial height and mandibular length) were compared. The GROW++ group showed significant width increases of the posterior maxillary implants (P <.001) and the mandibular implants (P =.009); there was no significant change for the anterior maxillary implants. The GROW+ group showed no significant width changes between the maxillary and mandibular implants. We conclude that (1) there are significant width increases during late adolescence of the basal mandibular and maxillary skeletal structures and (2) the width changes are related with growth potential.

Calcium hydroxide root canal dressing. Histopathological evaluation of periapical repair at different time periods.

The objective of this study was to evaluate periapical and apical repair using calcium hydroxide root canal dressings for different lengths of times in teeth with induced chronic periapical lesions. A total of 61 root canals of maxillary and mandibular premolars from 4 dogs were used. After mechanical preparation of the root canals using the crown-down technique, and 5.25% NaOCl as irrigating solution, the apical foramen was enlarged in all cases. A calcium hydroxide root canal dressing was applied. The control group did not receive a root canal dressing. The animals were killed at 7, 15 or 30 days. After histological preparation, serial sections were stained with hematoxylin-eosin and Mallory's trichrome. The best histopathological results occurred at 15 and 30 days, and the worst results occurred at 7 days and in the control group.

Biometric analysis of the maxillary permanent molar teeth and its relation to furcation involvement.

A high rate of root exposure and consequently the exposure of the furcation area is usually observed in multirooted teeth. In maxillary molar teeth, this fact may endanger the three existent furcations (buccal, mesial and distal), causing serious problems. In this research, distance measures from the buccal furcation to the mesial (F1M) and distal (F1D) surfaces of the mesio-buccal and disto-buccal roots; from the mesial furcation to the buccal (F2B) and palatal (F2P) surfaces of the mesio-buccal and palatal roots and from the distal furcation to the buccal (F3B) and palatal (F3P) surfaces of the disto-buccal and palatal roots, respectively were established. One hundred maxillary first molar teeth were used, 50 of the right and 50 of the left side. Reference marks and demarcations were determined on the furcations and also on the root surfaces involved in the measures. We concluded that these measurements are important because they may effectivelly contribute to diagnosis, prevention and treatment of periodontal problems.

Unusual anatomy of permanent maxillary molars

The purpose of this study was to show anatomical variations in permanent maxillary molars. Two clinical cases of four-rooted maxillary molars and a macroscopic study of an extracted tooth, showing a five-rooted maxillary molar, are presented.

Natal maxillary primary molars: Case report

An unusual case of a newborn with two immature natal maxillary molars is presented. Clinical and histological examination showed that the teeth were rootless and incompletely mineralized. The patient was followed up during one year and we confirmed that the natal teeth were from normal primary series.

Effect of microwave treatments on dimensional accuracy of maxillary acrylic resin denture base

Microwave energy has been used as an alternative method for disinfection and sterilization of dental prostheses. This study evaluated the influence of microwave treatment on dimensional accuracy along the posterior palatal border of maxillary acrylic resin denture bases processed by water-bath curing. Thirty maxillary acrylic bases (3-mm-thick) were made on cast models with Clássico acrylic resin using routine technique. After polymerization and cooling, the sets were deflasked and the bases were stored in water for 30 days. Thereafter, the specimens were assigned to 3 groups (n=10), as follows: group I (control) was not submitted to any disinfection cycle; group II was submitted to microwave disinfection for 3 min at 500 W; and in group III microwaving was done for 10 min at 604 W. The acrylic bases were fixed on their respective casts with instant adhesive (Super Bonder®) and the base/cast sets were sectioned transversally in the posterior palatal zone. The existence of gaps between the casts and acrylic bases was assessed using a profile projector at 5 points. No statistically significant differences were observed between the control group and group II. However, group III differed statistically from the others (p<0.05). Treatment in microwave oven at 604 W for 10 min produced the greatest discrepancies in the adaptation of maxillary acrylic resin denture bases to the stone casts.

Intercommissural width in 4 racial groups as a guide for the selection of maxillary anterior teeth in complete dentures

Purpose: To determine whether intercommissural width is a reliable guide for the selection of maxillary denture teeth width. Materials and Methods: Casts were made of 160 subjects from 4 different racial groups. Locations of intercommissural width landmarks (the corners of the mouth) were made on the subjects and transferred to the casts. The distances between the corners of the mouth and the distal of the canines were measured on the casts and compared. Results: A weak correlation was found between the distal of the canines and the distance between the corners of the mouth in the 4 racial groups. Conclusion: The use of the corners of the mouth for the selection of artificial teeth is generally inaccurate.

Nasal width as a guide for the selection of maxillary complete denture anterior teeth in four racial groups

Purpose: Selecting artificial teeth for edentulous patients is difficult when pre-extraction records are not available. Various guidelines have been suggested for determining the width of the maxillary anterior denture teeth. This study was undertaken to evaluate the use of the nasal width as a guide for the selection of proper width maxillary anterior denture teeth in four racial groups of the Brazilian population. Materials and Methods: One hundred and sixty subjects (40 Whites, 40 Mulattos, 40 Blacks, and 40 Asians) were selected. Using a sliding caliper, the nasal width and the intercanine distance were measured. The Pearson product-moment correlation coefficient was used to determine the relationship between the above measurements. A prediction was made of the percentage of subjects of the White, Mulatto, Black, and Asian populations in which the selection error due to the clinical application of the method of the nasal width would be within 0 to 2 mm, within 2 to 4 mm, and greater than 4 mm. Results: The four racial groups showed a weak correlation between the intercanine distance and the nasal width. In 39.7% of the White, 55.7% of the Mulatto, 81.9% of the Black, and 48.2% of the Asian populations, errors greater than 4 mm would be present with the use of the nasal width. Conclusions: The correlation found between the intercanine distance and the nasal width was not high enough to be used as a predictive factor. The relationship between natural tooth width and artificial tooth width as predicted by the nasal width showed that the nasal width method is not accurate for all the studied groups. Copyright © 2006 by The American College of Prosthodontists.

Root trunk height as a risk factor for periodontal furcation involvement in maxillary first molars: an in vitro study.

The aim of this study was to correlate the root trunk height from the furcation openings on the buccal, mesial and distal surfaces to the cemento-enamel junction in upper first permanent molars in human beings with risk for periodontal disease progression. One hundred extracted maxillary first molars were used. Reference points and demarcations were determined from the entrance of the buccal (F1), mesial (F2) and distal (F3) furcations to the cemento-enamel junction in millimeters. The mean distances found were 3.50 mm, 4.44 mm and 4.26 mm for the buccal, mesial and distal furcations, respectively, in relation to the cemento-enamel junction. The statistical analyses were Student's t-test and Chi-square (X2). With periodontal disease progression, the buccal furcation presents a greater compromising risk due to its proximity to the cemento-enamel junction, while the mesial furcation is the most distant, comprising a lesser risk.

Measurement of sealant surface area by clinical/computerized analysis: 11-year results.

OBJECTIVE: To analyze the clinical behavior of 2 pit and fissure sealants through clinical/computerized evaluation. METHOD AND MATERIALS: Occlusal sealants were placed on maxillary and mandibular first and second premolars according to a split-mouth design. All premolars were sealed with either Concise (3M Espe) or Prisma Shield (Caulk/Dentsply) sealant agents. A hematoxylin-based staining solution was applied on the occlusal surface 7 days, 18 months, 36 months, and 11 years after occlusal sealing to allow checking of the sealant material on the surface. At each analysis time all occlusal surfaces were photographed, and the photographs corresponding to each time period were analyzed with SigmaScan 4.0 Software. The alterations of the sealed area of each sealant were analyzed with the software and recorded. Next, the measurements of the areas were tabulated and analyzed according to each period. Analysis of variance (ANOVA), with parts subdivided into time, and the t test, with a significance level of 5%, were used. RESULTS: The greatest sealed area was maintained by the sealant Concise. However, over the course of 11 years, all sealants began to show the same level of alteration in sealed area. CONCLUSION: The sealing materials showed alteration in sealed area over time, but they were efficient in controlling caries lesion formation on premolar pits and fissures.

Influence of storage period and effect of different brands of acrylic resin on the dimensional accuracy of the maxillary denture base

The aim of this study was to evaluate the dimensional changes of denture bases made from different resins after different storage periods. For this purpose, 25 sets of plaster models/resin bases were prepared using 4 acrylic resins submitted to two types of polymerization: 1- QC-20 submitted to polymerization by microwave energy; 2- QC-20 submitted to polymerization by water hot bath; 3- Vipi Cril submitted to polymerization by water hot bath; 4- Vipi Wave submitted to polymerization by microwave energy; and 5- Onda Cryl submitted to polymerization by microwave energy. After polymerization, the specimens were sectioned for accuracy readings using a comparison microscope. Readings were taken at 3 points: the crests of the right (A) and left (B) ridges, and the median region of the palate, in 4 different periods. The data obtained were submitted to two-way ANOVA and Tukey's test at 5% significance level. The greatest distortions were found in the posterior palatal region of the base (M), with statistically significant difference (p<0.05) for the studied resins. All acrylic resins presented dimensional changes and the storage period influenced these alterations.